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clinical pathology > Serological Conditions > Flashcards

Serological Conditions Flashcards

1
Q

Infectious mononucleosis pathophysiology

A

Epstein Barr virus spread through salvia to tonsils and pharynx; can have it without knowing

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2
Q

Epidemiology & incidence of mono

A

Ages 10-30 (esp. 15-25)

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3
Q

Clinical findings for infectious mono

A

Fatigue, high fever, sore throat, generalized lymphadenopathy

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4
Q

CBC findings in infectious mono

A

RBC: NL
Leukocytosis with lymphocytosis (>50%), large amts of reactive lymphocytes
Thrombocytopenia possible

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5
Q

Special tests for infectious mono

A

Heterophile antibody tests (monospot), specific Epstein Barr virus titers (anti-VCA antibody & anti-EBNA antibody)

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6
Q

Heterophile antibody tests

A

Inexpensive, rapid, less sensitive, less specific, less reliable in 1st week of infection, not reliable in patients under 5 yoa

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7
Q

Anti-VCA antibody test

A

IgM: early, disappear in 4-6 weeks
IgG: peaks at 2-4 weeks, persists for life

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8
Q

Anti-EBNA antibody test

A

Elevates after acute phase ~2-4 months after onset of s/s, then persists for life

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9
Q

Management of infectious mono

A

No specific treatment, saline gargles, tea w/ honey can be supportive

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10
Q

Contraindications for infectious mono

A

Avoid strenuous exercise, contact sports, heavy lifting for ~4 weeks; avoid side posture and thoracic adjustments
Aspirin/acetylsalicyclic acid (associated with Reye syndrome)

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11
Q

Acute rheumatic fever

A

Inflammatory disease (autoimmune) (heart, joints, skin, CNS), untreated group A streptococcal infections, recurrence common without prophylactic antibiotic treatment

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12
Q

ARF epidemiology

A

Most common in children 5-15 yoa, once patient has it, it may come back

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13
Q

Clinical findings for ARF

A

Arthritis, carditis, subcutaneous nodules on skin, erythema merginatum, Sydenham chorea (late finding)

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14
Q

Carditis findings for ARF

A

Tachycardia common, high fever, chest pain, valvulitis, murmurs, damage may be permanent

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15
Q

Erythema marginatum

A

Flat, painless rash on trunk and proximal extremities seen with ARF

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16
Q

ARF lab findings

A

Elevated CRP and ESR, leukocytosis, neutrophilia

17
Q

Additions test for ARF

A

Throat culture for GABHS (often negative by time ARF develops), ASO titer (elevated), DNase B (elevated)

18
Q

Major criteria for ARF diagnosis

A

Carditis, arthritis, chorea, erythema marginatum, subcutaneous nodules

19
Q

Minor criteria for diagnosis of ARF

A

Fever, arthralgia, previous rheumatic fever, acute phase reactant labs, prolonged P-R interval on ECG

20
Q

Management of ARF

A

Limit activities with symptoms of arthritis, chorea, or carditis
Treatment aimed at eliminating streptococcal infection, prophylactic prevention, pain reduction, anti-inflammatory

21
Q

Systemic lupus erythematosus (SLE)

A

Multi-system, autoimmune inflammatory condition of the connective tissue, fluctuating, chronic course, may be mild to severe

22
Q

SLE epidemiology/risk factors

A

Female > male (10:1)
Possible in all ages, 15-45 most common

23
Q

Clinical findings in SLE

A

Variable onset, variable system involvement, exacerbations

24
Q

Joint involvement in SLE

A

Metacarpophalangeal, interphalangeal, wrist, and knee most impacted; commonly the first symptom to appear, may looks like RA, arthritis is non-erosive

25
Q

Dermatologic clinical findings in SLE

A

Malar erythema (butterfly rash), photosensitivity, alopecia, mottled erythema on side of palm into fingers

26
Q

Other clinical findings in SLE

A

Vascular: Reynauds
GI: ulcers on mucus membranes
Cardiac
Obstetrics: higher prevalence of miscarriage
CNS: seizures, hyperthyroidism
Renal: lupus nephritis

27
Q

UA findings in SLE

A

Proteinuria, hematuria (if kidney involvement)

28
Q

CBC findings for SLE

A

Hypochromic microcytic anemia, leukopenia with lymphocytopenia, thrombocytopenia

29
Q

Immunologic tests for SLE diagnosis

A

Antinuclear antibody test & anti-double-stranded DNA test

30
Q

Antinuclear antibody test (ANA)

A

More sensitive, less specific
Screening test
Will be elevated

31
Q

Anti-ds-DNA test

A

Less sensitive, more specific
Diagnostic test

32
Q

What is needed for diagnosis of SLE

A

4 of 11 manifestations

33
Q

Management of SLE

A

Avoidance of UV light, stress avoidance/management, activity as tolerated

34
Q

Prognosis of SLE

A

Remission and exacerbation

clinical pathology (6 decks)

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