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IMSERO Flashcards

1
Q

the most common hepatitis

due to easy transmission

A

HAV

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2
Q

self-limited, causing only acute diseases

A

HAV

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3
Q

aka INFECTIOUS HEPATITIS and has an abrupt onset

(short incubation hepatitis)

A

HAV

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4
Q

Incubation period: 15 – 50 days (ave: 28 days)

A

HAV

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5
Q

unlike HBV, it does not produce a coat protein and is not detectable in serum

only detectable in the feces

A

HAV

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6
Q

HAV MOT

A

1)fecal-oral/fecal matter ingestion, even in microscopic amounts, from:
* close person-to-person contact with infected person
* ingestion of contaminated food or drinks

2)NEW: direct oral-anal sexual contact with infected person

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7
Q

can release viral antigen in the small intestine, passed out during defecation

A

HAV

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8
Q

Persons at risk with this virus are the following:
* Travelers to region with intermediate/high rates of HAV
* Sex contacts of infected person
* Household members or caregivers of infected persons
* Men who have sex with men (homosexual intercourse)
* Users of certain illegal drugs (injections and non-injection) – very rare, but possible if the infected person have a severe hepatitis A infection that had reached the blood (VIREMIA)
* Persons with clotting-factor disorders (blood transfusions)

A

HAV

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9
Q

Who are the persons at risk for Hepatitis A virus?

A

Persons at risk for HAV:
* Travelers to region with intermediate/high rates of Hepa A
* Sex contacts of infected person
* Household members or caregivers of infected persons
* Men who have sex with men (homosexual intercourse)
* Users of certain illegal drugs (injections and non-injection) – very rare, but possible if the infected person have a severe hepatitis A infection that had reached the blood (VIREMIA)
* Persons with clotting-factor disorders (blood transfusions)

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10
Q

very rare but possible in cases when the virus reaches blood

seen in VERY SEVERE HAV cases (rarely)

A

viremia

presence of viruses in the blood

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11
Q

the spx recommended for antigen testing during first two weeks

used to detect HAV antigen (shed off in the intestine)

A

stool

px infected in first 2 wk (no Ab in serum)

viral Ag detected in stool is recommended

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12
Q

how long does early shedding of the virus in stool last?

A

first 15 days / 2 weeks

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13
Q

A marker of HAV infection:

It happens after 2nd week of infection; during onset of symptoms

Icterus/jaundice, inc liver enzyme levels
SGPT/ALT – liver specific

other liver enzymes may also increase (SGOT, nucleotidase)

A

IgM anti-HAV

IgM Ab starts to be produced in the serum/plasma

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14
Q

A marker of HAV infection:

during recovery phase

A

IgG anti-HAV and immunity development

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15
Q

detect the presence of specific HAV Abs

A
  1. ELISA
  2. RIA
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16
Q

true or false

INDIRECT ELISA DETECTS ANTIBODY

A

true

Indirect ELISA is used for detecting antibodies in a sample in order to quantify immune responses

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17
Q

true or false

DIRECT ELISA DETECTS ANTIGEN

A

true

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18
Q

what spx is used in direct elisa?

A

stool

Direct ELISA detects viral antigen

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19
Q

what marker is present in:

acute infection with HAV

A

IgM anti-HAV

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20
Q

what marker is present in:

Old infection (immune to HAV)

A

IgG anti-HAV

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21
Q

what marker is present in:

convalescence/recovery period in px with HAV

A

IgG anti-HAV

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22
Q

aka serum hepatitis

A

HBV

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23
Q

attacks the liver (hepatocytes) causing both acute and progress to chronic disease - more fatal and severe than HAV

A

HBV

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24
Q

Incubation period: 45-160 days (ave. 120 days)

A

HBV

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25
Q

MOT somewhat similar to HIV

A

HBV

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26
Q

MOT for this virus are the following:

o Direct contact with infectious blood, semen, and other body fluids primarily through:
– Birth to an infected mother
– Sexual contact with an infected person
– Sharing of contaminated needles, syringes, or other injection drug equipment
– Needle sticks or other sharp instrument injuries

A

HBV

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27
Q

what are the modes of transmission of HBV?

A
  • HBV MOT: (somewhat similar to HIV)
    o Direct contact with infectious blood, semen, and other body fluids primarily through:
    – Birth to an infected mother
    – Sexual contact with an infected person
    – Sharing of contaminated needles, syringes, or other injection drug equipment
    – Needle sticks or other sharp instrument injuries
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28
Q

the one and only DNA virus causing hepatitis

A

HBV

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29
Q

complete hepatitis B virion is called the _?

A

dane particle

replicate inside hepatocytes (liver cells)

Family: Hepadnaviridae

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30
Q

what are the six serologic markers of HBV?

A
  1. HBsAg
  2. HBcAg
  3. HBeAg
  4. Anti-HBs
  5. Anti-HBc
  6. Anti-HBe
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31
Q

a marker of HBV infection

previously known as the Australia antigen

A

HBsAg (hepatitis B surface antigen)

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32
Q

a marker of HBV infection

best indicator of early or acute hepatitis infection

A

HBsAg (hepatitis B surface antigen)

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33
Q

a marker of HBV infection

presence indicates active infection in either acute or chronic stage

A

HBsAg (hepatitis B surface antigen)

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34
Q

a marker of HBV infection

screened routinely; determines whether the patient requires vaccine or booster

A

HBsAg (hepatitis B surface antigen)

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35
Q

a marker of HBV infection

found within the core of intact virus

A

HBcAg (hepatitis B core antigen)

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36
Q

a marker of HBV infection

not detectable in serum; found only in hepatocytes (uncoats inside the cell/tissues)

A

HBcAg (hepatitis B core antigen)

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37
Q

a marker of HBV infection

specimen for detection: liver biopsy

A

HBcAg (hepatitis B core antigen)

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38
Q

a marker of HBV infection

NOT routinely tested in hepatitis profile

A

HBcAg (hepatitis B core antigen)

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39
Q

a marker of HBV infection

indicates chronic hepatitis

A

HBeAg (hepatitis B envelope antigen)

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40
Q

a reliable marker for the presence of high viral load, high degree of infectivity

A

HBeAg (hepatitis B envelope antigen)

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41
Q

first Ab to appear at the same time that liver enzyme elevations are first seen

A

Anti-HBc (anti-hepatitis B core)

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42
Q

a marker of HBV infection

found among asymptomatic carriers

A

Anti-HBc (anti-hepatitis B core)

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43
Q

only marker present during the WINDOW period

A

Anti-HBc (anti-hepatitis B core)

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44
Q

first serologic evidence of convalescence/recovery phase from hepatitis infection

A

Anti-HBe (anti-hepatitis B envelope)

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45
Q

may also indicate low level of virus; low degree of infectivity

A

Anti-HBe (anti-hepatitis B envelope)

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46
Q

bestows long-term immunity to further HBV infection

A

Anti-HBs (anti-hepatitis B surface)

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47
Q

measured several months after hepatitis B vaccination (assess vaccine effectiveness or if booster shot is needed)

A

Anti-HBs (anti-hepatitis B surface)

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48
Q

developed by a patient who had been infected to HBV or vaccinated

A

Anti-HBs (anti-hepatitis B surface)

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49
Q

confirms that the patient had past infection to HBV

A

Anti-HBc

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50
Q

Five possibilities:
* Resolved infection (most common)
* False-positive anti-HBc, thus susceptible
* “Low level” chronic infection
* Resolving acute infection
* Window/recovery period

A

Anti-HBc

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51
Q

what marker/s is/are present?

HBV chronic infection

A
  1. HBsAg
  2. Anti-HBc
  3. IgG anti-HBc
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52
Q

what marker/s is/are present?

HBV acute infection

A
  1. HBsAg
  2. anti-HBc
  3. IgM anti-HBc
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53
Q

what marker/s is/are present?

immunity due to HBV vaccination

A

Anti-HBs

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54
Q

what marker/s is/are present?

Immune due to natural infection (Past infection)

A
  1. Anti-HBc
  2. Anti-HBs
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55
Q

One way to improve immunity is __________. It promotes faster release and movement of lymphocytes in the blood. High levels produce sensitive and active immune response. Ab titer will remain in high levels for a long period.

A

exercise/physical activities

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56
Q

enumerate the tests for HBV detection

A
  • 1st generation test - ouchterlony
  • 2nd generation test
    1. Counter Immunoelectrophoresis
    2. rheophoresis
    3. complement fixation
  • 3rd generation test
    1. reverse passive latex agglutination
    2. reverse passive hemagglutination
    3. ELISA
    4. RIA
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57
Q

HBV detection

1st generation test

A

ouchterlony

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58
Q

HBV detection

2nd generation test

A
  1. Counter Immunoelectrophoresis (CIE)
  2. Rheophoresis
  3. Complement Fixation
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59
Q

HBV detection

3rd generation test

A
  1. Reverse Passive Latex Agglutination
  2. Reverse Passive Hemagglutination
  3. ELISA
  4. RIA
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60
Q

what is the specific procedure of ouchterlony?

A

Specific procedure: double-diffusion double-dimension

ouchterlony specific procedure

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61
Q

HBV detection

Principle: Precipitation reaction

Specific procedure: double-diffusion double-dimension

A

1st generation test
ouchterlony

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62
Q

HBV detection

principle: precipitation with current

A

2nd generation test
counter immunoelectrophoresis

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63
Q

HBV detection

principle: precipitation by evaporation

A

2nd generation test
rheophoresis

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64
Q

HBV detection

Agglutination

Anti-HBsAg artificially/passively coated with latex particles (latex – carrier for anti-HBs to detect HBsAg)

detected: _
carrier: _

A

3rd generation test
reverse passive latex agglutination test

Detected: HBsAg
Carrier: latex

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65
Q

what is the most sensitive test in HBV detection?

A

3rd generation test (MOST SENSITIVE)

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66
Q

HBV detection

Principle: Hemagglutination

Anti-HBsAg passively attached to RBCs carrier to detect Ag

Carrier: __

A

3rd generation test
Reverse Passive Hemagglutination

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67
Q

HBV detection

commonly used test to confirm hepatitis B infection

A

3rd generation test
ELISA

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68
Q

true or false

Direct ELISA – detects HBsAg (hepa B antigen)

A

true

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69
Q

true or false

Indirect ELISA – detects Anti-HBs (hepa B antibody)

A

true

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70
Q

what HBV marker?

first to appear

A

HBsAg

hepatitis B surface antigen

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71
Q

what HBV marker?

signifies high viral load = px highly infectious

A

HBeAg

|hepatitis B envelope antigen

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72
Q

what HBV marker?

starts to peak as HBeAg levels decrease, since it signifies recovery; thus, low viral load.

A

Anti-HBe

anti-hepatitis B enveloope

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73
Q

Made by a recombinant strain of the yeast

Saccharomyces cerevisiae - common bakers’ yeast

A

HBV Vaccine (1982)

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74
Q

common baker’s yeast

A

Saccharomyces cerevisiae

HBV Vaccine (1982)

Made by a recombinant strain of the yeast

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75
Q

Enumerate disease states caused by HBV

A
  1. acute hepatitis
  2. fulminant hepatitis
  3. chronic
  4. co-infection with HDV
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76
Q

delta virus requires HBsAg for its replication

HBV and HDV simultaneously infect and replicate in hepatocytes

A

co-infection with HDV

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77
Q

asymptomatic carrier; chronic persistent hepatitis; chronic active hepatitis

A

chronic hepatitis

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78
Q

sudden, severe onset of a condition

A

fulminant hepatitis

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79
Q

starts with infection; progress to cancer if not managed

A

infectious cancer

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80
Q

a liver cancer, severe progression if HBV infection is not controlled

A

PRIMARY HEPATOCELLULAR CARCINOMA (HEPATOMA)

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81
Q

give the infectious type of cancer:

HBV

A

hepatoma

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82
Q

give the infectious type of cancer:

HPV

A

cervical cancer

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83
Q

give the infectious type of cancer:

EBV

A

nasopharyngeal cancer

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84
Q

dx hbv serologic test

no active infection, cured, long term immunity

A

Anti-HBsAg

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85
Q

dx hbv serologic test

active/on-going infection, either acute/chronic

A

HBsAg

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86
Q

dx hbv serologic test

not new nor old

A

both IgM & IgG anti-HBc

“Middle infection”

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87
Q

dx hbv serologic test

old infection, may persists for years

A

IgG Anti-HBcAg

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88
Q

dx hbv serologic test

new/early stage of infection

A

IgM Anti-HBcAg

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89
Q

true or false

HBcAg - antibodies; no antigen

A

true

core Ag not detected in serum, only found in liver intact cells/biopsy

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90
Q

true or false

core antigen is detected in serum

found in liver intact cells/biopsy and other tissues

A

false

core antigen not detected in serum, only found in liver intact cells/biopsy

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91
Q

dx hbv serologic test

low infectivity, low viral load

A

Anti-HBeAg

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92
Q

dx hbv serologic test

High infectivity, high viral load

A

HBeAg

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93
Q

true or false

In viral serology, antibody detection comes first before antigen appearance

A

false

In viral serology, Ag detection comes first before Abs appearance

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94
Q

true or false

Ag is responsible for stimulating the immune system to produce Ab

A

true

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95
Q

true or false

It is also impossible to detect only the antibody (i.e. HBcAg)

A

false

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96
Q

true or false

Delayed dx (asymptomatic patient) – antigen can be tested;

While antibody is recommended in early stages

A

false

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97
Q

true or false

HBV PREVENTION AND TREAMENT
* Serologic test on donor blood = HBsAg
* SGPT/ALT
* Active immunization
* Anti-viral agents for tx of chronic or persistent HBV infection – helps lower the viral load
* Anti-HBV drug Lamivudine
* Tx with interferon alpha (interferon therapy)

A

true

98
Q

give the prevention and treatment for HBV infection.

A
  • Serologic test on donor blood = HBsAg
  • SGPT/ALT
  • Active immunization
  • Anti-viral agents for tx of chronic or persistent HBV infection – helps lower the viral load
  • Anti-HBV drug Lamivudine
  • Tx with interferon alpha (interferon therapy)
99
Q

NON-A, NON-B HEPATITIS

A

HCV

Hepatitis C

100
Q

Incubation period: 14-180 days (ave. 45 days)

A

HCV

101
Q

aka blood-borne hepatitis, post-transfusion hepatitis

A

HCV

102
Q

MOT: Commonly acquired thru blood transfusion

A

HCV

103
Q

NO established vaccines, as it is a highly complex agent

A

HCV

104
Q

true or false

HCV is a highly complex agent

A

true

no established vaccines

105
Q

HCV AB REACTIVE

A

Presumptive HCV infection

106
Q

Widespread infection in pregnant mothers (natural birthing process has high bleeding tendency; requires blood transfusion from increased blood loss)

A

HCV

107
Q

HCV is an RNA virus from family __?

A

Single-stranded RNA virus
Family Flaviviridae

108
Q

used to confirm HCV presence, a blood test that detects antibodies to the HCV

A

Recombinant ImmunoBlot Assay (RIBA)

SPECIALIZED TYPE OF METHOD - VIRAL CONFIMARTORY TESTING

109
Q

HCV SPECIALIZED TYPE OF METHOD - VIRAL CONFIMARTORY TESTING

A

RIBA

Recombinant ImmunoBlot Assay

used to confirm HCV presence, a blood test that detects antibodies to the HCV

110
Q

SEROLOGIC TESTS FOR HEPATITIS C

A
  1. Surrogate Testing for detecting NANBV/HCV in donated blood
  2. Serologic Tests for antibody against HCV Ag (Anti-HCV)
111
Q

hcv serologic test

  1. ALT Level detection – markedly ↑ in hepatocyte destruction
  2. Anti-HBc detection – by RIA or ELISA using Enzyme Inhibition Technique
A

Surrogate Testing for detecting NANBV/HCV in donated blood

112
Q

hcv serologic test

  1. ELISA
  2. RIA
A

Serologic Tests for antibody against HCV Ag (Anti-HCV)

113
Q

markedly ↑ in hepatocyte destruction

A

ALT level detection

114
Q

by RIA or ELISA using Enzyme Inhibition Technique

A

Anti-HBc detection

115
Q

true or false

HCV antibody – for confirmatory

A

False

HCV antibody – for screening

116
Q

true or false

HCV RNA – screening for reactive HCV Ab

A

false

HCV RNA – confirmatory for reactive HCV Ab

117
Q

interpretation:

No HCV antibody detected

A

HCV antibody nonreactive

118
Q

interpretation:

Presumptive HCV infection

A

HCV antibody reactive

119
Q

interpretation:

Current HCV infection
Link to care

A

HCV antibody reactive, HCV RNA detected

120
Q

interpretation:

No current HCV infection
Acquired past HCV infection due to reactive HCV Ab
Additional testing as appropriate

A

HCV antibody reactive, HCV RNA not detected

121
Q

an RNA virus
MOT: parenteral (replicate only with the help of HBV)

A

HDV

122
Q

Defective hepatotropic virus which requires obligatory helper functions from HBV in order to ensure its replication and infectivity

A

HDV

123
Q

aka DELTA VIRUS

A

HDV

124
Q

helical nucleocapsid actually uses HBV’s envelope, HBsAg (only replicates in cells infected with HBV)

A

HDV

125
Q

Two infections carried out by HDV

A

Co-infection with HBV
Superinfection with HBV

126
Q

px simultaneously becomes infected with both HBV and HDV

A

Co-infection with HBV

127
Q

MOST SEVERE TYPE OF HEPATITIS in terms of fast rate of replication, infection, destruction to hepatocytes

A

Superinfection with HBV

128
Q

px already chronically infected with HBV acquires HDV

A

Superinfection with HBV

129
Q

a not very useful HDV serological marker

A

HDV Ag

130
Q

a serological marker of HDV in the early stage of infection

A

HDV Ag

131
Q

a serological marker of HDV that rapidly disappears in the plasma

A

HDV Ag

132
Q

a serological marker of HDV in the acute phase of infection

A

IgM anti-HDV
total anti-HDV (IgM + IgG)

133
Q

a serological marker of HDV signifying co-infection

A

IgM anti-HDV
IgM anti-HBc
HBsAg

134
Q

a serological marker of HDV indicating HDV superinfection

A

IgM anti-HBc (-)

135
Q

a serological marker of HDV indicating chronic infection

A

IgG anti-HDV (+)

136
Q

rna virus, family calcivirus

A

HEV

137
Q

rna virus, family calicivirus

A

HEV

138
Q

HEV size

A

32-34 nm

139
Q

HEV dx serology Ag & Ab

A

western blot
PCR
electron microscopy

140
Q

HEV dx confirmatory

A

western blot

141
Q

HEV dx that can be used in all types of agents

A

PCR

142
Q

HEV dx with principle based on the detection of certain segments of the gene since all of these can be amplified

A

PCR

143
Q

these patients with HEV may develop fulminant liver failure and death

A

pregnant women

144
Q

true or false

there is a distinct serological marker for HEV, diagnosis based on symptoms for exposed individuals in endemic countries

A

false

NO distinct serological marker for HEV, diagnosis based on symptoms for exposed individuals in endemic countries

145
Q

true or false

pregnant women with HEV may develop fulminant liver failure and death

A

true

146
Q

an rna virus that has an envelope

same family as HCV - flaviviridae

A

HGV

147
Q

MOT:
contact with blood, sexually transmitted, transplacental (mot almost the same with HIV & HCV)

A

HGV

148
Q

an rna virus that is common worldwide but seems non-pathogenic

A

HGV

149
Q

mild version of HCV

A

HGV

150
Q

aka glandular fever

A

infectious mononucleosis

151
Q

aka kissing disease

A

infectious mononucleosis

152
Q

MOT:

exchange of mouth fluid / saliva during intense torrid kissing

A

infectious mononucleosis

153
Q

most common during adolescence and early adulthood (15-25 y/o)

common in females

A

EBV infection

154
Q

causative agent of infectious mononucleosis

A

EPSTEIN BARR VIRUS

155
Q

true/false

EBV is common among males

A

false

156
Q

DNA virus which infects B lymphocytes

A

EBV

157
Q

may inhabit nasopharyngeal tissues without causing disease (asymptotic carriers)

A

EBV

158
Q

enlarged lymphocytes affected by EBV with a characteristic atypical nuclei

A

downey cells or atypical T lymphocyte or reactive lymphocyte

159
Q

symptoms that are called as IM-like symptoms

A

Symptoms during early stage of aids:
Fever, fatigue, sore throat, swollen lymph glands

160
Q

IM classic symptoms which can also be found in the early stage of AIDS

A

fever
fatigue
sore throat
swollen lymph glands

161
Q

used for any substance that stimulated the formation of sheep hemolysin (anti-sheep cells)

A

forssman antigen

162
Q

antibodies produced by unrelated species, which can cross-react with the same antigen

used to dx IM

A

heterophil abs

163
Q

Enumerate cells used to differentiate 3 abs

A

sheep cells
ox/beef cells
horse cells
guinea pig cells

164
Q

What are the cells primarily useful in differentiation of IM antibodies?

A

guinea pig cells
ox/beef cells

165
Q

heterophil abs in IM (not forssman in nature) are nonreactive to:

A

guinea pig cells

166
Q

heterophil abs in IM (not forssman in nature) are reactive to:

A

sheep cells
ox cells
horse cells

167
Q

heterophil abs of forssman are nonreactive to:

A

ox cells

168
Q

heterophil abs of forssman are reactive to:

A

sheep cells
horse cells
guinea pig cells

169
Q

heterophil abs in serum sickness are nonreactive to:

A

none

170
Q

heterophil abs in serum sickness are reactive to:

A

all 4 cells
- sheep
- horse
- ox
- guinea pig

abs can be used as control since its positive in all 4 cells

171
Q

what are the tests for IM heterophil antibodies?

A
  1. paul bunnel test
  2. davidson differential test
  3. monospot
  4. rapid differential slide test using papain-treated sheep rbcs
172
Q

PRINCIPLE OF:

DAVIDSON DIFFERENTIAL TEST

A

Absorption-hemagglutination

173
Q

PRINCIPLE OF:

PAUL BUNNEL TEST

A

hemagglutination

174
Q

Presumptive/screening test for heterophil Ab presence

A

paul bunnel test

175
Q

Incapable of determining specificity of heterophil Abs; only indicative of presence or absence of heterophil Abs – requires further testing to determine specific Ab

A

paul bunnel test

176
Q

Paul Bunnel Test

reagent ag

A

2% suspension of sheep RBCs

177
Q

paul bunnel test

antibody

A

heterophil Abs in px serum

178
Q

paul bunnel test

Detected Abs

A

IM, forssman, serum sickness Abs

179
Q

paul bunnel test

(+) result

A

hemagglutination (heterophil Abs presence)

180
Q

Determine specific Ab that reports (+) in Paul Bunnel test

A

DAVIDSON DIFFERENTIAL TEST

181
Q

2 steps of davidson differential test

A
  1. absorption
  2. hemagglutination
182
Q

davidson differential test

exposure of test serum to both beef cells and guinea pig cell which causes absorption of either one or both of these antibodies

A

absorption

183
Q

davidson differential test

indicator cells

A

sheep rbcs

184
Q

davidson differential test

Ag

A

guinea pig kidney cells
beef RBCs

185
Q

davidson differential test

Ab

A

heterophil Abs in px serum (same sample used in paul bunnel test)

186
Q

davidson differential test

“absorbed agglutinins” (precipitates) are removed by centrifugation; resultant fluid (supernatant) are then tested with sheep RBC

A

hemagglutination

187
Q

true or false

If the absorption is positive in step 1, antibody titer decreases. Hence, agglutination in step 2 weakens.

A

true

188
Q

true or false

If the absorption is negative in step 1, antibody titer is retained low. Hence, agglutination in step 2 is strong.

A

false

If the absorption is negative in step 1, antibody titer is retained high. Hence, agglutination in step 2 is strong.

189
Q

PRINCIPLE

MONOSPOT

A

Absorption-hemagglutination

190
Q

SAME PATTERNS WITH DAVIDSON.

A

monospot

191
Q

monospot Ag

A

Guinea Pig Kidney cells
Beef RBC

192
Q

monospot Ab

A

Heterophil Abs in px’s serum

193
Q

monospot indicator cells

A

horse cells

194
Q

PRINCIPLE OF:

RAPID DIFFERENTIAL SLIDE TEST using Papain-Treated Sheep RBCs

A

hemagglutination

195
Q

Papain + sheep cells = ?

A

receptors for Abs are specifically INACTIVATED

196
Q

Causative agent of HIV infection
Family: Retroviridae
Subfamily: Lentivirus and Oncovirus

A

HIV

197
Q

Has a marked preference for T-helper/inducer lymphocytes (CD4+) which serves as the target cell of the HIV

A

HIV

198
Q

Higher rate of transmission making it a predominant type of HIV

A

HIV-1

199
Q

Majority occurred in West Africa, less pathogenic, lower rate of transmission

A

HIV-2

200
Q

HIV formerly called as
1. .
2. .
3. .

A

Formerly called:
1. Human T-cell lymphotrophic virus-type III (HTLV-III)
2. Lymphadenopathy associated virus (LAV)
3. AIDS-associated retrovirus (ARV)

201
Q

Destruction on CD4 lymphocytes – will allow opportunistic infections and malignancies

A

secondary effects of HIV

202
Q

gene & viral gene products

Codes for core structural (group Ags) proteins

A

gag

p24, p18, p15

203
Q

absorption pattern of beef rbcs in forssman

A

-

204
Q

absorption pattern of gpkc in forssman

A

+

205
Q

absorption pattern of beef rbcs in IM

A

+

206
Q

absorption pattern of gpkc in IM

A

-

207
Q

agglutination pattern of beef rbcs in forssman

A

++++

208
Q

agglutination pattern of gpkc in forssman

A

+

209
Q

agglutination pattern of beef rbcs in IM

A

+

210
Q

agglutination pattern of gpkc in IM

A

++++

211
Q

true or false

normal serum & IM serum has weak or no agglutination in papain-treated sheep rbcs

A

true

212
Q

target cell of HIV

A

T-helper/inducer cells

CD4+ cells

213
Q

transcribes ssrna into dsdna

A

reverse transcriptase
(which is a pol)

213
Q

true or false

If screening tests for HIV antibody is reactive, confirmatory tests is performed to rule out false positives.

A

true

214
Q

If screening tests for HIV antibody is nonreactive but patient is at high risk for HIV infection , re-testing using ELISA may be done after how many months?

A

3 to 6 months

215
Q

most widely used HIV test for screening

A

Indirect ELISA

216
Q

follow up with ELISA to rule out false positives

A

false

follow up with western blot

217
Q

principle:

Tests kits for screening

A

Lateral flow chromatography

218
Q

what are the 3 bands that must appear?

A

p24, gp41, g120/160

219
Q

what is considered as HIV positive for western blot assay?

A

(+) result: presence of 2 out of 3 major bands

220
Q

a confirmatory test, used to detect HIV infected cells

*western blot is more frequently used

A

Indirect immunofluorescence assay (IFA)

221
Q

list the criteria for dx of aids

A
  1. positive for HIV
  2. CD4 count fewer than 200 cells/ml
  3. CD4 cells account fewer than 14% of all lymphocytes
  4. experience one or more of a CDC-provided list of AIDS-defining illnesses
222
Q
  • 2-10 years after initial infection
  • A syndrome of CD4 depletion resulting in opportunistic infections and cancers suggestive of cell-mediated immunity defects
  • Fungal infections = Immunodeficiency or severely depleted immune state
A

final stage

223
Q

normal ratio of CD4:CD8

A

2:1

224
Q

CD4:CD8 intermediate stage ratio

A

0.5 : 1

225
Q

State known as the ARC (Aids-Related Complex)

A

intermediate stage

226
Q
  • Patient is either asymptomatic or may show mild lymphadenopathy
  • Resembles IM (Infectious Mononucleosis)
A

primary stage

227
Q

opportunistic pathogens

A
  1. Pneumocystis carinii, now known as Pneumocystis jeruveci
  2. Mycobacterium avium-intracellulare complex
  3. Candida albicans
  4. Cryptosporidium parvum
  5. Toxoplasma gondii
  6. Cryptococcus neoformans
  7. Herpes Simplex (I and II)
  8. Legionella spp.
228
Q
  • Tumors in skin and linings of internal organs, lymphomas, and cancers of rectum and lung
A

kaposi’s sarcoma

229
Q

causative agent of kaposi’s sarcoma

A

human Herpes simplex virus type 8

230
Q

caused by human Herpes simplex virus type 8

A

kaposi’s sarcoma

231
Q

caused by HSV type 8

Most frequent malignancy observed

A

kaposi’s sarcoma

232
Q

first antibody to be detected persist throughout the infection of kaposi’s sarcoma

A

anti-gp41

233
Q

In the Philippines, a new confirmatory procedure is being implemented to replace Western blot assay.

A

rHIVda

Rapid HIV diagnostic algorithm

234
Q

In rHIVda, px reported as inconclusive is advised to retest after _ ?

A

2 to 6 weeks

235
Q

if tested negative for rHIVda, px sample must be sent to this lab for possible western blot examination

A

NRL-SLH

236
Q

what is nonreactive to:

heterophile antibody in IM

A

guinea pig cells

237
Q

what is nonreactive to:

forssman

A

ox cells

238
Q

what is nonreactive to:

serum sickness

A

none

239
Q

what is reactive to:

serum sickness

A

all 4 cells:
1. ox / beef cells
2. horse cells
3. guinea pig cells
4. sheep cells

240
Q

An anti-HBV drug

A

Lamivudine

241
Q

This infection uses interferon therapy

A

HBV infection

*tx with interferon alpha

MTAP (11 decks)

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