Hema II Chapter 10_LE cell.pptx
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Hematology 2 ppt
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π¬ 1. WEIL-FELIX TEST
π Definition
Weil-Felix test is a heterophile agglutination test used for the diagnosis of rickettsial infections based on cross-reaction between Rickettsia antibodies and Proteus antigens.
βοΈ Principle
Rickettsia shares antigenic similarity with some Proteus strains
Patient serum containing antibodies reacts with Proteus OX antigens
Visible agglutination = positive reaction
π§« Antigens Used
OX19 β Typhus group
OX2 β Spotted fever group
OXK β Scrub typhus
π§ͺ Procedure (Slide Method)
Place drop of patient serum on slide
Add specific antigen (OX19 / OX2 / OXK)
Mix gently
Observe for agglutination within few minutes
π Interpretation
Agglutination β Positive
No agglutination β Negative
π High titer suggests active infection
π Uses
Screening test for:
Typhus
Scrub typhus
Spotted fever
β οΈ Limitations
Low sensitivity and specificity
False positive common
Cannot confirm diagnosis alone
β Key Point
π It is an old test β now replaced by more specific methods (ELISA, PCR)
π§ͺ 2. WIDAL TEST
π Definition
Widal test is a serological agglutination test used for diagnosing typhoid (enteric) fever.
π¦ Causative Organism
Salmonella typhi
Salmonella paratyphi
βοΈ Principle
Detects antibodies against:
O antigen (somatic)
H antigen (flagellar)
Antigen + antibody β agglutination
π§« Types of Antigens
O antigen β Early infection
H antigen β Late infection
AH / BH β Paratyphoid
π§ͺ Procedure
Slide Method (Screening)
Add serum on slide
Add antigen
Mix and observe
Tube Method (Quantitative)
Serial dilution of serum
Add antigen
Incubate
Read agglutination titer
π Interpretation
Significant titer (commonly β₯1:160)
Rising titer in paired samples is more reliable
π O = active infection
π H = past or late infection
π Uses
Diagnosis of:
Typhoid fever
Paratyphoid fever
β οΈ Limitations
False positive (previous infection, vaccination)
False negative in early stage
Must interpret with clinical findings
βοΈ DIFFERENCE (VERY IMPORTANT FOR EXAM)
FeatureWeil-FelixWidalDiseaseRickettsial infectionTyphoid feverAntigenProteus (OX strains)Salmonella (O, H)PrincipleCross-reactionAntibody detectionUseScreening (old)Common but limitedAccuracyLowModerate
π― QUICK REVISION
Weil-Felix β Rickettsia + Proteus cross reaction
Widal β Typhoid + O & H antibodies
π§ COMMON ERRORS IN LAB
Using expired antigen
Wrong serum dilution
Misreading weak agglutination
Not considering baseline titer
π’ FINAL MESSAGE
π Never rely only on these tests
π Always correlate with:
Clinical signs
Culture
Modern tests (ELISA, PCR)
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π Definition
Weil-Felix test is a heterophile agglutination test used for the diagnosis of rickettsial infections based on cross-reaction between Rickettsia antibodies and Proteus antigens.
βοΈ Principle
Rickettsia shares antigenic similarity with some Proteus strains
Patient serum containing antibodies reacts with Proteus OX antigens
Visible agglutination = positive reaction
π§« Antigens Used
OX19 β Typhus group
OX2 β Spotted fever group
OXK β Scrub typhus
π§ͺ Procedure (Slide Method)
Place drop of patient serum on slide
Add specific antigen (OX19 / OX2 / OXK)
Mix gently
Observe for agglutination within few minutes
π Interpretation
Agglutination β Positive
No agglutination β Negative
π High titer suggests active infection
π Uses
Screening test for:
Typhus
Scrub typhus
Spotted fever
β οΈ Limitations
Low sensitivity and specificity
False positive common
Cannot confirm diagnosis alone
β Key Point
π It is an old test β now replaced by more specific methods (ELISA, PCR)
π§ͺ 2. WIDAL TEST
π Definition
Widal test is a serological agglutination test used for diagnosing typhoid (enteric) fever.
π¦ Causative Organism
Salmonella typhi
Salmonella paratyphi
βοΈ Principle
Detects antibodies against:
O antigen (somatic)
H antigen (flagellar)
Antigen + antibody β agglutination
π§« Types of Antigens
O antigen β Early infection
H antigen β Late infection
AH / BH β Paratyphoid
π§ͺ Procedure
Slide Method (Screening)
Add serum on slide
Add antigen
Mix and observe
Tube Method (Quantitative)
Serial dilution of serum
Add antigen
Incubate
Read agglutination titer
π Interpretation
Significant titer (commonly β₯1:160)
Rising titer in paired samples is more reliable
π O = active infection
π H = past or late infection
π Uses
Diagnosis of:
Typhoid fever
Paratyphoid fever
β οΈ Limitations
False positive (previous infection, vaccination)
False negative in early stage
Must interpret with clinical findings
βοΈ DIFFERENCE (VERY IMPORTANT FOR EXAM)
FeatureWeil-FelixWidalDiseaseRickettsial infectionTyphoid feverAntigenProteus (OX strains)Salmonella (O, H)PrincipleCross-reactionAntibody detectionUseScreening (old)Common but limitedAccuracyLowModerate
π― QUICK REVISION
Weil-Felix β Rickettsia + Proteus cross reaction
Widal β Typhoid + O & H antibodies
π§ COMMON ERRORS IN LAB
Using expired antigen
Wrong serum dilution
Misreading weak agglutination
Not considering baseline titer
π’ FINAL MESSAGE
π Never rely only on these tests
π Always correlate with:
Clinical signs
Culture
Modern tests (ELISA, PCR)
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π§ͺ To All MLS Exit Exam Takers β Our Team
Tomorrow is your day. You have studied, practiced, and prepared for this moment. Trust your knowledge and your skills in the laboratory.
Remember:
β Stay calm and focused
β Read each question carefully
β Manage your time well
β Believe in what you have learned
This exam is not beyond you β it is a reflection of your hard work. Step in with confidence and give your best.
πͺ We wish all of you success in your Exit Exam
π Your effort will pay off
You are ready. Go and make it happen.
@laboratorypractice
Tomorrow is your day. You have studied, practiced, and prepared for this moment. Trust your knowledge and your skills in the laboratory.
Remember:
β Stay calm and focused
β Read each question carefully
β Manage your time well
β Believe in what you have learned
This exam is not beyond you β it is a reflection of your hard work. Step in with confidence and give your best.
πͺ We wish all of you success in your Exit Exam
π Your effort will pay off
You are ready. Go and make it happen.
@laboratorypractice
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π’ For MLS Students Who Took the Exit Exam
First of all, congratulations to all Medical Laboratory Science students who have finished the Exit Exam! ππ¬
You have passed through a long academic journey, and completing this exam is a big achievement.
Now, we kindly want to ask you:
β How was the Exit Exam?
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β Was the exam easy, moderate, or difficult?
β What advice would you give for junior MLS students who will take the exam next year?
β What should students focus on during preparation?
Please share your ideas, experience, and recommendations in the comment section. Your feedback will help junior students prepare better and avoid mistakes.
Thank you for sharing your experience, and once again, congratulations for finishing the Exit Exam! ππ¬
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First of all, congratulations to all Medical Laboratory Science students who have finished the Exit Exam! ππ¬
You have passed through a long academic journey, and completing this exam is a big achievement.
Now, we kindly want to ask you:
β How was the Exit Exam?
β Which courses or topics were highly emphasized?
β Was the exam easy, moderate, or difficult?
β What advice would you give for junior MLS students who will take the exam next year?
β What should students focus on during preparation?
Please share your ideas, experience, and recommendations in the comment section. Your feedback will help junior students prepare better and avoid mistakes.
Thank you for sharing your experience, and once again, congratulations for finishing the Exit Exam! ππ¬
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β Short MCQ videos
β Practical laboratory explanations
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The Gram staining method, named after the Danish bacteriologist who originally devised it in 1882 Hans Christian Gram, is one of the most important staining techniques in microbiology. It is almost always the first test performed for the identification of bacteria.In Berlin, in 1884, Gram developed a method for distinguishing between two major classes of bacteria. This technique, known as Gram staining, continues to be a standard procedure of medical microbiology. This work gained Gram an international reputation. The staining method later played a major role in classifying bacteria. Gram was a modest man, and in his initial publication he remarked, "I have therefore published the method, although I am aware that as yet it is very defective and imperfect; but it is hoped that also in the hands of other investigators it will turn out to be useful."
A Gram stain is made using aprimary stain of crystal violet and a counterstain of safranin. Bacteria that turn purple when stained are termed.
A Gram stain is made using aprimary stain of crystal violet and a counterstain of safranin. Bacteria that turn purple when stained are termed.
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π§ͺ CULTURE MEDIA & BIOCHEMICAL TESTS (BY SAMPLE TYPE)
π For Laboratory Practice & Exam Preparation
βββββββββββββββββββ
π§ URINE SAMPLE
πΉ Escherichia coli (E. coli)
β’ CLED agar β Yellow colonies (Lactose fermenter)
β’ MacConkey agar β Pink colonies
β’ Biochemical β Indole + | MR + | Citrate β | Urease β
πΉ Klebsiella pneumoniae
β’ CLED agar β Yellow mucoid colonies
β’ MacConkey agar β Pink mucoid colonies
β’ Biochemical β Citrate + | Urease + | Indole β
πΉ Proteus mirabilis
β’ Blood agar β Swarming growth
β’ MacConkey agar β Non-lactose fermenter
β’ Biochemical β Urease + | HβS + | Indole β
πΉ Enterococcus spp.
β’ Blood agar β Small colonies
β’ Biochemical β Bile Esculin +
βββββββββββββββββββ
π© STOOL SAMPLE
πΉ Salmonella spp.
β’ Selenite F broth β Enrichment
β’ XLD agar β Red colonies with black center
β’ SS agar β Colorless with black center
β’ Biochemical β TSI (K/A), HβS +, Urease β
πΉ Shigella spp.
β’ XLD agar β Red colonies
β’ SS agar β Colorless colonies
β’ Biochemical β TSI (K/A), HβS β, Urease β
πΉ Vibrio cholerae
β’ Alkaline Peptone Water β Enrichment
β’ TCBS agar β Yellow colonies
β’ Biochemical β Oxidase +
πΉ Pathogenic E. coli
β’ MacConkey agar β Pink colonies
β’ Biochemical β Indole +
βββββββββββββββββββ
π« SPUTUM SAMPLE
πΉ Streptococcus pneumoniae
β’ Blood agar β Alpha hemolysis
β’ Biochemical β Optochin sensitive | Bile soluble
πΉ Klebsiella pneumoniae
β’ Blood agar β Mucoid colonies
β’ MacConkey agar β Pink mucoid
β’ Biochemical β Citrate + | Urease +
πΉ Pseudomonas aeruginosa
β’ Blood agar β Green pigment
β’ MacConkey agar β Non-lactose fermenter
β’ Biochemical β Oxidase +
πΉ Haemophilus influenzae
β’ Chocolate agar β Growth only
β’ Biochemical β Requires X & V factors
βββββββββββββββββββ
π THROAT SWAB
πΉ Streptococcus pyogenes
β’ Blood agar β Beta hemolysis
β’ Biochemical β Bacitracin sensitive | Catalase β
πΉ Corynebacterium diphtheriae
β’ Loeffler medium β Enhanced growth
β’ Tellurite agar β Black colonies
β’ Biochemical β Urease β | Albert stain +
βββββββββββββββββββ
π§ CSF SAMPLE
πΉ Neisseria meningitidis
β’ Chocolate agar β Growth
β’ Biochemical β Oxidase +
πΉ Streptococcus pneumoniae
β’ Blood agar β Alpha hemolysis
β’ Biochemical β Optochin sensitive
πΉ Haemophilus influenzae
β’ Chocolate agar β Growth
β’ Biochemical β X & V factors required
βββββββββββββββββββ
π©Έ BLOOD SAMPLE
πΉ Salmonella Typhi
β’ Blood culture (BHI broth) β Isolation
β’ MacConkey agar β Non-lactose fermenter
β’ Biochemical β TSI (K/A), HβS +, Urease β
πΉ Staphylococcus aureus
β’ Blood agar β Golden beta hemolysis
β’ Biochemical β Catalase + | Coagulase +
πΉ Streptococcus spp.
β’ Blood agar β Hemolytic colonies
β’ Biochemical β Catalase β
βββββββββββββββββββ
π©Ή PUS / WOUND SWAB
πΉ Staphylococcus aureus
β’ Blood agar β Golden colonies
β’ Biochemical β Catalase + | Coagulase +
πΉ Pseudomonas aeruginosa
β’ Blood agar β Green pigment
β’ MacConkey agar β Non-lactose fermenter
β’ Biochemical β Oxidase +
πΉ Streptococcus pyogenes
β’ Blood agar β Beta hemolysis
β’ Biochemical β Catalase β
βββββββββββββββββββ
πΈ VAGINAL SWAB
πΉ Candida albicans
β’ SDA β Creamy white colonies
β’ Biochemical β Germ tube +
πΉ Neisseria gonorrhoeae
β’ Thayer-Martin β Growth
β’ Chocolate agar β Growth
β’ Biochemical β Oxidase +
πΉ Group B Streptococcus
β’ Blood agar β Narrow beta hemolysis
β’ Biochemical β CAMP test +
βββββββββββββββββββ
π» URETHRAL SWAB
πΉ Neisseria gonorrhoeae
β’ Thayer-Martin β Growth
β’ Chocolate agar β Growth
β’ Biochemical β Oxidase +
βββββββββββββββββββ
π EAR SWAB
πΉ Pseudomonas aeruginosa
β’ Blood agar β Green pigment
β’ MacConkey agar β Non-lactose fermenter
β’ Biochemical β Oxidase +
πΉ Staphylococcus aureus
β’ Blood agar β Golden colonies
β’ Biochemical β Catalase + | Coagulase +
βββββββββββββββββββ
π¦ SPUTUM (TB)
πΉ Mycobacterium tuberculosis
β’ LowensteinβJensen β Rough, buff colonies
β’ MGIT β Rapid detection
β’ Biochemical β Niacin + | Nitrate reduction +
βββββββββββββββββββ
π₯ MOST IMPORTANT TESTS (MUST REMEMBER)
π For Laboratory Practice & Exam Preparation
βββββββββββββββββββ
π§ URINE SAMPLE
πΉ Escherichia coli (E. coli)
β’ CLED agar β Yellow colonies (Lactose fermenter)
β’ MacConkey agar β Pink colonies
β’ Biochemical β Indole + | MR + | Citrate β | Urease β
πΉ Klebsiella pneumoniae
β’ CLED agar β Yellow mucoid colonies
β’ MacConkey agar β Pink mucoid colonies
β’ Biochemical β Citrate + | Urease + | Indole β
πΉ Proteus mirabilis
β’ Blood agar β Swarming growth
β’ MacConkey agar β Non-lactose fermenter
β’ Biochemical β Urease + | HβS + | Indole β
πΉ Enterococcus spp.
β’ Blood agar β Small colonies
β’ Biochemical β Bile Esculin +
βββββββββββββββββββ
π© STOOL SAMPLE
πΉ Salmonella spp.
β’ Selenite F broth β Enrichment
β’ XLD agar β Red colonies with black center
β’ SS agar β Colorless with black center
β’ Biochemical β TSI (K/A), HβS +, Urease β
πΉ Shigella spp.
β’ XLD agar β Red colonies
β’ SS agar β Colorless colonies
β’ Biochemical β TSI (K/A), HβS β, Urease β
πΉ Vibrio cholerae
β’ Alkaline Peptone Water β Enrichment
β’ TCBS agar β Yellow colonies
β’ Biochemical β Oxidase +
πΉ Pathogenic E. coli
β’ MacConkey agar β Pink colonies
β’ Biochemical β Indole +
βββββββββββββββββββ
π« SPUTUM SAMPLE
πΉ Streptococcus pneumoniae
β’ Blood agar β Alpha hemolysis
β’ Biochemical β Optochin sensitive | Bile soluble
πΉ Klebsiella pneumoniae
β’ Blood agar β Mucoid colonies
β’ MacConkey agar β Pink mucoid
β’ Biochemical β Citrate + | Urease +
πΉ Pseudomonas aeruginosa
β’ Blood agar β Green pigment
β’ MacConkey agar β Non-lactose fermenter
β’ Biochemical β Oxidase +
πΉ Haemophilus influenzae
β’ Chocolate agar β Growth only
β’ Biochemical β Requires X & V factors
βββββββββββββββββββ
π THROAT SWAB
πΉ Streptococcus pyogenes
β’ Blood agar β Beta hemolysis
β’ Biochemical β Bacitracin sensitive | Catalase β
πΉ Corynebacterium diphtheriae
β’ Loeffler medium β Enhanced growth
β’ Tellurite agar β Black colonies
β’ Biochemical β Urease β | Albert stain +
βββββββββββββββββββ
π§ CSF SAMPLE
πΉ Neisseria meningitidis
β’ Chocolate agar β Growth
β’ Biochemical β Oxidase +
πΉ Streptococcus pneumoniae
β’ Blood agar β Alpha hemolysis
β’ Biochemical β Optochin sensitive
πΉ Haemophilus influenzae
β’ Chocolate agar β Growth
β’ Biochemical β X & V factors required
βββββββββββββββββββ
π©Έ BLOOD SAMPLE
πΉ Salmonella Typhi
β’ Blood culture (BHI broth) β Isolation
β’ MacConkey agar β Non-lactose fermenter
β’ Biochemical β TSI (K/A), HβS +, Urease β
πΉ Staphylococcus aureus
β’ Blood agar β Golden beta hemolysis
β’ Biochemical β Catalase + | Coagulase +
πΉ Streptococcus spp.
β’ Blood agar β Hemolytic colonies
β’ Biochemical β Catalase β
βββββββββββββββββββ
π©Ή PUS / WOUND SWAB
πΉ Staphylococcus aureus
β’ Blood agar β Golden colonies
β’ Biochemical β Catalase + | Coagulase +
πΉ Pseudomonas aeruginosa
β’ Blood agar β Green pigment
β’ MacConkey agar β Non-lactose fermenter
β’ Biochemical β Oxidase +
πΉ Streptococcus pyogenes
β’ Blood agar β Beta hemolysis
β’ Biochemical β Catalase β
βββββββββββββββββββ
πΈ VAGINAL SWAB
πΉ Candida albicans
β’ SDA β Creamy white colonies
β’ Biochemical β Germ tube +
πΉ Neisseria gonorrhoeae
β’ Thayer-Martin β Growth
β’ Chocolate agar β Growth
β’ Biochemical β Oxidase +
πΉ Group B Streptococcus
β’ Blood agar β Narrow beta hemolysis
β’ Biochemical β CAMP test +
βββββββββββββββββββ
π» URETHRAL SWAB
πΉ Neisseria gonorrhoeae
β’ Thayer-Martin β Growth
β’ Chocolate agar β Growth
β’ Biochemical β Oxidase +
βββββββββββββββββββ
π EAR SWAB
πΉ Pseudomonas aeruginosa
β’ Blood agar β Green pigment
β’ MacConkey agar β Non-lactose fermenter
β’ Biochemical β Oxidase +
πΉ Staphylococcus aureus
β’ Blood agar β Golden colonies
β’ Biochemical β Catalase + | Coagulase +
βββββββββββββββββββ
π¦ SPUTUM (TB)
πΉ Mycobacterium tuberculosis
β’ LowensteinβJensen β Rough, buff colonies
β’ MGIT β Rapid detection
β’ Biochemical β Niacin + | Nitrate reduction +
βββββββββββββββββββ
π₯ MOST IMPORTANT TESTS (MUST REMEMBER)
β€10
β Catalase + β Staphylococcus
β Coagulase + β Staphylococcus aureus
β Oxidase + β Pseudomonas | Vibrio | Neisseria
β Indole + β E. coli
β Urease + β Proteus | Klebsiella
β Citrate + β Klebsiella
β HβS + β Salmonella | Proteus
β Germ tube + β Candida albicans
β Optochin sensitive β S. pneumoniae
β Bacitracin sensitive β S. pyogenes
β CAMP test + β Group B Streptococcus
β X & V factors β Haemophilus influenzae
βββββββββββββββββββ
π’ Follow for more Laboratory Notes
π Telegram: @laboratorypractice
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π Read. Practice. Share.
β Coagulase + β Staphylococcus aureus
β Oxidase + β Pseudomonas | Vibrio | Neisseria
β Indole + β E. coli
β Urease + β Proteus | Klebsiella
β Citrate + β Klebsiella
β HβS + β Salmonella | Proteus
β Germ tube + β Candida albicans
β Optochin sensitive β S. pneumoniae
β Bacitracin sensitive β S. pyogenes
β CAMP test + β Group B Streptococcus
β X & V factors β Haemophilus influenzae
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Mcq question
A 25-year-old female presents with fatigue. CBC shows Hb 8 g/dL and MCV 65 fL.
What is the most expected peripheral smear finding?
A. Macrocytes
B. Microcytes
C. Spherocytes
D. Target cells
Answer: B
Explanation: Low MCV indicates microcytic anemia, commonly due to iron deficiency.
A patient presents with fever. CBC shows WBC 18,000/Β΅L with neutrophilia.
What is the most likely cause?
A. Viral infection
B. Bacterial infection
C. Allergy
D. Parasitic infection
Answer: B
Explanation: Neutrophilia is strongly associated with bacterial infections.
A patient has platelet count of 20,000/Β΅L.
What is the most immediate clinical concern?
A. Thrombosis
B. Bleeding
C. Infection
D. Anemia
Answer: B
Explanation: Severe thrombocytopenia increases risk of spontaneous bleeding.
Urine culture shows pink colonies on MacConkey agar.
Which organism is most likely?
A. Proteus
B. Escherichia coli
C. Salmonella
D. Shigella
Answer: B
Explanation: Lactose fermenters like E. coli produce pink colonies.
A culture plate shows swarming growth on blood agar.
Which organism is responsible?
A. Klebsiella
B. Staphylococcus
C. Proteus
D. E. coli
Answer: C
Explanation: Proteus species show characteristic swarming motility.
Gram stain shows purple cocci arranged in clusters.
What is the likely organism?
A. Streptococcus
B. Staphylococcus
C. Neisseria
D. Bacillus
Answer: B
Explanation: Gram-positive cocci in clusters indicate Staphylococcus.
A patient suspected of TB undergoes GeneXpert testing.
What does the test detect?
A. Antibodies
B. DNA of Mycobacterium tuberculosis
C. Culture growth
D. Protein antigens
Answer: B
Explanation: GeneXpert detects MTB DNA and rifampicin resistance.
A sample shows acid-fast bacilli after Ziehl-Neelsen staining.
What is the organism?
A. E. coli
B. Staphylococcus
C. Mycobacterium tuberculosis
D. Streptococcus
Answer: C
Explanation: AFB staining identifies Mycobacterium species.
AST results show a large zone of inhibition around an antibiotic disc.
What does it indicate?
A. Resistance
B. Sensitivity
C. Contamination
D. Mutation
Answer: B
Explanation: Larger zone = organism is sensitive to the antibiotic.
A blood sample is hemolyzed before analysis.
Which test result is most affected?
A. Sodium
B. Potassium
C. Chloride
D. Calcium
Answer: B
Explanation: Hemolysis releases intracellular potassium, falsely elevating levels.
A patientβs creatinine is elevated.
Which organ is primarily affected?
A. Liver
B. Kidney
C. Heart
D. Lung
Answer: B
Explanation: Creatinine reflects renal function.
Cobas e601 module is mainly used for:
A. Electrolytes
B. Hormones
C. CBC
D. Culture
Answer: B
Explanation: e601 uses immunoassay for hormones like TSH.
A stool sample shows trophozoites with motility in saline wet mount.
What does it indicate?
A. Dead parasite
B. Active infection
C. Contamination
D. Artifact
Answer: B
Explanation: Motility indicates live trophozoites.
Malaria smear shows banana-shaped gametocytes.
Which species is this?
A. P. vivax
B. P. malariae
C. P. falciparum
D. P. ovale
Answer: C
Explanation: Crescent-shaped gametocytes are characteristic of P. falciparum.
A thick blood film is mainly used for:
A. Species identification
B. Parasite detection
C. Cell morphology
D. Platelet count
Answer: B
Explanation: Thick film increases sensitivity for parasite detection.
During phlebotomy, which tube is drawn first?
A. EDTA
B. Citrate
C. Blood culture
D. Fluoride
Answer: C
Explanation: Blood culture is first to avoid contamination.
Which anticoagulant is used for CBC?
A. Heparin
B. EDTA
C. Citrate
D. Fluoride
Answer: B
Explanation: EDTA preserves cell morphology.
A patient tests positive for HBsAg.
What does it indicate?
A. Immunity
B. Active infection
C. Past infection
D. Vaccination
Answer: B
Explanation: HBsAg indicates current Hepatitis B infection.
CD4 count is <200 cells/Β΅L.
What does it indicate?
A. Normal immunity
B. Severe immunosuppression
C. Mild infection
D. Recovery
Answer: B
Explanation: CD4 <200 defines AIDS stage.
Urine microscopy shows many WBCs and bacteria.
What is the diagnosis?
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