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1992-01-01
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182 lines
NEW SET
A
The principal protector of the horseshoe crab's internal environment is
a primitive white blood cell called the amebocyte. Like the free-living
amebas for which it is named, it appears self-directed as it perambulates
the blood-stream in search of endotoxin-producing bacterial invaders,
including coliforms and other fecal bacteria. When it finds such a
bacterium, the amebocyte releases an enzyme and a clotting substance, which
reacts to transform the liquid blood around the bacterium into a sticky gel.
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1
1. As used in the above paragraph, the best definition for "perambulates" is:
A. strolls
B. rambles
C. travels through
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c
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B
Correct.
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wrong answer explanation
B
(C) The amebocyte travels through the bloodstream.
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B
The bacterium is immobilized and dies, like a tiger in a tar pit.
Usually only a tiny bit of gel is formed, but in a massive bacterial
infection, much of a horseshoe crab's blood turns to jelly - and the animal
may die as a result.
The active ingredients in this response can be extracted from the
amebocytes; the purified extract is called LAL, for limulus amebocyte
lysate. LAL is incredibly sensitive: It will detect as little as a
billionth of a gram of endotoxin in an eyedropper of water.
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1
1. Endotoxins are:
A. poisons released from bacteria
B. part of the crab's protective system
C. amebocytes
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a
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C
Correct.
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wrong answer explanation
C
(A) They are poisons which are released by bacteria.
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C
The present test for endotoxin requires injecting the drug product
into three to eight rabbits, then monitoring them carefully for several
hours to see if they become feverish. This is expensive and slow, and
takes many rabbits' lives. Blood specialist Levin decided that the same
information might be obtained more expeditiously using horseshoe crab
blood. Dr. Levin and his colleague, Dr. Frederick Bang, demonstrated that
the crab's blood could detect endotoxin.
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1
1. Based on this paragraph, it appears that:
A. Endotoxin is an ingredient used to manufacture drugs.
B. Endotoxin contaminates drugs.
C. Rabbits are immune to endotoxins.
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b
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D
Correct.
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wrong answer explanation
D
(B) Endotoxins contaminate drugs.
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D
Producers of LAL test kits freeze-dry the lysate extract. It is
then reconstituted with sterile water and added to a sample of the drug
or antibiotic or biological product to be tested or, in the case of a
medical device, to the saline solution in which the device has been
washed. If endotoxin is present in a sample, a firm clot will form.
In this way manufacturers can withhold from distribution products
contaminated with endotoxin levels that could cause serious reactions.
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1
1. The lysate extract is freeze-dried:
A. to make it edible
B. to make it sensitive to endotoxins
C. for ease of handling
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E
Correct.
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wrong answer explanation
E
(C) The extract is freeze-dried for shipping.
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E
"The test is now generally accepted as the best assay for
endotoxin," hematologist Peter A. Tomasulo told a Woods Hole conference
on horseshoe crabs and medicine. "The test is simple and easy to learn,
and requires no sophisticated equipment."
The test's principal users thus far are drug companies, for whom,
Levin says, it provides a far more sensitive endotoxin assay than
the rabbits.
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1
1. An endotoxin assay is:
A. a substance used to eliminate endotoxins
B. a method of producing endotoxins
C. a chemical test to determine if endotoxins are present
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c
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F
Correct.
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wrong answer explanation
F
(C) This is a test used for determining endotoxin presence.
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F
The LAL test also is being used to detect endotoxin in the body fluid
specimens withdrawn from critically ill patients, although FDA has not
specifically approved it for this purpose. It is particularly valuable,
Levin reports, in the diagnosis of bacterial meningitis, a dangerous
infection of the brain's membranes.
"Of all the infectious diseases we treat," Levin says, "meningitis is
the one in which rapid diagnosis and treatment are particularly critical.
The difference between treating now and in six hours may be life and death."
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1. The LAL test is the fastest way to detect endotoxin.
A. True
B. False
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a
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G
Correct.
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wrong answer explanation
G
(A) The LAL test is much faster than testing with rabbits.
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G
The standard tests are complicated and time-consuming. Using the
experimental LAL test and a single drop of spinal fluid from the patient,
meningitis due to gram-negative bacteria can be diagnosed in an hour,
speeding the start of appropriate antimicrobial therapy.
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1
1. The LAL test can be used to diagnose meningitis due to gram-negative
bacteria.
A. True
B. False
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a
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H
Correct.
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wrong answer explanation
H
The LAL test can be used to test for meningitis due to gram-negative
bacteria.
end