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Visceral Disorder and Lab Interpretation > Serology Notes > Flashcards

Serology Notes Flashcards

1
Q

Represents the waste products of digested food. It includes bile, mucus, shed epithelial cells, bacteria, and inorganic salts.

A

Stool

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2
Q

Matching Stool

__ Normal

__ Blood, undigested meats, beets

___ upper GI bleed, ulcer

__ Biliary obstruction

___ green leafy vegtables, broad spectrum antibiotics

a) Black and tarry
b) Brown
c) Green
d) Red
e) Clay, Tan

A
  • Brown = normal
  • Clay = biliary obstruction
  • Red = lower GI bleed, undigested meats, beets
  • Black and tarry = Upper GI bleeds
  • Green = veggies and BSA
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3
Q

Hard, small spherical mass of stool

A

Scybala

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4
Q

Stool consistency noted with increased fats from gallbladder disease

A

Pasty stools

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5
Q

Stool form noted with cystic fibrosis

A

Greasy/buttery

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6
Q

T/F Mucuous in the stool is consistent with megacolon

A

FALSE

  • Mucus = mucous colitis, if bloody mucus clinign to a fecal mass, think neoplasm or inflammatory process of the rectum
  • Megafeces = megacolon
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7
Q

Stool characteristic found in ulcerative colitis and chronic dysentery, abscesses, fistulas

A

Pus

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8
Q

Part of screening for colorectal cancer in patients > 50

A

Guiac FOBT

-Guiac Fecal Occult Blood Test

Lower GI bleeds = red stools

Upper GI bleeds = dark tarry stools

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9
Q

Infections usually present as ____ diarrhea, excessive _______, abdominal discomfort, and fever

A

Acute diarrhea

Excessive flatus

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10
Q

T/F Normal flora can never be pathologic

A

FALSE

-E. coli is normal flora in the GI, but can become pathologic in most cases of UTI

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11
Q

Important factor for pathology. The less number of bacteria needed to cause an infection, the least number it is.

A

Virulence

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12
Q

Proteins in the blood

-_______ one of the many types of globulins

A

Albumin and globulin

-Gamma globulin is one of the many types of globulins.

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13
Q

Ig Types:

____ constitutes 75% of serum Ig

___ constitutes 15% of serum Ig. Present in respiratory and GI secretions and in saliva and tears and small amounts in blood

___ responsible for ABO blood and RF and elevated in many infections

____ Often mediates allergic response

___ Rarely elevated

a) IgD
b) IgM
c) IgG
d) IgE
e) IgA

A

igG = 75%

IgA = 15%, respiratory and GI secretions, saliva, tears, small amount of blood

IgM = ABO blood type, RF, elevated in many infections

IgE = mediates allergic response

IgD = rarely elevated

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14
Q

Screening test to semiquantitatively measure various proteins which are electrically separated

A

Electrophoresis

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15
Q

Part of cellular immunity. Precursors migrate to the thymus

A

T cells

B cell maturation (Humeral immunity) occurs in bone marrow and lymphoid tissue

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16
Q

Substances capable of binding to an antibody

A

Antigens

Antibody = produced by lymphocytes from the patients serum.

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17
Q

T/F If the antigen and the antibody form a reaction, agglutination or clumping will occur

A

True

Antigen (test) and the antibody (patients serum)

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18
Q

Indicates the strength of the antibody

-if it decreases, the patient is getting ________

A

Titer

-Patient is getting better (serial dilutions are done until the positive test becomes negative)

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19
Q

T/F The higher the titer, the less virulent the organism

A

FALSE

-Higher titer = higher virulence

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20
Q

Syphilis is an STD caused by the bacteria___________

A

Trepenoma pallidium

-Spirochete

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21
Q

Stage of syphilis. Goes systemic and has variable symptoms, fever, malaise, rash, may have CNS involvement. Typically followed by a latent period lasting years.

A

Secondary Syphilis

PRIMARY = 3-4 weeks after infection painless ulcer (Chancre)

TERTIARY = 3-10 years post infection. Soft granuloma lesions (Gummas). CNS involvement or CNS involvement (neurosyphilis, Charcots joints)

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22
Q

Darkfield examination is diagnostic for what stage of syphilis

A

Primary stage syphilis

23
Q

Tests used in patient’s suspected of having syphilis (screening tests)

A

Nontreponemal test

  • VDRL
  • RPR

Nontreponemal tests should be confirmed with treponemal tests to help exclude false positives (measles, mono, malaria, TB, pregnancy). Tests measure IgM and IgG antibody not specific for T. pallidum

24
Q

T/F Treponemal tests are used to confirm nontreponemal tests (detect specific antibodies for treponema)

A

True

25
Q

Causative agent of lyme disease

A

Borrelia burgdorferi

26
Q

Early symptoms of Lyme disease may include fever, ________, fatigue, depression, and a characteristic skin rash called ________

A

Headache

-Erythema migrans (bulls eye rash)

27
Q

What is the two tiered protocol recommended by the CDC to confirm Lyme disease?

A

1) Sensitive ELISA test, if +, perform:
2) More specific Western blot

28
Q

T/F Visual inspection of the pharynx can help determine if the causative agent is viral or bacterial

A

FALSE

-Need CBC to see how the body is reacting to the infection to see if viral or bacterial

29
Q

Test measures antibodies produced against extracellular toxins, increased titer indicates recent or current infection.

A

Antistreptolysin O titer (ASOT)

-done only if we suspect a post-streptococcal complication. If we think they have stept, we would do a rapid stress test and a CBC

30
Q

Caused by an RNA virus of the togavirus family. Can be devastating to the fetus, especially in the ___ trimester.

A

Rubella (German Measles)

-1st trimester

31
Q

What is the main concern to determine in pregnant women with a suspicion of rubella?

A

Immune status

-want to make sure the mom does not have or has antibodes against rubella

32
Q

When the CD4 count drops below ___ due to advanced HIV, the person is diagnosed with ______

A

CD4 < 200

AIDS

-Normal range = 600-1,500

33
Q

T/F Viral load tests how well the immune system is functioning

A

FALSE

  • Viral load = measure the amount of HIV in the blood. Lower levels are better than higher levels (how rapidly HIV is progressing)
  • CD4 count = how well the immune system is functioning
34
Q

Opportunistic infections and malignancies associated with AIDS

A
  • Kaposi Sarcoma
  • Pneumocystis jarevieci/carrini
35
Q

Screening test for HIV antibodies

-If positive, what test is also done

A

ELISA- screening

Western blot- Confirmatory

36
Q

T/F Patient with normal blood values has a positive ELISA and Western blot for HIV. Patient has AIDS

A

FALSE.

-Patient has a HIV infection, if his CD4 count drops below 200 = AIDS

37
Q

T/F Any FDA approved rapid test should be confirmed with a Western blot if HIV is suspected

A

True

38
Q

Rheumatoid Types (Seropositive)

A
  • RA
  • SLE
  • Scleroderma
  • Jaccoud’s

(Need RF test to confirm X-ray findings like rat bite erosions, uniform loss of joint space, juxtaarticular osteoporosis)

39
Q

Seronegative Spondyloarthopathies

A

RF-, HLA B27+

  • Ankylosing Spondylitis
  • Psoriatic Arthritis
  • Reiter’s Disease (Reactive Arthritis)
  • Enteropathic Arthritis
40
Q

ANA is a groups of antinuclear antibodies used to diagnose ________.

A

SLE

  • Positive results found in 95% of SLE cases
  • Other rheumatic diseases are still associated with ANA
41
Q

Chronic inflammatory disease that affects most joints especially the MCPs PIPs, and wrist, however any synovial joint can be involved.

A

RA

42
Q

Reactive IgM that can be tested in people with Rheumatoid

A

Rheumatoid Factor

  • Considered positive if found in titers >1:80
  • Negative RF does not rule out RA
43
Q

Patient has had morning stiffness for over 6 weeks will bilateral symmetric swelling of the MCP joints with Haggards nodes

-What is the Dx?

A

RA

44
Q

If we find evidence of rat bite erosion with uniform loss of joint space on all the MCPs of the hands, what labs or additional films would we need?

A

Radiographic evidence looks like RA

  • LAB: do a RF and CBC (confirm rheumatoid and check for anemia of chronic disease)
  • X-ray: Do flexion/extension films of the cervical spine to assess the ADI for instability
45
Q

T/F The most common cause of increased ADI in the world is rheumatoid

A

True

46
Q

Why does periarticular osteoporosis occur in someone with RA?

A

Due to hyperemia secondary to inflammation

47
Q

A diagnostic adjunct in certain rheumatoid disoders, particularly ________ in which 90% are positive

A

Human Leukocyte Antigen B27

(HLA B27)

48
Q

T/F 100% of cases of AS have sacroiliitis

A

True

49
Q

Which is not true of AS?

a) MC seronegative spondyloarthropathy
b) definite female preponderance
c) Produces inflammatory infiltrate causing pannus
d) MC in 15-35 year olds

A

B)

has a MALE preponderance

50
Q

If X-ray shows unilateral sacroiliitis, what pathologies and labs would be appropriate?

A
  • Infection
  • Could be a early seronegative spondyloarthropathy

Need HLA B27, CBC, ESR, and biochemical profile to help DDx

51
Q

You notice bilateral symmetric sacroiliitis, so you run some labs that show:

  • HLA B27 negative
  • Elevated Ca+2

What is the Dx most likely?

A

Hyperparathyroidism

  • HLA B27 negative rules out the spondyloarthopathies
  • Elevated calcium points toward HPTH
52
Q

X-ray shows a shiny corner sign, Dagger sign, Romanus lesion, and Trolley Track sign.

What is the Dx?

A

AS

53
Q

We notice either a shiny corner sign of a blastic mets lesion. What film view would help us differentiate between the two?

A

View of the SI joints

  • Involvement = probably AS
  • No involvement = Blastic mets or DDD

Visceral Disorder and Lab Interpretation (7 decks)

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