Immunology/Toxicology Flashcards
What/how does the following laboratory method test: ELISA
measures Ig G/M/A
used in dz detection and allergen identification
What/how does the following laboratory method test: RAST
quantifies IgE
What/how does the following laboratory method test: IgG
delayed hypersensitivity rxn to antigen
What/how does the following laboratory method test: IgE
immediate hypersensitivity rxn to antigen
IgG is associated with what and is a measure of what?
long term exposure/delayed rxns (food allergy)
marker of exposure, not sucessful tx
IgM is associated with what and is a measure of what?
acute phase rxns
marker of recent infection or reexposure
IgA is associated with what and is a measure of what?
secretory Ig (serum, stool, saliva)
shows mucosal response and is a good marker of successful tx
IgE is associated with what and is a measure of what?
anaphylaxis (type 1 rxn)
what would the folowing ab testing results indicate:
high IgG
low IgM or IgA
probable past infxn/exposure that is inactive or cured
in food allergy testing, ig G is always considered active, but delayed response allergy
what would the folowing ab testing results indicate:
low IgG
high IgM
new infxn / exposure
what would the folowing ab testing results indicate:
high IgG
high IgM
reactivated infection / exposure
what would the folowing ab testing results indicate:
high IgG
low IgM
high IgA
current immune response (mucosal) that is past the initial IgM response window (ongoing problem)
ANA is the typical screening test for which type of disorders?
RA, SLE, lupus, MCTD, CREST syndrome, scleroderma, polymyositis
what titer level for ANA is positive?
> 1:160
what is what of the only conditions the nonspecific measure of ESR can be diagnostic in?
giant cell arteritis
what testing would you consider in someone with a RA like presentation who tested negative for RF?
parvo B19 viral assay
HLA B27 is what type of testings and gives diagnostic information about what conditions/when will it be elevated?
glycoproteins; seronegative arthritities; AS, reiters, MS, chronic active hepatitis, gluten sensitive enteropathy, SLE, DM, hemochromatosis
also done for tranplantation matches
what infection would you want to test for in a patient with reiters?
chlamydia
anti-thyroid ab (anti microsomal or TPO Ab) is a marker for which disorders?
hashimotos thyroiditis
atophic thyroiditis
graves disease
antithyroglobulin (Anti TG) ab is a marker for what disorders?
autoimmune thyroiditis
hashimoto thyroiditis
thyroid stimulating ig (TSI) (thytrophin receptor ab) is a marker for what disorder(s)? when would you order this testing?
graves dz
order when graves sn/sx and TPO elevation
what testing would you run in someone you suspect is having post streptococcal sequelae? what would be a positive result?
anti streptolysin O (ASO) test
pos >200 iu/ml
what types of testing is available for EBV?
monospot (sx, more sensitive in first infxn, IgM for 4-21 days)
PCR (chronic reactivating cases)
panel (early phase IgM antiVCA, acute illness IgG anti VCA and anti EA, convalescence/reactivation anti EBNA)
e coli testing
stool ag testing O157-H7
giardia testing
stool assay in sx pt
h pylori testing
nitrogen breath test
igG (PAST infxn)
igM (current, will dec regardless of tx status)
serum/salivary/stool IgA (rises with ifxn, falls with tx)
HAV testing
IgM (acute)
IgG (years after)
HBV testing
HbsAg - detected 1-4 months post infection
appearance past >6 mo exhibit chronic illness
antiHbs Ab - protected against HBV
HbcAg- IgM and IgG
HCV testing
PCR
HCV ab - 4x inc foir HCC
HDV testing
coexists with HB and makes HB more deadly; worst in pregnancy
HSV testing
IgG/M type (1 or 2) specific serology best for dx
PCR available
virus isolation (tzank smear) is OLD method, not specific to 1 or 2 and can have false pos
HIV testing
ELISA measures anti HIV titers; confirmed by western blot analysis
may take 6 months to seroconvert
decreased CD4/8 ratio
newly dx: t cell subset
earliest dx: PCR
types of HPV common causes for plantar and genital warts
6, 11
types of HPV common causes for cervical cancer and how to test for them
16, 18, 31, 33
PCR on pap smear
what testing would indicate a present infection of rubella
presence of IgM and/or four fold inc in IgG
syphilis testing
VDRL/RPR
nontreponemal tests used primarily for detection of primary syphilic infection
tuberculosis testing
intradermal skin test; read 48-72 hours for induration
BCG: post ID, check serology results
lyme testing
> 250 rxn units
skin, blood, synovial, CSF
ELISA or western blot checking for ab detection
PCR now available
nystatin MOA
disrupts fungal wall
nystatin uses
cutaneous, intestinal, vaginal, and mucocutaneous candida infxns
nystatin adverse effects
contact dermatitis
poorly absorbed/ better for topical
miconazole MOA
disrupts fungal wall
miconazole uses
tineas, cutaneous and vulvovaginal candida
miconazole adverse effects
pruritis, skin irritation, burning, contact dermatitis
amphotericin class, uses
IV only (unless compounded) antifungal; two types
high potential side effect profile
triazole drugs are what type of drugs and end in what suffix
antifungals
-conazole aside from terbinafine
triazole MOA
inhibits fungal p450, degrading fungal cell wall
main side effect concern with triazoles
liver damage; inhibits p450
dont take with other drugs with hepatotoxicity risks
terbinafine uses
topical and oral; toenail fungus
where can nystatin be used?
topical infxns (includes GI tract)
nystatin dosing
GI infxns: 500k-1 mil units po tid
fluconazole dosing
varies based on infxn and immunocompetence
150-200mg single dose
200 mg bid for 2-4 weeks
100 mg daily for months (long term may dose 5 days on/2 days off rotation)
terbinafine dosing
fingernail onychomycosis: 250 mg qd x 6 weeks
toenail: 250 mg qd x 12 weeks
permethrin MOA/uses
causes paralysis by disrupting sodium current in the parasite
scabies, pedivulosis
permethrin adverse effects
pruritis, edema, rash, burning, stinging
if a child gets a hold of permethrin and drinks it they can have seizures and die since it is a CNS irritant
permethrin method of dosing
topical
mebendazole class/MOA/uses
antihelminthic; irreversibly inhibits nutrient uptake by helminthes
pinworms, roundworks, hookworks
mebendazole adverse effects
abdominal pain
diarrhea
fever
mebendazole dosing
pinworm: 100 mg single dose, repeat 2-3 weeks
roundworm, hookwork, whipworm: 100 mg po bid x 3 days, repeat 3 weeks
metronidazole class/MOA/uses
antiprotozoal; inhibits DNA synthesis in microorganism causing cell death
amoebas, trich, giardia
metronidazole AEs
GI distress, seizures, ataxia, cramping, rash, joint pain
metronidazole CIs
do NOT take with Etoh (acts like antabuse)
potentizes p450 metabolized drugs
hyroxychloroquinine class/MOA/uses
antimalarial; unknown MOA
malaria, extraintestinal amebiasis
hyroxychloroquinine AEs
HA
dizziness
pruritis
neuropathy
seizures
retinal changes
ototoxic
metronidazole dosing
intestinal amebiasis: 750 mg bo BID 5-7 days > then iodoquinol rx
trich: 750 mg po TID 7 days OR 1 g po bid x 1 day, repeat in 4-6 weeks
BV: 500 mg po bid x 7 days
is the following medication/medication class safe for lactation: gentamycin
generally safe due to low transfer and low oral availability
is the following medication/medication class safe for lactation: cephalosporins
considered safe; low transfer into milk (third generation have greater potential to alter bowel flora)