QUESTIONS WITH SOLUTIONS GRADED A+
◉ Chronically Infected
IgM (RECENT infection
IgG (OLD infection)
anti-HBc - antibody hep b CORE. Answer: HBsAG - POS
anti-HBc - POS
IgM anti-HBc - NEG
anti-HBs - NEG
What does this mean?
◉ Acutely Infected. Answer: HBsAG - POS
anti-HBc - POS
IgM anti-HBc - POS
anti-HBs - NEG
What does this mean?
,◉ Interpretation unclear 4 possibilites:
- Resolved infection (most common)
- False-positive anti-HBx, thus susceptible
- Low level chronic infection
- Resolving acute infection. Answer: HBsAG - NEG
anti-HBc - POS
anti-HBs - NEG
What does this mean?
◉ · Confirming the presence of an outbreak
· Identifying investigation team and resources
· Verifying the diagnosis
· Establishing a preliminary case definition
· Alerting administration and key healthcare partners about the
investigation
· Performing a detailed literature review
· Developing a methodology for case finding
· Preparing an initial line list and epidemic curve
· Observing and reviewing potentially implicated patient care
activities
,· Considering whether environmental sampling or HCP sampling
should be performed
· Implementing initial control measures
· Defining and refining the case definition
· Continuing case finding and surveillance
· Reviewing regularly control measures
· Maintaining surveillance activities
· Considering whether an analytic study should be performed.
Answer: Steps on conducting an outbreak investigation
◉ Individuals with and without the EXPOSURE to a potential risk
factor that do NOT have the outcome of interest AT the time of study
enrollment
Retrospective versus prospective. Need to follow up for long period
of time to see if patient gets the outcome
LONG + EXPENSIVE. Answer: Cohort Studies
◉ Measles IgM antibody by EIA - confirms recent measles
Measles IgM antibodies may not be present until 72 hours after rash
onset
Diagnosis of measles can usually be made on the basis of clinic
presentation alone: cough, coryza (inflammation of mucous
, membrane in nose), and conjunctivitis (red eyes) with or w/o Koplik
spots (white spots in mouth)
Rubella no diagnostic test.. Answer: MMR Diagnostics and Labs
◉ Cultures: blood, skin, synovial fluid, CSF infected patients
ELISA- detects antibodies followed by Western Blot for confirmation.
Answer: Lyme Disease Diagnostics & Labs
◉ June - August everywhere EXCEPT Southeast. Answer: When is
tick season? (lyme disease)
◉ Color/clarity - Cloudy
Protein - High
Glucose - Low
WBC Count - High
Neutrophil - High. Answer: Bacteria Meningitis characteristics
◉ The greater NUMBER of isolates the more accurate the sensitivity.
Remember to read the numbers under the antibiotics as
PERCENTAGES!
Antibiograms test SENSITIVIES NOT RESISTANCE TO ABx. Answer:
How do you read this antibiogram?