Cardiovascular

Question 1

presence of any viable bacteria in blood. does not always mean a blood infection

Answer 1

Bacteremia

Question 2

false positive blood culture due to improper phlebotomy

Answer 2

Pseudo-bacteremia

Question 3

presence of bacteria in blood of a febrile child, <2 years, who has NO APPARENT FOCUS ON INFECTION AND DOES NOT APPEAR ILL;
S PNEUMONIAE AND H. INFLUENZAE TYPE B USED TO BE THE CAUSE

Answer 3

Occult Bacteremia

Question 4

temporary (few minutes to few hours) bacteria in blood-removed immediately by immune system

Answer 4

Transient Bacteremia

Question 5

PERIODIC SEEDING of the same bacteria into blood by an EXISTING INFECTION in the body, such as an abscess or pneumonia- immune system clears bacteremia

Answer 5

Intermittent Bacteremia

Question 6

bacteria is coming from an INTRAVASCULAR SOURCE and released into the blood at a constant rate- is always present in blood;
due to heart valve infections, or indwelling venous or arterial catheters

Answer 6

Continuous/ Persistent Bacteremia

Question 7

Classification of Bacteremia by site of Origin:
-bacteria in the vascular system due to an infected cardiac valve or IV catheter

Answer 7

Primary Bacteremia

Question 8

Classification of Bacteremia by site of Origin:
-bacteria come from an infected extravascular source such as lungs in a patient with pneumonia

Answer 8

Secondary Bacteremia

Question 9

Classification of Bacteremia by site of Origin:
-source of bacteremia is undefined- usually the patient has a poor prognosis than with primary or secondary bacteremia;
INCREASED MORTALITY RATE

Answer 9

Bacteremia of unknown origin

Question 10

classifying by source is important because it determines the appropriate _______ and _________

Answer 10

therapy
prognosis

Question 11

Classification of bacteremia by Place of Acquisition:
-organism acquired from the general community
-S pneumoniae is one of the most common causes

Answer 11

Community Acquired Bacteremia

Question 12

Classification of bacteremia by Place of Acquisition:
-organism acquired from being in a healthcare facility;
-indication of bacteremia must occur in >___ hrs after admission

Answer 12

Nosocomial Bacteremia
72

Question 13

the presence of and multiplication of bacteria in the blood- it is considered an infection
-person will have symptoms of bacterial invasion and toxin production

Answer 13

Septicemia

Question 14

a systemic inflammatory response caused by Septicemia

Answer 14

Sepsis

Question 15

used by doctors to categorize the spectrum of increasingly severe inflammatory reactions from septicemia

Answer 15

Systemic Inflammatory Response Syndrome (SIR)

Question 16

non-infectious inflammatory response–> sepsis—>_______ _______—>_______ _______—>death

Answer 16

severe sepsis
septic shock

Question 17

most common causative agents for septicaemia:

Answer 17

S aureus
E coli
S pneumoniae

Question 18

bacteria enter circulation via lymphatics;
-come from an infection in another part of the body or a bacteria that can disseminate as part of its pathogenesis (Listeria)

Answer 18

Extravascular Septicemia

Question 19

bacteria are directly implanted in the vascular system;
-usually due to IV catheters

Answer 19

Intravascular Septicemia

Question 20

infection of the sac around the heart

Answer 20

Pericarditis

Question 21

Bacteria seed heart valves- form a biofilm and infection
-cause valve damage an heart failure
-investigated the most in the lab

Answer 21

infective endocarditis

Question 22

progresses rapidly, affects healthy hearts
-caused by virulent bacteria;
-exceptions to rule S lugdunensis or Corynebacterium jekeium

Answer 22

Acute endocarditis

Question 23

organisms that cause rapid progression of endocarditis in those with Prosthetic heart valves or pace-makers

Answer 23

S lugdunensis
Corynebacterium jekeium

Question 24

progresses slowly
-affects already abnormal or damaged hearts
-caused by less virulent organisms- normal flora of the mouth like Viridans group

Answer 24

Sub acute endocarditis

Question 25

Specimen for Blood infections

Answer 25

Blood culture

Question 26

A positive blood culture is a ______ value, indicates a potentially fatal outcome

Answer 26

critical

Question 27

_____ must be called immediately.

Answer 27

gram

Question 28

in collecting blood cultures: cleanse skin with ___%-____% ethanol followed by __% chlorexidine- leave on for at least ___ sec, let air dry

Answer 28

70-95 2 30

Question 29

BC vials have ___ 0.025-0.050% as anticoagulant- but may inhibit Neisseria and P anaerobius

Answer 29

SPS

Question 30

don't use ____, __ ____ or _______- can inhibit organism growth

Answer 30

EDTA Na Citrate Heparin

Question 31

both O2 and ANO2 BC bottles are nutritionally enriched and contain ______ or ______ to absorb toxins and antibiotics

Answer 31

resins charcoal

Question 32

ANO2 vial has _________ as an O2 reducing agent and empty space in neck has gas mix that is not O2

Answer 32

thioglycolate

Question 33

it is the _______ __ _______ and not the number of sets of cultures that is drawn that is most important in the recover of organisms

Answer 33

volume of blood

Question 34

optimum ratio of blood to media is _:_ or _:_

Answer 34

1:5 1:10

Question 35

draw __ ml per blood culture bottle of set (total of __-___ ml per complete set)

Answer 35

10 ml 20-30 ml

Question 36

highest recovery of organism takes _-_ sets with 10ml in each= total of ___-___ml drawn in a 24 hr period

Answer 36

3-4 60-80

Question 37

general practice is 2 sets of BCs with 10 ml in each bottle= __ ml in 24 hr period

Answer 37

40

Question 38

take the sets _-_ hours apart from a different venipuncture site

Answer 38

1-2

Question 39

it is important to try and take BC during ____episodes and before taking antibiotics

Answer 39

febrile

Question 40

In acute endocarditis, time is of the essence so take _-_ sets of BC within a __ min time period

Answer 40

2-3 30

Question 41

In subacute endocarditis time is less important, focus is to catch the bacteria when it is in high numbers in the blood; draw _-_ BC sets spaced __ min to __ hour apart within 24 hrs

Answer 41

3-5 30 1

Question 42

Criteria to determine contamination of BC vials: 1. Identity of organism -S aureus, Enterobacteriaceae, S pneumoniae, P aeruginosa and C albicans are almost always a ____ infection 2. How many bottles is the organism growing in. 3. Isolation of organism from the blood+ another sterile or non-sterile site

Answer 42

true

Question 43

done in labs where it is too expensive or do not have adequate number of BC tests requested

Answer 43

Manual Blood Cultures

Question 44

Manual Blood cultures: -Media inoculated with patient blood and incubated at __ C for up to ___ days Examine _ times a day for visual signs of bacterial growth Darkening of media may be _________ Bubbles may be ____ formation

Answer 44

35 7 hemolysis gas

Question 45

it is the sub of manual aerobic BC vial to solid media even when there is no visible evidence of growth- not advised for ANO2 vials Done at __-___ hours of incubation to increase the chances of detecting a positive vial sooner If negative may be done again after another __ hrs May also be done on the __ day to ensure the bottle is truly negative Subbed to ____, ______

Answer 45

24-48 48 7th CHOC, Brucella

Question 46

Automated BC systems: incubators hold all bottles at ___ 35C

Answer 46

O2

Question 47

Detects colorimetric change caused by shifts in pH from increase CO2 levels due to organism growth

Answer 47

BacT/ALERT

Question 48

detects changes in fluorescence caused by shifts in pH from increased CO2 levels due to organism growth

Answer 48

BACTEC

Question 49

measures pressure changes caused by gas consumption or production due to organism

Answer 49

Versa TREK

Question 50

Negative BC: In automated BC systems, a ________ report of No growth after 48 hours is sent on all bottles that are negative at this time Negative bottles are kept for___ days before a final report of No growth is sent out

Answer 50

Preliminary 5

Question 51

Positive BC- MUST BE WORKED ON IMMEDIATELY inform the physician of the _______ _______result also include which bottle is positive (O2/ANO2) and in how many sets after how many hours incubation

Answer 51

gram stain