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PROTHROMBIN TIME TEST
The PT test is used to monitor patients taking certain medications as well as to help diagnose clotting disorders.

A sample of the patient's blood is obtained by venipuncture. The blood is decalcified (by collecting it into a tube with oxalate or citrate ions) to prevent the clotting process from starting before the test. The blood cells are separated from the liquid part of blood (plasma) by centrifugation. The PT test is performed by adding the patient's plasma to some source of Tissue Factor (e.g.: a protein, thromboplastin, from homogenized brain tissue) that converts prothrombin to thrombin. The mixture is then kept in a warm water bath at 37°C for one to two minutes. Calcium chloride (excess quantities of ionized calcium) is added to the mixture in order to counteract the sodium citrate and allow clotting to start. The test is timed from the addition of the calcium chloride until the plasma clots. This time is called the Prothrombin Time.

The prothrombin test specifically evaluates the presence of factors VII, V, and X, prothrombin, and fibrinogen. A prothrombin time within the 11 -15 second range (depends on the source of thromboplastin used) indicates that the patient has normal amounts of the above clotting factors.
A prolonged prothrombin time indicates a deficiency in any of factors VII, X, V, prothrombin, or fibrinogen. It may mean that the patient has a vitamin K deficiency (vitamin K is a co-factor in the synthesis of functional factors II (prothrombin), VII, IX and X) or a liver disease (the liver is the site of synthesis of the plasma protein factors). The prothrombin time of patients receiving a vitamin K-competing coumarin drug such as warfarin (anticoagulation therapy used in deep venous thrombophlebitis) will also be prolonged, usually in the range of one and one half to two times the normal PT time.

𝗖𝗔𝗠𝗣 𝗧𝗲𝘀𝘁: 𝗠𝗲𝗱𝗶𝗰𝗮𝗹 𝗠𝗶𝗰𝗿𝗼𝗯𝗶𝗼𝗹𝗼𝗴𝘆🔬🧫🏥
● It is used for the identification of 𝑺𝒕𝒓𝒆𝒑𝒕𝒐𝒄𝒐𝒄𝒄𝒖𝒔 𝒂𝒈𝒂𝒍𝒂𝒄𝒕𝒊𝒂𝒆.
● It is a Group B beta-hemolytic streptococci.
● It is the only beta-hemolytic Streptococcus which secrete a protein called 𝗖𝗔𝗠𝗣 𝗳𝗮𝗰𝘁𝗼𝗿 or “𝗽𝗿𝗼𝘁𝗲𝗶𝗻 𝗕”.
● It is one of the causative agents of mastitis in cows.
● CAMP is an acronym for the authors of this test (𝗖𝗵𝗿𝗶𝘀𝘁𝗶𝗲, 𝗔𝘁𝗸𝗶𝗻𝘀𝗼𝗻, 𝗠𝘂𝗻𝗰𝗵, and 𝗣𝗲𝘁𝗲𝗿𝘀𝗼𝗻) which was identified in 1944.

𝗣𝗿𝗶𝗻𝗰𝗶𝗽𝗹𝗲
● Streptococcus agalactiae produces a diffusible, thermostable, extracellular protein known as CAMP factor.
● CAMP factor acts 𝐬𝐲𝐧𝐞𝐫𝐠𝐢𝐬𝐭𝐢𝐜𝐚𝐥𝐥𝐲 with the 𝐛𝐞𝐭𝐚 𝐥𝐲𝐬𝐢𝐧 produced by 𝑺𝒕𝒂𝒑𝒉𝒚𝒍𝒐𝒄𝒐𝒄𝒄𝒖𝒔 𝒂𝒖𝒓𝒆𝒖𝒔 to produce a zone of enhanced lysis of sheep or bovine erythrocytes.
● The group B streptococci are streaked perpendicular to a streak of S. aureus on sheep blood agar.
● A 𝐩𝐨𝐬𝐢𝐭𝐢𝐯𝐞 𝐫𝐞𝐚𝐜𝐭𝐢𝐨𝐧 appears as an enhanced hemolysis is indicated by an arrow head-shaped zone of beta-hemolysis at the junction of the two organisms.
● 𝐍𝐞𝐠𝐚𝐭𝐢𝐯𝐞: No enhancement of hemolysis.

𝗨𝘀𝗲𝘀 𝗼𝗳 𝗖𝗔𝗠𝗣 𝘁𝗲𝘀𝘁
● It can be used to determine the ability of an organism to produce the CAMP factor.
● It is used to differentiate 𝑺𝒕𝒓𝒆𝒑𝒕𝒐𝒄𝒐𝒄𝒄𝒖𝒔 𝒂𝒈𝒂𝒍𝒂𝒄𝒕𝒊𝒂𝒆 from other species of beta-hemolytic Streptococcus.
● It is used to identify 𝑳𝒊𝒔𝒕𝒆𝒓𝒊𝒂 𝒎𝒐𝒏𝒐𝒄𝒚𝒕𝒐𝒈𝒆𝒏𝒆𝒔 which also produces a positive CAMP reaction.

𝗪𝗶𝗱𝗮𝗹 𝗧𝗲𝘀𝘁: 𝗠𝗲𝗱𝗶𝗰𝗮𝗹 𝗠𝗶𝗰𝗿𝗼𝗯𝗶𝗼𝗹𝗼𝗴𝘆🔬💉🧫🏥
● Widal test is an agglutination test used for diagnosis of enteric fever caused by 𝑺𝒂𝒍𝒎𝒐𝒏𝒆𝒍𝒍𝒂 𝒕𝒚𝒑𝒉𝒊 or 𝑺𝒂𝒍𝒎𝒐𝒏𝒆𝒍𝒍𝒂 𝒑𝒂𝒓𝒂𝒕𝒚𝒑𝒉𝒊.
● This test is widely used throughout the world as a major diagnostic tool for detecting enteric fever.
● This test was introduced in 1896 by a French physician and bacteriologist Georges Fernand Isidor Widal.
● This tests measure agglutinating serum antibodies level produced against the O (somatic) and H (flagellar) antigen of Salmonella Typhi and Paratyphi A, B, and C.

𝗣𝗿𝗶𝗻𝗰𝗶𝗽𝗹𝗲
● This test is based on the principle of an 𝐚𝐧𝐭𝐢𝐠𝐞𝐧-𝐚𝐧𝐭𝐢𝐛𝐨𝐝𝐲 𝐚𝐠𝐠𝐥𝐮𝐭𝐢𝐧𝐚𝐭𝐢𝐨𝐧 𝐫𝐞𝐚𝐜𝐭𝐢𝐨𝐧.
● Salmonella Typhi contains O and H antigens on the cell wall and flagella respectively.
● Salmonella Paratyphi A and Paratyphi B contain AH and BH antigens on flagella respectively.
● These antigens are immunogenic and when introduces to on host’s immune system, they induce the production of specific antibodies.
● These purified antigens of Salmonella are commercially available.
● The patient’s serum is tested against these commercial antigens and observed for visible agglutination reaction.
● If the serum agglutinates, the test is considered positive.
● Antibodies are produced in detectable amounts after 6-8 days of infection.
● O antigen of Salmonella Paratyphi is not used because they cross-react with O antigens of Salmonella typhi.

𝗪𝗶𝗱𝗮𝗹 𝗧𝗲𝘀𝘁 𝗠𝗲𝘁𝗵𝗼𝗱𝘀
● Widal test is done by two methods
1. 𝐑𝐚𝐩𝐢𝐝 𝐬𝐥𝐢𝐝𝐞 𝐚𝐠𝐠𝐥𝐮𝐭𝐢𝐧𝐚𝐭𝐢𝐨𝐧 𝐦𝐞𝐭𝐡𝐨𝐝
2. 𝐓𝐮𝐛𝐞 𝐚𝐠𝐠𝐥𝐮𝐭𝐢𝐧𝐚𝐭𝐢𝐨𝐧 𝐦𝐞𝐭𝐡𝐨𝐝.
● Slide agglutination may be either a qualitative or quantitative test.
● The tube method is more sensitive and accurate, but the slide agglutination method is widely used.

(A) S.hematobium
(B) E. Vermicular
(C) E.hstolytic
(D) None

Proteins are made of

(a) Sugar
(b) Fatty acid
(c) Nucleic acid
(d) Amino acid

Egg of schistosoma mansoni in Stool

Neisseria