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Serology 1 Flashcards

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1
Q

who are stool cultures indicated in?

A

patients who have unrelenting diarrhea (>7 days), fever and abdominal bloating
patients who have been drinking well water, prolonged antibiotics, traveled outside the country

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2
Q

inspecting feves is important because it can lead to the diagnosis of?

A 
parasitic infectation
obstructive jaundice
diarrhea
malabsorption
obstructions
dysentery
ulcerative colitis
gastrointestinal bleeding
malignancies
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3
Q

what are the normal findings in a fecal sample?

A 
100-200 g/day
70% water
1/2 bacteria, 1/2 cellular debris
shape of the colonic lumen
consistency is pliable
brown color
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4
Q

brown color from fecal material is from?

A

stercobilin

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5
Q

normal colonic transit time

A

24-48 hours

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6
Q

clay, grey, wihite, or tan stools

A

biliary obstruction

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7
Q

red stools

A

lower GI bleed

undigested red meat, beets

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8
Q

black and tarry stools

A

upper GI bleed

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9
Q

green stools

A

leafy green veggies

broad spectrum antibiotics

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10
Q

physical characteristics of stools

A

formed
semiformed
diarrhea
scybala

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11
Q

spastic colon or rectal narrowing has what stool?

A

ribbon like

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12
Q

pasty stools

A

increased fats from gallbladder disease

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13
Q

greasy/butter stools

A

cystic fibrosis

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14
Q

megafeces

A

megacolon

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15
Q

mucous stools

A

mucous colitis

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16
Q

blood mucous clinging to fecal mass

A

neoplasm or inflammatory process of trectum

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17
Q

mucous associated with blood and pus is found in

A

ulcerative colitis
dysentery
diverticulitis

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18
Q

pus is found in

A

ulcerative colitis
chronic dysentery
abscesses
fistulas

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19
Q

fats is found in

A

malabsorption syndromes
pancreas
liver
biliary disease

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20
Q

FOBT/GUIAC

A

fecal occult blood test

part of screening for colorectal cancer in patients over 50

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21
Q

what is the least amount of blood a GUIAC test can detect?

A

5ml

needs further evaluation

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22
Q

apple core sign is seen with?

A

spastic colon

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23
Q

normal bacteria in gut

A 
enterococcus
e coli
proteus
staph aureus
candida
bacteriodes
clostridium
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24
Q

pathogens for the gut

A

salmonella
shigella
campylobacter
yersina

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25
infections present as?
acute diarrhea excessive flatus abdominal discomfort fever
26
normal microscopic examination of feces
``` no RBCs few WBCs no ova or parasites mucous no harmful bacteria ```
27
neurodystrophic theory
subluxations can decrease organ function and therefore reduce resistance
28
virulence of an organism
how much of the organism it takes to form a disease 57 spirochetes can cause syphilis 250,000 leprosy bacteria needed for leprosy
29
proteins in the blood are made up of
albumin and globulin
30
gamma globulin
one of the many types of globuline | antibodies are made up of it
31
IgG
75% of serum immunoglobulins secreted by plasma cells able to cross platenta in fetus
32
IgA
15% of immunoglobulins present in respiraotry and GI secretions saliva and tears, small amounts in blood breast milk
33
IgM
ABO blood grouping rheumatoid factor elevated in many infections may be attached to the surface of a B cell or secreted in blood
34
IgE
allergic response | protects against parasitic worms
35
IgD
rarely elevated part of B cell receptor activates basophils and mast ells
36
what are the 3 ways antibodies and immunooglobulins can be measured?
quantitative and qualitative agglutinin titers antibody titers
37
electrophoresis
a screening test to semiquantitatively measure various proteins which are electrically separated
38
T cells
their precursors migrate to the thymus
39
B cell maturation occurs when?
bone marrow and lymphoid tissue
40
cell-mediated immunity
inflammatory response begins after nonspecific detection and rpcessing of infectious agents by macrophages they become activated and interact with T lymphocytes phagocytosis and killing of infectious agents ensues
41
humoral immunity
activated macrophages may present processed infectious agen antigens to specific memory B-lymphocytes in the presence of helper T cells transforms into antibody producing plasma cells
42
what rises in humoral immunity?
IgM first | then IgG
43
antigens
substances capable of binding to an antibody
44
antibody
produced by lymphocytes | from patient's serum
45
titers are reported as?
reactive (positive) | or non-reactive (negative)
46
what are titers?
indicates the strength of the antibody
47
when is the patient getting better?
when the titer is decreased
48
high titer indicates?
a highly virulent organism
49
agglutination
Ab+Ag= clumping
50
immunofluorescence
fluorescent tagged Ab reacts with Ag in ultraviolet light
51
enzyme immunoassay
enzymes label Ag-AB reactions
52
ELISA
enzyme linked immunosorbent assay | an indirect EIA
53
immunoblot
western blot | electrophoresis
54
syphilis is caused by?
treponema pallidium pallidium
55
primary syphyilis
begins 3-4 weeks after infection | recognized by a chancre, painless ulcer that will resolve
56
what is diagnostic for primary syphilis?
darkfield exam
57
secondary syphilis
goes systemic and has variable symptoms fever, malaise, RASH, may have CNS involvement typically followed by a latent period lastting years
58
tertiary syphilis
3-10 years post infection and are soft granulomatous lesions called gummas this stage may be asymptomatic or have CNS involvement, leading to insanity Charcot's joints
59
what may be negative in tertiary syphilis?
nontreponemal test
60
darkfield exam
test of choice for moist chancres | specific for treponema pallidum pallidum
61
syphilis screening tests
darkfield exam (for chancres) nontreponemal test (for pts suspected of having syphilis) WDRL (venereal disease research lab RPR (rapid plasma reagin
62
when should nontreponemal tests be used?
to confirm treponemal tests to exclude false positives (measles, mono, malaria, TB, pregnancy, leprosy, old age, etc
63
nontreponemal tests
VDRL RPR measure IgM and IgG antibody not specific for treponema pallidum
64
syphilis confirmation tests
treponemal tests treponema pallidium immobilization microhemagglutination fluorescent treponemal antibody-absorption
65
what syphilis confirmation test is the most sensitive?
fluorescent treponmenal antibody absorption | FTA-Abs
66
6 Ds of syphilis
``` distantion density debris dislocation disorganization destruction ```
67
traditional algorithm for syphilis
nontreponemal screening test if positive, then treponemal test if positve, syphilis
68
proposed algorithm with treponemal screening test
``` treponemal screening test if positve, then nontreponemal test if positve, syphilis if negative, secondary treponemal test ```
69
if there is a positive treponemal test?
must be followed by a nontreponemal test to differentiate between an active infection and one that occured in the past and was successfully treated

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