MOL BIO LEC: INHERITED DISEASES PART 2

Chlamydia

The primary route of transmission of this disease is through sexual contact?

Chlamydia

What disease?

Intrapartum transmission can produce neonatal disease

Chlamydia

Infection can cause urethritis, endometritis, salpingitis, pelvic

inflammatory disease (PID), and perihepatitis in women and

urethritis, epididymitis, and proctitis in men?

Chlamydia

The most common signs of infection are mucopurulent cervicitis in women and urethritis in men?

MOMP

LPS

What conventional tests are used for detecting Chlamydia?

Gonorrhea

In men, ____________ manifests itself within 7 d of infection as acute urethritis,

with a penile discharge that ranges from scant, clear to copious and mucopurulent?

Gonorrhea

Symptoms of women with acute endocervical infection include vaginal

discharge and dysuria. The cervical os is friable and erythematous?

Gonorrhea

Transmission requires direct, usually sexual contact and the bacterium is transmitted more effectively from men to women than from women to men?

Gonorrhea

Intrapartum transmission can also occur,

producing disease in neonates?

Enriched media (Chocolate agar-based)

What conventional tests are used for detecting Gonorrhea?

Nucleic acid hybridization tests

Nucleic acid amplification tests

Two assay formats have been developed to detect Gonorrhea?

nonamplification-based nucleic acid hybridization

method

The first molecular-based assay for N. gonorrhoeae and C. trachomatis was a _________that detected the rRNA with an acridinium-labeled single-stranded DNA probe?

- Urine from men and women

- Urethral swabs in men and women

- Endocervical swabs

Specimens that have been cleared for use in most NAATs include?

4 degrees C

One of the primary advantages of SCLVSs compared to urine is the lack of a

requirement for storage at______ after collection, facilitating screening at remote

sites?

M. tuberculosis

is an important cause of respiratory tract infections,

causing significant levels of morbidity and mortality?

Tuberculosis

The _______diagnosis may take prolonged periods, during which time infections can spread?

4.4 million

4, 000

The genome of M. tuberculosis has ________base pairs (bp) with about ________genes?

Smears and cultures

Fluorochrome staining

Kinyoun and Ziehl-Neelsen stains

Conventional test used in detecting Tuberculosis?

10^4 organisms/mL

At least ____________ are required to see mycobacteria in a smear, and even then, not all of those smears read as positive?

10^1 to 10^2 organisms/ mL

Cultures for M. tuberculosis are more sensitive than smears and can detect

____________of the specimen; however, they take time due to

the slow in vitro growth of the organism.

Xpert MTB/RIF Assay

The _____________is an automated in vitro diagnostic test using nested real-time PCR to detect MTB-complex and RIF resistance qualitatively?

rpoB

81

The primers in Xpert MTB/RIF assay test amplify a portion of the ______ gene containing the _____-base pair core region.

Xpert MTB/RIF Assay

__________simultaneously detects MTB-complex and RIF resistance by amplifying an MTB-complex specific sequence of the rpoB gene, which is probed with five molecular beacons (Probes A - E) for mutations within the rifampin resistance determining region (RRDR)?

2.0.

MTB DETECTED is reported when at least two probes result in Ct values

within the valid range and a delta Ct min (the smallest Ct difference between

any pair of probes) of less than?

39.0

36.0

The valid maximum cycle threshold (Ct) of _____for Probes A, B, and C and _____ for

Probes D and E are set for MTB/RIF data analysis

≤4.0

Rif Resistance NOT DETECTED is reported if the delta Ct max (the Ct

difference between the earliest and latest probe) is ______?

>4.0

Rif Resistance DETECTED is reported if the delta Ct max is?

High

What MTB result?

Ct is <16

Medium

What MTB result?

Ct is 16-22

Low

What MTB result?

Ct is 22-28

Very low

What MTB result?

Ct is >28

Human immunodeficiency virus (HIV)

is an RNA virus that makes a

DNA copy of genomic RNA using its own virally encoded reverse

transcriptase?

HIV-2 is only transmitted

is a minor isolate found mainly in West Africa and is less pathogenic

than the other type of HIV causing more latent infections?

M- Major

O - Outlier

N - Non-M and Non-O

P

4 subtypes of HIV?

A-J

Group M is further divided into eight clades?

below 50 copies/mL

The goal of antiretroviral therapy is a viral load __________ of

blood, which is undetectable by most methods.

Fewer than 10,000 copies/mL

Patients who maintain viral levels at _________

the early stages of the infection are at decreased risk of progres- sion

to acute immunodeficiency syndrome (AIDS).

2 to 8 weeks

3 to 4 months

Viral load should be determined before therapy is started, _______ after

therapy initiation to see the initial response, and then every _______- to

assess therapeutic effectiveness.

CD4

Viral load testing is performed in conjunction with determining ______ counts?

- PCR of integrated DNA (ROCHE AMPLICOR HIV MONITORTM V1.5 ASSAY)

- NASBA (NUCLISENS HIV-1 RNA QT ASSAY)

- bDNA (Versant branched DNA)

HIV in patient samples can also be detected by?

HIV-1 RNA testing

Quantitative _________in plasma has been the standard for monitoring drug therapy and HIV disease progression?

0.5 log10 unit

In order to be clinically relevant, viral load changes from one determination to another must vary by threefold?

Primary resistance mutations

________are those specific to a particular drug,

reduce the virus's susceptibility to that drug, and appear in the viral genome

shortly after treatment with that agent has begun?

Secondary resistance mutation

_____________ occurs when the virus tries to recover the

ability to replicate at a normal rate.

Secondary resistance mutation

do not affect the virus's susceptibility to the drug but rather help

the virus replicate in the presence of the drug when one of its replication enzymes is not

100% functional?

184

A mutation in codon _____ of the reverse transcriptase gene from ATG to GTG

results in an amino acid change from methionine to valine, or M184V → Resistance to cytidine analog, lamivudine.

Q151M

_____ located at the dNTP-binding site of reverse transcriptase, confers

resistance to reverse transcriptase inhibitors.