Sero-positive Conditions Flashcards
What are the two antibody tests for mono?
Viral capsid antibody (anti-VCA)
Epstein Barr nuclear antibody (anti-EBNA)
What is the clinical triad for mono?
Pharyngitis
Pyrexia
Lymphadenopathy
Infectious mono can cause both hepatitis and splenomegaly - T/F
True: 50% of patients have splenomegaly and hepatomegaly causes a mild, self resolving hepatitis. Jaundice is rare however.
What are the common CBC findings with infections mono?
Leukocytosis
Lymphocytosis
Thrombocytopenia (sometimes)
Which type of antibody is detected first, which is lifelong?
IgM is detected early and gone after 4 to 6 weeks
IgG appears after 2 to 4 weeks and persists
Which antibody test for infectious mono shows IgM and/or IgG levels?
Anti-VCA
The anti-EBNA test shows results after how long and for how long would those results continue to appear?
After acute phases (2-4 weeks); lifelong
Which two viruses can cause infectious mono?
HIV and cytomegalovirus
For how long does a patient with infectious mono need to avoid strenuous activity? Why?
4 to 6 weeks; splenomegaly
Untreated group A streptococcal infections can cause what inflammatory autoimmune disease?
Acute Rheumatic Fever
What age group is acute rheumatic fever most often seen in?
Children (5-15)
Acute rheumatic fever causes a migratory arthritis. Which areas are most common and which is never involved?
Wrists, ankles and knees most common
Shoulder, hands and hips possible
Vertebrae are never involved
How long after an initial strep infection does acute rheumatic fever develop?
2 to 3 weeks
Acute rheumatic fever can cause heart valve stenosis how quickly?
Within 2 weeks and lasts 6 weeks to 6 months. Sometimes damage is permanent.
Which condition can cause subcutaneous nodules and erythema marginatum?
Acute rheumatic fever
What is erythema marginatum? What does it look like?
A flat painless rash which looks like rings and arcs
What neurological finding can be seen late in an acute rheumatic fever infection?
Sydenham Chorea
Which two tests can be used to check for acute rheumatic fever?
ASO titer
DNAse B
What CBC and blood tests results expected with acute rheumatic fever?
Elevated acute phase reactants (CRP) and ESR
Leukocytosis
Neutrophilia
Is the throat culture for GABHS (group A beta-hemolytic Streptococcus) a reliable test for acute rheumatic fever?
No, it is often negative.
What are the diagnostic criteria for acute rheumatic fever? (Modified Jones criteria)
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
Acute rheumatic fever has a very long management plan what is it and how does carditis play a role?
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
Most common age range and gender for SLE?
Female 10:1
15-45 yo
SLE causes arthritis which is most commonly seen where?
A non-erosive, non-deforming arthritis in the hands, wrists, and knees. Other locations possible.
What is the butterfly rash common with SLE called?
Malar erythema
Which organ system becomes involved with more severe SLE?
Renal involvement is seen in severe SLE
CBC findings expected with SLE?
Hypo/micro anemia
Leukopenia
Lymphopenia
Thrombocytopenia
Elevated BUN and creatine
ESR >100 mm/hr
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
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.
