Immunology Exam 2 Flashcards
Gumma
Painful immune tumors associated with Tertiary Syphilis
Latent Syphilis can be found in
Bone marrow
lymph glands
vital organs
central nervous system (CNS)
Darkfield Exam
- Used in detection of primary and secondary syphilis
- Looking for rapid motility
VDRL Heat Inactivation
- Heat serum to 56C for 30 min to destroy complement
- If repeat testing, must re-heat for 10 min
RPR stands for
Rapid Plasma Reagin
RPR adds _____ to VDRL
- Charcoal for visualization
- Choline Chloride to destroy complement
FTS-ABS
- 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
Relapsing Fever (Epidemic)
- Causitive agent: Bornelia recurrentis
- Widespread
- Lice vector
Relapsing Fever (Endemic)
- Causitive agent: Borrelia spp.
- Pockets of infection
- Soft-shell tick vector
Lyme’s Disease
- Causitive agent: Borrelia burgdorferi
- Hard-shell tick vector
- “Bulls-eye” rash
- Flu-like and neurological symptoms
Relapsing fever microbe also seen by
Hematology - spirochete on Wright’s Stain
Treatment for Lyme’s Disease
- Doxycycline followed by amoxicillin
- Neuroborreliosis requires IV antibiotics
Lyme’s Disease Tests
- EIA
- IFA
- Western Blot
Western Blot for Lyme’s Disease
Detects Outer Surface Protein
- 23-25 kDa (Osp C)
- 31 kDa (Osp A)
- 34 kDa (Osp B)
- 39 kDa
- 41 kDa
- 83-89 kDa
Blood Supply is screened for:
- HepB
- HepC
- HTLV-1
- West Nile Virus
- Chagas Disease
- CMV
Fulminant hepatitis
Rare acute form, leads to liver failure and death
ALT
Liver-specific enzyme elevated in blood in cases of liver damage
AST
Non-liver-specific enzyme elevated in blood in cases of liver damage
Alkaline phosphatase (ALP)
- Found in biliary duct lining
Elevates with: - large bile duct obstruction
- Intrahepatic cholestasis
- Infiltrative diseases of the liver
Lactate dehydrogenase (LD.LDH)
- Elevated in liver disease (especially LD5)
- Present in RBCs, cardiac and skeletal muscle
Liver Disease Bilirubin
Direct > Indirect
HepA
- ssRNA
- HAV shed in feces 1-4 weeks after infection
- Anti-HAV (IgM) and (IgG) by Immunoassay
HepB General Info
- dsDNA
- Hepadnaviridae family
- “Dane” particle
- Antigens: Surface, Envelope, Core
Indicates clearing of HepB infection
Anti-HBs
- known as “seroconversion”
- goal response from vaccination
Detectable during the “core window” of HepB (4-6 weeks)
Anti-HBc IgM and IgG
Indicates progression toward convalescene in HepB
Anti-HBe
Not produced in chronic carriers of HepB
Anti-HBs
HepB Antigen Detectability
HBsAg: 1.5-4 weeks (normal testing)
HBeAg: 1.5-3 weeks (normal testing)
HBV DNA: 1.5-2.5 weeks (donor bags only)
HepC General Info
- ssRNA
- Flaviviridae family
- No vaccine
- 50-80% of infected become chronic carriers
HepC Testing
- Antigenic testing for virus (6-10 weeks)
- Anti-HCV (~4 months)
HIV General Info
- dsRNA Retrovirus (with reverse transcriptase)
- Icosahedral (20-sided) enveloped virus
- Antigens: Envelope, Matrix, Core/Capsule
Structural Genes
- Group Specific Antigen (Gag)
- Envelope (Env)
- Polymerase (Pol)
Gag antigens
p15 and p24
Env antigens
gp160 (polyprotein), gp120 (knobs), gp41 (transmembrane)
Pol antigens
p66, p51, p31 (less important for detection)
Threshold of HIV/AIDS
CD4 count drops below 500 cells / uL
Normal CD4/CD8 Ratio
1:1 or 2:1
HIV Testing
- Sandwich ELISA for p24
- Western Blot (p24, p41, gp120/160 most important)
- Viral Load (how much HIV-RNA in 1 mL of blood)
Western Blot principle
- Antigens separated on Lysate paper via electrophoresis form bands based upon mass
- Only as good as the antigens you maintain for controls
