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Serology > Infectious Mononucleosis and Epstein Barr Virus > Flashcards

Infectious Mononucleosis and Epstein Barr Virus Flashcards

1
Q

What 4 viruses belong in the Herpesviridae family and establish latency and can recur when the host is stressed?

A
  1. Herpes Simplex Virus
  2. Cytomegalovirus
  3. Varicella Zoster Virus
  4. Epstein Barr Virus
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2
Q

What are the three Epstein Barr Virus Related Syndromes?

A
  1. Infectious Mononucleosis
  2. Reactivation-related Syndromes
  3. Malignancies (Burkitt’s Lymphoma and Nasopharyngeal Carcinoma)
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3
Q

Symptoms of Infectious Mononucleosis

A

fatigue, pharyngitis, rash, others

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4
Q

What was Infectious Mononucleosis originally called?

A

Glandular Fever

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5
Q

What are heterophile antibodies?

A

Antibodies that react with antigens other than the antigens that stimulated their production

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6
Q

Heterophile antibodies in Infectious Mono patiens agglutinate what?

A

sheep erythrocytes

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7
Q

Globulin class antibody of the heterohile antibody

A
  • IgM antibodies
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8
Q

Time of appearance of the heterohile antibody

A
  • appear 6-10 days after onset
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9
Q

Time of disappearanceof the heterohile antibody

A
  • disappear shortly after symptoms (6 wks to 6months)
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10
Q

Percentage of infectious mono cases in which the heterophiles antibody is NOT produced

A
  • present in 80-90% of infected so NOT produced in 10-20% of infected people
  • most healthy individuals do not have heterophiles antibodies
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11
Q

How did Paul and Bunnell contribute in the development of diagnostic tests for infectious mono?

A

They had a presumptive test for heterophiles antibodies:

- Direct Hemagglutination assay

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12
Q

Principle of Paul and Bunnell’s Direct Hemagglutination Assay

A

Sheep erythrocytes are mixed with serial dilutions of serum, incubated, and observed for agglutination

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13
Q

What is the problem with Paul and Bunnell’s Direct Hemagglutination Assay

A

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)

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14
Q

Heterophile antibodies of the Forssman type react with Forssman antigen which is found in the tissue of many animals for example: ______ _____

A

guinea pigs

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15
Q

What is a syndrome resulting from therapeutic administration of animal blood and serum products?

A

Serum Sickness

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16
Q

Why is serum sickness a problem for Paul and Bunnell’s direct hemagglutination assay?

A

Patients with serum sickness have antibodies that agglutinate sheep erythrocytes!!

17
Q

Who discovered Hererophile Antibodies of serum sickness?

A

Davidsohn

18
Q

What are the steps in the Daividsohn Differential Test (Combined Heterophile Antibody Test)?

A
  • 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
19
Q

Guinea Pig Kidney absorbs what?

A
  1. Forssman Ab

2. Serum Sickness Ab

20
Q

Beef Stroma absorbs out what?

A
  1. Infectious Mono Ab

2. Serum Sickness Ab

21
Q

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?

A

Infectious Mononucleosis

22
Q

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?

A

Forssman

23
Q

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?

A

Serum Sickness

24
Q

What rapid test (1-2 min) detects heterophiles antibodies?

A

Contemporary Heterophiles (mono spot) Slide Test

25
Q

Contemporary Heterophile (mono spot) Slide Test uses what antigen ONLY?

A

Guinea pig absorbing antigen

26
Q

Contemporary Heterophile (mono spot) Slide Test uses what indicator particles?

A

erythrocyte indictor particles

27
Q

Steps of the Contemporary Heterophile (mono spot) Slide Test

A
  • Add patients serum and guinea pig kidney absorbing antigen onto a card and mix
  • add erythrocytes and mix
  • observe agglutination
  • If agglutination: positive for Infectious Mono
28
Q

Passive Latex Agglutination Methods for Detecting Heterophile Antibodies of Infectious Mononucleosis:

  • What is the antigen?
  • What is the antigen coated on?
A
  • antigen is an extract of bovine red cells (includes the “mononucleosis antigen”)
  • the antigen is coated on latex particles
29
Q

Passive Latex Agglutination Methods for Detecting Heterophile Antibodies of Infectious Mononucleosis:
- principle

A

Serum from patient is mixed with the coated latex particles

- if agglutination is seen, the patient has infectious mononucleosis

30
Q

Passive Latex Agglutination Methods for Detecting Heterophile Antibodies of Infectious Mononucleosis:
- what can cause a false positive reaction

A

Serum Sickness

31
Q

What are the issues with IM tests that detect heterophiles antibodies

A
  • too many variables
  • heterophile antibodies are nonspecific
  • some of IM cases (10-20%) are heterophiles negative
32
Q

Epstein Barr Virus does not proliferate in standard cell cultures so antibodies to several EBC antigen are detected by _____ _____

A

serologic tests

33
Q

What clinical situation is testing for EBV antibodies most helpful in the diagnosis of infectious mono?

A

EBV antibody tests are used mainly in confirming IM in heterophile negative cases

34
Q

What are the three types of of Epstein-Barr virus antibodies that are known to be produced in infectious mono, and indicate what order they appear.

A
  1. EBV VCA IgM
  2. EBV VCA IgG
  3. EB EA
  4. EBNA
35
Q

What syndrome do you have if:

  • EBV VCA IgM = NEG
  • EBV VCA IgG = NEG
  • EB EA = NEG
  • EBNA = NEG
A

No EBV

36
Q

What syndrome do you have if:

  • EBV VCA IgM = POS
  • EBV VCA IgG = POS
  • EB EA = POS
  • EBNA = POS/NEG
A

Acute Infection

37
Q

What syndrome do you have if:

  • EBV VCA IgM = NEG
  • EBV VCA IgG = POS
  • EB EA = NEG
  • EBNA = POS
A

Past Infection

38
Q

What syndrome do you have if:

  • EBV VCA IgM = POS/NEG
  • EBV VCA IgG = POS
  • EB EA = POS/NEG
  • EBNA = POS
A

Reactivation

Serology (17 decks)

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