infectious diseases
Understand the concept of pathology, infection and disease. Appreciate the role of the normal microbiota Describe the relationship between the normal microbiota and host. Describe ways of acquiring infectious agents. Establish the causes of infectious diseases (Koch’s postulates) Classify infectious diseases and describe the development of infectious diseases.
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Time limit: 20 minutes
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Question 1
Multiple choiceWhat is the primary purpose of serum protein electrophoresis?
Explanation
Serum protein electrophoresis specifically evaluates serum proteins to identify monoclonal gammopathies such as multiple myeloma.
Question 2
Multiple choiceIn serum protein electrophoresis, what indicates a monoclonal gammopathy?
Explanation
A sharp spike-like peak in the gamma-globulin zone is a characteristic of monoclonal gammopathy, indicating a clonal plasma cell disorder.
Question 3
Multiple choiceWhat are monoclonal gammopathies typically associated with?
Explanation
Monoclonal gammopathies are associated with malignant or potentially malignant disorders, such as multiple myeloma and related conditions.
Question 4
Multiple choiceWhich fraction of proteins is primarily responsible for the increased band seen in acute inflammation on serum protein electrophoresis?
Explanation
Acute inflammation usually leads to an increase in the alpha-2 fraction due to acute-phase reactants.
Question 5
Multiple choiceWhat is the primary protein component of the serum?
Explanation
Albumin is the major protein in serum, produced primarily by the liver.
Question 6
Multiple choiceWhich condition is least likely to lead to a decrease in albumin levels?
Explanation
Severe dehydration typically leads to an increase in albumin concentration due to reduced plasma volume, rather than a decrease.
Question 7
Multiple choiceWhat is a characteristic feature of multiple myeloma as indicated by serum protein electrophoresis?
Explanation
Multiple myeloma typically presents with a narrow spike in the gamma, beta, or alpha-2 regions on electrophoresis.
Question 8
Multiple choiceWhat does the presence of Bence Jones protein in urine suggest?
Explanation
Bence Jones protein, which is composed of free light chains, is a hallmark of multiple myeloma and related disorders.
Question 9
Multiple choiceWhat laboratory test would you perform to confirm a diagnosis of multiple myeloma if serum protein electrophoresis is inconclusive?
Explanation
A bone marrow biopsy is essential for confirming multiple myeloma by assessing plasma cell involvement.
Question 10
Multiple choiceWhich of the following is a common condition that can cause polyclonal gammopathy?
Explanation
Polyclonal gammopathy is often caused by conditions like chronic infections and inflammatory processes.
Question 11
Multiple choiceWhat is the relationship between albumin levels and dehydration?
Explanation
Dehydration leads to a relative increase in albumin concentration due to decreased plasma volume.
Question 12
Multiple choiceIn the context of serum protein electrophoresis, what does a high beta-globulin peak indicate?
Explanation
An increased beta-globulin peak can suggest conditions like biliary cirrhosis or malnutrition.
Question 13
Multiple choiceWhen should serum protein electrophoresis be considered in a clinical setting?
Explanation
Serum protein electrophoresis is indicated in red flag situations, such as unexplained peripheral neuropathy or suspicion of malignancy.
Question 14
Multiple choiceWhich of the following patterns in serum protein electrophoresis is indicative of acute inflammation?
Explanation
Acute inflammation typically leads to increased levels of alpha-1 and alpha-2 globulins due to acute-phase reactants.
Question 15
Multiple choiceAfter identifying an abnormal M-protein spike in serum protein electrophoresis, what follow-up is recommended?
Explanation
Referral to a hematologist-oncologist is necessary to further evaluate and manage potential plasma cell disorders.
Question 16
Multiple choiceHypogammaglobulinemia, as seen on serum protein electrophoresis, is most often indicative of which condition?
Explanation
Hypogammaglobulinemia indicates a decrease in immunoglobulins, commonly seen in multiple myeloma.
Question 17
Multiple choiceWhich of the following factors is least likely to influence serum protein level changes?
Explanation
While dietary protein intake affects nutritional status, it is less critical in acute reactions compared to trauma, malignancy, and infections.
Question 18
Multiple choiceWhat key characteristic differentiates monoclonal gammopathy from polyclonal gammopathy during serum protein electrophoresis?
Explanation
Monoclonal gammopathy is characterized by a narrow spike in the gamma region due to the proliferation of a single clone of plasma cells, unlike polyclonal gammopathy which displays a broad diffuse band.
Question 19
Multiple choiceIn the evaluation of abnormalities in serum protein electrophoresis, what is a common follow-up procedure for patients with a serum M-protein spike of less than 1.5 g per dL?
Explanation
Patients with an M-protein spike of less than 1.5 g per dL are recommended to undergo serum protein electrophoresis annually to monitor for any changes.
Question 20
Multiple choiceWhich of the following clinical conditions can lead to an increased gamma-globulin level in serum protein electrophoresis?
Explanation
Chronic infections, such as tuberculosis, can lead to an increase in gamma-globulin levels due to heightened immune response, while dehydration typically increases albumin and does not affect gamma-globulin.