Cardiovascular Flashcards

Question

CONTAMINATION OF BC BOTTLES

Answer 1

-False positive -bacteria growing isnt what is actually in pts blood -due to contamination from improper technique -acceptable rate is 2% -common contaminants are skin flora except in endocarditis -if skin flora is reported the physician needs to decide if it should be treated

Answer 2

S. aureus, Enterobacterales, GAS, S. pneumoniae, P. aeruginosa & C. albicans almost always a true septicemia CoNS, Micrococcus, diphtheroids & P. acnes are contaminants EXCEPT in endocarditis

Answer 3

if same organism is in multiple bottles or set then it is a true infection doesnt matter if it is skin flora or not can be endocarditis

Answer 4

person has a urine culture with the same organism – could mean a true septicemia

Answer 5

- colorimetric change caused by shifts in pH from increased CO2 levels due to organism growth

Answer 6

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

Answer 7

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

Answer 8

Preliminary report of No growth after 48 hrs sent on all bottles negative at this time. Kept for 5 days before final report of No growth sent out

Answer 9

in BSC L2 - broth removed and inoculated to slide for gram and to BA, CHOC, CNA, MAC, BRUC. -do gram and issue preliminary -phone physician with GRAM -inform which bottles are positive (Aer or Anaero) and in how many sets after how many hours of incubation

Answer 10

set up ID & AST -Maldi for some organisms can be done right from the BC vial broth -centrifuge to concentrate and lyse to remove protein in RBC (interferes with MALDI) -molecular can be done from the broth as well -phone and send reports to dr everyday -BC are like CSF STAT

Answer 11

Normal flora of skin, but MOST COMMON CAUSE of prosthetic joint, native valve endocarditis, sepsis, & meningitis -nosocomial -very virulent & multi drug resistant. Vancomycin drug of choice Strict aerobe, ppt/small NH, white small pleomorphic gram pos bacilli Cat pos Urease neg Sucrose - neg -BC DO MALDI

Answer 12

fastidious, gnb that are slow-growing – may take > 5 days - like increased CO2 for growth Haemophilus spp. including H. aphrophilus Aggregatibacter Cardiobacterium hominis Eikenella corrodens Kingella kingae NF of mouth but can cause mouth infections -cause native or prosthetic valve endocarditis -cause subacute endocarditis -if endocarditis is suspected and BC is negative then subculture the BC to CHOC and keep longer

Answer 13

NF of mouth of human and animals -peridontal disease -risky for sick ppl and those who have spleen removed are at risk of septicemia & endocarditis. -GNB slender with pointed ends (fusiform). -Facultative but like CO2. -Slow growing take 48-72hrs. -Grows on BA/CHOC –sm colonies that look like film that spreads away from center of colony due to gliding motility -Oxidase: positive

Answer 14

-infectious (BSL3)- -from eating unpasteurized dairy Brucella abortus from cattle Brucella suis from pigs Brucella canis from dogs Brucella melitensis from goat or sheep CL2- BSC class II with PPE when working with specimen -CL3 when working with colonies on culture plates. MOST COMMON LAB WORK ASSOCIATED INFECTION -arthritis and spleen/liver enlargement -can invade cells and cause septicemia, endocarditis and meningitis

Answer 15

tests from colony must be CL3 –sent to PHL -blood, tissues, fluids, bone marrow. -Cultures incubated 21 days before negative report can be sent out. -BA, CHOC & Brucella agar in 5-10%CO2. - BA: small, grey NH MAC: NG -Gram: gncb, -Oxidase & Urease: positive - ID to genus level. - use MALDI or PCR. -Serology Reported to MOH –potential bioterrorism agent. Treatment is combination of multiple antibiotics

Answer 16

Abiotrophia & Granulicatella -Oral NF but can cause endocarditis & septicemia. -needs pyridoxal (vitamin B6) to grow -Can add to BA ingredients or as a disk or a staph streak. -satellite around Staph as NH or AH colonies -grows in BC vials because human blood has vitamin B6. -Gram: pleomorphic cocci both in pairs & chains that may look bacillary

Answer 17

-gastroenteritis, from eating undercooked meat or animal products -can be missed in BC because it only grows on CHOC or CAMPY because it like a microaerophilic conditions 42C for 48 hours -hard to see on gram -use fuchcin counterstain -acridine orange fluorescent stain -small curved GNB - gull wings

Answer 18

-BC media needs enrichment like LJ or Middlebrook base - 6-8 wks. to grow. -Mycolic acid won’t stain with gram –use ZN, kinyoun or Auramine Rhodamine.

Answer 19

-Zoonotic, from cows or goats- highly infectious, transmitted by inhalation or rarely by eating raw animal products. -<5% of those infected especially those with valve defects or vascular grafts will get endocarditis – called Q fever -Gnb, fastidious, obligate intracellular pathogen, won’t grow on routine media. -Must use serology to diagnose endocarditis.

Answer 20

Fungal growth in blood C albicans - most common -yeast is quick to grow in vials -dimorphs grow in vials but they take longer and can be missed after the 5 day incubation check -if youre investigating a slow grower sub negative BC vials to fungal plates & keep up to 4 weeks

Answer 21

Presence of virus in blood BC are negative Diagnosed by serology or molecular testing