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Immunology II > Diagnostic Assays in Infectious Diseases > Flashcards

Diagnostic Assays in Infectious Diseases Flashcards

1
Q

viruses

A
  • acellular
  • non-living
  • DNA or RNA
  • protein capsid +/- envelope
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2
Q

bacteria

A
  • prokaryote
  • DNA genome no nucleus
  • cell membrane and cell wall (gram +/-)
  • many but not all are free-living
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3
Q

fungi

A
  • eukaryotes
  • DNA genome in the nucleus
  • cell membrane and cell wall
  • free- living
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4
Q

protozoa

A
  • eukaryote
  • DNA genome in nucleus
  • cell membrane only
  • free living
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5
Q

accuracy

A

telling the truth

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6
Q

precision

A

telling the same story over and over again

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7
Q

sensitivity

A

the extent to which the test is accurate for those who have the disease avoiding false negative

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8
Q

specificity

A

the extent to which the test is accurate for those who do not have the disease avoiding false positive

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9
Q

positive predictive value

A

extent to which positive test indicates person with disease

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10
Q

negative predictive value

A

extent to which a negative test indicates absence of disease

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11
Q

sensitivity of light microscopy, antigen testing, culture, and nucleic acid amplification tests

A

light microscopy < culture < antigen testing < nucleic acid amplification tests

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12
Q

Immunoassays

A

ELISA, western blots, rapid immunochromatographic strip tests, and particle agglutination tests

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13
Q

epitope

A

single smallest piece of pathogen that an antibody can recognize

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14
Q

enzyme linked immunosorbent assay (ELISA)

A
  1. antigen detection- starts with antibody
  2. antibody detection starts with antigen
    sensitivity and specificity generally pretty good
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15
Q

antigen detection tests are indicators of

A

current infection

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16
Q

antibody detection tests are indicators of

A

past infection

17
Q

limitations of antibody detection tests

A

not all infections produce antibodies

18
Q

low organism burden

A

sensitivity

19
Q

potential detection of closely related organisms

A

specificity

20
Q

too little specimen

A

sensitivity

21
Q

low prevalence population

A

specificity

22
Q

In a low/high prevalence population the PPV is much lower meaning you need to do another test to decide to confirm

A

low

23
Q

nucleic acid amplification tests

A
  • amplification
  • molecular detection assays for bacteria, viruses, and eukaryotic pathogens
  • targets microbial DNA or RNA
  • more sensitive and specific
  • quick
24
Q

nucleic acid amplification tests does/does not require live organisms

A

does not

25
Q

Advantages of NAAT versus culture

A
  • increased sensitivity, less likely false negative
  • faster results = quicker treatment
  • contact tracing so could identify other potentially exposed people

Faster NAAT results than culture, so quicker treatment of the patient is possible.
Faster NAAT results, so contact tracing, if indicated, could identify other potentially exposed persons more quickly.
More sensitive NAAT is less likely to yield a false negative result.

26
Q

Dis-Advantages of NAAT versus culture

A
  • more expensive
  • requires technical expertise, could cause delay
  • can detect non-viable organisms and thus is limited as a test of cure

NAAT is more expensive than culture.
NAAT requires more technical expertise and may only be available at distant reference lab, thus delaying testing.
NAAT can detect non-viable organisms, and thus is limited as a test-of-cure.

27
Q

T/F culture always works for every organism

A

false

some bugs cannot cultivate in vitro

28
Q

most mistakes in testing process occur in the

pre-analytical, analytical, or post analytical portion ?

A

pre-analytical

29
Q

antimicrobial susceptibility testing is based widely on in vitro/in vivo testing

A

in vitro

30
Q
  1. In which of the following situations would a nucleic acid amplification test be most likely to produce a false positive result?

A: 1 week after antibiotic treatment of a susceptible bacterial infection.
B: 6 months after antibiotic treatment of a susceptible bacterial infection.
C: during asymptomatic infection with a low organism burden.
D: during symptomatic infection with a high organism burden.
E: in a patient population with a high prevalence of infection.

A

A: 1 week after antibiotic treatment of a susceptible bacterial infection.

31
Q 
2.  Antibiotic susceptibility testing in the clinical microbiology laboratory relies primarily on which of the following methods?
A:	culture
B:	microscopy
C:	nucleic acid amplification
D:	serology
E:	antigen detection
A

A: culture

32
Q 
3.  Which of the following diagnostic tests would become positive at the earliest time during viral infection?
A:	viral nucleic acid amplification
B:	viral protein detection
C:	viral culture
D:	virus-specific IgM detection
E:	virus-specific IgG detection
A

A: viral nucleic acid amplification

33
Q 
4.  If you were to use a highly sensitive (99%) and highly specific (99%) test to screen for detection of HIV infection among the general population in Orange County, NC, how would you interpret a positive result?
A:	it is very likely a true positive
B:	it is possibly a true positive
C:	it is definitely a true positive
D: 	it is very likely a false positive
E: 	it is possibly a false positive
F: 	it is definitely a false positive
A

E: it is possibly a false positive

34
Q
  1. In the scenario described above in Question 4, what would you do next as a physician receiving the positive test result?
    A: tell the patient s/he is HIV positive, and prescribe highly active antiretroviral therapy
    B: tell the patient s/he is HIV positive, but delay the start of antiretroviral therapy
    C: tell the patient s/he has a positive screening test, and order a confirmatory test
    D: do not tell the patient about the screening result, and order a confirmatory test
A

C: tell the patient s/he has a positive screening test, and order a confirmatory test

Immunology II (11 decks)

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