AFB

Question 1

Intro:

1. oxygen requirementmen2. to enhance growth, place them in _______
2. Mycobacterium tuberculosis Complex (MBTC)
3. NTM = Fast Growers

Answer 1

1. obligate aerobes
2. increased CO2 conc.
3. M.tuberculosis; M.bovis; M.africanum; M.carnetti; M.microti
4. M.fortuitum, M.chelonae, M.abscessus

Question 2

Specimen Collection:

Sputum
1. _____mL
2. early morning specimen for ______
3. difficulty in coughing: perform _______
- inhale ______ or _______
4. criteria _____ epithelial cells w/ ______ PMS

______: recover bacteria that have been swallowed at night
1. _____mL
2. ____ specimens within ______ after overnight fast
3. neutralize with _______
4. for patients: _____,______,______

Answer 2

Sputum
1. 5-10mL
2. 3 consecutive days
3. aerosolization
- aerosol hypertonic saline or aerosol sodium chloride
4. <10 epithelial cells w/ >25 PMS

Gastric Lavage
1. 20-25mL
2. 3 specimen within 3 days
3. sodium carbonate
4. aerosol induction, for children <3yrs, nonambulatory individuals

Question 3

Urine
1. ____mL
2. first morning ______ special,em
- can be collected thru ______
3. in some reference: should collect ______ for ______, then centrifuge to concentrate the bacteria

Stool
1. immediately perform ______ after collection to decontaminate
2. for patients with _____
- for _________ bacteria

Answer 3

Urine
1. 15mL
2. first morning midstream specimen
- indwelling catheter
3. 3 specimen for 3 days

Stool
1. acid fast staining
2. AIDS
- M.avium intracellulare

Question 4

Blood
1. Perform ________
- w/ use of _____ (lysing agent)
2. Among _____

Tissue
1. Needs to _______
2. Sample tissues (3)

Answer 4

Blood
1. lysis centrifugation
- saponin
2. AIDS patient

Tissue
1. homogenize
2. bone marrow, lymph node, liver specimens

Question 5

Decontamination & Digestion:

1. kills contaminating organism
2. dissolve mucous substances

Answer 5

1. DECONTAMINATION
2. DIGESTION

Question 6

DECONTAMINATION (5)

Decontamination + Digestion (5)

No Decontamination (3)

Answer 6

DECONTAMINATION
- Voided urine
- Autopsy
- Tissue
- Abdominal fluid
- Any contaminated fluid

Decontamination + Digestion
- Sputum
- Gastric washing
- BAL
- Bronchial washing
- Transtracheal aspirate

No Decontamination
- CSF
- Synovial fluid
- Deep organ biopsy

Question 7

agents for decontamination & digestion:

1. digestant & decontaminating agent
   - conc of higher contamination risk but higher recovery
   - conc of effective decontaminating agent but severely reduce viability
2. decontaminating agent only for specimen with cystic fibrosis
   - sputum w/ _____
   - strong alkali acts as both _____ & _______
3. prolongs shelf life of sputum

Answer 7

1. Sodium Hydroxide
   - 2%
   - 4%
2. 4-5% Oxalic Acid
   - P.aeruginosa
   - mucolytic & antibacterial agent
3. Cetyl-Pyridium Chloride

Question 8

agents for decontamination & digestion:

1. most common method used in the laboratory
   - digestant (mucolytic agent)
   - decontaminating agent
2. _______ + _____
   - decontaminating agent (reduces the time of exposure )
   - digestant (rapidly liquify the sputum)

Answer 8

1. N-Acetyl-L-Cysteine
   + Sodium Hydroxide
   - N-Acetyl-L-Cysteine
   - Sodium Hydroxide
2. Benzalkonium Chloride
   + Trisodium Phosphate
   - Benzalkonium Chloride (Zephiran)
   - Trisodium Phosphate

Question 9

POST-DECONTAMINATION: centrifuged at

_____ for ______

or

_____ for _____

Answer 9

3000 x g for 15 minutes

2000 x g for 20 minutes t