Immunology Exam 2

Question 1

Gumma

Answer 1

Painful immune tumors associated with Tertiary Syphilis

Question 2

Latent Syphilis can be found in

Answer 2

Bone marrow
lymph glands
vital organs
central nervous system (CNS)

Question 3

Darkfield Exam

Answer 3

• Used in detection of primary and secondary syphilis
• Looking for rapid motility

Question 4

VDRL Heat Inactivation

Answer 4

• Heat serum to 56C for 30 min to destroy complement
• If repeat testing, must re-heat for 10 min

Question 5

RPR stands for

Answer 5

Rapid Plasma Reagin

Question 6

RPR adds _____ to VDRL

Answer 6

• Charcoal for visualization
• Choline Chloride to destroy complement

Question 7

FTS-ABS

Answer 7

• Indirect fluorescent antibody test
• Confirmatory test
• Reiter strain as a sorbent
• Nichols strain adsorbed to slide
• 80% positive in Primary Siphilis, 100% by secondary, antibodies for life

Question 8

Relapsing Fever (Epidemic)

Answer 8

• Causitive agent: Bornelia recurrentis
• Widespread
• Lice vector

Question 9

Relapsing Fever (Endemic)

Answer 9

• Causitive agent: Borrelia spp.
• Pockets of infection
• Soft-shell tick vector

Question 10

Lyme’s Disease

Answer 10

• Causitive agent: Borrelia burgdorferi
• Hard-shell tick vector
• “Bulls-eye” rash
• Flu-like and neurological symptoms

Question 11

Relapsing fever microbe also seen by

Answer 11

Hematology - spirochete on Wright’s Stain

Question 12

Treatment for Lyme’s Disease

Answer 12

• Doxycycline followed by amoxicillin
• Neuroborreliosis requires IV antibiotics

Question 13

Lyme’s Disease Tests

Answer 13

• EIA
• IFA
• Western Blot

Question 14

Western Blot for Lyme’s Disease

Answer 14

Detects Outer Surface Protein
- 23-25 kDa (Osp C)
- 31 kDa (Osp A)
- 34 kDa (Osp B)
- 39 kDa
- 41 kDa
- 83-89 kDa

Question 15

Blood Supply is screened for:

Answer 15

• HepB
• HepC
• HTLV-1
• West Nile Virus
• Chagas Disease
• CMV

Question 16

Fulminant hepatitis

Answer 16

Rare acute form, leads to liver failure and death

Question 17

ALT

Answer 17

Liver-specific enzyme elevated in blood in cases of liver damage

Question 18

AST

Answer 18

Non-liver-specific enzyme elevated in blood in cases of liver damage

Question 19

Alkaline phosphatase (ALP)

Answer 19

• Found in biliary duct lining
  Elevates with:
• large bile duct obstruction
• Intrahepatic cholestasis
• Infiltrative diseases of the liver

Question 20

Lactate dehydrogenase (LD.LDH)

Answer 20

• Elevated in liver disease (especially LD5)
• Present in RBCs, cardiac and skeletal muscle

Question 21

Liver Disease Bilirubin

Answer 21

Direct > Indirect

Question 22

HepA

Answer 22

• ssRNA
• HAV shed in feces 1-4 weeks after infection
• Anti-HAV (IgM) and (IgG) by Immunoassay

Question 23

HepB General Info

Answer 23

• dsDNA
• Hepadnaviridae family
• “Dane” particle
• Antigens: Surface, Envelope, Core

Question 24

Indicates clearing of HepB infection

Answer 24

Anti-HBs
- known as “seroconversion”
- goal response from vaccination

Question 25

Detectable during the "core window" of HepB (4-6 weeks)

Answer 25

Anti-HBc IgM and IgG

Question 26

Indicates progression toward convalescene in HepB

Answer 26

Anti-HBe

Question 27

Not produced in chronic carriers of HepB

Answer 27

Anti-HBs

Question 28

HepB Antigen Detectability

Answer 28

HBsAg: 1.5-4 weeks (normal testing) HBeAg: 1.5-3 weeks (normal testing) HBV DNA: 1.5-2.5 weeks (donor bags only)

Question 29

HepC General Info

Answer 29

- ssRNA - Flaviviridae family - No vaccine - 50-80% of infected become chronic carriers

Question 30

HepC Testing

Answer 30

- Antigenic testing for virus (6-10 weeks) - Anti-HCV (~4 months)

Question 31

HIV General Info

Answer 31

- dsRNA Retrovirus (with reverse transcriptase) - Icosahedral (20-sided) enveloped virus - Antigens: Envelope, Matrix, Core/Capsule

Question 32

Structural Genes

Answer 32

- Group Specific Antigen (Gag) - Envelope (Env) - Polymerase (Pol)

Question 33

Gag antigens

Answer 33

p15 and p24

Question 34

Env antigens

Answer 34

gp160 (polyprotein), gp120 (knobs), gp41 (transmembrane)

Question 35

Pol antigens

Answer 35

p66, p51, p31 (less important for detection)

Question 36

Threshold of HIV/AIDS

Answer 36

CD4 count drops below 500 cells / uL

Question 37

Normal CD4/CD8 Ratio

Answer 37

1:1 or 2:1

Question 38

HIV Testing

Answer 38

- Sandwich ELISA for p24 - Western Blot (p24, p41, gp120/160 most important) - Viral Load (how much HIV-RNA in 1 mL of blood)

Question 39

Western Blot principle

Answer 39

- Antigens separated on Lysate paper via electrophoresis form bands based upon mass - Only as good as the antigens you maintain for controls