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Medical Micro/Immunology > Chapter 17 > Flashcards

Chapter 17 Flashcards

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USMLE® Step 1 flashcards
1
Q

what are the 3 methods of diagnosis to prepare for the survey of microbial disease?

A

Phenotypic
Genotypic
Immunologic

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2
Q

Phenotypic

A

Microscopic and macroscopic morphology
Physiological and biochemical characteristics
Chemical composition

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3
Q

Genotypic

A

Genetic composition

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4
Q

Immunologic

A

Exploits the host’s antibody reaction to microbial antigens for purposes of diagnosis

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5
Q

Genetic composition uses which method of diagnosis?

A

genotypic

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6
Q

Chemical composition uses which method of diagnosis?

A

phenotypic

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7
Q

physiological and biochemical characteristics use which method of diagnosis?

A

phenotypic

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8
Q

Reviewing the microscopic and macroscopic morphology refers to which method of diagnosis?

A

phenotypic

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9
Q

Exploiting the host’s antibody reaction to microbial antigens for purposes of diagnosis refers to which method of diagnosis?

A

immunologic

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10
Q

What is the common point that guides the health care decision of every member of a clinical team?

A

specimen collection

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11
Q

What is the most vital concern with specimen collection?

A

Aseptic techniques must be used

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12
Q

In order for identification and treatment to be successful what 3 things are important when concerning specimens?

A

How the specimen is collected, handled, and stored.

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13
Q

What is the phenotypic method for testing the specimen?

A

immediate direct examination of the specimen

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14
Q

What test/method is used to detect syphilis?

A

Phenotypic method - Direct fluorescent antibody test (DFA)

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15
Q

Two examples of phenotypic method of testing?

A

DFA (Direct fluorescent antibody) test for syphilis

Direct antigen testing

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16
Q

DNA analysis using genetic probes refers to which method of diagnosis?

A

genotypic method

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17
Q

Hybridization is which method?

A

genotypic method

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18
Q

What is one example of genotypic method of diagnosis?

A

PCR and rRNA identification

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19
Q

The branch of immunology that deals with in vitro diagnostic testing of serum

A

serology

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20
Q

What do serological (immunological) tests involve?

A

Most are in vitro assessments for the detection, identification, and quantification of Antigen - Antibody from a variety of body fluids

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21
Q

Visible results can be obtained from

A
  1. Agglutination
  2. precipitation
  3. immunodiffusion
  4. complement fixation
  5. fluorescent antibodies
  6. immunoassay techniques (ELISA)
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22
Q

What is used to read a titer?

A

Ag - Ab reaction

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23
Q

How are Ag - Ab reactions used to read a titer?

A

A sample is diluted in tubes or a multiple welled microtiter plate and mixed with antigen. Titer is expressed as the highest dilution of serum gives a visible reaction with an Ag. The higher the titer, the more antigen present in the serum. Knowing the relative quantity of antibody permits different samples to be standardized and compared.

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24
Q

How can reading a titer be useful?

A

Reading a titer allows us to figure out how much antibody is present in a sample. Then samples can be standardized and compared.

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25
Q

In regards to agglutination antigens are ______.

A

whole cells (RBC, bacteria with determinant groups on surface)

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26
Q

In agglutination antibodies are called _________ which cross link the Ag ___________ to form to form _________.

A

agglutinins
agglutinogens
3D visible clumps

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27
Q

Agglutination determines ____ and ____ blood types.

A

ABO and Rh (Rhesus)

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28
Q

Explain how agglutination works?

A

Antisera containing Ab against the blood group antigens on RBC are mixed with a small sample of blood and read for the presence or absence of clumping. This will detect the specific antibodies and also gives the serum titer.

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29
Q

What technique is used for salmonellosis and undulant fever?

A

Widal Test

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30
Q

The Weil-Felix reaction is used for?

A

rickettsial infections

31
Q

What technique is used for detection of the pregnancy hormone in urine?

A

Latex agglutination

32
Q

What technique tests for staphylococci, streptococci, and gonococci?

A

latex agglutination

33
Q

Viral hemagglutination is the technique used to test for….?

A

some viral Ag

34
Q

Name 4 agglutination techniques?

A

Viral hemagglutination
latex agglutination
Weil-Felix reaction
WIdal test

35
Q

In precipitation antigens are ________ called ____________.

A

soluble molecules, precipitinogen

36
Q

In precipitation antibodies are called

A

precipitins

37
Q

Precipitinogens are _____ by precipitins.

A

precipitated

38
Q

Precipitates are easily disrupted in __________

A

liquid media

39
Q

Most precipitation reactions are carried out in ________.

A

Agar gels

40
Q

Why are agar gels used for precipitation?

A

Substrates are soft enough to allow (Ag/Ab) to freely diffuse, yet firm enough to hold the Ag-Ab precipitate in place.

41
Q

Name 5 precipitation techniques

A
  1. Double diffusion (Ouchterlony)
  2. Immunoelectrophoresis
  3. Western Blot
  4. Complement fixation
  5. Fluorescent antibodies (immunofluorescence)
42
Q

Outerlony refers to?

A

Double diffusion - precipitation technique

43
Q

What happens in both agglutination and precipitation when Ag and Ab are optimally combined so neither is in excess?

A

One Ag is interlinked by several Abs to form insoluble 3D clumps so large that cannot remain suspended.

44
Q

Define Complement fixation (CF) - lysin or cytolysin

A

An Ab that “fixes” complement to complete the lysis of its Ag target cell

45
Q

What happens when the lysins act with the C-system on RBC

A

the cells hemolyze

46
Q

Define hemolyze

A

lyse and release hemoglobin

47
Q

The CF test is used to detect _____.

A

hemolysis

48
Q

If hemolysis is detected, then the unfixed complement lysed ________.

A

Sheep RBC

49
Q

Name 3 diseases Verification of CF is needed for.

A

Scarlet fever
Rheumatic fever
several streptococcal syndromes

50
Q

Western Blot is used to verify ____ in the ELISA test.

A

Ab+ for HIV

51
Q

Western Blot has significant applications for detecting _______ in specimens.

A

microbes and their Ag

52
Q

Explain Western Blot

A

Precipitation technique:
Specific and sensitive for the identification of protein Ab or Ag electrophoresed in a gel which separates out particular bands.
Gel is transferred to a special blotter that binds reactants in place.
Blot is incubated with solution with Ab or Ag labeled with radioactive, fluorescent, or luminescent labels.
Sites of specific bindings appear
Patterns of bands are compared with known positive or negative samples.

53
Q

Numerous applications in diagnostic immunology

A

Fluorescent antibodies and immunofluorescence testing

54
Q

Antibodies are labeled with fluorescent dye

A

Fluorescent antibodies and immunofluorescence testing

55
Q

Need fluorescent microscopy (UV light lamp)

A

Fluorescent antibodies and immunofluorescence testing

56
Q

Name two techniques for Fluorescent antibodies and immunofluorescence testing

A

Direct testing and indirect testing

57
Q

Define direct testing in regards to Fluorescent antibodies and immunofluorescence testing

A

valuable for identifying and locating antigens on the surface of cells or in tissues

58
Q

Fluorescent antibodies can be ________.

A

anti-isotypic

59
Q

Anti-isotypic means _________.

A

made to react with the fluorescent region of another Ab (remember that Ab can be antigenic)

60
Q

What does ELISA stand for?

A

Enzyme-Linked Immunosorbent Assay

61
Q

ELISA is also called _______.

A

Enzyme Immunoassay (EIA)

62
Q

Name 2 enzymes used in ELISA

A

Horse-radish peroxidase

Alkaline phosphatase

63
Q

Both enzymes release a dye called _____ when exposed to their substrate?

A

chromogen

64
Q

ELISA relies on a solid support such as _____ that adsorb (attract on surface) the reactants

A

plastic microtiter plate

65
Q

ELISA screens for *name 5

A 
HIV
Helicobacter 
rickettsias
Salmonella
Vibria
66
Q

In ELISA the enzymes affixed to the Ag will ____ the substrate and release a _____

A

hydrolyze, colored dye

67
Q

ELISA contains an enzyme-Ab complex that can be used as a _______

A

color tracer for Ag-Ab reactions

68
Q

Two techniques for ELISA

A

direct and indirect

69
Q

Type of In vivo testing

A

tuberculin testing

70
Q

Tuberculin Test

A

uses small amounts of purified protein (PPD) from Mycobacterium tuberculosis injected in the skin.

71
Q

The aim of in vivo testing is to

A

detect presence of neutralizing antibodies and elicit a visible Ag-Ab response after an Ag has been introduced into the host

72
Q

Name 5 diagnostic skin sensitivity tests for

A 
Coccidiodin
Histoplasmin
Allergens
Schick for diptheria
Dick for scarlet fever
73
Q

How is a tuberculin test deemed positive

A

Raised lesion on the skin indicates previous exposure to tuberculosis.

Medical Micro/Immunology (8 decks)

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