EXPERIMENT 15 Flashcards

1
Q

Hepatitis B virus is a member of the

A

Hepadnaviridae family

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2
Q

Hepatitis B virus is a (?), with an (?) containing a rapidly (?) DNA genome.

A

42 mm enveloped virion

icosahedral nucleocapsid core

double stranded circular

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3
Q

– the only DNA virus, all other hepatitis virus is RNA.

A

Hepatitis B virus

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4
Q

The envelope contains a protein called the (?), which is important for laboratory diagnosis and immunization.

(Example, for vaccines – ?)

A

surface antigen (HBsAg)

Anti-HBsAg

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5
Q

is the earliest serological marker that indicates the presence of acute infection.

A

HBsAg

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6
Q

It is also indicative of chronic infection.

A

HBsAg

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7
Q

REAGENT:

A

Test kit (cassette) for HBsAg

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8
Q

SAMPLE:

A

Plasma or serum (should be free from contamination, hemolysis and lipemia)

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9
Q

– detecting the presence of an antigen with multiple epitopes.

A

Immunochromatography (Solid Phase “Sandwich” Immunoassay)

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10
Q

is a colloidal gold enhancement immunoassay that detects hepatitis B surface antigen in human serum or plasma.

A

HBsAg test

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11
Q

The sample initially reacts with the (?) on the sample pad.

A

monoclonal antibody – colloidal gold conjugate

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12
Q

This mixture migrates across the membrane by capillary action and reacts with the (?) in the test region.

A

anti-HBsAg

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13
Q

The HBsAg will bind to the monoclonal antibody (?) gold conjugate forming a complex.

A

first reagent – bread 1

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14
Q

The mixture of monoclonal antibody and HBsAg (palaman) present in the patient’s sample will migrate across the membrane by the capillary action and reacts with the anti-HBsAg (?) in the test region, creating a sandwich.

A

second reagent – bread 2

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15
Q

PROCEDURE:
1. Bring the kit components and specimen to (?) before testing
2. Remove the test card from the sealed foil pouch. Once opened, the test card must be (?).
3. Label the test card with(?).
4. Dispense (?) of the sample to the center of the sample well (marked as “S”)
Note: Follow the volume of the sample recommended by the manufacturer (depend on the brand)
5. Read and interpret the results
Note: Strictly follow the manufacturer’s recommended time for reading test results

A

room temperature

used immediately

patient’s identity

3 drops (100 µL)

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16
Q

Distinct colored band appears on the Test region (T) in addition to a colored band on the Control region (C)

A

POSITIVE (REACTIVE) (repeat testing)

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17
Q

No colored band appears on the Test region (T) but distinct colored band appears on the Control region (C)

A

NEGATIVE (NON- REACTIVE)

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18
Q

Neither Test (T) nor Control (C) colored band appears, or colored band only appears on the test region (T) but not on the Control region (C) The specimen should be tested again using a new device

A

INVALID (repeat testing)

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19
Q

Keywords:
hepa-
itis:

A

liver

inflammation

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20
Q
  • general term for the inflammation of the liver.
A

Hepatitis

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21
Q

Hepatitis Causes:

A

viral infection, chemicals, ionizing radiation and autoimmune process

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22
Q

Two stages of inflammation:

A
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23
Q
  • the patient will exhibit general flu-like symptoms
A

Acute stage

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24
Q

The patient can exhibit hepatomegaly, jaundice

A

Progressive stage/ chronic stage

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25
Q

(enlargement of the liver)

A

hepatomegaly

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26
Q

(yellowish discoloration of the skin, dark urine and light feces In the urine, since the liver cannot conjugate the urobilinogen, it will be pass out as urobilin causing dark urine.

A

jaundice

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27
Q

In light feces, since the liver has a problem, it will not convert the conjugated bilirubin into the normal color of the feces which is the (?). Since there is no (?), the feces will be light instead of the normal color which is brown

A

stercobilin

stercobilin

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28
Q

Initial laboratory tests

A

Elevations in bilirubin and liver enzymes (ALT)

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29
Q

Asymptomatic- the patient will not exhibit any signs and symptoms

A

ACUTE

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30
Q

The liver cells are destroyed.

A

ACUTE

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31
Q

Liver cirrhosis

A

ACUTE

32
Q

Liver cancer

A

ACUTE

33
Q

IT CAN OCCUR 6 MONTHS OR MORE

A

ACUTE

34
Q

IT CAN OCCUR LESS THAN 6 MONTHS

A

CHRONIC

35
Q

Joint pain

A

CHRONIC

36
Q

Rash

A

CHRONIC

37
Q

Vomiting

A

CHRONIC

38
Q

Diarrhea

A

CHRONIC

39
Q

Dark urine

A

CHRONIC

40
Q

Yellowish color of the skin and the sclera of eyes

A

CHRONIC

41
Q

Muscle aches

A

CHRONIC

42
Q

Tiredness

A

CHRONIC

43
Q

Decrease appetite and weightloss

A

CHRONIC

44
Q

All of the genome of hepatitis virus is of RNA except (?) that is DNA.

A

hepatitis B

45
Q

For the transmission, all of the hepatitis virus is transmitted (?), except hepatitis A and E which are transmitted (?).

A

parenteral, sexual, or perinatal

fecal, and oral route

46
Q

For the progression to chronic state, all of the hepatitis virus can except (?) which is only in acute state

A

hepatitis A and E

47
Q

Note: For hepatitis D, it will not exist if the patient does not

A

hepatis B

48
Q

is a co-infection or super infection of hepatitis B

A

Hepatis D

49
Q

For the screening test (ST) for the diagnosis of HBV, take note this is blood test particularly we use

A

serum

50
Q

For ST most of the tests have already

A

high sensitivity

51
Q

Category 1:

A

Enzyme Linked Immunosorbent Assay (ELISA)

52
Q

Category 2:

A

Rapid test kits

53
Q
  • so this is what we test when it comes to screening test.
A

Hepatitis markers

54
Q

Only (?) is NOT detectable in blood. We can detect them in biopsy.

A

HBcAg (Hepatitis B Core Antigen)

55
Q

So in order to test for the presence of HBcAg we need to do (?). But when it comes to blood testing, it is not detectable.

A

liver biopsy

56
Q
  • done only by National Reference Laboratories (NRL) or other big hospitals that was accredited by our NRL.
A

Neutralization test

57
Q

Take note that NRL when it comes to serological test will be

A

San Lazaro Hospital (RA 4688).

58
Q

CONFIRMATORY TEST FOR HBV

A

Neutralization test

59
Q
  • This test is performed when we are going to monitor the course of infection for HBV or when we give treatment for patients having HBV, we need to monitor their viral load.
A

HBV Viral Load

60
Q

MONITORING TESTS

A

HBV Viral Load

Real time PCR

61
Q
  • number of the virus that is present in our body.
A

Viral load

62
Q
  • can detect as few as 10 copies of HBV DNA per mL
A

Real time PCR

63
Q

considered as a sensitive test for HBV

A

Real time PCR

64
Q

What we are testing under the screening test will be the

A

serological markers

65
Q

– it is an indicator that the patient has an active Hepatitis B infection, if the HBsAg is positive it indicates that the patient has an active Heptitis B

A

Hepatitis B Surface Antigen

66
Q

– active hepatitis B with high degree of infectivity

A

Hepatitis B Envelope antigen

67
Q
  • antibody against core, core will not be tested but can be only detectable using biopsy
A

IgM anti-HBe

68
Q

It indicates that the patient has current or recent Acute Hepatitis B

A

IgM anti-HBe

69
Q

– Current or past Hepatitis B

A

Total anti-HBe

70
Q

– recovery from hepatitis B

A

Anti- HBe

71
Q

– Immunity to hepatits B

A

Anti-HBs

72
Q

– Acute, atypical, or occult hepatitis B

A

HBV DNA

73
Q

viral load may be used to monitor effectiveness of therapy

A

HBV DNA

74
Q

– Performed hand in hand, together with clinical chemistry test.

A

ALT ENZYME

75
Q

HBsAg -
HBeAg -
AntiHBcIgM -
AntiHBcIgG +
AntiHbe +
AntiHbs +
ALT Normal

A

Convalescence – the patient is healing

76
Q

HBsAg -
HBeAg -
AntiHBcIgM -
AntiHBcIgG +
AntiHbe -
AntiHbs +
ALT Normal

A

Past HBV infection with immunity (why past? – because AntiHBc IgG and Anti-Hbs is present)

77
Q

HBsAg -
HBeAg -
AntiHBcIgM -
AntiHBcIgG -
AntiHbe -
AntiHbs -
ALT Normal

A

Immunization with Hepatitis B vaccine