Immunology Final Exam Review Flashcards

(231 cards)

1
Q

T/F Sterile gloves must be used for all laboratory work

A

False

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2
Q

T/F Immunology is defined as the study of molecules, cells, organs, and systems.

A

True

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3
Q

T/F Cooperation is required for optimal functioning of the immune system. Cooperative interaction
involves specific cellular elements, cell products, and nonlymphoid elements.

A

True

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4
Q

T/F The function of the immune system is to recognize self from non-self and to defend the body
against nonself

A

True

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5
Q

T/F The second barrier to infection is unbroken skin and mucosal membrane surfaces

A

False (The first barrier to infection is unbroken skin and mucosal membrane surfaces.)

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6
Q

The father of immunology is generally considered to be ______.

A

Louis Pasteur

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7
Q

A specific function of the immune system is

A

to recognize self from non-self and to defend the body against nonself

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8
Q

The first line of defense against infection is

A

unbroken skin or mucous membranes

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9
Q

A child who contracts a contagious disease from an older sibling could develop
______________ immunity against the disease.

A

natural active

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10
Q

Artificial passive immunity is achieved by

A

infusion or injection of preformed specific antibody

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11
Q

The innate immune system is:

A

the most ancient form of host defense. / mediated by germline-encoded receptors.

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12
Q

T/F Sterile gloves must be used for all laboratory work

A

True

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13
Q

T/F Gloves should be changed between each patient contact

A

True

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14
Q

T/F Gloves should be worn when performing fingersticks and heel sticks on infants and children

A

True

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15
Q

T/F In regard to handwashing in the medical laboratory environment, hands should be washed
after completing laboratory work. _

A

True

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16
Q

T/F in regard to handwashing in the medical laboratory environment, hands should be washed
after removing gloves.

A

True

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17
Q

T/F In regard to handwashing in the medical laboratory environment, hands should be washed
immediately after accidental skin contact with blood

A

True

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18
Q

Which of the following legislative documents ensures that workers have safe and healthful
working conditions?

A
  • Hazard Communication Standard

- Occupational Safety and Health Act

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19
Q

Safety in the clinical laboratory includes:

A
  • chemical hygiene plan.
  • chemical hazard identification.
  • bloodborne pathogen plan.
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20
Q

Standard Precautions refer to:

A

-treating blood and other body fluids as potentially infectious.

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21
Q

Infectious disease safety practices include:

A
  • Educate and train all health care workers in Standard Precautions and in the prevention of bloodborne infections.
  • Provide proper equipment and supplies (e.g., gloves).
  • Monitor compliance with the protective biosafety policies.
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22
Q

Nonanalytic factors in the quality assessment include:

A
  • qualified personnel

- established laboratory policies.

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23
Q

An example of a preanalytic error is:

A

the specimen obtained from the wrong patient.

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24
Q

Quality assessment programs include:

A
  • patient identification.
  • specimen procurement.
  • specimen transportation and processing procedures.
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25
For testing of moderate complexity, quality control requires:
-performing control procedures using at least two levels of control material each day of testing.
26
Sensitivity is defined as
- proportion of subjects with the specific disease or condition who have a positive test result.
27
Specificity is defined as:
- proportion of subjects without the specific disease or condition who have a negative test result.
28
How close a test result is to the true value:
-Accuracy
29
Highly purified substances of a known composition
-Standard
30
A specimen with a known value that is similar in composition to the test specimen
-Control
31
How close the test results are to one another when repeated analyses of the same material is performed.
-Precision
32
Complement can be inactivated in human serum by heating to _____° C.
56
33
Complement can be inactivated in human serum by heating to 56° C for _______ minutes.
30
34
A specimen should be reinactivated when more than ______ hour(s) has(have) elapsed since inactivation.
4
35
A meniscus is:
curvature in the top surface of a liquid.
36
A dilution is:
- ratio of volume or number of parts of the substance to be diluted in the total volume, or parts, of the final solution. - indication of relative concentration. - frequently used measure in serologic testing
37
Serum for the detection of antibodies should be drawn during:
acute and convalescent phases of illness.
38
A central concept of serologic testing is:
a manifestation of a rise in antibody titer.
39
The term antibody titer is defined as:
the reciprocal of the highest dilution of the patient’s serum.
40
Delivers the amount of liquid contained between two calibration marks on the pipette.
Graduated pipette
41
The letters TD (to deliver) appear on the pipette.
Serologic pipette
42
T/F Ultimate responsibility and control of point-of-care testing (POCT) reside within the CLIA-certified laboratory.
True
43
T/F A minimum of two laboratory staff members are required to be responsible for each POCT program.
False
44
T/F Written policies and procedures must be available to all laboratory personnel for patient preparation and for specimen collection and preservation.
True
45
T/F The greatest source of error is a preanalytic error, such as patient identification and specimen collection.
True
46
A major advantage of POCT is:
faster turnaround time.
47
Any over-the-counter test approved by the U.S. Food and Drug Administration (FDA) is automatically placed into the category of:
waived tests.
48
More complex than waived tests but usually automated
Moderately complex tests
49
Usually, nonautomated or complicated tests requiring considerable judgment
Highly complex tests
50
Simple procedures
Waived tests
51
Slide examinations
Provider-performed microscopy tests
52
An antigen is described as a substance that ____________________
- stimulates antibody formation - has the ability to bind to an antibody - is capable of stimulating an immune response
53
Haptens are characterized as being ___________________.
antigenic when coupled to a carrier molecule
54
The primary function of an antibody in body defenses is to___.
combine with antigen
55
Which immunoglobulin (Ig) class is the first to be manifested after antigen exposure?
IgM
56
``` Which immunoglobulin (Ig) class is produced in the highest concentration in a secondary (anamnestic) response? ```
IgG
57
IgE is an important immunoglobulin because of it:
-mediates some types of hypersensitivity (allergic) reactions. -is generally responsible for an individual’s immunity to invading parasites. -binds strongly to a receptor on mast cells and basophils and, with antigen, mediates the release of histamines and heparin from these cells.
58
Foreignness
The greater the difference, the better
59
Degradability
Avoidance of rapid destruction is essential.
60
Molecular weight
The higher, the better
61
Complexity
Contributes to greater effectiveness
62
If the first line of nonspecific body defense, intact skin, is cut with a piece of glass contaminated with Staphylococcus aureus, which cellular component of the immune system quickly responds?
Neutrophils
63
Place the stages of phagocytosis in the correct sequence of occurrence
1. Chemotaxis 2. Adherence 3. Engulfment 4. Phagosome formation and fusion 5. Digestion and destruction
64
PMN leukocytes
Primary phagocytic cells
65
Mononuclear monocytes-macrophages
Phagocytosis, antigen presentation, and secretion of biologically active molecules
66
Plasma cells
Antibody-synthesizing cells
67
Neutrophil
Principal leukocyte-associated with phagocytosis
68
Eosinophil
Homeostatic regulator of inflammation
69
Basophil
High concentrations of heparin and histamine
70
What is the source of undifferentiated T lymphocytes later in fetal development and throughout the life cycle of an individual?
Bone marrow
71
Surface markers on lymphocytes can be used to:
- identify and count CD4+ and CD8+ cells. - classify leukemic cells. - monitor patients on immunotherapy.
72
``` Cluster designation (CD) antigens are involved in various lymphocyte functions, which can include: ```
- promotion of cell to cell interactions and adhesion. | - transduction of signals that lead to lymphocyte activation.
73
When mature T lymphocytes leave the thymus, their T cell receptors are either CD4+ or
-CD8+
74
Helper T type 1 (Th1)
Responsible for cell-mediated effector mechanisms
75
Helper T type 2 (Th2)
Play a greater role in the regulation of antibody production and the release of cytokines required for B cell differentiation
76
Regulatory T (Treg)
Are an immunoregulatory type of helper T cells (Th cells)
77
T/F The normal ratio of T helper cells to T suppressor cells is about (~2:1) and can be reversed under certain conditions.
True
78
Complement is characterized by all except:
normally present in the circulation as an active enzyme
79
Functions of the complement system include:
host defense against infection, such as chemotaxis. - interface between innate and adaptive immunity. - clearance of immune complexes from the tissues
80
The classical complement pathway is activated by:
bonding of C1 complex, consisting of C1q, C1r, and C1s..
81
The alternate complement pathway is activated by:
bacterial exotoxins, viruses, and fungi.
82
The physiologic or cellular consequences of complement activation can include:
production of inflammatory mediators. - cytolysis or hemolysis. - opsonization.
83
The membrane attack complex (MAC) is characterized by all except:
the complement cascade reaches full amplitude at this stage.
84
Increased susceptibility to pyogenic infections can be caused by:
- deficiency of the opsonic activities of complement. - any deficiency that compromises the lytic activity of complement. - the deficient function of the mannose-binding lectin pathway.
85
Interferons:
mediate the early immune response to viral infections.
86
Which of the following characteristics is representative of C-reactive protein (CRP)?
- It has been used for monitoring infection, autoimmune disorders, and healing after myocardial infarction. - Its changes show great sensitivity - A prominent acute-phase protein
87
The measurement of C-reactive protein (CRP) can be used for all except:
-diagnosis of viral septicemia.
88
The definition of the term agglutination refers to:
the process whereby specific antigens aggregate to form larger visible clumps when the corresponding specific antibody is present in the test specimens.
89
Precipitation is the term applied to:
aggregation of soluble test antigens.
90
An artificial carrier could be:
- latex particles | - colloidal charcoal.
91
All the following procedures are typically performed by latex agglutination assays except for:
RPR for syphilis.
92
With latex slide agglutination in pregnancy testing (refer to pages 141-142 for the Pregnancy Latex Slide Agglutination discussion), a negative result is evidenced by:
no agglutination
93
The quality of test results depends on the following technical factors:
- time of incubation with the antibody source - amount and avidity of an antigen conjugated to the carrier - conditions of the test environment (i.e. pH, protein concentration)
94
The first phase of agglutination (specifically, hemagglutination) represents:
- physical attachment of antibody molecules to antigens on the erythrocytic membrane - a reversible chemical reaction.
95
The most efficient type of antibodies in agglutination (specifically, hemagglutination) reactions are _________.
IgM
96
Anti-human globulin (AHG) is used to:
form cross-links between antibodies bound to the surface of erythrocytes.
97
Prozone phenomenon
An excessive antibody concentration produces a false-negative reaction.
98
Postzone phenomenon
An excessive antigen concentration results in no lattice formation.
99
Electrophoresis is defined as:
- migration of charged solutes in an electrical field | - migration of charged particles in an electrical field..
100
Separation of proteins by electrophoresis is based on:
rate of migration of individual components in an electrical field.
101
``` In immunoelectrophoresis (IEP), when a favorable antigen-antibody ratio (equivalence point) is reached, the antigen-antibody complex becomes visible as: ```
- precipitation line - precipitation bands - a line representing one specific protein.
102
Differentiation of proteins using immunoelectrophoresis is based on:
- electrophoretic mobility - diffusion coefficient. - antibody specificity.
103
The immunoelectrophoresis of a normal serum typically depicts:
-IgG, IgA, IgM
104
A monoclonal gammopathy is:
- frequently diagnosed condition using immunoelectrophoresis (IEP). - condition in which a single clone of plasma cells produces increased levels of a single class of immunoglobulin. - condition in which a single clone of plasma cells produces increased levels of a single type of immunoglobulin.
105
Monoclonal gammopathies can be observed in:
- malignancy. - multiple myeloma. - macroglobulinemia.
106
The most common application of immunoelectrophoresis (IEP) of urine is:
demonstration of Bence Jones (BJ) protein.
107
The primary application of immunofixation electrophoresis (IFE) is for:
- characterization of monoclonal immunoglobulins.
108
T/F Immunofixation electrophoresis (IFE) is more sensitive and is easier to interpret than immunoelectrophoresis (IEP).
True
109
To be used for an enzyme immunoassay (EIA), an enzyme must:
- exhibit a high degree of stability. - show extreme specificity. - not be present in the antigen or antibody being tested.
110
Chemiluminescence refers to:
- light emission. | - a chemical reaction.
111
Chemiluminescence:
- has excellent sensitivity and dynamic range. | - does not require sample radiation
112
This type of immunofluorescence uses a conjugated antibody to detect antigen-antibody reactions at a microscopic level:
Direct fluorescent antibody (DFA)
113
T/F In competitive immunoassay, a fixed amount of labeled antigen competes with unlabeled antigen from the patient specimen for a limited number of antibody-binding sites.
True
114
T/F In sandwich immunoassay, the sample antigen binds to an antibody fixed onto a solid phase. A second antibody (labeled with a chemiluminescent label) binds to the antigen-antibody complex.
True
115
T/F Homogenous immunoassays involve a solid phase and require washing steps to remove unbound antigens or antibodies.
False
116
Noncompetitive EIA
-The amount of color that develops is proportional to the amount of antibody in the patient’s serum.
117
Competitive EIA
The amount of color that develops in the reaction is inversely proportional to the amount of antibody in the patient’s serum.
118
Capture EIA
Antibody specific for an immunoglobulin (such as IgM or IgG) is attached to a solid-phase surface
119
Latex particles act as ______________________ in nephelometry.
antigen-coated reaction intensifiers
120
Cryoglobulins are proteins that precipitate or gel when cooled to __________.
0° C
121
A blood specimen for testing for the presence of cryoglobulins should be:
immediately placed in warm water after collection.
122
Laser is an acronym for:
light amplification by stimulated emission of radiation.
123
A photon is a:
basic unit of all radiation.
124
The principle of flow cytometry is based on:
reaction of dyes with the cellular component of interest.
125
Quality control
Analytic
126
Specimen labeling
Preanalytic
127
Networking results with other computer systems
Postanalytic
128
All the following are true in regard to a polymerase chain reaction (PCR) except:
the target sequence to be amplified can be unknown.
129
The name of the product of the PCR is an _______.
amplicon
130
Amplification of nucleic acid fragments from a different target is performed with:
multiplex PCR.
131
Real-time PCR:
is less susceptible to amplicon contamination.
132
What is the correct order of the following steps in the enzymatic process of the PCR cycle?
- DNA denaturation - Primer annealing - Extension of the primed DNA sequence
133
The gold standard of molecular testing is
-DNA sequencing
134
Each cycle of PCR theoretically quadruples the amount of specific DNA sequence and results in an exponential accumulation of the DNA fragment being amplified.
False
135
Southern blot
-DNA
136
Northern blot
-RNA (specifically, mRNA)
137
Western blot
-Use of labeled antibodies specific for the protein of interest
138
Factors that can influence exposure to, or actual development of, an infectious disease include all the following factors except:
season of the year
139
For an infectious disease actually to develop in a host, a microorganism must:
- penetrate the skin or mucous membrane barrier (first line of defense). - survive natural body defense mechanisms. - survive adaptive body defense mechanisms.
140
Major immunologic defense mechanisms against bacteria include:
- lysozyme. | - phagocytosis.
141
A microorganism can survive phagocytosis if it possesses
capsule
142
Parasites can avoid being phagocytized because of:
- their ability to migrate away from an inflamed area. - their relatively large size. - the presence of a body (cell) wall.
143
Immune responses to parasitic infection include:
- immunoglobulin production. - antibody-dependent, cell-mediated cytotoxicity. - cell defenses, such as eosinophils and T lymphocytes
144
Histoplasmosis
Caused by a virus; can be found in soil contaminated with chicken, bird, or bat excreta.
145
Rubella
Sequelae of virus infection include three distinct neurologic syndromes.
146
Cytomegalovirus (CMV)
The most common congenital virus infection in the world.
147
Toxoplasmosis
Hydrocephalus, intracranial calcification, and retinochoroiditis are the most common manifestations of tissue damage.
148
Vaccines can be divided into _____________ and ___________ vaccines.
live attenuated; nonreplicating
149
The earliest host response to vaccination is
an innate immune response
150
Anthrax vaccine
Protection against bioterrorism
151
Cytomegalovirus vaccine
Not available for preventing congenital infection
152
Hay fever vaccine
DNA-based vaccine
153
Human papillomavirus vaccine
Protection against cervical cancer
154
Influenza vaccine
Annual vaccination required
155
Rotavirus vaccine
Since the introduction of this vaccine, diarrhea-associated health care utilization for U.S. children has decreased substantially
156
Polio vaccine
Has reduced disease by 99%
157
Smallpox vaccine
Given to high-risk individuals
158
Members of the Streptococcus pyogenes species are almost always ________-hemolytic.
beta
159
A characteristic of necrotizing fasciitis is that it:
a. is known as the “flesh-eating” bacteria. b. is caused by Streptococcus pyogenes. c. destroys the tissue covering the muscles.
160
Streptolysin O is:
the most frequently used serologic indicator (antibody response) of a recent streptococcal infection
161
Streptolysin S is:
an oxygen-stable enzyme
162
Laboratory diagnosis of S. pyogenes can be made by:
a. culturing of throat or nasal specimens. b. ASO procedure. c. anti–DNase B (ADN-B).
163
An elevated antistreptolysin O (ASO) titer indicates:
relatively recent streptococcal infection
164
Most patients who have Streptococcus pyogenes infection begin to demonstrate a rise in antibody titer in ______days.
- 7
165
Serologic testing for S. pyogenes should compare acute and convalescent specimens collected ________ apart.
3 weeks.
166
Shocklike symptoms of STSS can be produced by high levels of:
- S. pyogenes superantigens | - Cytokines
167
The case definition of STSS includes serological confirmation of Group A streptococcal infection by a ____________increase against SLO and DNAse B:
fourfold.
168
syphilis develops in which percentage of the sexual partners of persons with syphilitic lesions?
30% to 50%
169
In infected donor blood, Treponema pallidum does not appear to survive in citrated blood stored at 4° C for more than _____day(s).
3 days
170
Before clinical or serologic manifestations, the incubation period for syphilis usually lasts ______________________, but can range from 10 to 90 days.
about 3 weeks
171
The term for nontreponemal antibodies produced by syphilis-infected patients against components of their own or other mammalian cells is:
reagin antibodies.
172
The nontreponemal antibody produced by syphilis-infected patients can also be produced by patients with:
a. other infectious diseases. b. leprosy, tuberculosis, leptospirosis, or malaria. c. autoimmune disorders, drug addiction, or old age.
173
Tertiary syphilis is best evaluated by using:
cerebrospinal flui
174
The substance detected by the RPR assay is:
a reagin.
175
Untreated congential syphilis can lead to:
a. stillbirth. b. neonatal death. c. infant disorders.
176
A biological false-positive reaction is least likely to occur with which syphilis assay?
FTA-ABS.
177
Direct examination of the treponemes is most often performed by?
Darkfield Microscopy
178
What is the causative agent of Lyme disease?
Borrelia burgdorferi
179
Most cases of Lyme disease in the United States remain concentrated in the ________ regions.
a. northeastern b. north-central c. Pacific coastal
180
In the United States, the diagnosis for Lyme Disease is usually based on:
a. Recognition of the characteristic clinical findings b. History of exposure in areas where disease is endemic c. An antibody response to B. burdorferi
181
Definitive diagnosis of ehrlichiosis requires:
Acute and convalescent serum antibody titers
182
In symptomatic patients, a diagnostic evaluation of human erlichiosis can be made by visualization of intraerythrocytic organisms in thick or thin red blood cell films.
False : Intraleukocytic
183
The definitive host of Toxoplasma gondii is
House cat
184
Toxoplasmosis is a serious health treat to:
AIDS patients.
185
All mammals, including humans, can transmit T. gondii by:
Transplacental transmission
186
T/F The best evidence of toxoplasmosis infection is significant change in two appropriately timed specimens (paired acute and convalescent specimens.)
True
187
T/F Diagnosis of toxoplasmosis can be made by direct observation of parasite in stained tissue sections, cerebrospinal fluid, or biopsy material.
True
188
Cytomegalovirus (CMV) is related to:
a. Epstein-Barr virus (EBV). b. herpes simplex 1. c. herpes simplex 2.
189
Herpesviruses all share the characteristic of being
cell-associated.
190
Individuals with the greatest risk of developing cytomegalovirus (CMV) infection are:
- fetuses | - immunocompromised individuals.
191
Patients with the highest risk of mortality from cytomegalovirus (CMV) are:
-allograft transplant, seronegative patients who receive tissue from a seropositive donor
192
Forms of transfusion-acquired cytomegalovirus (CMV) infection include all except:
-latent infection.
193
Primary infection
The seronegative recipient is transfused with blood from actively or latently infected donor.
194
Reactivated infection
The seropositive recipient is transfused with blood from a CMV antibody-positive or antibody-negative donor
195
Reinfection
CMV strain in the donor’s blood differs from the strain originally infecting the recipient.
196
All the following statements about Epstein-Barr virus (EBV) are true except:
it is not an agent in the development of nasopharyngeal carcinoma.
197
Epstein-Barr virus (EBV) is:
a. a DNA herpesvirus. b. harbored by B lymphocytes.. c. the most ubiquitous virus known to humans.
198
In infectious mononucleosis, Epstein-Barr virus:
a. infects B lymphocytes. b. produces lymphocytes in peripheral blood with T cell characteristics. c. induces a cytotoxic response against the EBV-infected circulating B lymphocytes.
199
Epstein-Barr virus (EBV) is transmitted primarily by:
close contact with infectious oral-pharyngeal secretions.
200
Viral capsid antigen (VCA) is produced by:
infected B lymphocytes.
201
Anti-VCA immunoglobulin G (IgG) is usually detectable within _________________.
4 to 7 days.
202
Which of the following stages of infectious mononucleosis is characterized by antibody to Epstein-Barr nuclear antigen (EBNA)?
- Past infection (convalescent) period | - Reactivation of latent infection
203
In rapid MonoSlide testing, a false-positive result can be caused by:
a. observing agglutination after the observation time. b. misinterpreting agglutination. c. residual heterophil antibody present after clinical symptoms have subsided.
204
Primary hepatitis viruses account for approximately ______% of cases of hepatitis.
95
205
A patient with a known exposure to hepatitis B 3 weeks earlier has negative results for all markers when a hepatitis profile is performed, except for IgM anti-HBc. What is a possible reason for this result?
HBsAg was still too low in concentration to detect.
206
The serologic markers in expected order of appearance in the serum of a patient with hepatitis B infection are:
HBsAg, HBeAg, HBcAb, HBeAb, and HbsAb.
207
Which of the following hepatitis viruses can result in chronic infection and the potential development of liver cancer?
- Hepatitis B | - Hepatitis C
208
Which hepatitis viruses have been scientifically identified as being spread by the transfusion of unscreened blood transfusion products?
Hepatitis B and | hepatitis C
209
Which hepatitis B serologic marker is the classic first indication of a hepatitis B infection?
HBsAg
210
Hepatitis A virus infection
infectious hepatitis or short-incubation hepatitis
211
Hepatitis B virus infection
Long-incubation hepatitis
212
Rubella is also known as:
- German measles. | - 3-day measles.
213
Rubella infection is transmitted by:
respiratory secretions.
214
The risk of fetal anomalies in congenital rubella infections is highest at the _____________________.
first trimester.
215
Testing for ________antibody in the newborn is diagnostic for the confirmation of congenital rubella syndrome.
IgM
216
T/F Rubella and rubeola are caused by the same virus and cause the same type of infection.
False
217
The incubation period of acquired rubella infection varies, but ____ days is typical.
12- 14 days
218
. Infected persons are usually contagious for 12 to 15 days, beginning ____ days before the appearance (if present) of a rash.
5-7 days
219
Acute rubella infection lasts from___days and generally requires minimal treatment. Permanent effects are extremely rare in acquired infections.
3-5 days
220
IgM antibodies against the rubella virus become detectable a few days after the onset of signs and symptoms and reach peak levels at ____days .
7-10 days
221
These IgM antibodies persist but rapidly diminish in concentration over the next_____ until antibody is no longer clinically detectable.
4-5 weeks
222
Which of the following statements is (are) true about retroviruses?
a. They contain a single, positive-stranded ribonucleic acid (RNA). b. They contain a special enzyme called reverse transcriptase in their core. c. They reverse the normal process of transcription in which DNA is converted to RNA.
223
The major structural protein (core) of the human immunodeficiency virus type 1 (HIV-1) encoded by the gag gene is _______________.
p24
224
One of the glycoproteins associated with the viral envelope is _______________.
gp41
225
The HIV infectious process begins when the protein on the viral envelope binds to the protein receptor _______ on the surface of a target cell.
CD4
226
The human immunodeficiency virus (HIV-1) attaches itself to receptor sites by means of _________.
gp120
227
In HIV infections, a window period of seronegativity extends from the time of initial infection up to __________________________.
6 to 12 weeks or longer
228
The enzyme immunoassay for the HIV-1 antigen detects primarily uncomplexed ______antigen.
p24
229
Which procedure is considered to be a screening procedure for the detection of HIV?
EIA
230
Which analysis is currently considered the standard method for confirming HIV-1 seropositivity?
Western blot
231
A positive Western blot (WB) test result for HIV infection is indicated by the presence of two of the following bands, along with a positive EIA test result:
p24 and gp41