WorksheetsImmunology: Serological Diagnosis of Viral Infections pt 2
Total questions: 32
Worksheet time: 16mins
Target Cells (usually where latency occurs)
Varicella-Zoster Virus
epithelials of oropharynx and B lymphs where can become latent
myeloid cells (neutrophils, monocytes, macrophages)
sensory nerve cells
dorsal root ganglia
Target Cells (usually where latency occurs)
Herpes Simplex Virus (HSV)
epithelials of oropharynx and B lymphs where can become latent
myeloid cells (neutrophils, monocytes, macrophages)
sensory nerve cells
dorsal root ganglia
Target Cells (usually where latency occurs)
Cytomegalovirus
epithelials of oropharynx and B lymphs where can become latent
myeloid cells (neutrophils, monocytes, macrophages)
sensory nerve cells
dorsal root ganglia
Target Cells (usually where latency occurs)
Infectious Mononucleosis
epithelials of oropharynx and B lymphs where can become latent
myeloid cells (neutrophils, monocytes, macrophages)
sensory nerve cells
dorsal root ganglia
Signs & Symptoms
Children: usually asymptomatic
Teens/adults: fever, lymphadenopathy, sore throat
Later, if severe: splenohepatomegaly, periorbital edema
Mono
Rubella
CMV
HSV
VZV
Signs & Symptoms
mild fever, upper respiratory symptoms, transient rash, lymphadenopathy (German measles)
Mono
Rubella
CMV
HSV
VZV
Signs & Symptoms
Primary infections usually asymptomatic, but if symptomatic, similar to IM symptoms, except no sore throat
Mono
Rubella
CMV
HSV
VZV
Signs & Symptoms
fever, blister-like rash on face, scalp, then extremities
Mono
Rubella
CMV
HSV
VZV
Signs & Symptoms
cold sore, genital warts/sores
Mono
Rubella
CMV
HSV
VZV
Which is NOT true of Serum specific antibody detection of Rubella?
IgG and IgM by LA, IFA, EIA, and HI
Diagnose Acute infection: 4-fold rising titers, IgM or IgG
Determine Immune status: IgG >8
Diagnose Congenital infection: High IgM or rising IgM titer
Cannot be tested for during pregnancy
How do you test for Rubella during pregnancy?
check mother's IgG for immune status
check fetus IgG for immune status
check fetus IgM for immune status
Check mother's IgG after 5 days of pregnancy: 4-fold increase in IgG is diagnostic
What does the MMR vaccine do?
Induces both IgM and IgG production for mumps, measles, and Rubella
Carries IgG antibodies to the offspring in pregnant women
all of the above
IgM persists and tested for immune status
Which is NOT a characteristic of the Cytomegalovirus (CMV)?
Can be detected in saliva, stool, urine, cervicovaginal, semen, breast milk, blood
Major issue for transplant or diffusion patients that received latent CMV blood (reactivation infections)
CMV is identical in all aspects to IM
Testing for anti-CMV (ELISA) required for transfusion to neonates and immunocompromised patients
What is the importance of PCR (DNA) testing in CMV?
Help distinguish between latent and active infection in immunocompromised patient
Everyone has have some CMV exposure which makes diagnosis difficult
PCR for CMV is required for transfusion to neonates and immunocompromised patients
Detection of asymptomatic CMV
Congenital infection of herpes is caused by _______.
Fetus: transplacental
Neonate: birth canal
Test IgM
HSV1
HSV2
both
STD (only)
Serum antibody: IgM or IgG: 4-fold titer increase
HSV1
HSV2
both
Cold sore (only)
Serum antibody: IgM or IgG: 4-fold titer increase
HSV1
HSV2
both
STD
Genital lesions can be assayed using DFA or direct EIA
HSV1
HSV2
both
Which Serological Tests for Varicella-Zoster (VZV) is the least helpful because antibody class may not appear until convalescence?
PCR (DNA): skin lesions, CSF, tissue, mononuclear cells
Immune Status: IgG (ELISA)
Congenital: IgM (ELISA)
Antigen detection tests (matching)
diarrhea/stool by EIA/OIA
Rotavirus
Respiratory Syncytial virus (RSV)
Influenza A & B
Antigen detection tests (matching)
n/p swab (EIA/OIA)
Rotavirus
Respiratory Syncytial virus (RSV)
Influenza A & B
Antigen detection tests (matching)
n/p or sputum (EIA/OIA)
Rotavirus
Respiratory Syncytial virus (RSV)
Influenza A & B
Type of Hepatitis
fecal-oral. Contaminated food or water. Contaminated shell fish with epidemics in areas with poor sanitation
Disease progression
Usually self-limiting with recovery in 2-4 weeks
No chronic carrier state
hep. A
hep. B
hep. C
hep. D
hep. E
Type of Hepatitis
fecal-oral (poor sanitation, contaminated food/water)
Seen mainly in underdeveloped countries
Acute, self-limiting infection, except in pregnant women may be fatal
No chronic/carrier state
Laboratory tests not done in the US at the present time
hep. A
hep. B
hep. C
hep. D
hep. E
Type of Hepatitis
Acute onset: active infection damaging the liver, with a long clinical course that may last for 6 months
If chronic infections are active, severe liver damage occurs causing cirrhosis and possibly liver cancer
Chronic/carriers shed HBsAg forever
hep. A
hep. B
hep. C
hep. D
hep. E
Type of Hepatitis
Transmission occurs only if infected with HBV parenterally
hep. A
hep. B
hep. C
hep. D
hep. E
Type of Hepatitis:
Acute infections asymptomatic or mild
Can develop chronic carrier state with progression to cirrhosis and liver cancer
hep. A
hep. B
hep. C
hep. D
hep. E
Hepatitis B Serologic Markers
Acute infection or chronic carrier; infectivity
HBsAg/HBeAg
Anti-HBc (total IgM & IgG)
Anti-HBc (IgM)
Anti-HBe
Anti-HBs
Hepatitis B Serologic Markers
Current or previous infection or carrier
HBsAg/HBeAg
Anti-HBc (total IgM & IgG)
Anti-HBc (IgM)
Anti-HBe
Anti-HBs
Hepatitis B Serologic Markers
Recent acute infection
HBsAg/HBeAg
Anti-HBc (total IgM & IgG)
Anti-HBc (IgM)
Anti-HBe
Anti-HBs
Hepatitis B Serologic Markers
Disease resolution; reduced infectivity
HBsAg/HBeAg
Anti-HBc (total IgM & IgG)
Anti-HBc (IgM)
Anti-HBe
Anti-HBs
Hepatitis B Serologic Markers
Recovery and immunity
HBsAg/HBeAg
Anti-HBc (total IgM & IgG)
Anti-HBc (IgM)
Anti-HBe
Anti-HBs
