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Immunology: Serology of Viral Infections questions with correct answers 2024/2025
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Immunology: Serology of Viral Infections questions with correct answers 2024/2025
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Immunology: Serology of Viral InfectionsSerology for viral infections - ANS1) diagnostic detection of antibodies in serum a) viral culture
difficult/lengthy (if can be done at all) b) serologic tests are easy and fast
Detection of viral infection - ANS• IgM Ab = current/recent infection • IgG = current/past infection
& usually immunity •Newborns: -IgM=congenital infection (newborn making Abs) -IgG=maternal
Abs x placenta (doesn't mean infection) • Viral Ag can also be used for serodiagnostics (esp
Hep)
What Family are the Herpes Viruses? - ANSHerpesviridae
Are the Herpes Viruses DNA or RNA viruses? - ANSDNA
True or False: the Herpes Viruses are capable of establishing a latent infection w/ life-long
persistence in the host - ANSTrue
Name 5 viruses in the Herpesviridae Family - ANS1) Epstein-Barr Virus (EBV or HHV-4) 2)
Cytomeglovirus (CMV or HHV-5) 3) Varicella-Zoster Virus (VZV) 4) Herpes Simplex Viruses: no
cure (HSV-1 cold sores, HSV-2 genital) 5) Human Herpes Viruses (HHV-6, HHV-7, HHV-8)
Epstein-Barr Virus (EBV) causes what disease? - ANSa wide spectrum of diseases including:
infectious mononucleosis, lymphoproliferative disease & a # of cancers
How is Epstein-Barr Virus (EBV) transmitted? - ANSvia oral contact w/ saliva (the kissing
disease)
Describe the virus lifecycle in Epstein-Barr Virus (EBV): - ANSInfects: 1) epithelial cells of
oropharynx (throat--why saliva infectious) 2) B Lymphocytes: enters by binding CD21 on B cell
membrane→B cells spread virus thru lymph system & become polyclonally activated→B cells
proliferate, secrete EBV-specific Ab, heterophile Ab, & autoAbs 3) if process not checked by NK,
cytotoxic T cells, latent infection established. Can flare up if you are immunocomp
Describe the Epstein-Barr Virus (EBV) Viral Antigens (important diagnostic tools) - ANS1) Early
Ag: (EBV-EA) made during initial stages of viral replication in lytic cycle 2) Late Ags: appear
during lytic cycle following period of DNA synthesis = Viral Capsid Ag (EBV-VCA) 3) Latent
Phase Ags: a. EBV Nuclear Ag (EBNA) and b. Latent Membrane Proteins (LMP's) not as
important.
Describe symptoms and disease course for EBV clinical illness (infectious mononucleosis): -
ANS1) Spreads: oral transmission via droplets 2) benign self-limiting acute illness 3) symptoms:
fever, sore throat, lymphadenopathy (swollen lymph nodes) 4) some develop chronic infection
, >6mths 5) Virus can be reactivated after latency (chronic fatigue) 6) EBV associated w/
malignancies
What are the malignancies that have been associated w/ EBV? - ANS1) Hematologic: Burkitt's
lymphoma & Hodgkin's disease 2) Nonhematologic: nasopharyngeal & gastric carcinoma 3)
lymphoproliferative disorder in immunocompromised: organ transplants & AIDS, primary
immunodeficiency
Lab Diagnosis of EBV: - ANS1) hemotologic: High WBC counts, proliferative/atypical or reactive
lymphocytes 2) Serologic: presence of heterophile Ab & Ab to certain EBV Ag (nuclear & viral
capsid)
Name the 2 rapid tests that use Heterophile Abs? - ANS1) Monospot: tests ability of patient
serum absorbed w guinea pig,cow,kidney RBC Ag to agglutinate horse RBCs. Lacks specificity
but widely used.
2) Wampole Mono-Latex: LA slide test for qual/semi-qual detection of IM heterophile Abs in
serum or plasma (some False+s w/ pts. have lymphoma,viral Hep, AI disease & neg test doesn't
rule out IM!)
What types of serological confirmation testing is available for EBV and what does it detect? -
ANS• Ab can be detected by indirect immunofluorescence, ELISA, or immunoblot. • Detects Abs
to viral capsid Ag (VCA): 1) Anti-VCA IgM in acute stage (disappears after 2-4mths) 2) Anti-VCA
IgG (appears w/in 4-7d of onset & persists indefinitely)
What is detected serologically for pediatric and transplant patients? - ANS• Ab to Early Ag (EA):
1) EA-D=acute infection, titer may ↑ in reactivity 2) EA-R=acute infection in young children &
transiently in convalescent stage (monitoring Ag)
In addition to EA-R, what Ab is also associated with convalescent phase & appears along with
what other Ab? - ANSAb to EB nuclear Ag (EBNA) and appears along w/ Anti-VCA IgG
EBV serology in IM: chart - ANSAnti-VCA (IgM) Anti-VCA (IgG) Anti-EA Anti-EBNA
Acute + + + -
Recent +/- + +/- +
Remote - + - +
Reactivation - + + +
Name the TORCH infections (perinatal infections) - ANST= Toxoplasmosis/Toxoplasma gondii O
= other: Hep B, VZV, HIV, Syphillis, parvovirus B19 R = Rubella C = Cytomeglovirus H = Herpes
simplex virus
How is Cytomeglovirus (CMV), Human Herpes virus-5 transmitted? - ANSvia prolonged contact
w body secretions: saliva, stool, vaginal & cervical secretions, semen, breast milk, blood. Sexual
contact and perinatally as well.
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