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MLT-MLS Spring 2022 > Immunology Exam 5 > Flashcards

Immunology Exam 5 Flashcards

1
Q

Treponema pallidum causes which infectious disease?

A

Syphilis

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2
Q

An ulcerative disease that facilitates the transmission of HIV

A

Syphilis

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3
Q

Why is syphilis cultivation not practical for the clinical laboratory?

A

The organism is very sensitive to heat, cold, drying, and soap.

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4
Q

What is the method of transmission for syphilis?

A

Usually sexually and congenital via placenta

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5
Q

What nickname was given to syphyilis?

A

“The Great Imitator”

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6
Q

A chancre typically appears during which type of syphilis?

A

Primary

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7
Q

TRUE or FALSE:

A patient will be serum reactive for syphilis 1-3 weeks after a chancre appears.

A

TRUE

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8
Q

Rash and fever are clinical manifestations that appear during which stage of syphilis?

A

Secondary

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9
Q

What is another name for the secondary stage syphilis?

A

Disseminated Stage

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10
Q

This stage of syphilis can last for years - typically 10-30.

A

Latent Stage

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11
Q

In this stage of syphilis, the patient will be serologically positive but not always infectious

A

Latent Stage

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12
Q

What is Hutchinson’s triad?

A

Notches in a child’s teeth along with eye damage (keratitis) and deafness due to congenital syphilis

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13
Q

What causes Hutchinson’s triad?

A

Congenital syphilis

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14
Q

Gumma lesions are seen in which stage of syphilis?

A

Tertiary

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15
Q

Which stage of syphilis is neurosyphilis most often associated with?

A

Tertiary

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16
Q

TRUE or FALSE:

Neurosyphilis can be seen in all stages of syphilis

A

TRUE - most often seen in tertiary

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17
Q

Direct examination of syphilis in the lab includes dark microscopy and _______

A

Fluorescent antibody testing of specimen

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18
Q

What is the fastest method of detecting syphilis?

A

Dark Microscopy

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19
Q

Delay in examining the slide, poor specimen collected, or antibiotic treatment would cause what type of result for dark field microscopy when looking for syphilis?

A

False NEGATIVES

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20
Q

Contamination with normal flora spirochetes from the mouth or rectal mucosa would cause what type of result when testing for syphilis using dark field microscopy?

A

False POSITIVES

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21
Q

Which type of direct examination of syphilis detects the antigen and is very sensitive and specific?

A

Fluorescent testing

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22
Q

What type of fluorescent testing is used to detect syphilis?

A

Direct AND Indirect fluorescent antibody

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23
Q

Which fluorescent antibody test for syphilis requires an extra step? What is the extra step?

A

Indirect Fluorescent Antibody test. FITC-labeled anti-human antibody is added after the anti-Tp antibody instead of just FITC-labeled anti-Tp antibody

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24
Q

DEFINITION: Indicates the frequency of positive results in patients WITH a particular disease. Detects TRUE POSITIVES.

A

Sensitivity

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25
DEFINITION: Indicates the frequency of negative test results in patients WITHOUT a particular disease. Detects TRUE NEGATIVES,
Specificity
26
TRUE or FALSE: Non-treponemal tests are used as confirmatory test due to their specificity for syphilis.
FALSE- They are screening tests that are sensitive to syphilis but they are testing patient antibodies-reagin to cardiolipin
27
TRUE or FALSE: Confirmatory tests for syphilis are called Treponemal tests
TRUE
28
Reagent used for these tests include a mix of cardiolipin antigen, cholesterol, and lecithin
Nontreponemal Tests
29
What is the name for the special precipitation Nontreponemal tests known as special precipitation tests called?
Flocculation
30
Name of the non-specific antibody utilized in nontreponemal tests
Reagin
31
Nontreponemal test results are USUALLY positive within how many weeks after the appearance of a chancre?
1 to 4 weeks
32
Prozone will cause what type of nontreponemal test result in the secondary stage of syphilis?
False negative
33
What are some of the infectious diseases that may cause false positives for a patient's nontreponemal test?
TB, HIV, Measles, EBV
34
What are some non-infectious reasons a nontreponemal test would be falsely positive?
Drug addiction, autoimmune diseases (SLE/Hashimotos), lymphoma
35
TRUE or FALSE: | Pregnancy can cause a false positive nontreponemal test result
TRUE
36
What are the nontreponemal tests utilized in the lab?
VDRL and RPR
37
Which nontreponemal test is used for serum and CSF?
VDRL
38
How is complement inactivated in the VDRL test?
Heating the specimen at 56C for 30 minutes
39
What is the timeframe to run a VDRL after complement has been inactivated?
4 hours
40
Reagent for the VDRL test
Cardiolipin + lecithin + cholesterol
41
TRUE or FALSE: The reagent for the VDRL test is not stable, therefore it is prepared daily and patient samples are typically ran in batches
TRUE
42
What controls are ran for the VDRL?
Nonreactive, weakly reactive, and reactive
43
TRUE or FALSE: A positive qualitative VDRL result for CSF is diagnostic for neurosyphilis
TRUE
44
For a Semi-Quantitative VDRL, how would you read a titer result?
The highest dilution with a reactive result
45
Would a low temperature cause a false positive or false negative for a VDRL test?
False NEGATIVE
46
Rapid Plasma Reagin is a modified version of what type of test?
VDRL
47
Can you test CSF using RPR?
NO
48
Why is the RPR utilized in labs more than the VDRL?
There is no heating step required and it is read macroscopically
49
Reagent for the RPR test
Cardiolipin + lecithin + cholesterol + choline + charcoal
50
What part of the reagent utilized in RPR tests deactivates complement?
Choline
51
What does the charcoal do in the RPR reagent?
Helps make reading the test result easier
52
What tests are considered confirmatory for syphilis?
Treponemal tests: FTA-ABS, Hemagglutination tests, Gelatin particle agglutination - Serodia- TP-PA
53
Fluorescent Treponemal Antibody-Absorption Test is what type of confirmatory test?
Indirect fluorescent assay for the antibody from a patient
54
What is the reagent utilized in FTA-ABS?
Treponemal pallidum (Nichol's strain)
55
The following procedure is for what treponemal test: 1. Pretreat heat inactivated serum - Dilution in sorbent to remove cross reacting antibody 2. Add serum to slide, incubate, rinse 3. Add antibody labeled with fluorescein, rinse, coverslip 4. Examine with fluorescent microscope
Fluorescent Treponemal Antibody - Absorption test
56
What type of hemagglutination test is utilized to confirm syphilis?
Passive hemagglutination
57
Which hemagglutination treponemal test uses treated turkey RBCs?
HATTS & TPHA
58
Which hemagglutination treponemal test uses treated sheep RBCs?
MHA-TP
59
The following procedure is for what treponemal test: 1. Incubate serum with reagent antigen at 25C for 1 hour 2. Read
Hemagglutination
60
Which treponemal test is more sensitive in detecting primary syphilis?
Gelatin particle agglutination
61
What new technologies are being utilized to test for IgM or IgG or both with a 99% sensitivity for syphilis?
Enzyme or Chemiluminescence immunoassay
62
What type of test is done to verify discrepant syphilis results?
Western Blot
63
Preferred test for congenital syphilis infections
VDRL
64
Drug of choice to treat primary and secondary syphilis
Penicillin
65
Drug used to treat syphilis if patient is allergic to penicillin
Doxycycline
66
Drug utilized to treat neurosyphilis
Probenecid
67
Causative agent for Relapsing fever
Borrelia recurrentis
68
How is Borrelia recurrentis spread?
Louse-borne
69
What causes Lyme disease?
Borrelia burgdorferi
70
A bullseye rash is a clinical manifestation of which disease?
Lyme disease
71
What are the screening tests for Lyme disease?
IFA and ELISA
72
Which is more sensitive for Lyme disease testing?: IFA or ELISA?
ELISA
73
Screening tests for Lyme disease may have false positives with what other diseases?
Syphilis, relapsing fever, and leptospirosis
74
What is the confirmation test for Lyme disease?
Western Blot
75
``` A patient sample is tested for Lyme disease and the results are as follows: -Negative for IgM ABY -Positive IgG ABY -Positive Western Blot What is the patient's result? ```
Late or previous disease
76
``` A patient sample is tested for Lyme disease and the results are as follows: -Positive for IgM ABY -Positive IgG ABY -Positive Western Blot What is the patient's result? ```
Likely Lyme disease
77
``` A patient sample is tested for Lyme disease and the results are as follows: -Negative for IgM ABY -Negative IgG ABY -Negative Western Blot What is the patient's result? ```
No infection present
78
How is Lyme disease treated?
- Penicillins, tetracyclines, and macrolides for adults | - Amoxicillin and cefuroxime axetil for children
79
Who grouped the different streptococcus bacteria?
Rebecca Lancefield
80
What is the scientific name for Group A strep?
Streptococcus pyogenes
81
Which GAS streptolysin is oxygen labile?
Streptolysin O
82
Streptolysin O is oxygen labile meaning it is ______________ in the presence of oxygen
Inactivated
83
Which GAS streptolysin is oxygen stable?
Streptolysin S
84
What is excreted by bacterial cells as it metabolizes and contributes to the virulence of the bacteria?
Exoantigens
85
Hemolysin (toxin) that destroys RBCs and WBCs
Streptolysin
86
What are the GAS exoantigens? (4)
- Deoxyribonuclease (DNAse) - Hyaluronidase - Nicotinamide adenine dinucleotidase (NADase) - Streptokinase
87
This follows a group A strep pharyngitis in 2-3% of untreated infected patients. Clinical manifestations include joint pain, carditis with murmurs, and chorea.
Acute Rheumatic Fever
88
What can occur after a skin or pharyngeal streptococcal infection?
Poststreptococcal glomerulonephritis

MLT-MLS Spring 2022 (14 decks)

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