Exam1- Serology

Question 1

fecal oral route**, travelers, MSM, IV drugs, daycare

Answer 1

Hep A

Question 2

Hep A
jaundice w/in?
Sx: fatigue, N/V, RUQ pain
serology?

Answer 2

2 weeks

IgM anti-HAV Ab

Question 3

Hep A, B, and AI Hep» ALT & AST?

Answer 3

10-100x

Question 4

Hep B Serology

1. needed for acute or chronic infix?
2. right before Sx?
3. acute infx?
4. window period- between ? and ?; will find?
5. resolved infx?

Answer 4

1. HBsAg (surface Ag)- first found
2. IgM anti-HBc Ab
3. HBsAg & IgM anti-HBc Ab
4. HBsAg & HbsAb; will detect IgM anti-HBc Ab
5. Core Total Ab (HBc total) & HepBsAb

Question 5

Hep C
MC from?
positive ? test must be confirmed w/?

Answer 5

blood (IV drug users very common too)

HCV Ab, qualitative HCV RNA

Question 6

HIV
screen w/ ? and confirm w/ ?
2/3 antibodies must be detected:

Answer 6

ELISA, western blot

p24, gp41, gp120

Question 7

HIV- indeterminate western blot

• characterized by?
• causes: partial seroconversion, HIV2, autoAb
• repeat in ? w/ ?

Answer 7

only one band

3 months, HIV-RNA

Question 8

EBV

-nonspecific test? detects?

Answer 8

monospot (rapid); heterophile Ab (bind to surface of RBCs from cows, horses, etc)

Question 9

negative monospot:

• too early
• decreased sensitivity in ?
• mono-like Sx from ?

Answer 9

young children

CMV

Question 10

EBV

SPECIFIC test? (viral capsid Ag)

Answer 10

IgM anti- VCA

Question 11

syphilis:

primary: ? at site of contact
secondary: rash on ? and ?
tertiary: thoracic aortic aneurysm, aortic valve insufficiency, and ?

Answer 11

chancre
palms, soles
neurosyphilis

Question 12

• syphilis tests?

- confirmation/specific?

Answer 12

• VDRL, RPR&raquo_space; Non-treponomal, SEMI QUANTITATIVE

- fluorescent treponemal Ab absorption (FTA-Abs), Treponema Pallidum Particle Agglutination (TP-PA)

Question 13

B hemolytic strep group A
initial test?
if negative?
if also negative?
FINALLY if also negative?

Answer 13

rapid strep
throat culture
return in 2-4w for an ASO (post strep rheumatic fever & glomerulonephritis)
Anti-DNAse B (post strep glomerulonephritis only)

Question 14

SLE:
95% sensitive?
specific tests? (2)
nonspecific lupus anticoagulant aka?
can see a false positive ?

Answer 14

ANA
Smith’s, (anti-sm), anti-dsDNA
antiphospholipid Ab
VDRL (syphilis)

Question 15

“grain of sand in eye”?
female ~40-60
serology?

Answer 15

sjogren’s syndrome

anti-SS-A, anti-SS-B

Question 16

“rubber hose esophagus”, “pursed mouth”
female ~ 40
serology?

Answer 16

scleroderma (diffuse*)

anti-Scl-70

Question 17

CREST syndrome (scleroderma- limited)
serology?

Answer 17

anti-centromere antibody

Question 18

• mixed Sx of SLE, RA, polymyositis, scleroderma?

- serology?; ANA w/ ? pattern

Answer 18

RNP; speckled

Question 19

RA arthritis serology?

Answer 19

CCP (95% specific)

Question 20

polymyositis/dermatomyositis serology?

Answer 20

muscle Bx and CK

Question 21

pernicious anemia serology?

Answer 21

anti-parietal cell Ab, anti-intrinsic factor Ab

Question 22

primary biliary cirrhosis:

• serology?
• labs consistent w/ ?
• fatigue, pruritis
• increased ALP >2
• Dx?

Answer 22

anti-mitochondrial Ab
cholestasis
Liver Bx

Question 23

autoimmune hep

• unknown origin
• serology?
• diagnosis?
• associated with hemolytic anemia, thyroiditis
• may cause ? or progress to ?

Answer 23

ANA, **anti- smooth muscle Ab, liver Bx
Dx of exclusion
fulminant hep, cirrhosis

Question 24

Myasthenia Gravis

-serology?

Answer 24

anti-ach receptor Ab

anti-musk Ab (for people negative for anti-AchR)

Question 25

rapid HIV uses:

Answer 25

labor occupational- getting sticked at work clinic- IV users