Serology

Question 1

Serology

Answer 1

The diagnostic identification of antibodies in the serum

Question 2

HIV anitbody Testing

Answer 2

All US tests detect HIV-1 and some HIV-2

HIV 1 - most common in US
HIV 2- Africa

Sensitive - ELISA
Specific - Western Blot

Screening test - ELISA

Question 3

Western Blot Testing

Answer 3

immunoassay test method that detects specific proteins in blood or tissue.

combines an electrophoresis step with a step that transfers (blots) the separated proteins onto a membrane.

often used as a f/u test to confirm the presence of an antibody and to help diagnose a condition such as HIV or Lyme Disease testing.

Question 4

Hepatitis A, B, C

Answer 4

Inflammation of the liver, can lead to liver cancer and transplant need.

Active Test - Antigen - HsAg
Prior Exposure - Antibody - HsAb

Question 5

HEP A (HAV)

Answer 5

Aquired through food or water
There is a Hepatitis A Vaccine

Symptoms may include jaundice and severe stomach pains and diarrhea
Self-limiting

Question 6

HEP A Test Results

Answer 6

HAV-Ab IgM- exposed. Antibodies will begin 2-3 weeks after first being infected and persist about 2-6 months

HAV-Ab IgG-produced 1-2 weeks after IgM and persist for life

HAV-Ab total-may help determine if you have been infected and have some immunity to the disease

Question 7

HEP B

Answer 7

not as common, generally self-limiting

Can create a “Chronic-active” state in some people who recover from symptoms but are still contagious and never fully recover.

contracted through blood, blood products, and sex

*STI-like

Question 8

HEP B Testing

Answer 8

HBV-Ag
HBV-Ab
HBV-D

Hepatitis B tests may be used for a variety of reasons.
detect antibodies produced in response to HBV infection

detect antigens produced by the virus
detect viral DNA.

Question 9

HEP C (HVC)

Answer 9

Hepatitis C infection is caused by the hepatitis C virus (HCV).

Hepatitis C is transmitted by blood and sexual activity
**very infectious

Exposure may occur:
After a needle stick or sharps injury If blood from someone who has hepatitis Ccontacts a cut on your skin or contacts your eyes or mouth

Question 10

People at high risk for HEP C

Answer 10

Inject street drugs or share a needle with someone who has hepatitis C

Have been on long-term kidney dialysis

Have regular contact with blood at work (such as a health care worker)

Have unprotected sexual contact with a person who has hepatitis C

Were born to a mother who had hepatitis C

Received a tattoo or acupuncture with needles that were not disinfected properly after being used on another person (risk is very low with practitioners who have a tattoo license or permit or an acupuncture license)

Received an organ transplantfrom a donor who has hepatitis C

Share personal items such as toothbrushes and razors with someone who has hepatitis C (less common)
Received a blood transfusion (rare in the U.S.)

Question 11

Clearance rates for HEP A, B, C

Answer 11

90% clear Hep B, 95% clear Hep A, 95% of people DO NOT clear Hep C

Question 12

HEP D

Answer 12

Hepatitis D virus (HDV) is found only in people who carry the hepatitis B virus.

**If someone is taking a long time to clear HEP B - suspicious of D.

HDV may make a recent (acute) hepatitis B infection or an existing long-term (chronic) hepatitis B liver disease worse.

It can even cause symptoms in people who carry Hepatitis B virus but who never had symptoms

Hepatitis D infects about 15 million people worldwide.
It occurs ina small numberof people who carry hepatitis B.

Question 13

HEP D Risk Factors

Answer 13

Abusing intravenous (IV) or injection drugs

Being infected while pregnant (the mother can pass the virus to the baby)

Carrying the hepatitis B virus
Men having sexual intercourse with other men

Receiving many blood transfusions

Question 14

Cystic Fibrosis

Answer 14

Autosomal recessive genetic disorder

Delayed growth, Clay or pale colored stools, coughing, sinus pain, recurrent respiratory infections

In CF, thick mucus can obstruct pancreatic ducts and prevent trypsinogen from reaching the intestine. Blood IRT levels will be elevated in newborns with CF, but positive results must be followed by confirmatory testing.

Question 15

CF Testing

Answer 15

ACMG recommends a panel of 23 of the most common CFTR mutations be used to screen general or targeted populations for cystic fibrosis and CF carrier status.

Trypsin/chymotrypsin: stool test, screening for pancreatic insufficiency

Immunoreactive Trypsinogen (IRT): This test is a newborn screening tool for trypsinogen, which is produced in the pancreas and transported to the intestine, where it is activated to form the enzyme trypsin.

Question 16

CF Sweat Chloride Test

Answer 16

the sweat of a person with CF may be up to five times saltier than normal.

Positive sweat chloride test results should be confirmed and followed with CF gene mutation testing whenever possible

Question 17

ASO Titer

Answer 17

<200 IU/mL

Streptococcal Infections (pharyngitis, scarlet fever, rheumatic fever, poststreptococcal glomerulonephritis)
RA
Other collagen diseases

Question 18

Monospot

Answer 18

normal= negative

POSITIVE-
Mononucleosis
Viral Hepatitis
RA

Infectious mononucleosis, commonly called mono, refers to an infection caused by the Epstein-Barr virus (EBV). This test detects proteins in the blood called heterophile antibodies that are produced by the immune system in response to an EBV infection.

No sports for 6-8weeks - splenic enlargement

Question 19

Heterophile Antibody Testing

Answer 19

specifically refers to a rapid test for antibodies produced against the Epstein-Barr virus (EBV), the causative agent of infectious mononucleosis

Question 20

Epstein Barr/ Herpesvirus 4

Answer 20

Someone w/neg. monospot

Also associated with cancers: Hodgkin’s lymphoma, Burkitt’s lymphoma, nasopharyngeal carcinoma and lymphomas associated with HIV

Question 21

CMV

Answer 21

IgM <1:8; IgG<1:16

generally passed from infected people to others through direct contact with body fluids, such as urine, saliva, vaginal secretions, and semen.

Common exposure for babies is from kissing babies.

Self-limiting, can cause an eye infection which can cause blindness.

Question 22

Syphilis

Answer 22

An STD caused by Treponema pallidum

VDRL: Veneral Disease Research Laboratory Test, invented before WWI

Question 23

Syphilis Testing

Answer 23

RPR: Rapid Plasma Reagin - Screening Test ( sensitive)

And FTA-Abs: Fluorescent treponemal antibody-absorption ( confirmation test - specific)

MHA-TP: Microhemagglutination assay-confirms a syphilis infection after another method tests positive for the syphilis bacteria

Question 24

Syphilis Stages

Answer 24

Primary: single sore marks the first (primary) stage of syphilis symptoms, but there may be multiple sores.

Secondary Stage: Papulosquamous lesions

Latent Tertiary Stage: dementia, blindness, damage to brain, nerves, eyes, heart, etc.

Question 25

Anti-nuclear antibodies

Answer 25

(ANA) Useful screening test in patients with symptoms suggesting collagen-vascular disease esp. if titer is >1:160 Positive: SLE, lupus like syndromes, scleroderma, RA, Polymyositis, raynaud's

Question 26

c-ANCA

Answer 26

Wegener’s granulomatous-Wegener's granulomatosis is a rare disorder in which blood vessels become inflamed, making it hard for blood to flow. Wegener's granulomatosis mainly affects blood vessels in the nose, sinuses, ears, lungs, and kidneys, although other areas may be involved.

Question 27

p-ANCA

Answer 27

polyarteritis nodosa Polyarteritis nodosa is a disease that affects arteries, the blood vessels that carry oxygen-rich blood to organs and tissues. The cause is unknown, but it occurs when certain immune cells attack the affected arteries.

Question 28

Rheumatoid Factor

Answer 28

A test for RF may be ordered if a patient has signs of RA. Symptoms may include pain, warmth, swelling, and morning stiffness in the joints, nodules under the skin, and, if the disease has progressed, evidence on X-rays of swollen joint capsules and loss of cartilage and bone.

Question 29

Rheumatoid Factor

Answer 29

A test for RF may be ordered if a patient has signs of RA. <15 IU Increased- Collagen-vascular disease (RA, SLE, scleroderma, polyarteritis nodosa) Infections (TB, syphilis, viral hepatitis)

Question 30

Symptoms of RA

Answer 30

Symptoms may include pain, warmth, swelling, and morning stiffness in the joints, nodules under the skin, and, if the disease has progressed, evidence on X-rays of swollen joint capsules and loss of cartilage and bone. **usually effects joints symmetrically. Most frequently the writs, hands, elbows, shoulders, knees and ankles.

Question 31

Legionella

Answer 31

<1:32 titers Cases of Legionnaires' disease have been linked to many types of equipment that contain water, but plumbing systems and air conditioning systems are most often blamed. most cases have been legionella cases are traced to large buildings. Larger piping networks are generally more conducive to legionellae growth. Also, the air conditioning systems for large buildings often include cooling towers, which contain a pool of warm water in which legionellae can flourish.

Question 32

Legionares disease

Answer 32

causes pneumonia

Question 33

H-pylori

Answer 33

IgG <0.17=negative May test by Serology, C-breath test, gastric mucosal biopsy, and the Campylobacter-like organism test (rapid urease test) from biopsy sample as well.

Question 34

H. Pylori Tx

Answer 34

1. Triple Clarithromycin+amoxicillan+PPI 2. Quadruple Bismouth+ metronidazole+ tetracycline+ PPI 3. Sequential- PPI+amoxicillin 5 days, followed by PPI + clarithromycin + metronidazole for 5 days 4. Combo products- Helldac Pylera Prevpac

Question 35

Rocky Mountain Spotted Fever

Answer 35

Causative agent-Rickettsia Rickettsii Mostly in spring/summer Vector- American Dog Tick found in high grass and low shrubs, and fields

Question 36

Symptoms of Rocky Mountain Spotted Fever

Answer 36

Abdominal pain, diarrhea, muscular and joint pain Severeve headsche, chills, Fever to 103-104, Restlessness Petechial rash on wrists/ankles, palms/soles and forearms.

Question 37

Lyme Disease

Answer 37

Causative Agent- Borrelia Burgdorferi Mostly spring, but year round Deer tick vector. May use Western Blot test Can look for antibodies and antigen via ELISA. **bullseye rash

Question 38

PSA

Answer 38

<4ng/dL Most useful as a measure of response to therapy of prostate cancer; approved for screening of prostate cancer. Levels >10ng/dL are frequently associated with carcinoma

Question 39

Indications of increased PSA

Answer 39

Prostate Cancer Acute Prostatitis Some cases of BPH Prostate surgery Vigorous prostate massage

Question 40

Indications of decreased PSA

Answer 40

Radical prostatectomy Response to therapy of prostatic carcinoma (radiation or hormonal)

Question 41

CEA

Answer 41

Used to monitor the treatment of people diagnosed with colon cancer Good marker to follow for recurrence of carcinomas of the GI tract

Question 42

Indications of Increased CEA

Answer 42

Carcinoma of the colon Pancreatic cancer Lung cancer Stomach cancer UC/Crohn’s disease

Question 43

CA19-9

Answer 43

<37kU/L Tumor marker helpful to differentiate between cancer of the pancreas and other conditions, such as pancreatitis Increased in GI cancers-pancreas, stomach, liver, colorectal, hepatobiliary, some cases of lung and prostate, pancreatitis. Mostly pancreatic/hepatocellular Not specific or sensitive Order with other tests

Question 44

CA-125

Answer 44

<35kU/L Not a useful screening tool for ovarian cancer when used alone-best used in conjunction with ultrasound and physical examination

Question 45

Indications of Increased CA-125

Answer 45

Ovarian Cancer Endometrial Cancer Colon Cancer Endometriosis IBD PID

Question 46

AFP

Answer 46

alpha feto protein - liver function

Question 47

Indications of increased and decreased AFP

Answer 47

Increased- Hepatoma Hepatocellular Carcinoma Testicular Tumor Neural Tube Defects Decreased- Trisomy 21 (Down Syndrome) in maternal serum

Question 48

HCG

Answer 48

Human Corinotic Gonadotrpoic <0.3mIU/mL Hydatidiform mole is a rare mass or growth that forms inside the womb (uterus) at the beginning of a pregnancy. It is a type gestational trophoblastic disease (GTD). A cancerous form of GTD is choriocarcinoma. Usually >100,000 mIU/mL HCG is elevated in normal pregnancy as well.

Question 49

Indications for Increased HCG

Answer 49

Pregnancy Some germ cell tumors Hydatidiform mole Molar pregnancy choriocarcinoma

Question 50

A molar pregnancy

Answer 50

also known as hydatidiform mole — is a noncancerous (benign) tumor that develops in the uterus. A molar pregnancy occurs when the placenta develops into an abnormal mass of cysts rather than becoming a viable pregnancy.