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IBI Test 2 > B3-003 Laboratory Diagnosis of Infectious Disease > Flashcards

B3-003 Laboratory Diagnosis of Infectious Disease Flashcards

1
Q

nucleic acid hybridization
NAAT
Sequencing
Mass spectrometry

are examples of

A

molecular testing

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2
Q

advantages: molecular testing

A

fast

sometimes increased sensitivity

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3
Q

limitations: molecular testing

A

expensive
targeted
no susceptibility testing

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4
Q

source of false positives for molecular testing

A

contamination at collection or lab

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5
Q

sources of false negatives for molecular testing

A

below limit of detection
biological inhibitors

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6
Q

steps of PCR

A

extract
denature
anneal
elongate
repeats

detection and quantification

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7
Q

examples of NAAT amplification and detection tests

A

single panel
multipanel: respiratory panel

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8
Q

most FDA-cleared NAAT test are

A

amplification + detection

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9
Q

all laboratory developed NAAT tests are

A

amplification and sequencing

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10
Q

examples of NAAT amplification and sequencing tests

A

broad range PCR
metagenomics

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11
Q

MALDI is used to

A

identify cultured bacteria

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12
Q

MALDI technique

A

isolate is spotted onto a metal plate
laser vaporized
separated by mass-to-charge ratio
profile created
comparison

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13
Q

MALDI may be used in the future for

A

susceptibility testing
strain typing
direct from sample detection

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14
Q

Method: antigen detection

A

use lab generated antibodies to detect patient antigen in specimen

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15
Q

specimens: antigen detection

A

urine, serum, sputum, CSF, stool

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16
Q

Galactomannan serum is used to detect

A

invasive aspergillus

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17
Q

cryptococcal urine or CSF is used to detect

A

cryptococcus

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18
Q

method: Antibody detection

A

use lab generated antigens to detect IgG, IgM, etc.

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19
Q

Specimen: antibody detection

A

serum

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20
Q

what technique would you use to diagnose Lyme disease?

A

Serology: antibody detection

Borrelia burgdorferi

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21
Q

what technique would you use to diagnose Syphilis?

A

Serology: antibody detection

Treponema pallidum

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22
Q

what technique would you use to diagnose Q fever?

A

Serology: antibody detection

Coxiella burnetti

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23
Q

Agglutination

A

serology method
antibody or antigen is fixed to latex beans, specimen added and observed for clumping

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24
Q

lateral flow immunoassay

A

serology method
antibodies attach to pad, wicked along, accumulate as visible line

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25
Q

what kind of diagnostic test is a pregnancy test?

A

lateral flow assay

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26
Q

advantages of lateral flow assay

A

rapid, cheap, POC

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27
Q

limitations of lateral flow assay

A

decreased sensitivity, difficult to read

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28
Q

ELISA has a _______ predictive value

A

high negative
(high sensitivity, low specificity)

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29
Q

all positive ELISA assays must be

A

confirmed with a screening confirmation test assay

**if the first is positive, and the second is negative, the result is NEGATIVE

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30
Q

method: ELISA

A

antibody or antigen immobilized in well
add patient sample
add reported antibodies/antigens
add substrate and read colormetric change

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31
Q

Screen confirmation tests are

A

labor intensive
low sensitivity but very high specificity

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32
Q

screening confirmation tests

A

Immunoblot, Immunodiffusion

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33
Q

What diagnostic test should you choose if you are trying to determine vaccination status?

A

serology

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34
Q

What diagnostic test should you concerned with an organism that won’t grow in culture or is eliminated quickly?

A

serology

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35
Q

what organisms don’t grow in culture

A

Lyme, Syphilis, Mono

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36
Q

What organisms are cleared quickly?

A

west nile, zika, dengue

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37
Q

What diagnostic test should be chosen for HIV, HCV, HBV screening?

A

serology

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38
Q

what would cause a false positive on a serology test?

A

heterophil antibodies/ RF
cross reaction to closely related antigens
maternal transfer

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39
Q

what would cause a false negative on a serology test?

A

immunocompromised
too early/late

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40
Q

gram stain technique

A

heat fix sample
crystal violet: stains all cells purple
iodine: mordant
destain with ethanol-acetone
safranin counterstain

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41
Q

gram positive organisms will be

A

purple

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42
Q

gram negative organisms will be

A

pink

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43
Q

acid-fast stain

A

mycobacteria

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44
Q

wright-giemsa stain

A

spirochetes, rickettsiae

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45
Q

gram + cocci in clusters

A

staphylococcus

46
Q

gram + cocci in chains

A

streptococcus

47
Q

sputum should be collected when _______ is suspected

48
Q

urine is collected when ______ is suspected

49
Q

feces is collected when ______ is suspected

50
Q

when getting a tissue culture, you should get the

A

center and border of tissues

51
Q

aspirate _______, avoid swabs

52
Q

how much blood should be collected for a blood culture?

A

10 mL per bottle, 2 bottles x2

53
Q

swabs are used when _______ is suspected

54
Q

a direct gram stain is done on what specimens

A

sputum, positive blood culture, abcess fluid, CSF, vaginal discharge

55
Q

presence of PMNs in sputum indicates

A

active, purulent infection

56
Q

> 10 epithelial cells per field suggests

A

contamination with oral flora

57
Q

enriched media

A

contain nutrients to support growth of a wide variety of organisms

58
Q

selective media

A

inhibit growth of certain groups of organisms

59
Q

differential

A

distinguish organisms based on growth characteristics

60
Q

MacConkey Agar is

A

selective: inhibits growth of gram+
AND
differential: distinguishes between ability to ferment lactose

61
Q

obligate aerobe

A

requires oxygen for growth

62
Q

facultative anaerobe

A

will grow in aerobic and anaerobic conditions

63
Q

microaerophillic

A

grows best with low concentrations of oxygen

64
Q

obligate anaerobe

A

oxygen is toxic

65
Q

when should you draw blood cultures?

A

before antibiotics

66
Q

2 bottle sets of blood cultures

A

1 aerobic
1 anaerobic

67
Q

how many sets of blood cultures should you do?

A

two sets
(4 bottles, 40 mL total)

68
Q

mycobacterial culture is done on

A

broth and solid media

69
Q

fungal cultures are done on

A

specialized media
incubated at a lower temp

70
Q

green, incomplete lysis around colony

A

alpha hemolysis

71
Q

clear zone around colony

A

beta hemolysis

72
Q

no hemolysis

A

gamma hemolysis

73
Q

what color colonies are S. aureus?

74
Q

what color are Serratia colonies?

75
Q

what color are P. aeruginosa colonies?

A

blue green

76
Q

what bacteria grows mucoid colonies?

A

klebsiella

77
Q

what organism grows projection-like colonies?

A

candida albicans

78
Q

what organism demonstrates swarming on colony growth?

A

Proteus vulgaris

79
Q

gas formation (bubbles) indicates

A

catalase positive

80
Q

precipitate formation indicates

A

coagulase positive

81
Q

blue color indicates

A

oxidase positive

82
Q

clostridium
actinomyces
propionibacterium

A

gram positive anaerobic bacilli

83
Q

listeria
cornyebacterium
bacillus
nocardia

A

gram positive aerobic bacilli

84
Q

catalase +, coagulase + cocci grown in clusters

A

staphylococcus

85
Q

catalase -, cocci grown in chains

A

streptococcus

86
Q

anaerobic streptococcus

A

peptostreptococcus

87
Q

S. pneumoniae
S. mutans
Viridians

A

alpha hemolytic streptococcus (GAS)

88
Q

S. pyogenes
S. agalactiae

A

beta hemolytic streptococcus (GBS)

89
Q

enterococcus

A

gamma hemolytic streptococcus

90
Q

gram negative cocci

A

neisseria
moraxella

91
Q

escherichia
klebsiella
enterobacter

A

gram negative
+ growth on MacConkey
+lactose fermentors

92
Q

salmonella
shigellaa
proteus
serratia
yersinia

A

gram negative
+growth on MacConkey
-lactose fermentors
+glucose fermentors

93
Q

pseudomonas
burkholderia
acinetobacter

A

gram negative
+growth on MacConkey
-lactose fermentor
-glucose fermentor

94
Q

haemophilus
bordetella
legionella
brucella
franciella
pasteurella
campylobacter
helicobacter
vibrio

A

gram negative
- growth on MacConkey
+oxygen tolerance

95
Q

bacteriodes
fusobacterium
prevotella
porphyromonas

A

gram negative
- growth on MacConkey
-oxygen tolerance

96
Q

PCR based detection of the genes associated with resistance to a drug

A

genotypic antimicrobial susceptibility testing

97
Q

tests ability of organism to grow in presence of drug

A

phenotypic antimicrobial susceptibility testing

98
Q

susceptible

A

isolate is inhibited

99
Q

intermediate

A

response rate for isolate is lower than that for susceptible isolates

100
Q

resistant

A

isolates are not inhibited

101
Q

limitations of antimicrobial susceptibility testing

A

imprecise
does not account for host response, toxin production, or biofilm formation

102
Q

mecA gene

103
Q

vanA/B gene

A

Vanc resistant E. faecium

104
Q

bla kpc gene

A

carbapenem resistance
beta lactamase resistant KPC

105
Q

advantages of genotypic susceptibility testing

A

fast
very sensitive
very specific

106
Q

limitations of genotypic susceptibility testing

A

expensive
single target: does not detect resistance by multiple genes

107
Q

MIC

A

minimal inhibitory concentration

minimum concentration of a drug that will inhibit growth of an organism

108
Q

phenotypic susceptibility testing: microbroth dilution

A

the concentration without bacterial growth is the MIC

109
Q

phenotypic susceptibility testing: strip testing

A

read MIC at area of growth of inhibition

110
Q

phenotypic susceptibility testing: Kirby Bauer (disk)

A

does not give MIC
measure zones of growth inhibition

IBI Test 2 (14 decks)

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