BSF Staff Nurse - 2015
Medical Surgical Nursing
Easy

Which test is used to diagnose typhoid?

Appeared in: BSF Staff Nurse - 2015

Explanation

  • The Widal test is a classic serological agglutination assay specifically used to aid in the diagnosis of typhoid (enteric) fever.
  • It functions by detecting the presence of agglutinating antibodies in the patient's serum against the O (somatic) and H (flagellar) antigens of the bacterium Salmonella typhi.
  • Antibody titers typically begin to rise by the end of the first week of illness, making the test most useful from the second week onwards.
  • A four-fold or greater increase in antibody titers between two samples taken about 7-10 days apart is considered strong evidence of an active infection.

Why Other Options Were Wrong

  • Option A: ELISA is a general laboratory method, not a specific named test for typhoid in the context of the other options. While modern ELISA-based kits for typhoid (like Typhidot) exist, 'Widal test' refers to the specific, traditional agglutination test.
  • Option B: The Western blot is a highly specific confirmatory test, not a primary diagnostic tool for typhoid fever. It is used to confirm positive screening tests for other infections, most notably HIV.
  • Option D: The TOTHRA test is not a recognized or standard medical diagnostic procedure for typhoid fever or any other common disease. It is an incorrect option.

Related Visual

Visual explanation — Related Visual
Clinical Relevance
  • Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Diagnosis of Typhoid Fever as background academic context rather than a clinical decision trigger.
  • Nurses must understand that the Widal test has significant limitations. A negative result early in the illness does not rule out typhoid, and a positive result must be interpreted cautiously due to potential false positives from vaccination or past infections.
  • The gold standard for diagnosing typhoid fever, especially in the first week, is a blood culture. The Widal test is a supplementary test that becomes more reliable as the illness progresses into the second week.
  • Patient education is crucial. A nurse may need to explain to the patient or family why a second blood sample is needed a week later to look for a rising antibody titer, which provides more conclusive evidence than a single test.
How to Approach the Question
  • Analyze the question: The question asks to identify the specific test used to diagnose typhoid fever from the given options.
  • Evaluate the options based on medical knowledge. Recall or deduce the primary application of each test.
  • Option A (ELISA) is a broad technique, not a specific test name like Widal.
  • Option B (Western blot) is famously associated with confirming HIV, not diagnosing typhoid.
  • Option C (WIDAL test) is the classic, historically significant serological test for typhoid fever.
  • Option D (TOTHRA test) is not a standard medical term, making it an unlikely correct answer.
Concept Tested & Keywords
  • Concept Tested: Diagnosis of Typhoid Fever
  • Stem keywords: test, diagnose, typhoid
  • Lead-in keywords: Which
  • Negative lead-in flag: false

Question ID

QVXACSDiHo_f__H0sERQ2z

Reference Book

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 267-269

E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart B (pp 202-403 of 604) p. 92-94

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