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ID Labs 1
Infectious Disease
| Question | Answer |
|---|---|
| FTA-ABS, MTA-TP: to dx: | Syphilis |
| catalase pos GNR, facultative intracellular parasite | Legionella |
| Motile, oxidase-pos GNR +/- polysaccharide slime prodn, blue-green pus: | Pseudomonas |
| Nonmotile facultative anaerobe GNR, contains endotoxic lipopolysaccharide, does not produce H2S: | Shigella |
| large GNR, produces mucoid capsule on agar | Klebsiella |
| Legionella will only grow on: | charcoal yeast extract agar w/iron & cysteine |
| Mildly GN, fried egg colonial morphology on special media: | Mycoplasma pneumoniae |
| Giant Multinucleated cells | Herpes virus (Genital) |
| Tzank Smear | Herpes virus (Genital) |
| Gram negative intracellular diplococci = | Gonorrhea |
| bacterial meningitis: CSF | turbid to purulent; high pressure; high WBC w/segs; pro: 100-500; low glucose |
| viral meningitis: CSF | normal pressure; WBC <1000 (lymph/mono); pro & glu normal |
| granulomatous meningitis: CSF | high pro, low glu, lymphocytosis |
| granulomatous meningitis: dx studies | Cx to dx but takes weeks; CT/MRI: enhancement of meninges, poss hydrocephalus |
| brain abscess: dx studies | CT/MRI, then LP (CSF usu polymicrobial) |
| Lymphocyte pleomorphism; heterophile Ab: | EBV |
| Gram-positive encapsulated box-shaped rods in chains (box cars) = | B. anthracis |
| Gram-neg pleomorphic bacillus = | B. pertussis |
| CMV labs | lymphocytosis or leukopenia; intracytoplasmic inclusions (owl eyes) on tissue bx |
| Orbital cellulitis | sinus xray & CT (soft tissue infiltration) |
| Chronic sinusitis | MRI > CT for malig; CT > Waters view xray for sinus opacification |
| HIV labs | +ELISA & Western blot; anemia, leukopenia, low pltateles, polyclonal hypergammaglobulinemia, high chol |
| What are the 4 methods for diagnosis of HIV | Detect antibodies to the virus, detect viral p24 antigen, detect viral nucleic acid, culture HIV virus |
| What is the most widely used method to diagnose HIV | Detection of antibody to HIV |
| Most common cause of false positive tests for HIV in low risk pts | Recent immunization |
| Initial screening for HIV = | EIA enzyme immunoassay (ELISA) |
| What is the confirmatory test for HIV (done after the screening test) | Western blot or IFA (Immunofluorescence Assay) |
| HIV requirement: | Patient must be informed of HIV testing; informed consent/ counseling no longer required nationally |
| HIV Detuned testing | both sensitive & low-sensitivity tests; if only 1 is pos = recent infxn |
| HIV p24 test | free antigen or bound antigen/Ab complexes; detectable 2-6 weeks post infection |
| HIV p24 to dx: | viral Rx, neonatal infxn, detect HIV before seroconversion, dz progression |
| HIV viral load | reflects Rx response better than CD4; detects transplacental transmission |
| 95% of HIV-infected patients test positive within: | 6 weeks of infection |
| Counts predictive of risk fo opportunistic infection or malignancy in absence of HIV tx | CD4 <200 and CD4 lymph <14% |
| Best test for dx of HIV before seroconversion and to monitor disease progression & response to tx | HIV viral load |
| HIV-positive patients may also test positive for: | PPD, RPR, VDRL, CMV, toxyplasma IgG, hepatitis, Pap |
| gold standard for imaging for acute sinusitis | CT |
| EBV labs | Granulocytosis in first week, then lymphocytosis & many ATLs. +/- high AST/ALT & bili. Heterophile Ab pos within 4 weeks of onset. IgM rises & falls, IgG pos for life. |
| Mumps labs | Serum IgM is diagnostic (may be delayed in immunized pt). May see high amylase, mild ARF. |
| Rabies labs | DFA stain of bx / necropsy tissue (back of neck is 60-80% sensitive). RT-PCR or viral isolation from CSF/saliva also definitive |
| SARS on CT | Ground glass opacities +/- focal consolidations |
| SARS dx testing | RT-PCR for SARS-CoV in urine, stool (most likely pos), nasal secretions often neg early and variably positive by day 14. Serologies may be neg x3 weeks |
| West Nile virus labs | IgM capture ELISA on serum/CSF. Acute & convalescent IgM titers may confirm acute infxn. PCR for blood donor screening. There is no vax. |
| Anthrax diagnosis | Cx of skin lesion, blood, pleural fluid, CSF with box cars on microscopy. Widened mediastinum on CXR |
| Campylobacter labs | Dark-field or phase contrast microscopy: GN, S-shaped or seagull-shaped bacteria |
| Sigmoidoscopy shows punctate areas of ulceration and inflamed mucosa in infection with: | Shigella |
Created by:
Abarnard
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