Infectious Mononucleosis and Epstein Barr Virus Flashcards
What 4 viruses belong in the Herpesviridae family and establish latency and can recur when the host is stressed?
- Herpes Simplex Virus
- Cytomegalovirus
- Varicella Zoster Virus
- Epstein Barr Virus
What are the three Epstein Barr Virus Related Syndromes?
- Infectious Mononucleosis
- Reactivation-related Syndromes
- Malignancies (Burkitt’s Lymphoma and Nasopharyngeal Carcinoma)
Symptoms of Infectious Mononucleosis
fatigue, pharyngitis, rash, others
What was Infectious Mononucleosis originally called?
Glandular Fever
What are heterophile antibodies?
Antibodies that react with antigens other than the antigens that stimulated their production
Heterophile antibodies in Infectious Mono patiens agglutinate what?
sheep erythrocytes
Globulin class antibody of the heterohile antibody
- IgM antibodies
Time of appearance of the heterohile antibody
- appear 6-10 days after onset
Time of disappearanceof the heterohile antibody
- disappear shortly after symptoms (6 wks to 6months)
Percentage of infectious mono cases in which the heterophiles antibody is NOT produced
- present in 80-90% of infected so NOT produced in 10-20% of infected people
- most healthy individuals do not have heterophiles antibodies
How did Paul and Bunnell contribute in the development of diagnostic tests for infectious mono?
They had a presumptive test for heterophiles antibodies:
- Direct Hemagglutination assay
Principle of Paul and Bunnell’s Direct Hemagglutination Assay
Sheep erythrocytes are mixed with serial dilutions of serum, incubated, and observed for agglutination
What is the problem with Paul and Bunnell’s Direct Hemagglutination Assay
There are other heterophiles antibodies!
- Heterophiles of the Forssman type (antibodies that also agglutinate sheep erythrocytes - we thought you could only do that if you had mono)
Heterophile antibodies of the Forssman type react with Forssman antigen which is found in the tissue of many animals for example: ______ _____
guinea pigs
What is a syndrome resulting from therapeutic administration of animal blood and serum products?
Serum Sickness
Why is serum sickness a problem for Paul and Bunnell’s direct hemagglutination assay?
Patients with serum sickness have antibodies that agglutinate sheep erythrocytes!!
Who discovered Hererophile Antibodies of serum sickness?
Davidsohn
What are the steps in the Daividsohn Differential Test (Combined Heterophile Antibody Test)?
- Take patients serum and do the presumptive test (no absorption)
- Add Guinea pig kindey to the serum which absorbs Forssman and Serum Sickness ab
- Add Beef Stroma to the serum and absorbs out the IM and Serum Sickness Ab
Guinea Pig Kidney absorbs what?
- Forssman Ab
2. Serum Sickness Ab
Beef Stroma absorbs out what?
- Infectious Mono Ab
2. Serum Sickness Ab
After using Guinea Pig Kidney absorbing antigen, you got a POS agglutination of Erythrocytes and after using Beef Stroma you got NEG agglutination.
What type of Heterophile Antibody is found?
Infectious Mononucleosis
After using Guinea Pig Kidney absorbing antigen, you got a NEG agglutination of Erythrocytes and after using Beef Stroma you got POS agglutination.
What type of Heterophile Antibody is found?
Forssman
After using Guinea Pig Kidney absorbing antigen, you got a NEG agglutination of Erythrocytes and after using Beef Stroma you got NEG agglutination.
What type of Heterophile Antibody is found?
Serum Sickness
What rapid test (1-2 min) detects heterophiles antibodies?
Contemporary Heterophiles (mono spot) Slide Test
