[M] Lec 04: TORCH Flashcards
1
Q
What does TORCH stands for?
A
Toxoplasmosis
Other agents
Rubella
Cytomegalovirus
Herpes simplex
2
Q
Refers to infections that can cause birth defects, developmental delays, and even death
A
TORCH
3
Q
Refers to:
Procedures that specifically evaluate the presence of IgM or IgG antibodies, frequently used to determine infections causing congenital defects
A
TORCH Test
4
Q
Also called Torch Syndrome which occurs with maternal exposure for certain infectious diseases
A
Congenital defect
5
Q
Other name for Torch Syndrome
A
Congenital defect
6
Q
Refers to:
- Caused by Toxoplasma gondii, which is a tissue coccidian
A
Toxoplasmosis
7
Q
Toxoplasmosis
Definitive host:
Transmission:
A
- Cats
- Organ transplantation, blood transfusion, transplacental
8
Q
Transplacental transmission of Toxoplasma gondii that occurs from mother to fetus is also called _________
A
Congenital toxoplasmosis
9
Q
T or F: Toxoplasmosis can also infect cold-blooded animals like humans
A
False (warm-blooded)
10
Q
Study the life cycle of Toxoplasma gondii
A
Plsplsplspls edi ‘wag eh
11
Q
Familiarize the stages of Toxoplasma gondii
A
- Oocyst formation
- Oocyst shedding
- Infection of the intermediate host
- Tachyzoite formation
- Tissue cyst formation
- Infection of cat
12
Q
Toxoplasma gondii
- The oocyst containing the _______ form in the intestinal cells of the _______
- The oocyst are released by the definitive host through _______
- Oocyst can survive in ____ and other environment
- It will undergo asexual reproduction in the cells of the _________
- The tissue cyst formation can be in the muscles, brain, and other tissues of the ________
- The tissue cyst can infect cat where the _______ undergo sexual reproduction forming oocyst
A
- Sporozoites, cats
- Feces
- Soil
- Intermediate host
- Intermediate host
- Bradyzoites
13
Q
Familiarize the modes of transmission of Toxoplasma gondii
A
- Ingestion of undercooked meat
- Transplacental transmission
- Organ transplantation
- Blood transfusion
- Ingestion of contaminated soil and water
14
Q
High risk groups of Toxoplasmosis
A
- Pregnant women
- Immunocompromised indivual (HIV, cancer patients, immunosupressive therapies)|
- Organ transplant recipient from infected donor
15
Q
T or F: Toxoplasmosis mostly are symptomatic at birth
A
False (asymptomatic)
However, there are some indiv that may develop symptoms later in life particularly if the infection affects the CNS or the eyes
16
Q
Classic triad symptoms of Congenital toxoplasmosis
A
Chorioretinitis
Hydrocephalus
Intracranial calcification
17
Q
Classic triad of Congenital toxoplasmosis
- Inflammation of the colloid and the retina of the eye that may lead to blindness
- Accumulation of fluid in the brain (leading to intracranial pressure, headache, vomiting, and seizures)
- Deposits of calcium salts in brain tissue (detected by imaging studies like CT scan or MRI
A
- Chorioretinitis
- Hydrocephalus
- Intracranial calcification
18
Q
Familiarize the serologic tests of Toxoplasmosis (especially in pregnant women and immunocompromised patients)
A
- IgM and IgG antibodies
- IgA antibodies
- Sabin-Feldman Dye Test
- IFA Test
- Avidity Test
- PCR
- Histology
- Cell Culture
19
Q
Toxoplasmosis serologic test that refers to
- Chemiluminescent immunoassay
- The IgG antibodies test detects the IgG antibodies which indicate past or chronic infection
- The IgM antibodies detect IgM antibodies that detect recent or acute infection
A
IgM and IgG antibodies
20
Q
Toxoplasmosis serologic test that refers to
- Detects the infection in newborn or young children
A
IgA antibodies
21
Q
Toxoplasmosis serologic test that refers to
- Detecting presence of Ab against Toxoplasma gondii in Px serum
- Principle: Live virus organism will not take up the Methylene Blue dye when they are exposed to antibodies against the parasite
- Dye Test: Px serum + Toxoplasma antigen + Methylene Blue Dye
A
Sabin-Feldman Dye Test
22
Q
Sabin-Feldman Dye Test
- Does not take up the methylene blue dye (presence of antibodies)
- Take up the dye (absence of antibodies against Toxoplasma gondii)
A. Positive
B. Negative
A
- Positive
- Negative
23
Q
Toxoplasmosis serologic test that refers to
- Detects the presence of Ab against Toxoplasma gondii in Px serum
- Uses fluorescent dye to visualize
- Toxoplasma gondii antigens are fixed on a slide (incubated with the Px serum)
- Fluorescent label is applied to the slide and examined under fluorescence microscope
POSITIVE: Fluorescent pattern (there is binding of Ag and Ab)
A
Immunofluorescence Assay Test
24
Q
Toxoplasmosis serologic test that refers to
- Confirmatory tool in patients with positive IgM test
A
Avidity Test
25
Principle of Sabin-Feldman Dye Test
Neutralization
26
Congenital infection under "Other Agents"
Syphilis
27
Refers to:
* Caused by Treponema pallidum, subspecies pallidum
* Can be transmitted by sexual contact
* Placental transmission as early as 6 weeks gestation
Syphilis
28
Syphilis
* Caused by __________, subspecies pallidum
* Can be transmitted by_________
* Placental transmission as early as ___________gestation
1. Treponema pallidum
2. Sexual contact
3. 6 weeks
29
Syphilis
* ___________ _______ is transmitted from pregnant women to her fetus
* Untreated syphilis during pregnancy may lead to _______, ________ _______, and ________ disorders such as deafness, neurologic impairment, and bone deformities
1. Congenital syphilis
2. Stillbirth, neonatal death, infant disorders
30
Refers to:
* Characteristic symptom of secondary syphilis and congenital syphilis
* Ulcers covered with a gray or white pseudomembrane, often found on the oral mucosa, including the tongue, soft palate, and buccal mucosa
* Smooth grayish white or yellowish lesion that appear on the mucous membrane
* Small pinpoint lesions to large irregular shaped patches
Mucous patches
31
Refers to:
* Classic sign of congenital syphilis
* Characterized by notched or peg-shaped incisors (upper) and widely spaced teeth, often with enamel thinning or discoloration
* Suggests that the individual was infected with syphilis in utero
Hutchinson's Teeth
32
Refers to:
* Hard palate perforation or soft palate perforation
* A hole in the roof of the mouth
* Can be rare but serious late manifestation of congenital syphilis
* Suggests that the individual was infected with syphilis in utero
Perforation of Palate
33
Define
1. There is a hole or defect in the hard palate (which is the bony part of the roof of the mouth)
2. A hole in the soft palate (which is the muscular part of the roof of the mouth)
1. Hard palate perforation
2. Soft palate perforation
34
Suggests that the individual was infected with syphilis in utero
A. Perforation of the palate
B. Hutchinson's Teeth
C. Both
D. Neither
C
35
Suggests that the individual was infected with Toxoplasma gondii in utero
A. Perforation of the palate
B. Hutchinson's Teeth
C. Both
D. Neither
D.
Syphilis po 'yan
36
Laboratory diagnosis for syphilis
1. Non-treponemal Test
2. Treponemal Serologic Test
37
Laboratory diagnosis for syphilis
1. Particle agglutination (TP-PA), immunofluoresence (FTA-ABS), EIA, CIA
2. RPR (Rapid plasma reagin) test, VDRL (Venereal Disease Research Laboratory)
1. Treponemal Serologic Test
2. Non-treponemal Test
38
Refers to:
* Detect antibodies against cardiolipin
* Sensitive but not specific
* Exaples: RPR, VDRL
Non-treponemal Test
39
Refers to:
* Measures antibdoy directed against T. pallidum antigen
* Specific but not sensitive
Treponemal Serologic Test
40
Refers to:
* Also known as German measles
* Highly contagious; transmission through respiratory droplets secretions
* Contracting and vaccinating usually are the ways we can develop immunity
* 5-7 days before rashes appear
Rubella
41
Rubella
* Also known as _________
* Highly contagious; transmission through ________________
* _________ and _________ usually are the ways we can develop immunity
* _______ days before rashes appear
1. German Measles
2. Respiratory droplets secretions
3. Contracting and vaccinating
4. 5-7 days
42
T or F: There is no specific treatment for acquired Rubella infection
True
43
Often characterized by
* Fever
* Upper respiratory infection
* Swelling of the lymph nodes
* Skin rash
* Joint pains
Severely affected infants/newborns
* Visual/hearing impairment
* Heart defects
* Calcium deposit in the brain
Rubella
44
Prevention of Rubella
* Vaccination (MMR)
* Good hygiene
* Avoid contact with people with infection
45
Rubella
1. 20-21 days
2. 7-10 days
3. 7-21 days
A. IgM
B. IgG
C. Incubation
1. C
2. A
3. B
46
Rubella
* Result in death of the fetus
* Include bone defect, mental retardation, thrombocytopenic purpura, heart problems, spleen problem
Congenital infection
47
T or F: Testing for IgM is not useful in congenital infection of Rubella
True
48
Laboratory diagnosis for Rubella
1. Detection of rubella-specific IgM
2. Hemagglutination Inhibition Test
49
Laboratory diagnosis for Rubella
1. Detected in all classes of antibody and could be used to measure specific IgM in serum fractions
2. Demonstrate current infection and cases of reinfection
3. Does not require live virus but uses lyophilized antigen
4. Sensitive and can detect low levels of antibodies; specific for rubella antibodies
A. Detection of rubella-specific IgM
B. Hemagglutination Inhibition Test
1. B
2. A
3. B
4. B
50
The highest dilution of serum that still inhibit the agglutination
Antibody titer
51
Laboratory diagnosis for Rubella
* Can also demonstrate a significant rise in titer (which is important criterion for diagnosing acute rubella infection)
* Important for pregnant women to determine the risk of congenital rubella syndrome
HAI
52
A significant rise in titer is defined as ____-fold or greater increase in the antibody titer between the acute and convalescent phase serum samples
Four-fold
53
Other serological techniques used for rubella antibody screening
1. ELISA
2. Detection of viral nucleic acid: RT PCR
3. Virus isolation and identification
54
Other serological techniques used for rubella antibody screening
1. Used for the diagnosis of rubella infection, especially congenital infection
2. Used for diagnosing post-natal acquired infection and congenital acquired disease
3. Used for screening for immunity against rubella
A. ELISA
B. Detection of viral nucleic acid: RT-PCR
C. Virus isolation and identification
1. B
2. C
3. A
55
Refers to:
* Belong to Herpesvirus family
* May cause growth retardation, abnormally small head, hepatitis, hemolytic anemia, calcium deposits in brain in severely affected newborns
Cytomegalovirus
56
Calcium deposits in brain
A. Cytomegalovirus
B. Rubella
C. Syphilis
D. A and B
E. A, B, and C
D
57
Transmission for CMV
1. Infected bodily fluids
2. Vertical transmission
3. Organ transplantation
58
T or F: CMV can be transmitted via intimate contact like kissing, sharing of food and utensils, etc
True (kaya 'wag makikipag-kiss pls lang)
59
A blueberry muffin rash is seen in which two infections?
Rubella/CMV rash
60
This is characterized by small, purplish, blister-like spots on the skin, can be a sign of congenital rubella and and congenital CMV
Blueberry muffin rash (Rubella/CMV rash)
61
The blueberry muffin rash is more commonly associated with what congenital infection?
CMV
62
Laboratory diagnosis of CMV
1. Cell culture
2. DEAFF (Detection of early antigen fluorescent foci)
3. Rapid culture methods
4. Histopathology
5. Tissue immunofluorescence
6. Electron microscopy
7. ELISAs for CMV antigen in the urine
63
Which is preferred testing for CMV between serology and molecular (PCR)?
PCR (or cell culture)
64
Laboratory diagnosis of CMV
* Isolate and grown CMV in a controlled environment
* Most common is Shell Vial Culture
Cell culture
65
Refers to:
* A rapid culture technique that uses a shell vial with a monolayer of cells such as human fibroblast
* The specimen is inoculated into a shell vial and the cells are examined for CMV-induced cytopathic effects (CPE) after 1-5 days
Shell vial culture (under Cell culture of CMV lab diagnosis)
66
DEAFF (lab diagnosis for CMV)
1. The presence of fluorescent foci indicates CMV infection
2. The absence of fluorescent foci suggest no CMV infection
A. Positive
B. Negative
1. A
2. B
67
T or F: In CMV (DEAFF lab diagnosis), the antigens are produced early before the virus has fully replicated
True
68
Sample for DEAFF CMV lab diagnosis
Blood or urine
The Px sample is inoculated and incubated for 24-48 hours. Cells are fixed to the slide; the labeled antibodies that detects the antigen is applied to the slide --> examined under fluorescent microscope
69
Basis for result in DEAFF CMV detection
Fluorescent foci
70
Laboratory diagnosis of CMV
* Rapid diagnosis
* Gold standard test for tissue
Rapid culture methods
71
Laboratory diagnosis of CMV
* Cytomegalic inclusions can be recognized from biopsy material by owl's eye appearance
Histopathology
72
Presence of large round or oval-shaped intranuclear inclusions within the infected cells. Inclusions are surrounded by a clear halo.
Can infect epithelial cells, endothelial cells, and fibroblasts
Owl's eye appearance (in CMV, diagnostic feature in lungs, liver, and kidney).
73
Laboratory diagnosis of CMV
1. Infected lung and liver cells may be stained by specific anti-CMV antibodies
2. Visualization of virions in the urine of congenitally infected infants
3. Has low sensitivity as CMV is combined to B2-microglobulin in urine
4. Uses labeled antibodies; the intensity of the color is proportional to the amount of CMV antigens present in the sample
A. ELISA
B. Electron microscopy
C. Tissue immunofluorescence
1. C
2. B
3. A
4. A
74
Laboratory diagnosis of CMV
1. Lung and liver cells; bronchioalveolar specimen
2. Urine
A. ELISA
B. Electron microscopy
C. Tissue immunofluorescence
1. C
2. A and B
75
Refers to:
* Can cause neonatal herpes
* Has two types: HSV 1 and HSV 2
Herpes Simplex Virus
76
How can HSV be acquired?
Antenal or perinatal period
Post-partum transmission
77
HSV transmission
1. During the vaginal delivery, the newborn comes into contant with the virus in the birth canal
2. Skin-to-skin contact with the infected mother
1. Antenal or perinatal period
2. Post-partum transmission
78
Match (HSV 1 or HSV 2)
1. Can affect mouth, lips, and face
2. Has painful blisters or ulcers
3. Can cause neonatal herpes in newborns and increase risk of HIV transmission
4. Transmitted through oral contact
5. Transmitted through genital contact
6. Primary infection site is the genital area
7. Symptoms are cold sores, fever, blisters, or oral herpes
8. Can cause herpetic keratitis (eye infection) an herpetic encephalitis (brain infection)
1. HSV 1
2. HSV 2
3. HSV 2
4. HSV 1
5. HSV 2
6. HSV 2
7. HSV 1
8. HSV 1
79
Laboratory diagnosis for HSV
1. Direct examination by antigen detection
2. Detection of viral nucleic acid
3. Virus culture
80
Laboratory diagnosis for HSV
1. Cells from specimens are treated in ice-cold acetone (cold acetone will help fix specimen more effectively)
2. More sensitive and specific than light and electron microscopy; in terms of cost and technical expertise, it is very much more demanding
3. Gold standard
4. Used for staining of fixed material
A. Detection of viral nucleic acid (FITC)
B. Direct examination of antigen detection
C. Virus culture
1. B
2. A
3. C
4. A
81
Easiest virus to cultivate
Infectious HSV 1 and 2
