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Visceral Disorders > Serology > Flashcards

Serology Flashcards

1
Q

What are the contents of stool?

A

bile, mucus, shed epithelial cells, bacteria and inorganic salts

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2
Q

Stool studies are looking at what?

A

function and integrity of the bowel

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3
Q

Stool cultures are indicated in patients with what?

A

unrelenting diarrhea, fever, and abdominal bloating, especially if diarrhea persists more than 7 days

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4
Q

What diagnosis might inspecting feces lead to?

A

parasitic infestation, obstructive jaundice, diarrhea, malabsorption, obstructions, dysentery, ulcerative, gastrointestinal bleeding, malignnancies, etc

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5
Q

What should be noted when examining feces?

A

quantity, form consistency, and color of the stool

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6
Q

Percentage of water in feces

A

70%

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7
Q

Grams of stool per day

A

100 to 200 grams of stool per day

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8
Q

How much of feces is bacteria and cellular debris?

A

one half

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9
Q

Normal evacuation of feces reflects what?

A

the caliber shape of the colonic lumen

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10
Q

Usual brown color comes from what?

A

stercoblin

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11
Q

What is the odor from stool?

A

From indole and skatole (formed from bacterial degradation of proteins through fermentation and putrefaction

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12
Q

Normal colonic transit time

A

24 to 48 hours

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13
Q

Clay (gray white), tan feces is due to

A

biliary obstruction

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14
Q

Red feces is due to

A

lower GI, undigested red meat, beets

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15
Q

Black and tarry feces is due to

A

upper GI bleeding

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16
Q

Green feces is seen with

A

green leafy vegetables and used of broad spectrum antibiotics

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17
Q

scybala

A

hard small spherical masses of stool

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18
Q

Ribbon like feces is seen with

A

spastic colon or rectal narrowing

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19
Q

Pasty feces is noted with

A

increased fats from gallbladder disease

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20
Q

Greasy/buttery is noted with

A

cystic fibrosis

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21
Q

Megafeces is noted with

A

megacolon

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22
Q

Mucous feces is noted with

A

mucous colitis, bloody mucous clinging to a fecal mass is a sign of neoplasm or inflammatory process of the rectum

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23
Q

Pus in feces is found in

A

ulcerative colitis and chronic dysentery, abscesses, fitulas

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24
Q

Fats (steatorrhea) found in

A

a variety of disorders (malabsorpation syndromes, pancreas, liver, biliary disease)

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25
Q

Loss of __-__ ml of blood from the upper GI tract can result in black tarry stools

A

50-75 ml

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26
Q

Tumors of the intestine grow into what? And what is the complication it causes?

A

Grows into the lumen and are subjected to repeated trauma from the fecal stream and the friable tumor ulcerate and bleeds

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27
Q

What happens to normal flora when they are out of their normal habitat?

A

could become pathogenic

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28
Q

What are the proteins of the blood?

A

albumin and globulin gamma (antibodies are made up of gamma globulin proteins)

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29
Q

Which Ig constitutes approximately 75% of serum immuoglobulins

A

IgG

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30
Q

Which Ig is responsible for the ABO blood grouping and the rheumatoid factor and elevated in many infections

A

IgM

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31
Q

IgA is present primarily where?

A

respiratory and GI secretions and in saliva and tears and small amounts in blood

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32
Q

Which Ig mediates allergic response

A

IgE

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33
Q

Is IgD ever elevated

A

rarely

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34
Q

How can antibodies and immunoglobulins be measured?

A
  1. guantitative and qualitative
  2. agglutinin titers
  3. antibody titers
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35
Q

What is a screening test to quantitatively measure various protein which are electrically separated?

A

electrophoresis

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36
Q

What is cell-mediated immunity?

A

Inflammatory response after nonspecific detection and processing of infectious agents by macrophages. They become activated and interact with t-lymphocytes. Phagocytosis and killing of infectious agents ensues

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37
Q

What is humoral immunity?

A

Activated macrophages may be present processed infectious agent antigens to specific memory b-lymphocytes in the presence of helper t cell transforms into antibody producing plasma cells

38
Q

In humoral immunity which antibody typically rises first

A

IgM rises first then IgG

39
Q

Substances capable of binding to an antibody

A

antigen

40
Q

What comes from the patient’s serum

A

anti bodies

41
Q

If the antigen (test) and the antibody (serum) form a reaction, what happens?

A

agglutination or clumping will occur

42
Q

Titer indicates the strength of ___.

A

the antibody

43
Q

If titer decreases the patient is getting better or worse

A

better

44
Q

The higher the titer number the more ____ the organism

A

virulent

45
Q

syphilis STD is cause by what?

A

spirochete preponema pallidium

46
Q

Primary stage of syphilis

A

begins 3-4 week after infection recognized by a chancre, painless ulcer that will resolve (darkfield examination is diagnostic at this stage)

47
Q

Secondary stage syphilis

A

goes systemic and has variable symptoms, fever, malaise, RASH, may have CNS involvement (the immunologic test are best method for this stage) typically followed by a latent period lasting years

48
Q

Tertiary stage of syphilis

A

3-10 years post infection and are soft granulomatous lesions called gummas. This stage may be asymptomatic or have CNS involvement (neurosyphilis) leading to insanity…Charcot’s joints

49
Q

Would the nontreponemal test be negative or positive at this stage

A

negative

50
Q

test of choice for moist genital lesions

A

darkfield exam

51
Q

Nontreponemal test should be confirmed with what test to help exclude false positives

A

treponemal test

52
Q

Nontreponemal test includes what?

A

VDRL, RPR

This test measure IgM and IgG antibody and are not specific for R. pallidum

53
Q

What is the algorithm for testing for syphilis?

A

A positive treponemal screening result must be followed by a nontreponemal test to differentiate between and active infection and one that occurred in the bast and was successfully treated

54
Q

Two tiered protocol for lyme disease

A

the sensitive ELISA test is performed first and if it is positive or equivocal then the more specific western blot is run

55
Q

Early symptoms of lyme disease

A

may include fever, headache, fatigue depression and a characteristic circular skin rash

56
Q

Erythema migrans

A

characteristic circular skin rash

57
Q

What may happen if lyme disease is untreated

A

later symptoms may involve the joints, heart, and central nervous system

58
Q

Organism that causes lyme disease

A

spirochete borrelia burgdorferi

59
Q

incubation for Rubella

A

10-21 days

60
Q

How is rubella spread

A

spread through respiratory secretions and is highly contagious

61
Q

T or F rubella is usually self limiting with occasional complications

A

true but it can be devastation to a fetus, especially in the first trimester

62
Q

What percent of women have spontaneous abortion after contracting Rubella while pregnant?

A

20%

63
Q

Signs and symptoms of Rubella in an adult

A

low grade fever, malaise, headache and cervical lymphadenopathy, 50% have maculopapular rash

64
Q

Signs and symptoms of rubella in children

A

transient rash and fever

65
Q

How would you test for steptococcal infection?

A

a rapid antigen detection can be done with a throat swab. Antistreptolysin O titer (ASOT) test measures antibodies produced against extracellular toxins. Increase titer indicates recent or current infection

66
Q

How does the test for streptococcl infections work?

A
  • streptococcal infections produce an enzyme called streptolysin O which can lyse RBCs
  • streptolysin O is antigentic, the body produces ASO a neutralizing antibody
  • ASO appears in the serum 1 week to 1 month after the onset of streptococcal infection
  • helpful in determining that post streptococcal diesease such as GN was due to previous strep infection
67
Q

What is infectious mononucleosis?

A

a self limiting systemic disorder lymphoproliferative condition occurring in early childhood and young adults

68
Q

What is the incubation period for infectious mononucleosis?

A

10-50 days, lasting about 1-4 weeks after fully developed

69
Q

Sign and symptoms of infectious mononucleosis?

A

fever, pharyngitis, lymphadenapthy, extreme fatigue and malaise May have hepatitis and jaundice with hepatospenomegaly

70
Q

Laboratory diagnosis of infectious mononucleosis is accomplished how?

A

by noting lymphocytosis and atypical lymphocytes in the peripheral blood

71
Q

What is the tests name that you run when you think infectious mononucleosis?

A

monospot (heterophile Ab screening test) approximately 2 weeks after onset, patients will have immunoglobin M antibodies that react with warm RBC’s

72
Q

When the CD4 count drops below 200 due to advanced HIV disease, what is the person diagnosed with?

A

AIDs

73
Q

What is the normal range for CD4 cells?

A

600 and 1500

74
Q

Test measure the amount of HIV in the blood

A

viral load test, lower levels are better than higher levels

75
Q

Test how well the immune system is functioning in HIV

A

CD4 count

76
Q

How rapidly HIV is progressing

A

Viral load

77
Q

What are the first clinical symptoms in HIV patients?

A

night sweats, fever, lymphadenopthy and fatigue followed by extreme weight loss, diarrhea, opportunistic infections and malignancies

78
Q

Tests for diagnosis of HIV

A

Elisa screening test and Western blot test

79
Q

What does Elisa screening test do?

A

test for antibodies

80
Q

What should you do if you get a positive Elisa test?

A

repeat test if positive again then to western blot test

81
Q

What is western blot test?

A

a confirmatory test

82
Q

Rheumatoid types - seropositive

A

rheumatoid arthritis
systemic lupus erythematosis (SLE)
scleroderma
jaccoud’s

83
Q

Rheumatoid Variants - seronegative

A

ankylosing spondylitis
psoriatic arthritis
reiters disease (reactive arthritis)
enteropathic arthritis

84
Q

HLA B27 positive and rheumatoid factor negative

A

rheumatoid variants - seronegative

85
Q

What is a group of antinuclear bodies used to diagnosis

A

SLE

86
Q

How does ANA work?

A

there are several patterns of fluorescence seen through the UV microscope and when combined with the specific ANA sub-types the patter becomes more specific for various autoimmune disease

87
Q

Besides SLE, what other disorders can show up positive with ANA

A

scleroderma, mixed connective tissue, sjorens syndrome, RA

88
Q

Rheumatoid arthritis diagnosis - 4 or more of the following

A
  • morning stiffness for at least 6 weeks
  • pain on joint motion for at least 6 weeks
  • swelling of at least one joint for at least 6 weeks
  • swelling in at least one other joint for more than 6 weeks
  • bilateral symmetrical joint swelling
  • subcutaneous nodules
  • radiographic changes
89
Q

What is the exact role of RF in the disease process?

A

not ell known, however 80% of patients with rheumatoid arthritis have positive RF titers

90
Q

What is the ratio to consider a positive RF?

A

must be found in titers greater than 1:80

91
Q

T or F in juvenile RA, RF is positive

A

false, negative (non-reactive)

Visceral Disorders (6 decks)

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