tutorial 2

Question 1

sAg+
sAB-
Anti-Core IgG+
Anti-core IgM+

Answer 1

• IgG and IgM being positive = immune reaction
  
  • But not a immune reaction to the surface because they do not have surface antibodies, but they do have antigens
  • Vaccine is for the surface
  • IgG is developed overtime
  • If patient mounted surface antibodies they would be cured
  • They are infected, and have been infected for a while with Hep B (positive)

Question 2

sAg-
sAB+
Anti-core IgG+
Anti-core IgM+

Answer 2

• Past infection or vaccinated, and not currently infected

Vaccine does not make core antibodies

If you have Hep B and continue to have it, your IgG would be positive, if you don’t surface antibodies you are infected

Question 3

sAg-
aAb-
Anti-core IgG-
Anti-core IgM-

Answer 3

• No current infection
  
  • Not protected
  • They do not have it
  • They are not vaccinated
  • Never have had it

Question 4

70yr old in ER w 101 fever, thinks septic. Collect blood cultures result comes back “Gram neg bacilli” in 1/4 blood culture sets. What organisms are on your differential?

Answer 4

• E coli
  
  • Klebsiella
  • Enterobacter
  • Salmonella (very uncommon)
  • Proteus
  • Pseudomonas
    Only 1/4 bottles flagged positive, you treat!

Question 5

Hbs Ag (+), HBe Ag (-)

Answer 5

HBs Ag = surface antigen and is the general marker of infection. since it is positive the patient has Hep B
HBe Ag = envelope antigen and the active replication of the virus. Since it is negative, the virus is not actively replicating in the patient

Question 6

Anti HBc IgM (+)

Answer 6

HBc IgM = early core antibody and is the marker of acute infection. It’s positive, meaning the patient has an acute infection

Question 7

HBs Ag (+), anti HBc IgM (-), anti HBs IgG (-)

Answer 7

HBs Ag = surface antigen and is the general marker of infection. since its positive it means the patient is currently infected with Hep B
HBc IgM = early core antibody and is the marker of acute infection. since its negative, it is not an acute infection
HBs IgG = past core antibody which indicates a past or chronic infection. since its negative, they have no past infection of Hep B