Q 1:
A
10-month-old child, who is below the 5th percentile for height and weight, has
recurrent thrush and chronic diarrhea. He has received his primary series of
diphtheria, tetanus, acellular pertussis vaccine; poliovirus vaccine,
inactivated; hepatitis B; Haemophilus influenzae type B; and pneumococcal
conjugate vaccine.
Of
the following, the BEST skin test to evaluate the adequacy of delayed
hypersensitivity in this child is:
A.
coccidioidin
B.
histoplasmin
C.
Schick test
D.
tetanus toxoid
E.
tuberculin, purified protein derivative
Answer
D
Answer
D
Intradermal
skin testing for delayed-type hypersensitivity is the best measure of T
cell-mediated immunity. This usually is performed by applying Candida,
Trichophyton, and tetanus skin tests. A healthy host who has had prior exposure
to these antigens will develop induration at the site of skin testing. A host
who has a defect in T-cell activity or production will be unable to mount the
delayed hypersensitivity response.
Coccidioidin
is used to diagnose coccidioidomycosis, histoplasmin is used in epidemiologic
studies to detect Histoplasma exposure, the Schick test is used to determine
immunity to diphtheria, and the tuberculin, purified protein derivative is used
to diagnose infection with Mycobacterium tuberculosis.
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