Serology 1 Flashcards
who are stool cultures indicated in?
patients who have unrelenting diarrhea (>7 days), fever and abdominal bloating
patients who have been drinking well water, prolonged antibiotics, traveled outside the country
inspecting feves is important because it can lead to the diagnosis of?
parasitic infectation obstructive jaundice diarrhea malabsorption obstructions dysentery ulcerative colitis gastrointestinal bleeding malignancies
what are the normal findings in a fecal sample?
100-200 g/day 70% water 1/2 bacteria, 1/2 cellular debris shape of the colonic lumen consistency is pliable brown color
brown color from fecal material is from?
stercobilin
normal colonic transit time
24-48 hours
clay, grey, wihite, or tan stools
biliary obstruction
red stools
lower GI bleed
undigested red meat, beets
black and tarry stools
upper GI bleed
green stools
leafy green veggies
broad spectrum antibiotics
physical characteristics of stools
formed
semiformed
diarrhea
scybala
spastic colon or rectal narrowing has what stool?
ribbon like
pasty stools
increased fats from gallbladder disease
greasy/butter stools
cystic fibrosis
megafeces
megacolon
mucous stools
mucous colitis
blood mucous clinging to fecal mass
neoplasm or inflammatory process of trectum
mucous associated with blood and pus is found in
ulcerative colitis
dysentery
diverticulitis
pus is found in
ulcerative colitis
chronic dysentery
abscesses
fistulas
fats is found in
malabsorption syndromes
pancreas
liver
biliary disease
FOBT/GUIAC
fecal occult blood test
part of screening for colorectal cancer in patients over 50
what is the least amount of blood a GUIAC test can detect?
5ml
needs further evaluation
apple core sign is seen with?
spastic colon
normal bacteria in gut
enterococcus e coli proteus staph aureus candida bacteriodes clostridium
pathogens for the gut
salmonella
shigella
campylobacter
yersina
infections present as?
acute diarrhea
excessive flatus
abdominal discomfort
fever
normal microscopic examination of feces
no RBCs few WBCs no ova or parasites mucous no harmful bacteria
neurodystrophic theory
subluxations can decrease organ function and therefore reduce resistance
virulence of an organism
how much of the organism it takes to form a disease
57 spirochetes can cause syphilis
250,000 leprosy bacteria needed for leprosy
proteins in the blood are made up of
albumin and globulin
gamma globulin
one of the many types of globuline
antibodies are made up of it
IgG
75% of serum immunoglobulins
secreted by plasma cells
able to cross platenta in fetus
IgA
15% of immunoglobulins
present in respiraotry and GI secretions
saliva and tears, small amounts in blood
breast milk
IgM
ABO blood grouping
rheumatoid factor
elevated in many infections
may be attached to the surface of a B cell or secreted in blood
IgE
allergic response
protects against parasitic worms
IgD
rarely elevated
part of B cell receptor
activates basophils and mast ells
what are the 3 ways antibodies and immunooglobulins can be measured?
quantitative and qualitative
agglutinin titers
antibody titers
electrophoresis
a screening test to semiquantitatively measure various proteins which are electrically separated
T cells
their precursors migrate to the thymus
B cell maturation occurs when?
bone marrow and lymphoid tissue
cell-mediated immunity
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
humoral immunity
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
what rises in humoral immunity?
IgM first
then IgG
antigens
substances capable of binding to an antibody
antibody
produced by lymphocytes
from patient’s serum
titers are reported as?
reactive (positive)
or non-reactive (negative)
what are titers?
indicates the strength of the antibody
when is the patient getting better?
when the titer is decreased
high titer indicates?
a highly virulent organism
agglutination
Ab+Ag= clumping
immunofluorescence
fluorescent tagged Ab reacts with Ag in ultraviolet light
enzyme immunoassay
enzymes label Ag-AB reactions
ELISA
enzyme linked immunosorbent assay
an indirect EIA
immunoblot
western blot
electrophoresis
syphilis is caused by?
treponema pallidium pallidium
primary syphyilis
begins 3-4 weeks after infection
recognized by a chancre, painless ulcer that will resolve
what is diagnostic for primary syphilis?
darkfield exam
secondary syphilis
goes systemic and has variable symptoms
fever, malaise, RASH, may have CNS involvement
typically followed by a latent period lastting years
tertiary syphilis
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
what may be negative in tertiary syphilis?
nontreponemal test
darkfield exam
test of choice for moist chancres
specific for treponema pallidum pallidum
syphilis screening tests
darkfield exam (for chancres)
nontreponemal test (for pts suspected of having syphilis)
WDRL (venereal disease research lab
RPR (rapid plasma reagin
when should nontreponemal tests be used?
to confirm treponemal tests to exclude false positives (measles, mono, malaria, TB, pregnancy, leprosy, old age, etc
nontreponemal tests
VDRL
RPR
measure IgM and IgG antibody
not specific for treponema pallidum
syphilis confirmation tests
treponemal tests
treponema pallidium immobilization
microhemagglutination
fluorescent treponemal antibody-absorption
what syphilis confirmation test is the most sensitive?
fluorescent treponmenal antibody absorption
FTA-Abs
6 Ds of syphilis
distantion density debris dislocation disorganization destruction
traditional algorithm for syphilis
nontreponemal screening test
if positive, then
treponemal test
if positve, syphilis
proposed algorithm with treponemal screening test
treponemal screening test if positve, then nontreponemal test if positve, syphilis if negative, secondary treponemal test
if there is a positive treponemal test?
must be followed by a nontreponemal test to differentiate between an active infection and one that occured in the past and was successfully treated
