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ORAL Practical IS > Rheumatoid factor and Widal Test > Flashcards

Rheumatoid factor and Widal Test Flashcards

1
Q

measures the amount of rheumatoid factor in your blood

A

RHEUMATOID FACTOR TEST

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2
Q

is commonly present and circulating around your body

A

Rheumatoid factor

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3
Q

These are also
inflammatory factors like your CRP.

A

Rheumatoid factor

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4
Q

RF drawback

A

nonspecific

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5
Q

Common signs and symptoms of increase RF

A

Joint pains,
joint stiffness, fatigue, swelling

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6
Q

are proteins produced by your
immune system that can attack healthy tissue inyour body.

A

Rheumatoid factors

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7
Q

are also immunoglobulins/antibodies)

A

Rheumatoid factors

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8
Q

They can attack healthy joints, glands or other normal cells by mistake

A

Rheumatoid factors

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9
Q

RF attacks

A

healthy joints, glands or other normal cells by mistake

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10
Q

Why RF attacks

A

autoimmune

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11
Q

aside from rheumatoid arthritis you can also have

A

Scleroderma,
Juvenial idiopathic diabetes,
Sjorgen

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12
Q

High levels of Rheumatoid factor in the blood are most often associated with autoimmune diseases such as:

A
  1. Rheumatoid arthritis
  2. Sjorgen’s syndrome
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13
Q

rheumatoid factor may be detected in some
_______, and people with _______ sometimes have normal levels of rheumatoid factor

A

healthy people; autoimmune diseases

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14
Q

T or F
Is it necessary and ideal to pair your RF testing with the other testing procedures?

A

T

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15
Q

is one of the group of blood
tests primarily used to help pinpoint a diagnosis of Rheumatoid arthritis.

A

rheumatoid factor test

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16
Q

OTHER TESTS FOR RHEUMATOID FACTOR ARTHRITIS

A

a) Anti – nuclear antibody test (ANA) (also for
Systemic Lupus Erythematosus)
b) Anti – cyclic citrullinated peptide (anti – CCP) antibody test
c) C- reactive protein test (CRP)
d) Erythrocyte sedimentation rate (ESR)

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17
Q

T or F
The amount of rheumatoid factor in your blood does not helps the physician choose the treatment approach that will
work best for the situation.

A

False

It does help the physician

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18
Q

T or F
Types of medications recommended by your doctor will depend on the severity of your signs and symptoms or the duration

A

T

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19
Q

Normal Range of RF

A

<20 IU/mL

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20
Q

Treatments

A
  1. NSAIDS (Non-steroidal Anti-Inflammatory Drugs)
  2. Corticosteroids
  3. Prednisone
  4. DMARDS (Disease Modifying Anti-Rheumatic Drugs)
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21
Q

use to reduce inflammation and pain of joints

A

Prednisone

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22
Q

Can slow the progression of rheumatoid arthritis and save the joints and other tissues from permanent damage

A

DMARDS (Disease Modifying Anti-Rheumatic Drugs)

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23
Q

HOME REMEDIES for RF

A

Exercises
Applying heat and cold pressures
Relax to reduce stress level

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24
Q

easing the pain and relaxing the tense and painful muscles

A

Heat

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25
Q

numb portions of the joint that is being inflamed and to reduce swelling

A

Cold

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26
Q

a type of autoimmune disorder that causes pain, swelling, and stiffness of the joints.

A

Rheumatoid arthritis

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27
Q

used to help diagnose Rheumatoid arthritis or other autoimmune disorders

A

RF

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28
Q

RF can also aid in diagnosing

A

Leukemia, and tuberculosis

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29
Q

Rheumatoid factors (RF) are

A

-IgM directed against IgG (FC portion)
-Detected using rapid tests
-75% to 85% or patients with Rheumatoid arthritis have elevated serum RF
-RF can be present in other conditions

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30
Q

tailed portion responsible for biological activities such as activation of your Immune system

A

FC portion

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31
Q

FAB portion

A

enables the binding of antigen

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32
Q

T or F
IgM undirected against the FC portion of IgG that’s for RF and once reacted it will form an immune complex and will proceed to auto immune disorders such as inflammatory arthritis

A

False; directed

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33
Q

Detected using rapid tests
Principle:

A

RF Slide Agglutination

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34
Q

T or F
74% to 83% or patients with Rheumatoid arthritis have elevated plasma RF

A

False; 75% to 85%; Serum RF

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35
Q

T or F
RF can be present in other conditions

A

T

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36
Q

Rheumatoid factor in other conditions:
give at least 3

A

 Lupus
 Sjorgen’s syndrome
 Juvenile arthritis
 Scleroderma
 Mononucleosis
 Tuberculosis
 Certain cancers, such as leukemia or multiple myeloma

37
Q

T or F
About 30 percent of people with rheumatoid arthritis have little or no rheumatoid factor in their blood.

A

F; 20%

38
Q

is not used to diagnose osteoarthritis.

A

RF test

39
Q

both affect the joints, they are very different
diseases

A

rheumatoid arthritis and osteoarthritis

40
Q

an autoimmune disease.

A

Rheumatoid arthritis

41
Q

T or F
Rheumatoid arthritis affects people at any age, but usually occurs between the ages of 41 and 60.

A

F; 40 and 60

42
Q

T or F
Rheumatoid arthritis affects more women than men

A

T

43
Q

is not an autoimmune disease.

A

Osteoarthritis

44
Q

It is caused by the wear and tear of joints
(degenerative) over time and usually affects adults over the age of 65.

A

Osteoarthritis

45
Q

Differentiate Rheumatoid Arthritis and Osteoarthritis

A

Rheumatoid Arthritis
-Affects multiple joints
-Autoimmune
-Express other conditions
-Immunosuppressant drugs

Osteoarthritis
-Affects one specific joint
-Degenerative
-Cannot express other
manifestations
-Therapy

46
Q

PRINCIPLE OF RF SLIDE TEST

A

Latex Agglutination

47
Q

Latex Agglutination

A

-Reagent is IgG – coated latex particles
-Combine patient serum with latex reagent
-Observe for agglutination
-RF (IgM) will cause agglutination

48
Q

is a positive (+) result

A

Agglutination

49
Q

Little or no Rheumatoid
Factor in blood but would not rule out that you do not have RA or other medical conditions

A

Negative or Normal Results

50
Q

Higher Level of RF is found in blood
(>20 IU/mL) but doesn’t always mean that the RF is causing your symptoms

A

Positive Result

51
Q

T or F
Conditions other than Rheumatoid arthritis can cause positive results

A

T

52
Q

___% - ___% of RA patients can be negative for RF

A

15% - 25%

53
Q

Note:
Remember that RF test is not specific for RA; Other conditions can have increase RF; Other tests can be used to follow disease course

A
54
Q

is a serological method to diagnose enteric or typhoid fever that is cause by the infection with pathogenic microorganisms like Salmonella typhi, Salmonella paratyphi a, b and c

A

Widal test

55
Q

In Widal test
The method of diagnostic test is based upon ______________ specifically prepared from Salmonella species

A

agglutination (clumps) reaction between antibodies of patient serum and antigens

56
Q

Salmonella possess the following (3) three antigens

A

Flagellar antigen or H antigen
Somatic antigen or O antigen
Surface antigen or Vi antigen

57
Q

composed of proteins, heat labile and sensitive, antibody formation are rapid and sustained, highly immunogenic, antibody level persists for a longer period.

A

Flagellar antigen or H antigen

58
Q

composed of polysaccharide, heat stable and alcohol resistant, antibody formation are rapid but only on a early phase, less immunogenic, antibody level falls off quickly

A

Somatic antigen or O antigen

59
Q

surface polysaccharide envelope covering the O antigen. This antigen is expressed only on few ser types and renders the bacilli inagglutirable with O antiserum. The name is believed that Vi is related to virulence.

A

Surface antigen or Vi antigen

60
Q

measures agglutination antibodies directed against a Salmonella O somatic surface antigen and/or a Salmonella H flagella antigen of the suspected organism

A

Widal test

61
Q

Widal test measures agglutination antibodies directed against a ______somatic surface antigen and/or a ______flagella antigen of the suspected organism

A

Salmonella O; Salmonella H

62
Q

detects antibodies against O and H antigens.

A

Widal test

63
Q

Widal test detects antibodies against

A

O and H antigens.

64
Q

Uses direct agglutination

A

Widal test

65
Q

First discovered by Fernand Widal in 1896

A

Widal Test

66
Q

Who discovered Widal Test

A

Fernand Widal in 1896

67
Q

Widal test

CLINICAL MANIFESTATIONS

A

Chest congestion
Constipation
Diarrhea
Gastroenteritis
Headache
Body malaise
High temperature
Loss of appetite
Stomach pains

68
Q

Note:
Widal test is already pa phase out and the gold standard for detecting typhoid fever is Blood culture for Salmonella typhii solation.

Other test: Typhidot

A
69
Q

MODES OF TRANSMISSION

A
  1. Ingestion of contaminated food or water
  2. Rarely, from person to person
  3. Fecal – oral route
  4. Most of the time carriers come from food handlers
70
Q

SERODIAGNOSIS OF TYPHOID

A

Widal test by Rapid Slide
(Screening) test =1 min

Widal test by Tube
Agglutination test= 2-4 hours

Typhidot test (IgG/IgM rapid test) =15 minutes

ELISA = 45 minutes – 2 hours

Electrochemiluminiscent immunoassays
= 45 minutes – 2 hours

PCR (Polymerase chain
reaction)
= 7-10 days

71
Q

Antibody in the serum produced in response to Salmonella organism, the kit contains antigen suspensions that are killed bacteria and they were stained to enhance the reading of agglutination tests.

A

PRINCIPLE OF WIDAL TEST

72
Q

Color of Stains

A

Blue
Red

73
Q

stained organisms – specific to somatic
antigens (O antigen)

A

Blue

74
Q

stained antigens - specific to the flagella
antigens (H antigen).

A

Red

75
Q

WIDAL KIT INCLUSIONS

A

1) Positive control vial
2) Negative control vial
3) Package insert
4) White glass slide
5) Stirring sticks

76
Q

contains no antibodies against the specific bacteria

A

Widal negative control (-)

77
Q

contains ready to use standardized (goat antiserum) with polyspecific antibodies having specific reactivity towards S. typhi O and H antigens and is useful in the validation of the performance of Widal reagents.

A

Widal positive control (+)

78
Q

The widal positive control contains ready to use standardized

A

goat antiserum

79
Q

should be run with
each test

A

positive and negative control

80
Q

T or F
if the reagent falls to agglutinate with the positive control, or dose agglutinate with the negative control, continue the test

A

F; it should be discarded or review the procedure and repeat the test with a new test kit.

81
Q

LIMITATIONS

The Widal test has

A

-very low specificity
-less sensitive
-confusing
-difficult to interpret for the diagnosis of typhoidfever

82
Q

Why is it difficult to interpret for the diagnosis of typhoid fever

A

because cross – agglutinating antibodies remaining from the past infections with related salmonella serotypes give false positive results.

83
Q

T or F

Furthermore, in areas where fever due to infections is a common occurrence. So false positive reactions may occur as a result of non-typhoid

A

T

84
Q

CAUSES OF FALSE POSITIVE WIDAL AGGLUTINATION TEST

A

-Previous immunization with Salmonella antigen
-Cross – reaction with non typhoid salmonella
-Variability and poorly standardized commercial antigen preparation kit.
-Infection with malaria
-Other Enterobacteriaceae sharing the same Endotoxins/lipopolysaccharides

85
Q

is an old serologic assay and no longer performed in many developed countries

A

Widal test

86
Q

WHY WIDAL TEST IS STILL USED?

A

because of its low cost and limited resources which releases results in a short period of time.

87
Q

is one of the best, easily accessible, cheap and simple method for the diagnosis of typhoid fever

A

Widal Test

88
Q

PROPHYLAXIS

A

-Simple hand hygiene and washing can reduce several cases of typhoid
-All milk and dairy products should be pasteurized
-Avoid drinking untreated water
-Avoid raw fruits and vegetables
-Screening of food handlers for S. typhi
-Vaccines

ORAL Practical IS (5 decks)

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