Glossary of 7. Viral serology
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- What 4 viruses are within the Herpes virus group?
- 1. EBV
3. Herpes Simplex
- What is the herpes group characterized by?
- What diseases does EBV cause?
- 1. Infectious mono
2. Chronic active EBV (chronic fatigue syndrome)
3. Burkitt's lymphoma
4. Nasopharyngeal carcinoma
- How is EBV transferred?
- What 3 things are used to diagnose infectious mono?
- 1. Clinical features
2. Relative/abs lymphocytosis with >10% reactive lymphs.
3. Demonstration of heterophile antibody
- In what populations is the heterophile more demonstrated?
- Adults: 90-98% seropositive
Children: <50%; less spcfc.
- What is a heterophile antibody?
- Ab stimulated by 1 Ag which reacts w/a completely unrelated antigen of different mammal.
- How does heterophile Ab relate to EBV?
- The EBV antigen cross reacts with RBCs from horse, sheep, and ox.
- What are 3 methods used to detect heterophile antibody?
- 1. Paul and Bunnell
3. Rapid slide tests
- What is the Paul-Bunnell screening test?
- -Hemagglutination test
-Mix inactivated Pt serum + Sheep RBCs.
-Look for agglutination
- What are the drawbacks of the Paul-Bunnel test?
- Does not distinguish btwn Ab against EBV, serum sickness, or Forssman; NOT SPECIFIC.
- What is the Davidsohn differential etst?
- Modified Paul-bunnell test;
-guinea pig RBCs absorb out the Forssman antigen.
-horse RBCs absorb out CMV antigen.
-absorbed serum then tested.
- What are drawbacks of the davidsohn test?
- What is the monoslide test?
- a faster alternative to davidsohn test.
-Reagent A has both guinea pig and horse RBCs.
-Horse cells are 'suped up' so the test is more senstive.
- Cite 4 situations when specific EBV antibody testing is done:
- 1. Confirm heterophile neg adult case of infectious mono.
2. In cases of childhood mono.
3. Cases w/out classic symptoms
4. Immunocompromised patients
- What are the 4 types of eBV antibodies?
- 1. Anti-EB viral capsid Ag
2. Anti-EBV early Ag
3. Anti-EBV nuclear Ag
4. Anti-EBV membrane Ag
- When do EBV antibodies appear?
- Viral capsid:
-IgG is 4-7 days; lifelong
-IgM indicates acute infection.
-Indic. acute inf, gone in 3mo
not there in acute, appears in convalescent stage.
- What antibodies would be positive in Burkitt's lymphoma and Nasopharyngeal carcinoma?
- -IgG Anti-VCA
- What antibodies are present during the reactivation phase?
- Anti-VCA (IgG)
- What type of testing is used to test for specific EBV Abs?
- In whom is Cytomegalovirus life-threatening?
- What can congenital CMV progress to?
- Cytomegalic inclusions disease.
- What causes congenital CMV infection in infants? (2 things)
- 1. Primary infection of mom
2. Reactivation of mom
- What 3 methods are usually used to diagnose CMV?
- 1. Urine or blood culture in shell vial assay, with DFA for confirmation.
2. Serological methods - ELISA
- What specimen should serology methods be done on? What spcf methods?
- Paired sera; there are no good IgM assays.
ELISA, C' fixatn, IFA, RIA, LA.
- What is the most common test for CMV?
- When is IgM preferred over paired sera?
- I don't know yet
- What 4 serology assays are used to detect herpes simplex virus?
- 1. Elisa
2. Compl. fixation
3. Indirect IFA
4. Indirect hemagluttination
- What antibodies are detected in HSV?
- Paired sera or IgM
- Why is serology used to test for Varicella-Zoster virus?
- To detect immune status.
- What types of tests are done for VZV?
- 1. Elisa (mostly)
2. Complement fixation (insensitive)
- What types of tests are done for Rotavirus?
- -EIA - for antigen in stool; VERY sensitive!!
-PCR in ref labs
-EM in research
- Why do the MMR, and how?
- for immune status
ELISA, HAI, Compl. fix, IFA
- What types of tests are done for Rubella?
- What does a torch panel test for?
- If the ToRCH is done on an infant, what would indicate infection?
- IgM; if IgG is found, that's impossible, must be mom's.
- What viruses are included in a normal respiratory panel?
- 1. RSV (resp synct virus)
2. Parainfluenza (croup)
5. Coxsackie virus
- What tests are used to detect RSV?
- what tests are used to detect parainfluenza?
- What test are used to detect adenoviruses?
- what does a nasal wash specimen screening test for?
- What are 5 types of HIV screening tests?
- 1. ELISA (best)
2. Rapid - OraQuick and UniGold
3. Orasure EIA on oral mucosal transudate
4. Urine tests
5. Home tests
- what are 3 types of confirmatory tests for HIV?
- 1. Western blot (gold standard)
2. Indirect Immunofluorescent Ab
3. Radioimmunoprecipitin (RIPA)
- what type of testing for HIV is done on babies? Why?
- PCR; b/c antibody from the mother will affect ELISA/Western blots.
- What data is used to monitor HIV status?
- -CD4 lymph count
-Viral load testing
- What testing is used to distinguish fresh vs. old infection of HIV?
- -RNA and p24 assays; detects the virus before seroconversion.
- What is the decreased sensitivity EIA used for?
- to indicate a nonreactive recent infection; would be negative in recent infection.
- How does West Nile virus normally present?
- 80% Asymptomatic
20% symptoms of flu
- Who are we really concerned about contracting WNV?
- Immunocomp, older, infants
- what is the gold standard for WNV diagnosis?
- serological testing
- what 2 serological tests are used to diagnose WNV?
- 1. IgM capture ELISA (MAC)
2. Plaque reduction neutralization tests (PRNT)
- what specimens are used for these tests?
- 1. serum
3. maybe urine
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