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BACTE MIDTERMS > 4.1 > Flashcards

4.1 Flashcards

1
Q

MAJOR GENERA AND SPECIES TO BE CONSIDERED

A

I. Mycobacterium tuberculosis Complex
II. Nontuberculous Mycobacteria

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2
Q

I. Mycobacterium tuberculosis Complex spp

A

✓ M. tuberculosis
✓ M. bovis
✓ M. bovis BCG
✓ M. africanum
✓ M. caprae
✓ M. canettii
✓ M. microti
✓M. pinnipedii

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3
Q

II. Nontuberculous Mycobacteria subgroups

A

A. Slow-Growing Nonphotochromogens
B. Photochromogens
C. Scotochromogens
D. Rapid-growing, potentially pathogenic

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4
Q

A. Slow-Growing Nonphotochromogens spp

A

✓ M. avium complex
✓ M. intracellulare
✓ M. celatum
✓ M. ulcerans
✓ M. gastri

✓ M. genavense
✓ M. haemophilum
✓ M. malmoense
✓ M. shimoidei
✓ M. xenopi

✓ M. heidelbergense
✓ M. branderi
✓ M. simiae
✓ M. triplex
✓ M. conspicuum

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5
Q

M avium complex

A

✓ M. avium
subsp. avium
subsp. silvaticum
subsp. paratuberculosis

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6
Q

B. Photochromogens spp.

A

✓ M. kansasii
✓ M. asiaticum
✓ M. marinum

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7
Q

C. Scotochromogens spp.

A

✓ M. szulgai
✓ M. scrofulaceum
✓ M. interjectum
✓ M. gordonae
✓ M. cookii
✓ M. hiberniae
✓ M. lentiflavum
✓ M. conspicuum
✓ M. heckeshornense
✓ M. tusciae
✓ M. kubicae
✓ M. ulcerans
✓ M. bobemicum

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8
Q

D. Rapid-growing, potentially pathogenic spp.

A

✓ M. fortuitum
✓ M. chelonae
✓ M. abscessus subsp. abscessus
✓ M. abscessus subsp. Bolletii
✓ M. smegmatis

✓ M. peregrinum
✓ M. immunogenum
✓ M. mucogenicum
✓ M. neworleansense
✓ M. brisbanense

✓ M. senegalense
✓ M. porcinum
✓ M. houstonense
✓ M. boenickei
✓ M. wolinskyi

✓ M. goodii
✓ M. septicum
✓ M. mageritense
✓ M. canariasense
✓ M. alvei

✓ M. novocastrense
✓ M. cosmeticum
✓ M. setense
✓ M. leprae

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9
Q

Non-cultivatable spp

A

✓ M. leprae

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10
Q

SPECIMEN COLLECTION AND TRANSPORT
* Recommend container

A

sterile, wide-mouth cup
with a lightly fitted lid

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11
Q

SPECIMEN COLLECTION AND TRANSPORT * Delayed longer than 1 hour transport method

A

refrigerated at 4°C
except blood

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12
Q

Respiratory specimens

A

✓ spontaneously expectorated sputum
✓ normal saline-nebulized induced sputum
✓ transtracheal aspirate
✓ bronchoalveolar lavage
✓ bronchoalveolar brushing
✓ laryngeal swab
✓ nasopharyngeal swab

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13
Q

Body fluids specimens

A

✓ pleural fluid
✓ pericardial fluid
✓ joint aspirate
✓ peritoneal fluid
✓ cerebrospinal fluid
✓ stool
✓ urine
✓ pus

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14
Q

Body tissues specimens

A

✓ blood
✓ bone marrow biopsy/aspirate
✓ solid organ
✓ lymph node
✓ bone
✓ skin

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15
Q

a. Sputum and Other Respiratory Secretions * Preferred specimen

A

Early-morning
specimen collected on 3 consecutive days

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16
Q

Sputum and Other Respiratory Secretions * Method of choice

A

Spontaneously produced sputum

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17
Q

Required volume for Sputum and Other Respiratory Secretions

A

5 to 10 ml

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18
Q

Type of sputum needed

A

->deep cough expectorated sputum or
aerosol of hypertonic saline induced

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19
Q

Microscopy results for Sputum and Other Respiratory Secretions to confirm a diagnosis

A

<10 SEC and >25 pus cells

from two of the first three sputum direct
smears (+)

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20
Q

Others Sputum specimens

A

Bronchial washing, bronchoalveolar lavage (BAL), or transbronchial biopsy-> Bronchoscopy

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21
Q

Specimen to recover mycobacteria swallowed during the night

A

Gastric Aspirates and Washings

22
Q

Gastric Aspirates and Washings used for which patients

A

✓ patients who do not produce sputum
by aerosol induction
✓ children younger than 3 years->
specimen of choice
✓ senile, nonambulatory patients

23
Q
  • obtained in morning after an overnight
    fast, before the patient arises and before
    exertion empties the stomach
A

Gastric Aspirates and Washings

24
Q

Gastric Aspirates and Washings collection method

A
  • 3 specimens within 3 days
25
Q

Used to neutraliz Gastric Aspirates and Washings specimen

A

sodium carbonate or buffer to PH 7.0

26
Q

required volume for Gastric Aspirates and Washings

A

20 to 25 ml

27
Q

Preferred specimen for Urine Specimens

A

First morning midstream specimens daily for at least 3 days

28
Q

Volume required for urine specimens

A

entire volume or, minimum of 15 mL

29
Q

Specimen used that identifies patients at risk for developing disseminated mycobacterial disease resulting from Mycobacterium avium complex (MAC) (AIDS)

  • do not use preservative
  • utilized in automated equipment
A

Stool

30
Q

Stool automated equipment used

A

MGIT 960

31
Q

Blood medium

A

MYCO/F bottle

32
Q

Specimen used for

  • disseminated mycobacterial infection-> MAC
    ✓ Isolator lysis-centrifugation system > quantitative data
A

Blood

33
Q

Blood automated equipment used

A

✓ Bactec MGIT 960 system

  • BacT/ALERT 3D or BacT/Alert MB
34
Q

Specimen for tissue and other body fluids

A

Pleural, pericardial, peritoneal, joint aspirates and CSF

35
Q

Volume Required for CSF

A

2 ml

36
Q

Volume Required for exudates and pericardial and synovial fluids

A

3 to 5 ml -

37
Q

Volume Required for abdominal and chest fluids

A

10 to 15 ml

38
Q

Volume Required best type of specimen for skin lesion or wound

A

Aspirate

39
Q

Volume Required to prevent dehydration

A

10 to 15 mL sterile NSS

40
Q

Specimens that needs to undergo DIGESTION AND DECONTAMINATION

A

Sputum, gastric washing, BAL, bronchial washing, and transtracheal aspirate

41
Q

Specimens that needs to undergo DECONTAMINATION

A

Voided urine, autopsy tissue, abdominal fluid,
and any contaminated fluid

42
Q
  1. liquefy sample through digestion of
    proteinaceous material (mucin)
    -> enables mycobacteria to use
    nutrients of the medium
  2. allow chemical decontaminating agent to
    kill the nonmycobacterial organisms
    ->concentrated with centrifugation
A

DIGESTION AND DECONTAMINATION OF
SPECIMENS

43
Q

DIGESTION AND DECONTAMINATION OF
SPECIMENS Factors

A

concentration of the chemical agent, exposure time, and temperature

44
Q

REAGENTS for Digestion and decontamination

main

A

2%-4% Sodium Hydroxide

N-Acetyl-L-cysteine-Sodium Hydroxide (NALCNaOH)

Benzalkonium Chloride (Zephiran)-Trisodium
Phosphate (Z-TSP)

5% Oxalic Acid

1% Cetylpyridium Chloride

45
Q

REAGENTS for Digestion and decontamination

others

A

a. 4% H2SO4
b. Sputolysin (Dithiothreitol)-Oxalic Acid
c. 20% Chlorox
d. 1% Cetylpyridium Chloride + 2% NaCI
e. Sputolysin + 2% NaOH
f. 2 parts of Antiformin (Na Hypochlorite) to 1 part sputum

46
Q
  • digestant and decontaminating agent
  • commonly used decontaminant (2ml sputum + 2ml NaOH)
A

2%-4% Sodium Hydroxide

47
Q

*>recommended technique
*>use in MGIT 960
NALC or Dithiothreitol > liquetying agent
NaOH ->decontaminant

A

N-Acetyl-L-cysteine-Sodium Hydroxide (NALCNaOH)

48
Q

_______ -> liquefies sputum rapidly ; long exposure time to decontaminate
________ -> shortens exposure time and destroys many contaminants

A

(Zephiran)-Trisodium Phosphate (Z-TSP)

Benzalkonium Chloride

Benzalkonium Chloride (Zephiran)-Trisodium
Phosphate (Z-TSP)

49
Q
  • decontaminate specimens contaminated with P. aeruginosa
A

5% Oxalic Acid

50
Q

prolong the shelflife of sputum up to 8 days
* ideal for transport of specimen

A

1% Cetylpyridium Chloride

51
Q

Procedure for digestion and decontamination

A
  1. Specimen + Digestant
  2. Mix and stand at room temp for several minutes
  3. Centrifuge ->SG: 0.79 to 1.07
  4. Decant
  5. Sediments for smears and cultures

BACTE MIDTERMS (17 decks)

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