Immunology & Serology Part 2 Flashcards
1
Q
HLA associated with Rheumatoid arthritis
A
HLA DR4
2
Q
Autoantibodies associated with rheumatic fever
A
Anti-streptococcal Ab
3
Q
Antibodies react with heart tissues
A
Rheumatic Fever
4
Q
Patient commonly has a positive ASTO/ASO
A
Post Streptococcal Glomerulonephritis
5
Q
Autoantibodies associated with Goodpasture’s syndrome
A
Anti-basement membrane (alveolar and glomerular)
6
Q
Affects both lungs and kidney
A
Goodpasture’s syndrome
7
Q
Autoantibodies associated with Idiopathic thrombocytopenic purpura
A
Antiplatelet antibodies
8
Q
Destruction of own platelets
A
Idiopathic Thrombocytopenic Purpura
9
Q
Autoantibody associated with Autoimmune hemolytic anemia
A
Anti-RBCs
10
Q
Destruction of RBCs
A
Autoimmune hemolytic anemia
11
Q
Autoantibody associated with primary biliary cirrhosis
A
Anti-mitochondrial antibodies
12
Q
Immune reaction in the intrahepatic interlobular bile ducts
A
Primary biliary cirrhosis
13
Q
Autoantibody associated with chronic active hepatitis
A
Anti-smooth muscle antibodies
14
Q
Autoantibody associated with Croh’s disease
A
Perinuclear antineutrophil cytoplasmic (p-ANCA 10 – 30%)
15
Q
Autoantibody associated with primary sclerosing cholangitis
A
Perinuclear antineutrophil cytoplasmic Ab (P-ANCA)
16
Q
Autoantibody associated with Wegener’s granulomatosis
A
Antineutrophil cytoplasmic (c-ANCA)
17
Q
Granulomatous inflammation. Necrotizing glomerulonephritis is common
A
Wegener’s granulomatosis
18
Q
Autoantibodies associated with Multiple Sclerosis
A
Anti-myelin sheath antibodies
19
Q
Chronic progressive inflammatory disease with demyelination of the nerves
A
Multiple sclerosis
20
Q
Autoantibodies associated with myasthenia gravis
A
Anti-acetylcholinesterase
21
Q
Neuromuscular transmission disorder
HLA B8
A
Myasthenia gravis
21
Q
Autoantibodies associated with Insulin-dependent DM
A
Anti-glutamic acid decarboxylase
Anti-b-islet cells
Anti-insulin antibodies
22
Q
Selective destruction of beta cells of the islets of Langerhans in the pancreas > leads to TYPE I DM
HLA DR3 and HLA DR4
A
Insulin-dependent DM
23
Q
Autoantibody associated with anti-adrenal cells
A
Addison’s disease
24
Autoantibodies associated with pernicious anemia
Anti-parietal cells
Anti-intrinsic factor
25
Destruction of the parietal cells of the stomach mucosa
Pernicious anemia
26
Autoantibody associated with Grave’s disease
Anti-TSH receptor
27
autoAb reacts with the TSH receptor of the thyroid glands leading to overstimulation > hyperthyroidism
Grave’s disease
28
Autoantibodies associated with Hashimoto’s thyroiditis
Anti-thyroid peroxidase
Anti-microsomal
Anti-thyroglobulin
29
Destruction of the thyroid gland > leads to hypothyroidism
Hashimotos thyroiditis
30
Benign or malignant condition that results from a single clone of lymphoid-plasma cells producing elevated levels of a single class of immunoglobulin, referred to as M protein, paraprotein or monoclonal protein
Monoclonal gammopathy
31
AKA lytic bone disease. Plasma neoplasm that leads to overproduction of immunoglobulins particularly IgG (IgM and IgA may also be increased).
BJP is present in the urine.
IL-6 is the growth factor for plasma cell transformation
Multiple Myeloma
32
Infiltration of lymphoplasmacytic cells into the bone marrow.
Increase in IgM and cryoglobulins
Waldenstrom’s macroglobulinemia
33
Presence of monoclonal proteins but MM signs and symptoms are absent
Monoclonal gammopathy of undetermined significance
34
Only kappa and lambda chains are produced
BJP is also present
Light chain disease
35
AKA Franklin’s disease. Leads to overproduction of heavy chains, no production of light chains.
Alpha chain disease is the most common disorder
Heavy chain disease
36
Consist of one or more heavy chain classes and both light chain types
Polyclonal gammopathy
37
Failure of the immune system to protect against diseases or malignancies
Immunodefiency
38
Caused by genetic or developmental defects of immune system
Primary immunodeficiency
39
Loss of immune function due to aging, exposure to infectious agents and immunosuppression
Secondary acquired immunodeficiency
40
x-linked recessive disorder
Defect in the production of NADPH oxidase resulting in decreased intracellular killing of ingested organisms
Chronic Granulomatous Disease (CGD)
41
Test used for diagnosis of CGD
Nitroblue tetrazolium test (NBT)
42
Deficiency in myeloperoxidase which is an important microbicidal agent in neutrophils
Myeloperoxidase deficiency
43
Impaired chemotaxis and phagosome degranulation
Presence of giant cytoplasmic granules
Chediak-Higash syndrome
44
Neutrophils demonstrate defective chemotaxis
Job’s syndrome
45
Defective chemotactic response and random movement
Lazy Leukocyte Syndrome
46
Deficiency of tuftsin, a phagocytosis-promoting serum tetrapeptide that is cleaved from an Ig like molecule, leukokinin, in the spleen
Tuftsin Deficiency
47
Lack of CD 18
Leukocyte Adhesion Deficiency
48
Genetic defect in the long arm of X chromosome
-Block in the maturation of pre B cells
-Recurrent infections and low serum levels of immunoglobulin and lack of B cells
Bruton’s C-Linked agammaglobulinemia
49
Arrest in the development of B cells is the cause
Selective Ig Deficiency (dysgammaglobulinemia)
50
Most common form of selective Ig deficiency. Recurrent sinopulmonary infections. IgA levels lower than 5 mg/dL
Selective IgA deficiency
51
Results when the onset of Ig synthesis is delayed. Hypogammaglobulinemia is common in infnats between the 5th – 6th month of life.
Transient hypogammaglobulinemia
52
Faulty development of 3rd and 4th pharyngeal pouches. Associated with defect if chromosome 22
Digeorge syndrome (Congenital Thymic Hypoplasia)
53
Thymic dysplasia resulting in decreased to absent T cell mediated immunity. Usually have marked lymphadenopathy and hepatosplenomegaly
Nezelof’s Syndrome
54
Impaired synthesis of MIF (Migration Inhibitory Factor) by T cells
Chronic Cutaneous Candidiasis
55
Deficiency in the expression of MHC II gene products on the T cell surface leading to a failure of antigen presentation
Bare Lymphocyte Syndrome
56
Combined defect of both humoral and cell mediated immunity. Autosomal recessive type is associated with adenosine deaminase deficiency. Rarely survive beyond age 1 if no treatment is done.
Severe Combined Immunodeficiency Disease (SCID)
57
Mutation in the WASP gene. Triad of eczema, thrombocytopenia, and immunodeficiency
Wiskott Aldrich Syndrome
58
Mutation in SH2DAI/SAP gene resulting in weakening of both cellular and humoral immunity
Vulnerability to EBV infection
X Linked Lymphoproliferative Disease (Duncan’s Syndrome)
59
Exaggerated response to a typically harmless antigen that results in injury of tissue, disease or even death.
Hypersensitivity
60
Anaphylactic or immediate hypersensitivity reaction
Type I
61
Examples of Hypersensitivity Reaction Type I
Hay fever
Asthma
Food allergies
Urticaria
Anaphylactic reaction
62
Cytotoxic or antibody-mediated hypersensitivity reaction
Type II
63
Examples of Type II hypersensitivity reaction
Transfusion reactions
HDN
Autoimmune HA
Grave’s disease
Myasthenia Gravis
Goodpasture Syndrome
HTR
Drug-induced HA
Warm-induced HA
64
Immune complex hypersensitivity reaction
Type III
65
Examples of Type III hypersensitivity reactions
SLE
RA
Post-strep GN
Arthus reaction
Farmer’s lung
Serum sickness
66
T cell mediated or delayed hypersensitivity reactions
Type IV
67
Examples of Type IV hypersensitivity reactions
Contact dermatitis
Tuberculin test
Poison ivy
Mantoux reaction
MS
Hashimoto’s thyroiditis
68
Needle or pricking device is used to introduce a small drop of allergen into the upper layer of skin of the forearm or back. Positive result is wheal and flare with a size of 3-4 mm
Percutaneous / Prick / Puncture Test
69
Greater amount of antigen is used and is more sensitive than percutaneous test but higher chance of anaphylactic reaction
Intradermal test
70
Used to measure the amount of specific IgE
Radioallergosorbent Test (RAST)
71
Patient serum is incubated with allergen coated cellulose sponge > washed > enzyme labeled anti-IgE is added > washed > add the chromogenic substrate > fluorescence if IgE specific to the allergen is present
Noncompetitive Fluoroimmunoassay
72
Patient IgE competes with radiolabeled IgE for a limited antibody binding site attached in a solid phase
Radioimmunosorbent Test (RIST)
73
Detects in vivo sensitization of RBCs and to check if a patient is suffering from HTR, HDN, AIHA,
Direct Antiglobulin Test
74
Contains antibodies directed to IgG, C3b, C3d
Polyclonal AHG
75
Determines whether IgG, C3b, C3d
Monoclonal AHG
76
Detects in vitro sensitization of RBCs and is used for antibody screening, identification, crossmatching and weak-D testing
Indirect antiglobulin test
77
Nonadsorbent adhesive patch containing allergens is applied in the back of the patient > check for redness over the next 48 hours
Patch testing
78
Skin testing for exposure for M. tuberculosis
Mantoux method
79
Particulate antigens such as cells aggregate to form larger complexes when a specific antibody is present
Agglutination
80
Antigen-antibody combination through single antigenic site
Sensitization phase
81
Sum of interaction between antibody and multiple antigenic determinant on a particle
Lattice formation
82
Insoluble particles react with an antibody which results in aggregation or clumping
Direct agglutination
83
Agglutination is caused when an antibody reacts with an antigen that is ___ in the cell
Naturally present
84
Examples of direct immune agglutination
ABO blood grouping (Hemagglutination)
85
Aggregation of indicator cells (sRBCs) but not caused by antigen-antibody interaction
Direct Non-immune
86
Examples of Direct non-immune agglutination
Viral hemagglutination test
87
Used to detect if an antibody is present. Reaction where antigen is attached to a carrier particle
Indirect or Passive Agglutination
88
Examples of Indirect/Passive Agglutination
Rapid Latex Agglutination for RA
89
Used to detect if antigen is present in a patient sample. Antibody attached to a carrier particle
Reversed Passive Agglutination
90
Examples of Reversed Passive Agglutination
CRP assays and haptoglobin detection
91
Based on competition between particulate and soluble antigen for limited antibody-binding sites
Agglutination inhibition
92
Indicator of positive reaction for agglutination inhibition
Lack of agglutination
93
Examples of agglutination inhibition
Pregnancy test / HCG
94
Used to detect patient antibodies while utilizing RBCs as indicator cells
Viral Hemagglutination inhibition
95
Positive result for viral hemagglutination inhibition
No agglutination
96
Uses antibodies directed against the Fc portion of a human antibody. Used to detect incomplete antibodies.
Antihuman Globulin Test
97
Used to detect in vivo sensitization
DAT
98
Examples of DAT
HDFN
HTR
AIHA
DIHA
99
Used to detect in vitro sensitization
IAT
100
Examples of IAT
Antibody screen
Antibody identification
Crossmatching
Weak D testing
101
Antibody is adsorbed in bacteria, most frequently used carrier bacterium is S. aureus due to presence of protein A
Coagglutination
102
Uses gold as carrier
Sol Particle Immunoassay
103
Uses dye as carrier
Disperse Dye Immunoassay
104
Most sensitive, uses latex as carrier
IMPACT/ Immunoassay by particle counting
105
Combination of soluble antigen with soluble antibody to produce insoluble complexes that are visible
Precipitation
106
Presence of excess antibody leading to false negative reaction
Prozone
107
Remedy of prozone
Dilute patient sample
108
Presence of excess antigen, poor crosslinking of immune complexes leading to false negative reaction
Post-zone
109
Remedy for post-zone
Wait for a week or two, then retest the patient
110
There are equal amounts of antigen and antibody, leading to maximum precipitation
Zone of equivalence
111
Overall strength and is the sum of affinities of antigen-antibody interaction. Strength with which a multivalent antibody binds with multivalent antigen
Avidity
112
Interaction of single Fab site and a single epitope
Affinity
113
Soluble antigen and/or antibody diffuses through the gel pore until optimum concentration is achieved and forms a stable immune complex
Precipitation in a Gel Medium
114
One reactant diffuses through the gel. Either antigen (more common) or antibody
Single Diffusion
115
116
Reactants move only in one direction (up or down). Tube is commonly used.
Single dimension
117
Reactants move radially
Double dimension
118
Single diffusion single dimension
Oudin
119
Single diffusion double dimension
Radial immunodiffusion
120
Double diffusion single dimension
Oakley and Fulthrope
121
Double diffusion double dimension
Ouchterlony and Elek
122
Principle: Ag diffuses through the gel containing immobilized Abs forming insoluble Ag-Ab complexes
Oudin
123
Circular wells cut into the gel (with antibody) and antigen is loaded. Antigen diffuses producing a ring of precipitate
Radial immunodiffusion
124
Measurement is taken while the disc is still expanding. Read at 18 hours after loading
Kinetic (Fahey/McKelvy)
125
Measurement is taken when the ring has stopped expanding, allowing maximal precipitation. Read at 24-72 hours
Endpoint (Mancini)
126
Principle: Both Ag and Ab both diffuse towards each other. Antibodies place first in the tube followed by neutral agar. Lastly, antigen is added on the top of the part of the mixture
Oakley and Fulthrope
127
Antigen and antibody diffuses radially through a semisolid medium
Ouchterlony
128
Fused band or precipitate, indicating identical antigens
Serological identity
129
Spur formation is seen, antigens are not identical but have the same determinant. Spur always points toward the simpler antigen.
Partial identity
130
Precipitate cross react serologically distinct
Non-identity
131
Double spurring
Double partial identity
132
Molecules are separated based on their net charge when an electrical field is applied to the system
Electrophoresis
133
Single diffusion single dimension electrophoresis
Rocket IE/ Technique of Laurell
134
Single diffusion double dimension electrophoresis
Ressler’s Method/ Double crossed IE/ Crossed IE
135
Double diffusion single dimension electrophoresis
Counter IE/ countercurrent electrophoresis/ double electroimmunodiffusion
135
Double diffusion double dimension electrophoresis
Classic immunoelectrophoresis or IEP/ Grabar and Williams
136
Height of the rocket is proportional to antigen concentration
Rocket IE
137
Involves two electrophoretic separations. Antigen and antibody complexes form mountain peaks
Ressler’s Method
138
Reactants move linearly towards each other due to the electric current applied
Counter IE
139
Used for identifying multiple myeloma
Classic immunoelectrophoresis
140
All reactants are mixed simultaneously and labeled antigens compete with unlabeled patient antigen for limited antibody-binding site of the antibody
Competitive labeled assay
141
The relationship of the measured label is ___ to the amount of patient antigen
Inversely proportional
142
Captured antibody is adsorbed to a solid phase medium. Patient antigen is allowed to react with the antibody. Labeled antibodies are then added to the mixture.
Non competitive labeled assay
143
The relationship of the measured label is ___ to the amount of patient antigen
Directly proportional
144
Discovered by Rosalyn Yalow, uses radioactive substances as labels.
Radioimmunoassay (RIA)
145
Gamma emitters
(125I most common and 131) are measured by ___
Gamma counter
146
Beta emitters
(3H tritium) measured by ____
Liquid scintillation counter
147
Antigen in patient serum competes for antibody-binding sites with a known quality of antigen to which a radioactive label is attached
Competitive binding assay
148
Antibody is bound to a solid phase medium > analyte is added > solid phase is washed > second antibody that is labeled is added > preparation is washed and measured
Non- competitive assay (imunoradioteric assay)
149
Most commonly used enzyme in enzyme immunoassay
Horseradish peroxidase
150
Do not need a separation step, simpler to perform but less sensitive. Bound enzyme are catalytically inactive
Homogenous
151
Requires a separation step of bound and unbound labels. Bound enzymes are catalytically active
Heterogenous
152
Enzyme label antigen competes with unlabeled antigen form the patient for the limited number of antibody-binding sites. Enzyme activity is inversely proportional to the concentration of the test substance
Competitive ELISA
153
Patient antibody is incubated with a solid phase antigen. Signal detected is directly proportional to the patient antibody
Noncompetitive ELISA
154
Patient antigen is incubated with solid phase antibody. Directly proportional
Capture assay or sandwich immunoassay
155
antigen in the sample competes for limited antibody-binding sites with an enzyme labeled antigen
homogenous EIA
156
uses a fluor/ fluorochrome which has the ability to absorbed light at shorter wavelengths and emit light with lower energy with longer wavelength (visible spectrum)
immunofluorescence immunoassay
157
FITC emit ___
green color
158
Tetramethylrhodamine emits
red color
159
solid phase antigen fixed to a slide is incubated directly with a fluorescent labeled antibody. if specific antigen us present, fluorescence will be observed
Direct immunofluorescent assay
160
patient antibody is reacted with specific antigen fixed to a microscopic side
Indirect Immunofluorescent assay
161
solid phase antigen is exposed to a patient serum > labeled antibody is then added > washed > measured. If a patient has an antibody, the labeled antibody will not bind to the antigen
Inhibition immunofluorescence
162
based on the change of polarization of fluorescent light emitted from a labeled molecule when an antibody binds it
Fluorescence Polarization Immunoassay
163
invented by Kary/Kerry Mullis in 1993
- an in vitro method that amplifies low levels of specific DNA sequences to higher levels for further analysis
Polymerase Chain Reaction (PCR)
164
denaturation temperature
95 deg C
165
Annealing temperature
52 to 55 deg C
166
Extension temperature
72 deg C
167
PCR process is repeated approximately ___ times
30
168
If the nucleic acid of interest is RNA, it can be converted to cDNA in the initial step of PCR by using ____
reverse transcriptase
169
useful in identification of HIV and Hepatitis C
RT-PCR
170
Measures the amount of amplicons in each cycle with the use of ethidium bromide / SYBR green / TaqMan probes, which reduces the time it takes to run a PCR
qPCR
171
uses numerous primers within a single reaction to amplify nucleic acid fragments from different targets
Multiplex Polymerase Chain Reaction
172
analyzed using agarose gel electrophoresis after ethidium bromide staining.
Conventional method
173
does not require enzyme digestion or electrophoretic separation of DNA fragments
Dot blot
174
DNA from the patient is added and immobilized in the membrane. labeled probe is then added
Reverse Dot Blot
175
DNA is denatured with restriction enzymes to create DNA fragments
Southern Blot
176
mRNA is separated by electrophoresis and blotted
Northern blot
177
proteins are separatd electrophoretically and identified through the use of labeld antibodies specific for the protein of interest
Western Blot
178
AKA great pox, evil pox
Syphilis
179
Causative agent of Syphilis
Treponema palladium subspecies palladium
180
Presence of hard chancre painless, firm, raised with well-defined lesion. Seen 10 – 90 days after infection. Stage lasts for 1-6 weeks. Highly contagious
Primary Syphilis Infection
181
Most contagious stage, characterized with lymph-adenopathy, malaise, fever, pharyngitis, and rash (indicating disseminated organism).
Observed 1-2 month.
Condyloma lata
Secondary syphilis infection
182
Asymptomatic syphilis infection. diagnosis can only be made by serological methods.
Latent syphilis infection
183
Neurosyphilis, the most common complication. Gummas (granulomas). Can affect cardioivascular system. Tabes dorsalis: general paralysis
Tertiary syphilis infection
184
AKA cardiolipin, a diphosphatidyl glycerol (phospholipid) derived from the host
Wassermann antigen
185
Non virulent Treponemal antigen
Reiter strain
186
Virulent Treponemal antigen
Nichol strain
187
AKA regain antibodies. It is anticardiolipin/ anti-lipoidal antibodies. Produced by infected individuals against components of their own bodies
Non-treponemal antibodies
188
Produced against the antigen of the organism themselves. Specific for outer membrane protein, endoflaggelar protein
Treponemal antibodies
189
Treponemes are identified eon the basis of ____ and ____
Corkscrew morphology and flexing motility
190
Specimen of choice for Syphilis Dark field microscopy
Serous fluid
191
Non-Treponemal test
Principle: rapid slide microflocculation or precipitation
Sample: serum/CSF
Venereal Disease Research Laboratory (VDRL)
192
In VDRL, serum should be heat inactivated by heating at ___
56 deg C for 30 minutes
193
If the serum sample is not used for 4 hours after heat inactivation, it should be reheated at ____
56 deg C for 10 minutes
194
Equipment used for VDRL when sample is serum
14 mm diameter
195
Equipment used for VDRL when sample is CSF
16 mm diameter
196
Qualitative serum VDRL
Gauge:
Drops:
Bevel:
RPM:
Qualitative serum VDRL
Gauge: 18
Drops: 60/mL
Bevel: none
RPM: 180 RPM for 4 mins
197
Quantitative serum VDRL
Gauge:
Drops:
Bevel:
RPM:
Quantitative serum VDRL
Gauge: 19 or 23
Drops: 75/mL or 100/mL
Bevel:none
RPM: 180 RPM for 4 mins
198
CSF VDRL
Gauge:
Drops:
Bevel:
RPM:
CSF VDRL
Gauge: 21 or 22
Drops: 100 / mL
Bevel: none
RPM: 180 for 8 mins
199
Non-Treponemal Test
Principle: flocculation or charcoal agglutination
Recommended for screening test
Sample: serum
Slide: 18 mm ring diameter
Delivery needle: 20 gauge, 60 drops/mL, no bevel
Rotation: 8 mins for 100 RPM
Rapid Plasma Reagin (RPR)
200
3 other nontreponemal test
Toluidine Red Unheated Serum Test (TRUST)
Unheated Serum Reagin (USR)
Reagin Screen Test (RST)
201
Biological False (+) of Syphilis
Tuberculosis
Rheumatoid arthritis
Infectious mononucleosis
Pregnancy
Leprosy
Systemic lupus erythematosus
Measles
Malaria
Old age
202
Treponemal Test
Old reference method for confirmatory test.
Serum should mix with live treponemes or Nichols strain from testicular chancre of a rabbit and complement
Treponemal Pallidium Immobilization Test
203
Reporting for Treponemal Pallidium Immobilization Test
Positive:
Doubtful:
Negative:
Positive: >/= 50% of the treponemes are immobilized
Doubtful: 20 – 50%
Negative: < 20%
204
Treponemal Test
Serum is heat inactivated, then added with sorbent consisting of (Reiter strain) > Nichols strain of T. palladium is fixed in the slide > fluorescence microscopy
Fluorescent Treponemal Antibody Absorption Test (FTA Abs)
205
Reporting for FTA Abs:
Negative: No fluorescence
Minimal reactive: 1+
Reactive: >/= 2+
206
Employs blood cells coated with T. palladium antigens
-uses turkey RBC
Hemagglutination Tests
207
Reporting of Hemagglutination test
Reactive: smooth matte at the bottom of the reaction well
Non-reactive: compact button of cells
208
Patient serum is diluted in a microtiter plate and incubated with gel particules sensitized with T. palladium
Particle Agglutination (Serodia TP-PA Test)
209
Reporting of Particle Agglutionation
Positive: agglutination resulting to smooth mat
Negative: compact button
210
Deafness, keratitis and Hutchson’s teeth (Hutchinsonian Triad)
Congenital syphilis
211
Recommended test to confirm congenital syphilis
Western Blot
212
Most sensitive method for detection of congenital syphilis and primary syphilis (maybe used as an alternative for dark field microscopy)
PCR
213
Yaw
MOT: direct contact with skin lesion
T. palladium subspp pertenue
214
Bejel
MOT: direct contact (mouth to mouth or through utensils)
T. palladium subspp endemicum
215
Pinta (skin ulcers)
MOT: direct contact with skin lesion
T. carateum
216
Causative agent of typhoid fever
Salmonella typhi
217
Most common cause of Salmonellosis in N. America
Salmonella enteritidis
218
Causes typhoid fever, the most severe form
Salmonella typhi
219
Thermostable somatic antigen, made of polysaccharide
O antigen
220
Flagellar antigen, made of protein
H antigen
221
Capsular antigen, associated with virulent strain and indicative of carrier state
Vi antigen / K antigen
222
Gold standard for the diagnosis of Typhoid fever
Bacterial culture
223
Principle: direct agglutination
Widal test / Febrile Agglutination test
224
Dot enzyme immunoassay, which detects serum antibody to antigen dotted on a nitrocellulose membrane
Typhidot test
225
Ig for definite typhoid fever, acute typhoid fever
IgM (+) and IgM/IgG (+/-)
226
Ig for previously successfully treated case of typhoid fever. Reinfection with typhoid fever, typhoid carrier
IgG (+)
227
Ig for not typhoid fever
IgM and IgG (-)
228
Is a dot enzyme immunoassay for detection of specific IgM to Salmonella typhi
Typhidot-M
229
Gold standard for serological diagnosis of RMSF
Indirect Immunofluorescence Assay (IFA)
230
Principle: Direct agglutination
-A febrile agglutinin test that is based on the cross reaction of heterophile antibodies produced in response to rickettsial infection, with antigens in the three strains of Proteus
Weil Felix Reaction
231
Antigens in Proteus vulgaris
OX – 2 and OX-19
232
Antigens in Proteus mirabilis
OX-K
233
Causative agent: S. pyogenes / Group A strep
Disease: URTI, Scarlet fever, skin infection (impetigo, necrotizing faciitis), rheumatic fever, glomerulonephritis
Group A Streptococcus infection
234
Based on neutralization of hemolytic activity of streptolysin O
Antistreptolysin O (ASTO/ ASO) – Classical / Traditional Antistreptolysin O titer
235
Slide agglutination screening test in which sheep RBCs are coated with streptolysin, streptokinase, hyaluronidase, DNase, and NADase so that antibodies to any of the streptococcal antigens can be detected.
Multienzyme Test / Streptozyme
236
Most reliable measurement of recent S. pyogenes skin infection (used if ASTO is negative)
Sensitivity is increased for the detection of glomerulonephritis and rheumatic fever preceded by streptococcal skin infections
Streptococcal Anti-DNase B Determination
237
DNA is complex with methyl green, if anti-DNAse B antibodies are present, it will neutralize the reagent DNAse B preventing it from cleaving the complex
Classical Neutralization Method
238
Used for rapid quantitation of Anti-DNAse by measuring light scattering produced by immune complexes
Nephelometry
239
Causative agent Lyme disease
B. burgdorferi a vector-borne spread by ticks in the genus Ixodes
240
Second test in CDC-recommended two tier scheme. Recommended are supplemental test for positive for borderline, result from ELISA. Positive IgG blot is serological evidence of Lyme disease
Western Blot / immunoblotting
241
Most reliable test for Brucella infection if the culture is negative
Agglutination methods
242
Brucella antigen is printed as black dot
Surface Fixation or the Castaneda Strip Test
243
Most specific test to detect H. pylori
Culture
244
Method of choice for H. pylori antibody detection
ELISA
245
The primary antibody present and detected by serological methods since most infections have become chronic before diagnosis
IgG
246
Low sensitivity antibody for ELISA
IgA
247
Lack clinical value of ELISA
IgM
248
Detects urease activity in gastric mucosal biopsies, ideal for rapid diagnosis
CLOTEST
249
Positive result for CLOTEST
Bright magenta,
Negative: yellow
250
Patient ingest radioactive carbon > urea is the metabolized breaking down into ammonia and bicarbonate (excreted in the breath) and radiolabeled carbon is measured by its radioactivity.
Urea Breath Test
251
Detects the presence of the organism in a fecal sample but cannot distinguish living and dead H. pylori. Used to assess a patient’s bacterial load
Molecular method
252
Extracellular bacteria, without cell wall but with triple layered cell membrane
Mycoplasma pneumoniae
253
Diseases caused by Mycoplasma pneumoniae
Primary Atypical Pneumonia (PAP)/ Walking Pneumonia
254
IgM antibodies, develop in individuals with M. pneumonia
Cold agglutinin
255
Gold standard for diagnosis. Characterized with fried egg growth
Culture
256
Most widely used method of detection of M. pneumonia, can test for IgM and IgG. Requires small volume and can test large numbers in automation
ELISA
257
Detects IgM and IgG, observed under fluorescence microscope
IFA
258
No longer recommended for diagnosing M. pneumonia infection because some viral infections and collagen vascular disease may also produce cold agglutinins
>/= 64 titer is suggestive of atypical pneumonia
Cold agglutinins
259
Infectious hepatitis
Short incubation hepatitis
HAV
260
Viral family of HAV
Picornaviridae
261
MOT of HAV
Fecal-oral
262
Incubation period of HAV
15 – 45 days
263
Serum hepatitis
Long incubation hepatitis
HBV
264
Viral family of HBV
Hepadnaviridae
265
MOT of HBV
Sex
266
Incubation period of HBV
45 – 160 days
267
Most infectious agent hepatitis.
HBV
268
Non A, Non B hepatitis (NANB)
HCV
269
Viral family of HCV
Flaviviridae
270
MOT of HCV
Blood transfusion
271
Incubation of HCV
15 – 150 days
272
Most frequently caused by chronic hepatitis, liver cirrhosis and hepatocellular carcinoma
HCV
273
Delta agent
Hepatitis Delta virus
HDV
274
Viral family of HDV
RNA
275
Hepatitis same as HBV
HDV
276
Incubation of HDV
30 – 60 days
277
Coinfection – same time with HBV
Super infection – HBV infection first
HDV
278
Viral family of HEV
Calcivirade/ Hepeviridae
279
MOT of HEV
Fecal-oral
280
Incubation period of HEV
15 – 60 days
281
Hepatitis associated with high mortality among pregnant women.
HEV
282
Shed in the feces of infected individuals during incubation and acute stage. Not a useful indicator of disease
HAV Ag
283
Markers of acute hepatitis, peak during the first month but become undetectable after 6- 12 months. May indicate recent infection
Anti-HAV IgM
284
Indicate immunity to HAV. Produce either through vaccination of infection
Anti-HAV/ Total Anti-HAV
285
Can be used to detect RBA in clinical , food and water sampes
HAV RNA
286
Represents the outer lipoprotein coat (envelope) of hepatitis B virus. Indicates acute infection and infectivity
First serologic marker to appear. Used for screening blood donors. Also known as Australia antigen
HBsAg
287
Indicates past infection with immunity of immune response to HBV vaccine. It is a marker of immunity and recovery. Protective tier is 10 mIU/mL of higher.
Anti-HBs
288
Not detectable in the serum, only seen in the liver biopsy
HbcAg
289
Antibody produced against the core of HBV. Marker used during window period.
Total anti-HBc
290
Indicates previous or pat infection. persist for life of an infected individual
IgG anti-HBc
291
Indicates acute infection. used in addition to HBsAg for screening blood
IgM anti-HBc
292
Hepatitis B related antigen. Associated to the core of HBV (circulating form of the core)
A marker for acute viral replication and high infectivity of serum
HBeAg
293
Suggest low titer of HBV. First serologic evidence of convalescene phase
Anti-HBe
294
First marker of HBV infection
HBV-DNA
295
3rd generation serological test for HBV
RIA
ELIA
Reversed passive hemeagglutination
296
2nd generation serological test for HBV
Counterelectrophoresis, complement fication, rheophoresis
297
1st generation serological test for HBV
Ouchterlony double diffusion
298
Used to diagnose Hepatitis C infection. may indicate current or past infection.
Anti-HCV
299
AKA viral load. Used in monitoring response to antiviral therapy, indicating current infection
HCV-RNA
300
Current hepatitis E infection
IgM anti-HEV
301
Current or past hepatitis E infection
IgG anti-HEV
302
Current hepatitis E infection
HEV RNA
303
Codes for gp160, gp120, and gp41
Env gene
304
Codes for p55, p6, p9, p17, p24
Gag gene
305
Codes for enzymes necessary for HIV replication
Pol gene
306
CD4+ T cell counts for primary HIV infection
>500/uL
307
CD4+ T cell counts for intermediate HIV infection
200 – 499/ uL
308
CD4+ T cell counts for final HIV infection
<200/uL
309
Standard screening test for HIV
ELISA
310
Based on indirect binding assay, using viral lysate as a source of antigen to detect HIV 1 and 2 antibodies
First generation
311
Based on indirect binding assay, utilizing purified recombinant or synthetic antigens to detect HIV 1 and 2 antibodies
Second generation
312
Based on sandwich ELISA, which detects and differentiate HIV 1 and 2 antibodies
Third generation
313
Based on sandwich ELIS that can simultaneously detect HIV 1 and 2 antibodies and p24 antigen
Fourth generation
314
Bead-based immunoassay that can detect HIV antibodies and p24 antigen, same as fourth generation assay but can differentiate HIV 1 and 2
Fifth generation
315
Most sensitive and specific test for HIV 1
-Detects IgG antibodies specific to HIV antigens
Western Blot
316
Separated HIV 1 proteins in Western Blot are transferred to a ___
Nitrocellulose membrane
317
2 out of 3 possible bands should be present in Western blot for a positive result
P24, gp41, gp120/gp160
318
AKA Kissing disease/mono/ glandular fever. It is an acute infectious disease of the mononuclear phagocyte system
Infectious mononucleosis
319
Produced by infected B cells (cytoplasm) found in the acute phase
VCA
320
Produced within 4-7 days of infection and persists lifelong
Anti-VCA IgG
321
Seen in the early course of infection. disappears in 2-4 months after infection
Anti-VCA IgM
322
Present in the early course of HCV infection
Anti-EA-D IgM
323
Highly indicative of acute HCV infection
Anti-EA-D IgG
324
Appears transitently in the convalescent phase of HCV infection
Anti EA-R IgG
325
Appears in the convalescent period of HCV infection. almost always present if IgG antibodies to VCA is present
Anti-EBNA IgG
326
Most common cause of congenital infection and most important infectious agent in association with organ transplantation
Cytomegalovirus
327
Causative agent of Dengue virus
Dengue
328
Family of DNA virus
Flavivirus
329
Gold standard for the diagnosis of dengue virus
Virus isolation
330
Highly conserved glycoprotein which appears essential for virus visibility (Dengue virus)
NS1
331
Causative agent of toxoplasmosis
Toxoplasma gondii
332
Method of choice to detect T. gondii DNA in CSF
PCR
333
Gold standard in the diagnosis of T. gondii
Sabin-Feldman Dye test
334
Causative agent of malaria
Plasmodium spp
335
Most common vector of malaria in the Philippines
Anopheles flavirostris
336
Immunochromatographic assay that uses monoclonal antibodies to detect parasitic lactate dehydrogenase present in finger prick sample.
Optimal assay
337
Detects HRP-2 antigen in P. falciparum
Malaquick standby malarial test
338
3 virulence factors of E. histolytica
Adhesion
SREHP (Serine Rich entamoeba histolytica protein )
2 kD cysteine rich protein
339
Cross react with histoplasmosis
Coccidioidomycosis
340
Used to demonstrate capsule antigen in serum or CSF creating a halo around the yeast cell
India ink
341
Chronic inflammatory disease with symptoms such as swelling of the joints, erythematous rash/butterfly rash and deposition of immune complexes in the kidneys
SLE
342
Neutrophil with ingested antibody-coated nucleus
LE cell
343
Chronic, symmetric, erosive, non-infectious and systemic autoimmune disease that affects the synovial membrane of multiple joints ; most common autoimmune disease
Rheumatoid arthritis
344
Antibody to the Fc portion of an IgG
Rheumatoid factor
345
Significant titer for the lab diagnosis of RA
>80
346
More specific antibody for RA. Its presence preceded the onset of RA
Anti-cyclic citrullinated peptide antibody (anti-CCP)
347
homogenous staining pattern in ANA
SLE
RA
MCTD
Sjogren syndrome
348
Peripheral / Thread staining patterns of ANA
Active stage SLE and Sjogren syndrome
349
Speckled patterns in ANA
Scleroderma
MCTD
350
Nucleolar staining pattern in ANA
Sjogren syndrome
351
Seen in CREST
Centromere
352
