Serology Flashcards
(91 cards)
1
Q
What are the contents of stool?
A
bile, mucus, shed epithelial cells, bacteria and inorganic salts
2
Q
Stool studies are looking at what?
A
function and integrity of the bowel
3
Q
Stool cultures are indicated in patients with what?
A
unrelenting diarrhea, fever, and abdominal bloating, especially if diarrhea persists more than 7 days
4
Q
What diagnosis might inspecting feces lead to?
A
parasitic infestation, obstructive jaundice, diarrhea, malabsorption, obstructions, dysentery, ulcerative, gastrointestinal bleeding, malignnancies, etc
5
Q
What should be noted when examining feces?
A
quantity, form consistency, and color of the stool
6
Q
Percentage of water in feces
A
70%
7
Q
Grams of stool per day
A
100 to 200 grams of stool per day
8
Q
How much of feces is bacteria and cellular debris?
A
one half
9
Q
Normal evacuation of feces reflects what?
A
the caliber shape of the colonic lumen
10
Q
Usual brown color comes from what?
A
stercoblin
11
Q
What is the odor from stool?
A
From indole and skatole (formed from bacterial degradation of proteins through fermentation and putrefaction
12
Q
Normal colonic transit time
A
24 to 48 hours
13
Q
Clay (gray white), tan feces is due to
A
biliary obstruction
14
Q
Red feces is due to
A
lower GI, undigested red meat, beets
15
Q
Black and tarry feces is due to
A
upper GI bleeding
16
Q
Green feces is seen with
A
green leafy vegetables and used of broad spectrum antibiotics
17
Q
scybala
A
hard small spherical masses of stool
18
Q
Ribbon like feces is seen with
A
spastic colon or rectal narrowing
19
Q
Pasty feces is noted with
A
increased fats from gallbladder disease
20
Q
Greasy/buttery is noted with
A
cystic fibrosis
21
Q
Megafeces is noted with
A
megacolon
22
Q
Mucous feces is noted with
A
mucous colitis, bloody mucous clinging to a fecal mass is a sign of neoplasm or inflammatory process of the rectum
23
Q
Pus in feces is found in
A
ulcerative colitis and chronic dysentery, abscesses, fitulas
24
Q
Fats (steatorrhea) found in
A
a variety of disorders (malabsorpation syndromes, pancreas, liver, biliary disease)
25
Loss of __-__ ml of blood from the upper GI tract can result in black tarry stools
50-75 ml
26
Tumors of the intestine grow into what? And what is the complication it causes?
Grows into the lumen and are subjected to repeated trauma from the fecal stream and the friable tumor ulcerate and bleeds
27
What happens to normal flora when they are out of their normal habitat?
could become pathogenic
28
What are the proteins of the blood?
albumin and globulin gamma (antibodies are made up of gamma globulin proteins)
29
Which Ig constitutes approximately 75% of serum immuoglobulins
IgG
30
Which Ig is responsible for the ABO blood grouping and the rheumatoid factor and elevated in many infections
IgM
31
IgA is present primarily where?
respiratory and GI secretions and in saliva and tears and small amounts in blood
32
Which Ig mediates allergic response
IgE
33
Is IgD ever elevated
rarely
34
How can antibodies and immunoglobulins be measured?
1. guantitative and qualitative
2. agglutinin titers
3. antibody titers
35
What is a screening test to quantitatively measure various protein which are electrically separated?
electrophoresis
36
What is cell-mediated immunity?
Inflammatory response after nonspecific detection and processing of infectious agents by macrophages. They become activated and interact with t-lymphocytes. Phagocytosis and killing of infectious agents ensues
37
What is humoral immunity?
Activated macrophages may be present processed infectious agent antigens to specific memory b-lymphocytes in the presence of helper t cell transforms into antibody producing plasma cells
38
In humoral immunity which antibody typically rises first
IgM rises first then IgG
39
Substances capable of binding to an antibody
antigen
40
What comes from the patient's serum
anti bodies
41
If the antigen (test) and the antibody (serum) form a reaction, what happens?
agglutination or clumping will occur
42
Titer indicates the strength of ___.
the antibody
43
If titer decreases the patient is getting better or worse
better
44
The higher the titer number the more ____ the organism
virulent
45
syphilis STD is cause by what?
spirochete preponema pallidium
46
Primary stage of syphilis
begins 3-4 week after infection recognized by a chancre, painless ulcer that will resolve (darkfield examination is diagnostic at this stage)
47
Secondary stage syphilis
goes systemic and has variable symptoms, fever, malaise, RASH, may have CNS involvement (the immunologic test are best method for this stage) typically followed by a latent period lasting years
48
Tertiary stage of syphilis
3-10 years post infection and are soft granulomatous lesions called gummas. This stage may be asymptomatic or have CNS involvement (neurosyphilis) leading to insanity...Charcot's joints
49
Would the nontreponemal test be negative or positive at this stage
negative
50
test of choice for moist genital lesions
darkfield exam
51
Nontreponemal test should be confirmed with what test to help exclude false positives
treponemal test
52
Nontreponemal test includes what?
VDRL, RPR
| This test measure IgM and IgG antibody and are not specific for R. pallidum
53
What is the algorithm for testing for syphilis?
A positive treponemal screening result must be followed by a nontreponemal test to differentiate between and active infection and one that occurred in the bast and was successfully treated
54
Two tiered protocol for lyme disease
the sensitive ELISA test is performed first and if it is positive or equivocal then the more specific western blot is run
55
Early symptoms of lyme disease
may include fever, headache, fatigue depression and a characteristic circular skin rash
56
Erythema migrans
characteristic circular skin rash
57
What may happen if lyme disease is untreated
later symptoms may involve the joints, heart, and central nervous system
58
Organism that causes lyme disease
spirochete borrelia burgdorferi
59
incubation for Rubella
10-21 days
60
How is rubella spread
spread through respiratory secretions and is highly contagious
61
T or F rubella is usually self limiting with occasional complications
true but it can be devastation to a fetus, especially in the first trimester
62
What percent of women have spontaneous abortion after contracting Rubella while pregnant?
20%
63
Signs and symptoms of Rubella in an adult
low grade fever, malaise, headache and cervical lymphadenopathy, 50% have maculopapular rash
64
Signs and symptoms of rubella in children
transient rash and fever
65
How would you test for steptococcal infection?
a rapid antigen detection can be done with a throat swab. Antistreptolysin O titer (ASOT) test measures antibodies produced against extracellular toxins. Increase titer indicates recent or current infection
66
How does the test for streptococcl infections work?
- streptococcal infections produce an enzyme called streptolysin O which can lyse RBCs
- streptolysin O is antigentic, the body produces ASO a neutralizing antibody
- ASO appears in the serum 1 week to 1 month after the onset of streptococcal infection
- helpful in determining that post streptococcal diesease such as GN was due to previous strep infection
67
What is infectious mononucleosis?
a self limiting systemic disorder lymphoproliferative condition occurring in early childhood and young adults
68
What is the incubation period for infectious mononucleosis?
10-50 days, lasting about 1-4 weeks after fully developed
69
Sign and symptoms of infectious mononucleosis?
fever, pharyngitis, lymphadenapthy, extreme fatigue and malaise May have hepatitis and jaundice with hepatospenomegaly
70
Laboratory diagnosis of infectious mononucleosis is accomplished how?
by noting lymphocytosis and atypical lymphocytes in the peripheral blood
71
What is the tests name that you run when you think infectious mononucleosis?
monospot (heterophile Ab screening test) approximately 2 weeks after onset, patients will have immunoglobin M antibodies that react with warm RBC's
72
When the CD4 count drops below 200 due to advanced HIV disease, what is the person diagnosed with?
AIDs
73
What is the normal range for CD4 cells?
600 and 1500
74
Test measure the amount of HIV in the blood
viral load test, lower levels are better than higher levels
75
Test how well the immune system is functioning in HIV
CD4 count
76
How rapidly HIV is progressing
Viral load
77
What are the first clinical symptoms in HIV patients?
night sweats, fever, lymphadenopthy and fatigue followed by extreme weight loss, diarrhea, opportunistic infections and malignancies
78
Tests for diagnosis of HIV
Elisa screening test and Western blot test
79
What does Elisa screening test do?
test for antibodies
80
What should you do if you get a positive Elisa test?
repeat test if positive again then to western blot test
81
What is western blot test?
a confirmatory test
82
Rheumatoid types - seropositive
rheumatoid arthritis
systemic lupus erythematosis (SLE)
scleroderma
jaccoud's
83
Rheumatoid Variants - seronegative
ankylosing spondylitis
psoriatic arthritis
reiters disease (reactive arthritis)
enteropathic arthritis
84
HLA B27 positive and rheumatoid factor negative
rheumatoid variants - seronegative
85
What is a group of antinuclear bodies used to diagnosis
SLE
86
How does ANA work?
there are several patterns of fluorescence seen through the UV microscope and when combined with the specific ANA sub-types the patter becomes more specific for various autoimmune disease
87
Besides SLE, what other disorders can show up positive with ANA
scleroderma, mixed connective tissue, sjorens syndrome, RA
88
Rheumatoid arthritis diagnosis - 4 or more of the following
- morning stiffness for at least 6 weeks
- pain on joint motion for at least 6 weeks
- swelling of at least one joint for at least 6 weeks
- swelling in at least one other joint for more than 6 weeks
- bilateral symmetrical joint swelling
- subcutaneous nodules
- radiographic changes
89
What is the exact role of RF in the disease process?
not ell known, however 80% of patients with rheumatoid arthritis have positive RF titers
90
What is the ratio to consider a positive RF?
must be found in titers greater than 1:80
91
T or F in juvenile RA, RF is positive
false, negative (non-reactive)
