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micro 2 unit 1 > chapter 78 > Flashcards

chapter 78 Flashcards

1
Q

Quality control

A

internal activities that ensure diagnostic accuracy

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2
Q

Quality Assurance

A

external activities that ensure positive patient outcomes

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3
Q

performance improvement

A

improve patient care by note making mistakes in the first place; advocate continuous training to guard against having to correct deficiencies.

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4
Q

proficiency testing

A

maintain an average score of 80% in every area. Will evaluate procedures, reagents equipment and personnel. Should be treated as a real patient specimens.

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5
Q

Patient outcomes

A

????

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6
Q

benchmarking

A

compare your lab results with those of your peers

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7
Q

validity

A

how accurate is the results compared to the ATCC is concerned with the study’s success at measuring what the researchers set out to measure.

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8
Q

Reliability

A

the instrument should be 100% leaning to the exact valueis concerned with the accuracy of the actual measuring instrument or procedure

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9
Q

SOP

A

Standard operating procedures.

  • requirements for specimen collection and transport
  • daily or routine QC
  • procedure for processing specimens
  • procedure for direct examination of specimens and rapid testing
  • procedure for culture identification and susceptibility testing
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10
Q

Reference Organisms

A

a strain collection comprising bacteria, fungi, and algae, which can be used in standardized testing procedures as reference organisms

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11
Q

ATCC

A

American Type culture collection. They behave like an actual specimen in both physical and biochemical characteristics and are utilized and are utilized to confirm the validity and reliability of media, reagents and biochemical procedures.
reference organism. the number following the ATCC indicates the strain

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12
Q

CLSI

A

specimen collection, SOP manual, personnel: requires documentation of qualifications, continuing education, on the job training and competency.

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13
Q

Exempt vs non exempt media

A

commercially prepared media should be exempted form QC apart from chocolate. Personal prepared media should be always be QC and are non-exempted

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14
Q

panic values

A

must be communicated immediaetly to an authorized clinician and documented

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15
Q

turn around time

A

how quick the result can atoned or diagnosed

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16
Q

Qualitative vs Quantitative

A

Qualitative test does not you give the results in numbers(susceptible, intermediate, resistant )
Quantitative test give you results in numbers/count

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17
Q

MIC

A

Minimal Inhibitory concentration. Dilution testing methods are used to determine the minimal concentration of an antimicrobial agent required to inhibit or kill a microorganism..

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18
Q

MBC

A

minimum bacterial concentration ??????

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19
Q

SBT

A

serum bacterial test

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20
Q

Microdilution

A

technique used to measure antibiotic susceptibity in which the drug is diluted in a broth

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21
Q

peak and trough

A

peak is the highest point of the drug after intake

trough is the lowest level of the drug in the body before intake of the drug

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22
Q

Intrinsic and acquired resistant

A

intrinsic normal genetic structural or phsylogiacal state of an organism
acquired results from altered cellular physiology and structure changes in the organism usual genetic makeup. unpredictable

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23
Q

modes of action

A

how an antimicrobial functions

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24
Q

Synergy

A

activity of combination substantially greater than activity of single most active drug alone.

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25
Q

Antagosim

A

activity of the combination is substantially less than the activity of the single most active drug alone.

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26
Q

Drug of choice

A

This is predicting which isolate of bacteria is susceptible to the antimicrobial agent that is commonly used against them.

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27
Q

Erythromycin

A

class : Macrolides
spectrum: gram positive bacteria
mode of action: protein synthesis is inhibited
Bactriostatic

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28
Q

Gentamicin

A

class: Aminoglycosides
spectrum:gram pos & gram neg
mode of action: inhibits protein synthesis
bactericidal

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29
Q

Vancomycin

A

class: Glycopeptides
spectrum: gram pos
mode of action: inhibit bacterial wall synthesis
bactericidal

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30
Q

Levoflaxin

A

class: Quinolones
spectrum: gram pos and gram neg
mode of action: inhibits DNA synthesis
bactericidal

31
Q

Cefazolin
Ampicilin
piperacillin
Imipenem

A

class: Beta Lactams
spectrum: gram pos % gram neg
mode of action: inhibit cell wall synthesis
bactericidal

32
Q

Cefazolin

A

class: Beta Lactams
spectrum: gram pos % gram neg
mode of action: inhibit cell wall synthesis
bactericidal

33
Q

Ampicilin

A

class: Beta Lactams
spectrum: gram pos % gram neg
mode of action: inhibit cell wall synthesis
bactericidal

34
Q

piperacillin

A

class: Beta Lactams
spectrum: gram pos % gram neg
mode of action: inhibit cell wall synthesis
bactericidal

35
Q

Imipenem

A

class: Beta Lactams
spectrum: gram pos % gram neg
mode of action: inhibit cell wall synthesis
bactericidal

36
Q

Fluconazole

A

class: Azole
spectrum: Fungi(yeast)
modes of action: disrupt the fungal cells membrane

37
Q

Linezolid

A

class:Oxazolidinones
spectrum: gram pos
mode of action: interfere with initiation of protein synthesis
bacteriostatic

38
Q

predictor drugs for Strep.pneumoniae

A

Oxacillin disk for penicillin resistance in Strep.pneimoniae

39
Q

What are the 2 tests for beta-lactamases

A

chromogenic cephalosporin and acidometric

40
Q

what is bacterias are the beta-lactamase tests routinely used for

A

H.Influenza, N.gonorrhea, Strap. species. Moraxella.sp

41
Q

what is extended spectrum Beta-Lactamase

A

ESBL’s are enzymes that mediate resistance to extended-spectrum (third generation) cephalosporins and monobactams but do not affect cephamycins or carbapenems.

42
Q

what organisms are routinely tested for ESBL

A

K,pneumoniae,
E.coli
K.oytoca

43
Q

what is CRE

A

a family of bacteria that are hard to treat because they have a high resistant to antibiotics.
aka KPC
are plasmid borne resistant mechanisms and are capable of crossing genetic elements, from one organism to another and across genus and species lines

44
Q

CRE

A

Carbapenem-resistant Enterobacteriaceae

45
Q

Two organisms that can be carbapenem resistant and are normal flora to the gut bacteria

A

Klebsiella and E.coli

46
Q

what antibiotics are MRSA resistant

A

oxacillin, Methicillin, Penicillin, amoxicillin

47
Q

Name 3 examples of natural intrinsic resistant to antibacterial agents

A

1: gram negative bacteria VRS vancomycin
2: klebsiella spp versus ampicillin (a B-lactam) target
3: Enterococci versus aminoglycosides

48
Q

Mechanism of gram negative bacteria vrs vancomycin

A

lack of uptake resulting form inability of vancomycin to penetrate outer membrane

49
Q

mechanism of klebsiella spp versus ampicillin(B-lactam)

A

production of enzymes that destroy ampicillin before the drug can reach the PBP (penicillin binding proteins)

50
Q

Mechanism of Enterococci versus aminoglycosides

A

lack of sufficient oxidative metabolism to drive uptake of aminoglycosides

51
Q

what is the benefits of E-test

A

it combines the mic with disk diffusion

52
Q

ESBLs

A

Enzymes that mediate(brings out) resistance to extended-spectrum cephalosporins and monobactams but do not affect cephamycins or carbapenems

53
Q

CQI

A

continuous quality improvement

54
Q

name 4 criteria of antimicrobials to be tested

A

site of infections
availability
known strain resistant
method

55
Q

beta lactamase testing methods

A

chromogenic cephalosporin

acodometric

56
Q

what does natural selection mean in the subject of resistant strains

A

will kill of susceptible strains and leave resistant strains

57
Q

what 3 factors influence resistant?

A

biological, clinical and environmental

58
Q

???????

A

Due to increased resistance observed with penicillin, OX is more sensitive and reliable indicator
Perform MIC for confirmation

59
Q

what does the beta-lactamase enzyme do

A

it disrupts the beta-lactam ring. It can not bind to PBP and inhibits cell wall synthesis

60
Q

Describe the action of the (amoxicillin or ticarcillin)/clavulanic acid combination.

A

2 beta lactams beta lactam/ beta lactamase inhibitor. Inhibitor renders B-lactamase incapable , beta lactam drug (b-lact sens.) exerts it’s activity

61
Q

How does MRSA resist antibiotics

A

it produces altered PBP’s that the antimicrobial cannot inhibit cell wall synthesis

62
Q

what is MRSA

A

a strain of Staphylococcus aureus that is resistant to beta-lactam antibiotic.

63
Q

what is vancomycin screening agar used to detect

A

resistant enterococcus (VRE) or resistant or intermediate staphylococcus (VRSA, VISA)

64
Q

mechanism of gram neg bacteria vrs vancomycin

A

lack of uptake of vancomycin resulting to inability of the drug to penetrate the bacteria

65
Q

klebsiella spp vrs ampicillin

A

production of enzyme that destroys the drug before it reaches the penicillin binding protein.

66
Q

enterococci vrs aminoglycosides

A

lack of sufficient oxidation metabolism for the uptake of the aminoglycosides

67
Q

what is used to detect/screen MRSA

A

Oxacillin salt agar

68
Q

TQM

A

total quality management:

activity to improve total care by monitoring the lab work to detect deficiencies and correct them.

69
Q 
Preanalytical analytical postanalytical
patient preparation
sample collection
sample handling and storage
information dissemination to medical staff
A

preanalytical

70
Q

Preanalytical analytical postanalytical
preventive maintenance on equipment
instrumentation function checks and calibrations
quality control and management of media and reagents

A

analytical

71
Q

Preanalytical analytical postanalytical
recording of results
transmission of results within an acceptable interval

A

post analytical

72
Q

JCAHO

A

It monitors the quality of the care given by healthcare professionals, most often in hosptials, but they also over see nursing homes and such as well.

73
Q

CAP

A

give accreditation for the lab

micro 2 unit 1 (1 decks)

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