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Vis Dis > Serology 1 > Flashcards

Serology 1 Flashcards

1
Q

who are stool cultures indicated in?

A

patients who have unrelenting diarrhea (>7 days), fever and abdominal bloating
patients who have been drinking well water, prolonged antibiotics, traveled outside the country

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2
Q

inspecting feves is important because it can lead to the diagnosis of?

A 
parasitic infectation
obstructive jaundice
diarrhea
malabsorption
obstructions
dysentery
ulcerative colitis
gastrointestinal bleeding
malignancies
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3
Q

what are the normal findings in a fecal sample?

A 
100-200 g/day
70% water
1/2 bacteria, 1/2 cellular debris
shape of the colonic lumen
consistency is pliable
brown color
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4
Q

brown color from fecal material is from?

A

stercobilin

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5
Q

normal colonic transit time

A

24-48 hours

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6
Q

clay, grey, wihite, or tan stools

A

biliary obstruction

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7
Q

red stools

A

lower GI bleed

undigested red meat, beets

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8
Q

black and tarry stools

A

upper GI bleed

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9
Q

green stools

A

leafy green veggies

broad spectrum antibiotics

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10
Q

physical characteristics of stools

A

formed
semiformed
diarrhea
scybala

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11
Q

spastic colon or rectal narrowing has what stool?

A

ribbon like

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12
Q

pasty stools

A

increased fats from gallbladder disease

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13
Q

greasy/butter stools

A

cystic fibrosis

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14
Q

megafeces

A

megacolon

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15
Q

mucous stools

A

mucous colitis

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16
Q

blood mucous clinging to fecal mass

A

neoplasm or inflammatory process of trectum

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17
Q

mucous associated with blood and pus is found in

A

ulcerative colitis
dysentery
diverticulitis

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18
Q

pus is found in

A

ulcerative colitis
chronic dysentery
abscesses
fistulas

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19
Q

fats is found in

A

malabsorption syndromes
pancreas
liver
biliary disease

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20
Q

FOBT/GUIAC

A

fecal occult blood test

part of screening for colorectal cancer in patients over 50

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21
Q

what is the least amount of blood a GUIAC test can detect?

A

5ml

needs further evaluation

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22
Q

apple core sign is seen with?

A

spastic colon

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23
Q

normal bacteria in gut

A 
enterococcus
e coli
proteus
staph aureus
candida
bacteriodes
clostridium
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24
Q

pathogens for the gut

A

salmonella
shigella
campylobacter
yersina

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25
Q

infections present as?

A

acute diarrhea
excessive flatus
abdominal discomfort
fever

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26
Q

normal microscopic examination of feces

A 
no RBCs
few WBCs
no ova or parasites
mucous
no harmful bacteria
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27
Q

neurodystrophic theory

A

subluxations can decrease organ function and therefore reduce resistance

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28
Q

virulence of an organism

A

how much of the organism it takes to form a disease
57 spirochetes can cause syphilis
250,000 leprosy bacteria needed for leprosy

29
Q

proteins in the blood are made up of

A

albumin and globulin

30
Q

gamma globulin

A

one of the many types of globuline

antibodies are made up of it

31
Q

IgG

A

75% of serum immunoglobulins
secreted by plasma cells
able to cross platenta in fetus

32
Q

IgA

A

15% of immunoglobulins
present in respiraotry and GI secretions
saliva and tears, small amounts in blood
breast milk

33
Q

IgM

A

ABO blood grouping
rheumatoid factor
elevated in many infections
may be attached to the surface of a B cell or secreted in blood

34
Q

IgE

A

allergic response

protects against parasitic worms

35
Q

IgD

A

rarely elevated
part of B cell receptor
activates basophils and mast ells

36
Q

what are the 3 ways antibodies and immunooglobulins can be measured?

A

quantitative and qualitative
agglutinin titers
antibody titers

37
Q

electrophoresis

A

a screening test to semiquantitatively measure various proteins which are electrically separated

38
Q

T cells

A

their precursors migrate to the thymus

39
Q

B cell maturation occurs when?

A

bone marrow and lymphoid tissue

40
Q

cell-mediated immunity

A

inflammatory response begins after nonspecific detection and rpcessing of infectious agents by macrophages
they become activated and interact with T lymphocytes
phagocytosis and killing of infectious agents ensues

41
Q

humoral immunity

A

activated macrophages may present processed infectious agen antigens to specific memory B-lymphocytes in the presence of helper T cells transforms into antibody producing plasma cells

42
Q

what rises in humoral immunity?

A

IgM first

then IgG

43
Q

antigens

A

substances capable of binding to an antibody

44
Q

antibody

A

produced by lymphocytes

from patient’s serum

45
Q

titers are reported as?

A

reactive (positive)

or non-reactive (negative)

46
Q

what are titers?

A

indicates the strength of the antibody

47
Q

when is the patient getting better?

A

when the titer is decreased

48
Q

high titer indicates?

A

a highly virulent organism

49
Q

agglutination

A

Ab+Ag= clumping

50
Q

immunofluorescence

A

fluorescent tagged Ab reacts with Ag in ultraviolet light

51
Q

enzyme immunoassay

A

enzymes label Ag-AB reactions

52
Q

ELISA

A

enzyme linked immunosorbent assay

an indirect EIA

53
Q

immunoblot

A

western blot

electrophoresis

54
Q

syphilis is caused by?

A

treponema pallidium pallidium

55
Q

primary syphyilis

A

begins 3-4 weeks after infection

recognized by a chancre, painless ulcer that will resolve

56
Q

what is diagnostic for primary syphilis?

A

darkfield exam

57
Q

secondary syphilis

A

goes systemic and has variable symptoms
fever, malaise, RASH, may have CNS involvement
typically followed by a latent period lastting years

58
Q

tertiary syphilis

A

3-10 years post infection and are soft granulomatous lesions called gummas
this stage may be asymptomatic or have CNS involvement, leading to insanity
Charcot’s joints

59
Q

what may be negative in tertiary syphilis?

A

nontreponemal test

60
Q

darkfield exam

A

test of choice for moist chancres

specific for treponema pallidum pallidum

61
Q

syphilis screening tests

A

darkfield exam (for chancres)
nontreponemal test (for pts suspected of having syphilis)
WDRL (venereal disease research lab
RPR (rapid plasma reagin

62
Q

when should nontreponemal tests be used?

A

to confirm treponemal tests to exclude false positives (measles, mono, malaria, TB, pregnancy, leprosy, old age, etc

63
Q

nontreponemal tests

A

VDRL
RPR
measure IgM and IgG antibody
not specific for treponema pallidum

64
Q

syphilis confirmation tests

A

treponemal tests
treponema pallidium immobilization
microhemagglutination
fluorescent treponemal antibody-absorption

65
Q

what syphilis confirmation test is the most sensitive?

A

fluorescent treponmenal antibody absorption

FTA-Abs

66
Q

6 Ds of syphilis

A 
distantion
density
debris
dislocation
disorganization
destruction
67
Q

traditional algorithm for syphilis

A

nontreponemal screening test
if positive, then
treponemal test
if positve, syphilis

68
Q

proposed algorithm with treponemal screening test

A 
treponemal screening test
if positve, then
nontreponemal test
if positve, syphilis
if negative, secondary treponemal test
69
Q

if there is a positive treponemal test?

A

must be followed by a nontreponemal test to differentiate between an active infection and one that occured in the past and was successfully treated

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