Sero-positive Conditions Flashcards

1
Q

What are the two antibody tests for mono?

A

Viral capsid antibody (anti-VCA)

Epstein Barr nuclear antibody (anti-EBNA)

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2
Q

What is the clinical triad for mono?

A

Pharyngitis
Pyrexia
Lymphadenopathy

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3
Q

Infectious mono can cause both hepatitis and splenomegaly - T/F

A

True: 50% of patients have splenomegaly and hepatomegaly causes a mild, self resolving hepatitis. Jaundice is rare however.

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4
Q

What are the common CBC findings with infections mono?

A

Leukocytosis

Lymphocytosis

Thrombocytopenia (sometimes)

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5
Q

Which type of antibody is detected first, which is lifelong?

A

IgM is detected early and gone after 4 to 6 weeks

IgG appears after 2 to 4 weeks and persists

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6
Q

Which antibody test for infectious mono shows IgM and/or IgG levels?

A

Anti-VCA

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7
Q

The anti-EBNA test shows results after how long and for how long would those results continue to appear?

A

After acute phases (2-4 weeks); lifelong

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8
Q

Which two viruses can cause infectious mono?

A

HIV and cytomegalovirus

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9
Q

For how long does a patient with infectious mono need to avoid strenuous activity? Why?

A

4 to 6 weeks; splenomegaly

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10
Q

Untreated group A streptococcal infections can cause what inflammatory autoimmune disease?

A

Acute Rheumatic Fever

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11
Q

What age group is acute rheumatic fever most often seen in?

A

Children (5-15)

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12
Q

Acute rheumatic fever causes a migratory arthritis. Which areas are most common and which is never involved?

A

Wrists, ankles and knees most common

Shoulder, hands and hips possible

Vertebrae are never involved

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13
Q

How long after an initial strep infection does acute rheumatic fever develop?

A

2 to 3 weeks

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14
Q

Acute rheumatic fever can cause heart valve stenosis how quickly?

A

Within 2 weeks and lasts 6 weeks to 6 months. Sometimes damage is permanent.

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15
Q

Which condition can cause subcutaneous nodules and erythema marginatum?

A

Acute rheumatic fever

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16
Q

What is erythema marginatum? What does it look like?

A

A flat painless rash which looks like rings and arcs

17
Q

What neurological finding can be seen late in an acute rheumatic fever infection?

A

Sydenham Chorea

18
Q

Which two tests can be used to check for acute rheumatic fever?

A

ASO titer
DNAse B

19
Q

What CBC and blood tests results expected with acute rheumatic fever?

A

Elevated acute phase reactants (CRP) and ESR

Leukocytosis
Neutrophilia

20
Q

Is the throat culture for GABHS (group A beta-hemolytic Streptococcus) a reliable test for acute rheumatic fever?

A

No, it is often negative.

21
Q

What are the diagnostic criteria for acute rheumatic fever? (Modified Jones criteria)

A

Evidence of preceding streptococcal infection and:

2+ major criteria or 1 major and 2+ minor

Major: carditis, arthritis, chorea, erythema marginatum, subcutaneous nodules

Minor: pyrexia, arthralgia, previous ARF, lab values, prolonged P-R on ECG

22
Q

Acute rheumatic fever has a very long management plan what is it and how does carditis play a role?

A

Without carditis: 5 years of antibiotics or until you turn 21 whichever is longer

With carditis: make it 10 years or until you turn 21 whichever is longer

23
Q

Most common age range and gender for SLE?

A

Female 10:1

15-45 yo

24
Q

SLE causes arthritis which is most commonly seen where?

A

A non-erosive, non-deforming arthritis in the hands, wrists, and knees. Other locations possible.

25
What is the butterfly rash common with SLE called?
Malar erythema
26
Which organ system becomes involved with more severe SLE?
Renal involvement is seen in severe SLE
27
CBC findings expected with SLE?
Hypo/micro anemia Leukopenia Lymphopenia Thrombocytopenia Elevated BUN and creatine ESR >100 mm/hr
28
Which test is a screening test and which is diagnostic when determining SLE?
Screening: ANA is a high sensitivity low specificity test Diagnostic: anti dsDNA is low sensitivity and high specificity
29
SLE diagnostic criteria most have 4 of the 11 following:
Malar rash, maculopapular rash, photosensitivity, oral/nasopharyngeal ulcers, nonerosive arthritis, pleuritis/pericarditis, proteinuria or altered kidney function tests, neurological disorder, CBC abnormalities.