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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
Q

DEFINITION: Indicates the frequency of negative test results in patients WITHOUT a particular disease. Detects TRUE NEGATIVES,

A

Specificity

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26
Q

TRUE or FALSE: Non-treponemal tests are used as confirmatory test due to their specificity for syphilis.

A

FALSE- They are screening tests that are sensitive to syphilis but they are testing patient antibodies-reagin to cardiolipin

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27
Q

TRUE or FALSE: Confirmatory tests for syphilis are called Treponemal tests

A

TRUE

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28
Q

Reagent used for these tests include a mix of cardiolipin antigen, cholesterol, and lecithin

A

Nontreponemal Tests

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29
Q

What is the name for the special precipitation Nontreponemal tests known as special precipitation tests called?

A

Flocculation

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30
Q

Name of the non-specific antibody utilized in nontreponemal tests

A

Reagin

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31
Q

Nontreponemal test results are USUALLY positive within how many weeks after the appearance of a chancre?

A

1 to 4 weeks

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32
Q

Prozone will cause what type of nontreponemal test result in the secondary stage of syphilis?

A

False negative

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33
Q

What are some of the infectious diseases that may cause false positives for a patient’s nontreponemal test?

A

TB, HIV, Measles, EBV

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34
Q

What are some non-infectious reasons a nontreponemal test would be falsely positive?

A

Drug addiction, autoimmune diseases (SLE/Hashimotos), lymphoma

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35
Q

TRUE or FALSE:

Pregnancy can cause a false positive nontreponemal test result

A

TRUE

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36
Q

What are the nontreponemal tests utilized in the lab?

A

VDRL and RPR

37
Q

Which nontreponemal test is used for serum and CSF?

38
Q

How is complement inactivated in the VDRL test?

A

Heating the specimen at 56C for 30 minutes

39
Q

What is the timeframe to run a VDRL after complement has been inactivated?

40
Q

Reagent for the VDRL test

A

Cardiolipin + lecithin + cholesterol

41
Q

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

42
Q

What controls are ran for the VDRL?

A

Nonreactive, weakly reactive, and reactive

43
Q

TRUE or FALSE: A positive qualitative VDRL result for CSF is diagnostic for neurosyphilis

44
Q

For a Semi-Quantitative VDRL, how would you read a titer result?

A

The highest dilution with a reactive result

45
Q

Would a low temperature cause a false positive or false negative for a VDRL test?

A

False NEGATIVE

46
Q

Rapid Plasma Reagin is a modified version of what type of test?

47
Q

Can you test CSF using RPR?

48
Q

Why is the RPR utilized in labs more than the VDRL?

A

There is no heating step required and it is read macroscopically

49
Q

Reagent for the RPR test

A

Cardiolipin + lecithin + cholesterol + choline + charcoal

50
Q

What part of the reagent utilized in RPR tests deactivates complement?

51
Q

What does the charcoal do in the RPR reagent?

A

Helps make reading the test result easier

52
Q

What tests are considered confirmatory for syphilis?

A

Treponemal tests: FTA-ABS, Hemagglutination tests, Gelatin particle agglutination - Serodia- TP-PA

53
Q

Fluorescent Treponemal Antibody-Absorption Test is what type of confirmatory test?

A

Indirect fluorescent assay for the antibody from a patient

54
Q

What is the reagent utilized in FTA-ABS?

A

Treponemal pallidum (Nichol’s strain)

55
Q

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
A

Fluorescent Treponemal Antibody - Absorption test

56
Q

What type of hemagglutination test is utilized to confirm syphilis?

A

Passive hemagglutination

57
Q

Which hemagglutination treponemal test uses treated turkey RBCs?

A

HATTS & TPHA

58
Q

Which hemagglutination treponemal test uses treated sheep RBCs?

59
Q

The following procedure is for what treponemal test:

  1. Incubate serum with reagent antigen at 25C for 1 hour
  2. Read
A

Hemagglutination

60
Q

Which treponemal test is more sensitive in detecting primary syphilis?

A

Gelatin particle agglutination

61
Q

What new technologies are being utilized to test for IgM or IgG or both with a 99% sensitivity for syphilis?

A

Enzyme or Chemiluminescence immunoassay

62
Q

What type of test is done to verify discrepant syphilis results?

A

Western Blot

63
Q

Preferred test for congenital syphilis infections

64
Q

Drug of choice to treat primary and secondary syphilis

A

Penicillin

65
Q

Drug used to treat syphilis if patient is allergic to penicillin

A

Doxycycline

66
Q

Drug utilized to treat neurosyphilis

A

Probenecid

67
Q

Causative agent for Relapsing fever

A

Borrelia recurrentis

68
Q

How is Borrelia recurrentis spread?

A

Louse-borne

69
Q

What causes Lyme disease?

A

Borrelia burgdorferi

70
Q

A bullseye rash is a clinical manifestation of which disease?

A

Lyme disease

71
Q

What are the screening tests for Lyme disease?

A

IFA and ELISA

72
Q

Which is more sensitive for Lyme disease testing?: IFA or ELISA?

73
Q

Screening tests for Lyme disease may have false positives with what other diseases?

A

Syphilis, relapsing fever, and leptospirosis

74
Q

What is the confirmation test for Lyme disease?

A

Western Blot

75
Q 
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?
A

Late or previous disease

76
Q 
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?
A

Likely Lyme disease

77
Q 
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?
A

No infection present

78
Q

How is Lyme disease treated?

A
  • Penicillins, tetracyclines, and macrolides for adults

- Amoxicillin and cefuroxime axetil for children

79
Q

Who grouped the different streptococcus bacteria?

A

Rebecca Lancefield

80
Q

What is the scientific name for Group A strep?

A

Streptococcus pyogenes

81
Q

Which GAS streptolysin is oxygen labile?

A

Streptolysin O

82
Q

Streptolysin O is oxygen labile meaning it is ______________ in the presence of oxygen

A

Inactivated

83
Q

Which GAS streptolysin is oxygen stable?

A

Streptolysin S

84
Q

What is excreted by bacterial cells as it metabolizes and contributes to the virulence of the bacteria?

A

Exoantigens

85
Q

Hemolysin (toxin) that destroys RBCs and WBCs

A

Streptolysin

86
Q

What are the GAS exoantigens? (4)

A
  • Deoxyribonuclease (DNAse)
  • Hyaluronidase
  • Nicotinamide adenine dinucleotidase (NADase)
  • Streptokinase
87
Q

This follows a group A strep pharyngitis in 2-3% of untreated infected patients. Clinical manifestations include joint pain, carditis with murmurs, and chorea.

A

Acute Rheumatic Fever

88
Q

What can occur after a skin or pharyngeal streptococcal infection?

A

Poststreptococcal glomerulonephritis

MLT-MLS Spring 2022 (14 decks)

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