Questions from S 21 Flashcards
What is the meaning of these terms?
Internal control
material inserted at beginning of PCR process, usually to spike a sample
this helps assess for successful PCR amplification, and validity of PCR run
if internal control not detected, run is not valid
What is the meaning of these terms?
Positive control
used to assess for successful PCR amplification
can be patient sample, or external sample
What is the meaning of these terms?
Negative control
used to assess for any contamination during a PCR run
can be water, or PCR mastermix without DNA/RNA template
What is the meaning of these terms?
Internal Quality Control
in order to provide accurate, precise and repeatable result, can use labs own samples to check performance of a run
compare results to previous values on IQC chart
What is the meaning of these terms?
External Quality control
use of an external body e.g NEQAS to provide samples for testing, and provide feedback on performance
What is the meaning of these terms?
Lab quality assurance
series of processes and procedures which help ensue accurate, precise, reliable and reproducible results, in a timely manner
this includes various lab facets such as training, SOPs, calibration, IQA/ EQA
can be externally assured with lab accreditation from UKAS ISO 15189:2022
Mumps
Family contact havent been vaccinated
What PEP is required
No PEP for mumps
They should have MMR to protect from further episodes. It will not attenuate disease following exposure, as vaccine response takes too long
Which avian influenza strains are in Europe?
H5N1
H7N9 - not seen recently
H9N2 - China
Avian influenza suspected in bird in garden
What symptoms will it have?
Who needs to be notified?
Bird - respiratory distress, diarrhoea, die-off
UKHSA - notify if human case
DEFRA - notify if wildlife case
What are treatment options for HBV?
Tenofovir
Entecavir
Lamivudine
Peg-IFN
PEG-IFN for HBV
What are the stopping rules?
Side effects:
injection site reactions
renal disease
anaemia
When stopping, use quantitative HBsAg as measure before stopping
DNA levels will decrease significantly, but are less useful than HBsAg quantification
12 week stopping rule -
if HBsAg >20,000 iu/ml and HBV DNA has not decreased by 2 log, then no point continuing as will be a non-responder
This rule used to be 24 week rule, but data showed that it could be brought forward to 12 weeks
https://www.xiahepublishing.com/2310-8819/JCTH-2017-00073
Tenofovir/ entecavir for HBV infection
What are the stopping rules?
No stopping rules
PEG-IFN for HBV infection
What is normal treatment duration?
48 weeks or can be extended to 96 weeks
Can stop at 12 weeks if meets stopping rule
Who should be offered HBV treatment?
e antigen pos
Age >30
Persistent raised ALT
HBV DNA VL >20,000
e antigen neg
Age >30
Persistent raised ALT
HBV DNA VL >2000 (expect lower viral load)
Any patient with fibrosis/ cirrhosis irrespective of viral load/ ALT
