Serology

Front 1

--What two stages of syphilis are most infectious?

Back 1

--Primary and secondary: stages with moist lesions

Front 2

--What disease states other than syphilis can cause a true positive RPR and FTA-ABS?

Back 2

--Yaws, Pinta, and Bejel

--Caused by organisms morphologically and serologically indistinguishable from T pallidum

Front 3

--RPR

Back 3

--Non-treponemal

--Serum

--Flocculation

--Reagin detected

--Antigen used is cardiolipin

--Screening

--Specificity: not specific; very specific when used with EIA

Front 4

--VDRL

Back 4

--Non-treponemal

--Specimens: heat inactivated serum/CSF

--Flocculation

--Reagin detected

--Antigen used is Cardiolipin

--Screening test

--Confirmatory for Neurosyphilis

--Not specific

--Highly specific for neurosyphilis

Front 5

--EIA or Immunochemoluminescence

Back 5

--Treponemal

--Serum

--Specific antibody to T pallidum

--Antigen used is T pallidum ssp pallidum

--Screening

--Specific

--Confirm with RPR

Front 6

--FTA-ABS

Back 6

--Treponemal

--Heat inactivated serum

--Test principle is Indirect fluorescent antibody technique

--Detects specific antibody to T pallidum

--Antigen used in test is Nichols strain of T pallidum ssp pallidum

--Confirmatory

--Specific

Front 7

--What is the sensitivity of RPR for the stages of syphilis?

Back 7

--Primary: Low

--Secondary: High

--Latent and Tertiary: Low

Front 8

--What is the sensitivity of VDRL for the stages of syphilis?

Back 8

--Primary: Low

--Secondary: High

--Latent and Tertiary: Low

Front 9

--What is the sensitivity of FTA-ABS for the stages of syphilis?

Back 9

--Primary: Low

--Secondary: High

--Latent and Tertiary: High

Front 10

--What is the sensitivity of EIA or Immunochemoluminescence for the stages of syphilis?

Back 10

--Primary: Low

--Secondary: High

--Latent and Tertiary: High

Front 11

--What specific problems are encountered when performing testing to diagnose congenital syphilis?

Back 11

--Must detect baby's antibody, not the mother's

--IgG will cross the placenta

--Serological detection of congenital syphilis has low sensitivies and specificities

Front 12

--What test is used to diagnose neurosyphilis?

Back 12

--The non-treponemal VDRL test is highly specific but can have low sensitivities

Front 13

--What step in FTA-ABS removes non-specific treponemal antibodies from the test serum?

Back 13

--Dilution of the patient's serum with sorbent

Front 14

--Why should a serum reported as reactive for the RPR test be confirmed by a treponemal serologic test?

Back 14

--Subject to false positives

--Due to mono, hepatitis, varicella, herpes, measles, malaria, TB, SLE, IV drug use, autoimmune, advanced age and malignancy, pregnancy

Front 15

--How is laboratory diagnosis of Lyme disease most often done?

Back 15

--Serology: detection of antibodies in serum

Front 16

--What is useful in diagnosis of early stage Lyme disease?

Back 16

--Clinical symptoms

--Bulls eye rash

--IgM antibody can take 3 to 6 weeks to form

--Serological detection is useful in late stage disease

Front 17

--Why do serologic tests for Lyme disease lack specificity?

Back 17

--IFA and ELISA

--Cross reactivity with other treponemal diseases (syphilis, yaws, relapsing fever, leptospirosis)

--Screening test must be confirmed

Front 18

--How is laboratory diagnosis of Relapsing fever made?

Back 18

--Direct detection of spirochetes in body fluids by hematological stain

Front 19

--How is laboratory diagnosis of Leptospirosis made?

Back 19

--Serologic detection of antibodies in the serum

--Serologic microagglutination test

Front 20

--The streptozyme test screens for which antibodies?

Back 20

--Anti-streptolysin

--Anti-DNase

--Anti-NADase

--Anti-hyaluronidase

Front 21

--What does a positive Streptozyme test show?

Back 21

--Agglutination

Front 22

--How might a positive Streptozyme and a negative ASO latex test be explained?

Back 22

--The presence of antibodies to DNase B, streptokinase and hyaluronidase only

Front 23

--What are the long-term complications of Streptococcus pyogenes infection?

Back 23

--Acute rheumatic fever

--Post-streptococcal glomerulonephritis

Front 24

--Which single test/antibody detections is the most sensitive and specific in detecting a recent Group A Streptococcus infection?

Back 24

--Anti-DNase B

Front 25

--In a woman of childbearing years, what confers valid evidence of rubella immunity?

Back 25

--Serologic confirmation of past rubella infection

Front 26

--What clinical symptoms are associated with CMV?

Back 26

--Cytomegalovirus

--Congenital infection in infants whose mothers experienced primary CMV infections during pregnancy

--An infectious mononucleosis-like syndrome in adolescents and young adults

--Serious, often fatal, pneumonia in immunocompromised individuals, especially bone marrow transplant recipients

Front 27

--How is HSV tested?

Back 27

--Lesion sample can be tested for HSV antigen and inoculated into cell cultures

--Antigen tests are widely available and HSV grows quickly in culture

Front 28

--What diseases can TORCH screen help to diagnose?

Back 28

--Toxoplasmosis

--Rubella

--CMV

--Herpes

Front 29

--What groups should be tested for rubella?

Back 29

--Children

--Premarital exam

--Prenatal women

--All women of childbearing age

--Healthcare personnel

Front 30

--What does rubella cause in the fetus?

Back 30

--Deafness

--Cataracts

--Mental retardation

--Stillbirth

Front 31

--How is CMV transmitted?

Back 31

--Cytomegalovirus

--Adults: Venereal and blood products

--Children: Usually from mother: Cervical secretions, breast milk, saliva, urine

--Congenital: transplacental

Front 32

--What tests can detect WNV?

Back 32

--West Nile Virus

--Antibody capture ELISA (IgM and IgG)

--RT-PCR
--Neutralization

--IFA

Front 33

--What specimens are used for WNV testing?

Back 33

--CSF: test for WNV specific IgM Ab by ELISA

--Serum: test both acute and convalescent specimens by ELISA

--Tissue: brain tissue

Front 34

--Toxoplasma gondii

Back 34

--Can cause ocular lesions

--Felines are frequent host

--Can cause severe CNS abnormalities in newborns

--Can be acquired in utero

Front 35

--What does the presence of IgM to T gondii in adults indicate?

Back 35

--Active infection

Front 36

--When does Congenital toxoplasmosis exhibit the most serious effects?

Back 36

--If disease is acquired during the first trimester

Front 37

--How is toxoplasmosis transmitted?

Back 37

--Cats are definitive hosts: Pass oocysts in feces

--Eating undercooked meat

--Transplacental transfer

Front 38

--Why might antibody testing for Rocky Mountain Spotted fever not be helpful?

Back 38

--Antibody production takes at least a week before detection

Front 39

--According to the CDC, which bands need to be present for the Western Blot to be positive for HIV infection?

Back 39

--Any two of the following groups: p24, gp41, gp120/160

Front 40

--Human immunodeficiency virus is:

Back 40

--Retrovirus

Front 41

--The mode of transmission for HIV is:

Back 41

--Blood products

--Congenital

--Venereal

--Intravenous drug abuse

Front 42

--What diminishes as AIDS progresses?

Back 42

--CD4 and T lymphocytes

--Risk of opportunistic infection increases

Front 43

--HIV can affect what cells?

Back 43

--Helper-inducer subset of T lymphocytes

--Macrophages

--Monocytes

Front 44

--Which patient populations should be screened for HIV?

Back 44

--13-64 years of age

--Pregnant

--TB positive

--Screened for STDs

Front 45

--What does the HIV Western Blot analysis detect?

Back 45

--Antibody to HIV in the patient's serum

Front 46

--How is the new CDC/APHL testing algorithm for HIV advantageous over the traditional algorithm?

Back 46

--4th generation enzyme immunoassay test detects both HIV antigen and antibody to HIV

Front 47

--HIV EIA

Back 47

--A screening test that detects patient antibodies directed against the HIV particle

Front 48

--HIV PCR

Back 48

--Used to detect viral load, or quantitate the HIV particles per unit

Front 49

--HIV Western Blot

Back 49

--A confirmatory test that detects and separates patient antibodies directed against specific parts of the HIV particle

Front 50

--Complement fixation

Back 50

--Antigen-antibody complexes fix one of the test components

Front 51

--Precipitation

Back 51

--Soluble antigen plus specific antibody

--Immunodiffusion

Front 52

--Microparticle capture

Back 52

--Competitive assay using microbeads as the solid phase

Front 53

--Direct hemagglutination

Back 53

--Antigen is natural part of particulate or cellular antigen

--Bacterial cells clumped by antibody

Front 54

--Passive hemagglutination

Back 54

--Antigen coated particulate carrier

Front 55

----Direct immunofluorescence

Back 55

--Virus specific antibody labeled with fluorescein

Front 56

--Enzyme immunoassay

Back 56

--Enzyme labeled anti-species globulin

Front 57

--Neutralization

Back 57

--Antigen is inactivated when antibody binds to it

Front 58

--Mycoplasma pneumoniae can cause which infection?

Back 58

--Historically diagnosed with cold agglutinins

--Causes Primary atypical pneumonia

--Detected through antibody production

Front 59

--Mycoplasma pneumoniae infections cannot be treated with beta lactam antibiotic because:

Back 59

--Lack cell wall

Front 60

--Borrelia burgdorferi

Back 60

--Lyme disease

--Erythema chronicum migrams: skin lesion found at site of tick bite

Front 61

--Borrelia species

Back 61

--Relapsing fever

Front 62

--Leptospira interrogans

Back 62

--Leptospirosis

--Weil's disease: Fatal icterohemorrhagic fever

Front 63

--Streptozyme Test

Back 63

--Passive hemagglutination test

--Screening test: sensitive in 95% of patients with Group A Strep

Front 64

--Anti-streptolysin O (ASO) Test

Back 64

--Detects antibodies to Streptolysin O

--Neutralization Test: titer = highest dilution that neutralizes the streptolysin O antigen which lyses RBCs

Front 65

--Anti-DNase B titer

Back 65

--Neutralization procedure

--Blue indicator: Positive

--Pink indicator: Negative

--More frequently positive with acute glmoerulonephritis due to skin infections

--Considered to be the single best test for the serologic detection of Group A Non-suppurative Streptococcal infections