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IPAP > ClinLab 3 Quizlet > Flashcards

ClinLab 3 Quizlet Flashcards

1
Q

What is the standard for collecting blood cultures?

A

1 set= 1 aerobic, 1 anaerobic bottle, different sites/time, no more than 4 sets in 24 hrs

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2
Q

What kind of sample should be collected if there is suspected bacteremia, endocarditis, or sepsis?

A

Blood culture

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3
Q

A throat swab is primarily done to look for which organism?

A

Group A streptococcal pharyngitis

Neisseria Gonorrhoeae

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4
Q

A nasopharyngeal swab is primarily done to look for what organism?

A

MRSA

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5
Q

If you are culturing one of these organisms from respiratory swabs, you will need special media

A

Bordatella
Corynbacterium
Neisseria

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6
Q

Critical or Panic Values

A

Organisms in CSF or joint fluids, positive cryptococcal antigens, positive AFB smear, positive blood cultures, positive CSF cultures, isolation of M. tuberculosis, positive eye cultures P. aeruginosa or Bacillus, positive blood films for Plasmodium, or isolation of E. coli O157:H7

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7
Q

Diagnosis of viral respiratory infections, measles, C trachomatis pneumonia in infants, diphtheria, and pertussis are done by which collection method?

A

Nasopharyngeal aspirates, washings, and swab specimens

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8
Q

Suspected pneumonia is diagnosed by which sample collection methods?

A

Sputum and tracheal aspirates (first morning sputum is best)

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9
Q

What are the three main culprits for bacterial diarrhea?

A

Salmonella
Shigella
Campylobacter

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10
Q

What are the most prevalent drug resistant organisms?

A

Acinetobacter baumannii
Pseudomonas aeruginosa
MRSA

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11
Q

Which immunoglobulin will be present during a current infection (acute and convalescent) and a previous exposure, and can result due to having an infection or the vaccination?

A

IgG

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12
Q

A 4-fold increase in a titer indicates what?

A

Acute infection

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13
Q

If a day 5 titer reads 1:4 and then the day 12 titer reads 1:64, what does that indicate?

A

Primary response

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14
Q

Which type of Hepatitis is mostly chronic due to timing of catching the infection?

A

Hepatitis C

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15
Q

Which type of hepatitis is transmitted by the fecal-oral route, and is self-limiting so it does not result in chronic infection or liver disease?

A

Hepatitis A

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16
Q

What serum marker will turn negative in an acute Hep B infection with the development of Anti-HBs, but will remain consistently positive in a chronic infection?

A

HBsAg

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17
Q

What does the presence of Anti-HBs indicate?

A

HBV infection or vaccination

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18
Q

What serum marker comes from a portion of the viral core and shows the HBV is replicating actively and is infectious?

A

HBeAg

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19
Q

What does the presence of HBV DNA in the blood indicate and what is it used for?

A

Active infection (acute or chronic) used to monitor viral load

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20
Q

What serum marker for Hep B quickly degenerates in serum and is not measurably detectable?

A

HBcAg

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21
Q

What is the screening tool for Hep C?

A

EIA Assay

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22
Q

What is the confirmatory test for Hep C?

A

RIBA

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23
Q

What is the criteria for uncomplicated cystitis?

A

Healthy woman (over age 12), non-pregnant, no fever, nausea, vomiting, or flank pain and diagnosed by dipstick

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24
Q

What is the criteria for complicated cystitis?

A

Females w/ comorbidites
All males
Catheters/Hospitals
(May need urinalysis and culture)

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25
Q

What organism presents in urethritis with pyuria but no bacteria?

A

Chlamydia Trachomatis

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26
Q

Which results will be positive in a urinalysis when screening for a UTI?

A

Nitrite and Leukocyte (WBC) esterase

positive urine casts if there is kidney involvement

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27
Q

What are the two most common causes of UTIs in females? Males?

A

Females: E. Coli, Staph saprophyticus (young, sexually active females
Males: Enterobacteriaceae
S/Sx- sterile culture, discharge, dysuria, frequency

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28
Q

What are the most common pathogens for cystitis, prostatitis, and pyelonephritis?

A 
E. Coli
Staph saphrophyticus
Proteus mirabilis
Klebsiella
Enterococcus
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29
Q

Which test can detect both Chlamydia and Gonorrhea simultaneously?

A

Nucleic acid amplification (PCR)

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30
Q

What are the most common pathogens for urethritis?

A

Chlamydia

Gonorrhea

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31
Q

What are some of the conditions that can result from untreated cervicitis?

A

Endometritis
PID
HIV

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32
Q

What causes for vulvovaginitis will present with a positive amine test?

A

Trichomoniasis

Vaginosis

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33
Q

An infection that presents with copious amounts of frothy green/yellow/gray discharge, a motile organism, increased vaginal pH, strawberry cervix, and vaginal soreness is indicative of which condition?

A

Trichomoniasis

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34
Q

An infection that presents with slightly malodorous gray white discharge, often asymptomatic, but have an increased vaginal pH of >4.5 and a positive amine test is indicative of which condition?

A

Bacterial vaginosis

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35
Q

What stage of syphilis presents with rashes on the palms and soles?

A

Secondary

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36
Q

What cause for vulvovaginitis presents with a normal pH?

A

Candidiasis

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37
Q

An infection presenting with intense perivaginal itching/burning, thick white cottage cheese texture that is odorless and adherent to vaginal walls, dysuria, and a normal vaginal pH is indicative of which condition?

A

Candidiasis

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38
Q

What stage of syphilis is asymptomatic and non-contagious?

A

Latent

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39
Q

What is a very sensitive and specific test for Herpes?

A

Viral PCR

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40
Q

Which disease is caused by a virus that presents as warts, can cause cervical cancer (Types 16, 18, 31, 33, 35), and is diagnosed by an “anogenital” PAP smear?

A

HPV

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41
Q

What test for syphilis uses RPR, is sensitive but not specific, and requires a titer determination?

A

Non-treponemal test (Screening)

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42
Q

Which disease is marked by painful ulcers in the genital region, tender inguinal lymphadenopathy, and a school of fish/railroad track smear morphology?

A

Haemophilus ducreyi

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43
Q

What is the proper criteria for testing HIV if there is a positive result?

A

Positive ELISA specimen: re-run Positive 2nd ELISA: notify individual (face to face) and submit second blood specimen for Western Blot
If positive: notify of confirmed HIV and status
If negative: request a third blood specimen
If 3rd specimen positive HIV is confirmed
What is the proper criteria for testing HIV if there is a positive result?

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44
Q

What is the typical culprit of endocarditis in healthy cardiac valves with a catheter?

A

MRSA

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45
Q

What testing is done when a patient is confirmed HIV positive?

A

Baseline viral load
CD4 level
Screen for TB, HBV, HCV

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46
Q

Splinter hemorrhages, Roth spots, Osler nodes, clubbing of the digits, and Janeway lesions on palms and soles, elevated WBCs on a CBC, elevated C Reactive protein, and elevated ESR values are all signs of which infection?

A

Endocarditis

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47
Q

What is HACEK?

A

A group of organisms that commonly infects pediatric patients with endocarditis (Haemophilus species, Aggregatibacter, Cardiobacterium, Eikenella, and Kingella)

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48
Q

What is the causative agent for bacterial pharyngitis as well as scarlet and rheumatic fever?

A

Group A Strep

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49
Q

Which type of specimen is best for identifying B. pertussis?

A

Nasopharyngeal swab

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50
Q

What is the typical culprit of sub acute endocarditis in damaged cardiac valves?

A

Strep viridans

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51
Q

Which type of specimen is best for culturing viruses in URIs?

A

Nasopharyngeal wash

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52
Q

What is the recommended test for influenza?

A

PCR (Viral culture is gold standard for screening test and public health surveillance

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53
Q

Which organisms are most likely to cause bacterial pharyngitis (swollen uvula w/ white spots, gray furry tongue)?

A

Group A Strep

M. Pneumoniae

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54
Q

What is the typical culprit of prosthetic valve endocarditis?

A

Staph epidermidis

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55
Q

What are the diagnostic tests for Strep pyogenes (strep throat, scarlet fever, and rheumatic fever), which are GP cocci in chains?

A

Screening- Rapid antigen test takes 30 mins; Confirmatory- Throat culture is gold standard, follow up a negative rapid Ag test in children; Serology- Used to diagnose ARF

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56
Q

What are the diagnostic tests used to identify streptococcal pharyngitis?

A

Rapid antigen test (screening)
Throat culture (gold standard, confirm)
Serology (diagnose ARF)

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57
Q

What type of pharyngitis presents more in young adults with slow progression and what are the main causative agents?

A

Viral:
Epstein Barr
Adeno
Coxsackie A- vesicles

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58
Q

Which bacterial infection presents as an inflammatory disease that can affect the heart, joints, skin, and brain about 20 days after having strep throat or scarlet fever?

A

Rheumatic Fever

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59
Q

Which illness presents with dysphagia, drooling, and distress, muffled speech, “hot potato” voice, and is usually caused by Haemophilus influenzae type B?

A

Epiglottittis

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60
Q

Which illness presents as a thick, pseudo-membrane that covers tonsils, throat, and uvula with a sudden onset of malaise, sore throat, pharyngitis, and swollen lymph nodes that give a “bull-neck” appearance, and is diagnosed by nasopharyngeal swab?

A

Diptheria

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61
Q

Which illness presents with cold like symptoms and a “whooping” cough in severe bouts (paroxysms) and is diagnosed with nasopharyngeal swab?

A

Pertussis

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62
Q

What is the diagnostic screening test for strep pyogenes?

What is the gold standard test?

A

Rapid antigen test

Throat culture

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63
Q

Which illness is common in children (usually 3 months-5 years), caused by the parainfluenza virus, and presents with inspiratory stridor, barking cough, symptoms worse at night, and is diagnosed by a nasal wash?

A

Laryngotracheobronchitis (Croup)

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64
Q

What are the main culprits of swimmer’s ear?

A

P. aeruginosa

Aspergillus

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65
Q

A food borne that presents within 1 hour is usually indicative of what?

A

Ingestion of a chemical

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66
Q

What are the most common organisms responsible for pneumonia?

A

Children: RSV, parainfluenza, adenovirus
Young: M. Pneumoniae
Adult: S. pneumoniae

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67
Q

A food borne illness that presents within 1-6 hours is usually indicative of what?

A

Preformed toxin ingestion

B. Cereus, C. botulinum, C. Perfringens

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68
Q

A food borne that presents within 8-16 hours is usually indicative of what?

A

Clostridium perfringens

Enterotoxin-producing strains of Bacillus cereus

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69
Q

Which infectious type of diarrhea is characterized by watery, high volume, low frequency, small bowel, fecal leukocyte negative results, and is usually self-limited and caused by viral organisms, Giardia, Vibrio, or E coli?

A

Secretory diarrhea

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70
Q

Which type of infectious diarrhea is characterized by mucus and PMNs, positive for fecal leukocytes, low volume but high frequency, is in the large bowel, and has a longer duration?

A

Inflammatory diarrhea

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71
Q

Which type of infectious diarrhea is characterized by bloody stool, positive for fecal leukocytes, low volume but high frequency, is in the large bowel, usually is caused by E coli O157:H7, and has a longer duration with complications?

A

Hemorrhagic diarrhea

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72
Q

What are the main organisms that produce toxins and invade tissue in a gastrointestinal infection?

A

Vibrio parahemolyticus

Yersinia enterocolitica

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73
Q

What is fecal occult blood an indicator of?

A

Colon cancer

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74
Q

What test is used to determine inflammatory vs. noninflammatory diarrhea?

A

Fecal leukocytes

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75
Q

What are some of the conditions that you will see a large number of WBCs in the stool?

A

Chronic bacillary dysentery
Chronic ulcerative colitis
Colonic abscess

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76
Q

What disease shows monocytes on a fecal leukocyte test?

A

Typhoid fever

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77
Q

What is the protein released by neutrophils that is an indicator of intestinal inflammation?

A

Lactoferrin

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78
Q

Stool pH less than 5.5 indicative of:

A

Carbohydrate absorption abnormality

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79
Q

A high stool pH may be associated with:

A

Colorectal cancer

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80
Q

What is used to test stool pH?

A

Nitrazine paper

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81
Q

When is a stool culture warranted for diarrhea?

A

Bloody
>3 days
Prolonged w/ History of travel

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82
Q

What are the organisms that are tested for on the extended stool culture?

A

Vibrio cholerae
Yersinia enterocolytica
E. Coli

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83
Q

What are the top 3 parasitic infections for the GI tract?

A

Giardia
Cryptosporidium
Entamoeba

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84
Q

What assay is performed for all cases of bloody diarrhea?

A

Shiga toxin

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85
Q

What test is performed for organisms that may be difficult or slow to culture?

A

PCR

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86
Q

What organism would you suspect in a patient with diarrhea after eating rice/Chinese restaraunt?

A

Bacillus cereus

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87
Q

Which bacterial infection of infancy is associated with ingestion of honey?

A

Clostridium botulinum

Presents w/ flaccid paralysis and intoxication

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88
Q

Which bacterial infection is associated with traveler’s diarrhea?

A

ETEC

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89
Q

Which bacterial infection is associated with hemolytic uremic syndrome?

A

EHEC

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90
Q

What bacterial is commonly associated with ingestion of undercooked poultry and unpasteurized milk?

A

Campylobacter jejuni

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91
Q

What bacteria is associated with flu-like symptoms and meningitis from unpasteurized cheese or lunch meat?

A

Listeria monocytogenes

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92
Q

What parasite is associated with bulky diarrhea, fatty, yellow stools?

A

Giardia lamblia

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93
Q

What parasite is associated with dysentery, liver abscess, and intestinal blockage and shows trophozoite ingested RBCs on O&P?

A

Entamoeba histolytica

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94
Q

What type of arthritis is purulent and typically a collection of pus inside the joint of wrist, fingers, ankles and toes?

A

Non-gonococcal

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95
Q

What organisms are mainly associated with artificial joint arthritis?

A

Staph aureus

Staph epidermidis

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96
Q

Which type of osteomyelitis is caused by S. Aureus or streptococcus?

A

Acute

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97
Q

Which type of osteomyelitis is caused by Enterobacteriaceae (usually in diabetic ulcers)?

A

Chronic

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98
Q

What is the lab work up to diagnose osteomyelitis?

A

Blood cultures, bone biopsy, CBC, CRP, ESR, and needle aspiration of affected area

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99
Q

Multinucleated giant cells with a Wright or Giemsa stain on a Tzanck smear are a sign of which condition?

A

Herpes infection

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100
Q

What lab test is used to diagnose a viral agent by using wright or gives a stain?

A

Tzanck Smear

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101
Q

What is the syndrome caused by S. Pyogenes that causes superficial cellulitis with shiny, raised, indurated and tender plaque-like lesions with distinct margins?

A

Erysipelas

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102
Q

What are the causative agents for impetigo?

A

S aureus
MRSA
S pyogenes

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103
Q

What is a bacterial invasion into the subcutaneous tissue with rapid spread through superficial and deep fascial planes aided by toxins and enzymes causing necrosis, caused by S pyogenes or S aureus?

A

Necrotizing fasciitis

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104
Q

Which condition infects the superficial layers of the skin, is nonfollicular, progresses to a honey colored crusted vesicle, and is caused by S aureus (bullous), MRSA, or S pyogenes (non-bullous)?

A

Impetigo

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105
Q

What is the gram stain characteristic of clostridial infection?

A

GPR and NO PMNs

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106
Q

What is characterized by scabs/vesicles/pustules on the trunk that are contagious before they appear?

A

Varicella Zoster

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107
Q

Which condition is characterized by rash, Koplik spots, red eyes, and photophobia, fever greater than 101, lasts for at least 3 days or long, is spread by contact with droplets and can be isolated from the throat, urine, and nasal specimens?

A

Rubeola (Measles)

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108
Q

Which condition is characterized by a fever greater than 99 degrees, headache, runny nose before the rash appears but lasts 3 days or less, and is a severe congenital infection that can be isolated from the nose, throat, urine, CSF, and blood?

A

Rubella (German measles)

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109
Q

Which infection usually affects children by the age of 2 that is caused by HHV6 or HHV7, is characterized by a high fever followed by a pink/rose-colored rash, swollen lymph nodes, and is diagnosed by serology?

A

Roseola

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110
Q

What are the three major causes of bacterial meningitis?

A

Strep pneumoniae
Neisseria meningitidis
Haemophilus Influenzae

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111
Q

What kind of meningitis do you see 200-20,000 PMNs, low glucose, high protein in CSF?

A

Bacterial

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112
Q

Which type of meningitis is usually mild/self-limiting, presents with lymphocytes, normal glucose, and high protein in the CSF?

A

Viral meningitis

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113
Q

Which type of meningitis has a gradual onset, will have lymphocytes (100-1000), low glucose, and high protein in the CSF, and is usually found in immunocompromised patients?

A

Fungal meningitis

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114
Q

What microorganism causes aseptic meningitis?

A

Enterovirus

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115
Q

Which type of meningitis will have a CSF analysis with 100-1000 eosinophils, normal-low glucose, and high protein?

A

Parasitic meningitis

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116
Q

What is the primary cause of parasitic meningitis?

What are the other two causes?

A

Naegleria fowleri- warm fresh water causing Primary Amebic Encephalitis
Taenia Solium- seizures and Ca lesions
Toxoplasma gondi- abscess and encephalitis

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117
Q

Which type of meningitis is characterized by hydrocephalus, non-specific signs and symptoms, and is caused by slow-growing organisms?

A

Chronic

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118
Q

Which condition is brain swelling characterized by confusion, personality changes, altered mental status, seizures, and is caused by a virus that triggers the inflammation?

A

Encephalitis

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119
Q

Which organism lives in lung tissue and is reactivated during times of immunosuppression, is transmitted by respiratory droplets, and causes TB meningitis in children and AIDS patients?

A

Mycobacterium tuberculosis

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120
Q

What standard tests are performed on the tubes for CSF analysis?

A

Tube 1: glucose and protein
Tube 2: cryptococcal antigen, gram stain, cultures
Tube 3: hematology, cell count and diff
Tube 4: immunology, serology

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121
Q

What is very high in bacterial meningitis CSF sample?

A

Protein

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122
Q

What is the gold standard for bacterial meningitis diagnosis?

A

Culture

123
Q

What organism uses a capsule, fimbriae, and IgA protease transmitted through respiratory droplets in close quarters to cause meningitis?

A

Neisseria meningitidis

124
Q

What organism is characterized by intracellular survival in phagocytic cells and especially affects the pregnant and immunosuppressed?

A

Listeria monocytogenes

125
Q

Which organism is transmitted through exposure to deer ticks, changes the outer surface proteins, and causes facial palsy?

A

Borrelia burgdorferi

126
Q

Which fungi affects primarily AIDS patients (considered an AIDS defining illness), and causes meningitis?

A

Cryptococcus neoformans

127
Q

What can result in a patient with an untreated treponema pallium infection?

A

Neurosyphilis

128
Q

Which organism is found in cat feces and raw meat that often affects pregnant mothers or newborns or AIDS patients, and causes encephalitis and abscesses?

A

Toxoplasma gondii

129
Q

If TB is suspected, which test should be performed?

A

Obtain early morning sputum specimens for 3 consecutive days for smear and culture
Results in 6-8wks

130
Q

Which tests are used to detect latent TB infections?

A

TST

IGRA

131
Q

What test for TB can give false positives for BCG vaccinated patients and environmental non-tuberculosis mycobacteria?

A

TST

132
Q

What is usually negative in Active TB in a late HIV infection?

A

Tuberculin skin test

133
Q

What type of malaria is most common?

Most deadly?

A

P vivax

P falciparum- cerebral malaria

134
Q

What are the two most important pieces of information to account for in a malaria infection?

A

Travel history

Periodicity of fevers spikes

135
Q

Continual fevers with irregular spikes in a 36 hr cycle, CNS changes, respiratory distress, bleeding, circulatory collapse, fatigue, malaise, and possible hepatic involvement are all signs of what?

A

P. Falciparum malaria

136
Q

What is the gold standard for parasite detection for malaria?

What is the gold standard for speciation for malaria?

A

Thick blood smear

Thin blood smear
Both best taken AFTER fever spike

137
Q

When testing for malaria does a single set of negatives rule out malaria?

A

No, additional specimens 12hr intervals for 36hrs

138
Q

What is the organism responsible for “wool sorter’s disease”

A

Bacillus antracis

139
Q

What is characterized by a black scab (eschar), blister or ulcer, or a widened mediastinum, depending on the type?

A

Anthrax

140
Q

Which disease is also known as Rabbit fever, caused by direct contact through a break in the skin with an infected animal, and causes ulcers, chills, fever, joint stiffness, and requires a blood culture to diagnose?

A

Tularemia

141
Q

What diseases shows flu-like symptoms with undulant fever?

A

Brucellosis
Bang’s Dz
Malta fever

142
Q

Which organisms are included in a toxin assay?

A

Shiga toxin (Shigella), C diff, and Botulinum toxin

143
Q

What is the most common cause of meningitis in AIDS patients?

A

Cryptococcus neoformans

144
Q

What are the most common causative agent of subacute infectious endocarditis?

A

Strep viridans

145
Q

What is the most common causative agent of acute infectious endocarditis?

A

MRSA

146
Q

What respiratory pathogen presents with spherules in tissue, mold with arthroconidia, flulike illness with pneumonia?

A

Coccidiodes immitis

147
Q

What respiratory pathogen presents as encapsulated round yeast and pneumonia that precedes meningitis?

A

Cryptococcus neoformans

148
Q

What respiratory pathogen presents as pneumonia with clusters of 4-6um cysts in tissue and secretions, effecting immunocompromised individuals?

A

Pneumocystis jiroveci

149
Q

What parasite is associated with watery diarrhea, dehydration, weight loss and stomach cramps from a contaminated water source and shows with an acid fast cell wall?

A

Crypto parvum

150
Q

What kind of infection in pediatric patients causes a/febrile with non-bloody diarrhea?

A

Viral

151
Q

What kind of infection in pediatric patients causes afebrile with bloody diarrhea?

A

Bacterial w/ complications

152
Q

What kind of infection in pediatric patients causes febrile with bloody diarrhea?

A

Bacterial

153
Q

What samples need to be refrigerated if their delivery to the lab is delayed?

A

Respiratory specimens
Urine
Sputum
Stool

154
Q

What samples need to be maintained at room temps if their delivery to the lab is delayed?

A

Body fluids
Blood cultures
CSF

155
Q

What special transport medias are used for viruses, stool and stool parasites?

A

Virus- viral transport media
Stool- Cary-Blair media
Parasites- Formalin and Polyvinyl Alcohol

156
Q

What are the criteria for the labs to reject samples?

What is the exception?

A

Improper labels
Wrong specimen container
Leakage or unsuitable specimen
Duplicates- exception for blood cultures for endocarditis

157
Q

What facial infection can kids get from oral transmission?

A

Herpes Whitlow
Impetigo
Roseola

158
Q

When treating gonnorhea, what else is always treated?

A

Chlamydia

159
Q

What 3 findings will be seen on a UTI PE?

A

+ CVA pyelonephritis
urethral discharge
tender prostate

160
Q

All PTs w/ confirmed/suspected urethritis are tested for G/C but also ?

A

HIV

161
Q

S/Sx of Vaginosis

A 
ASx or abd pain
White/gray d/c
pH >4.5
\+ amine test
Clue cells/neg KOH
162
Q

S/Sx of Trichomoniasis

A 
Sore, dysparenia
Green/yellow/frothy
pH 5-6
Amine +
Trichomonads/neg KOH
163
Q

S/Sx of Candidiasis

A 
Pruritis, sore, dysparunia
Clumpy adherent d/c
pH 4-4.5 
No amine test
Pseudohyphae
164
Q

What is normally seen on a saline wet prep in a normal vaginal smear?

A

Lactobacilli

165
Q

What are the stages of syphilis and what occurs in each stage?

A

Primary- contagious, painless chancre
Secondary- contagious, wks/mons after primary w/ rash
Latent- ASx, not contagious, + serology
Late/Tertiary- Sx, no contagious AKA benign tertiary sysphilis, cardiovascular syphilis or neurosyphilis, tabes dorsalis

166
Q

What are the syphilis screenings?

A

Non-treponemal

RPR, VDRL

167
Q

What are the syphilis confirmations?

A

Treponemal tests
FTA-ABS
MHA-TP
TP-PA

168
Q

What is the triad of screenings, confirmation and interpretations of syphilis testing?

A

+ screen + confirm= active
+ screen - confirm= false pos
- screen + confirm= spirochete or previous infection

169
Q

4x decline of titer in syphilis treatment = ?

4x increase = ?

A

Response to therapy

Treatment failure

170
Q

What are the low/high sensitivity tests for HSV?

A

Low- direct detection= Tzanck, rapid Ag
High- semi-direct= DFA
Culture- gold standard

171
Q

When is Herpes viral PCR best used?

A

CSF testing of neonate w/ encephalitis

172
Q

What are the stages of LGV?

A

Chlamydia Trachomatis in S America
1- lesion, papule or ulcer
2- lymphadenopathy w/ “groove sign”

173
Q

Characteristics of Donovanosis

A 
Granuloma Inguinale
Klebsiella
Tropics, rare in US
Painless beefy granulomatus ulcer
Mononuclear cells w/ cytoplasmic vacuoles packed w/ bacteria- Donovan Bodies
174
Q

What medication is approved by FDA for HPV treatment?

A

Gardasil

175
Q

What makes up the Dx of PID?

A 
Endometriosis
Salpingitis
Tuboovarian abscess
Pelvic peritonitis
Usually as a complication of cervicitis
176
Q

What is the confirmatory test for HIV 1 and HIV 2

A 
1= Western Blot
2= Bio-Rad multispot
177
Q

What tests are Western Blots good for confirmatory results?

A

HIV EIA
HCV for RIBA
Burgdorferii

178
Q

Characteristics of Acute Infectious Endocarditis

A

Acute ABE rapid- septicemic episode on healthy cardiac valves(catheter) from Staph A (MRSA)
IVDU- MRSA in tricuspid valve

179
Q

Characteristics of Subacute Infectious Endocarditis

A

Gradual infection in damaged valves with congenital, sclerotic or RF damage from Strep V group or intestinal flora S Bovis which suggests intestine CA or from Staph A

180
Q

How do you tell if an endocarditis positive blood culture is significant

A 
Correlates to organism
Coag neg staph are significant in artificial valves
Multiple cultures + for same organism
Shorter incubation
Degree of severity
181
Q

What organisms are most commonly isolated from endocarditis blood cultures?

A 
Acute- Staph A
Sub acute- Strep Viridan
Prosthetic- Staph Epidermis
Gram Neg Bacilli
Enterococci
182
Q

What are the common organisms that cause endocarditis but are culture negative?

A 
Aspergillus
Brucella
Coxiella Burnetti
Chlamydia
HACEK
183
Q

What is the most common place for infectious agents to gain access to the body?

A

Respiratory tract

184
Q

What microbes cross over into warmer/summer months?

A 
Rhino
Enterovirus
Adeno
PIV 2 3 
MPV
185
Q

What 3 viruses make up the common cold?

What is unique about this triad?

A

Rhino
Corona
Adeno
Most frequent human Dz from contact w/ infected mucoids

186
Q

S/Sx of URI vs Influenza

A

URI- hacking cough, rare HA

Flu- Dry cough, HA, fever, malaise, myalgia

187
Q

S/Sx of allergies that are different from URIs and Influenza

A

Itchy watery eyes
Sneezing
Never fever
Never myalgia

188
Q

What type of pharyngitis needs to be evaluated and what kind needs to stay home

A

Bacterial- to clinic

Viral- stay home and gargle salt water

189
Q

S/Sx of non-bacterial/viral pharyngitis

S/Sx of bacterial?

A

Red swollen tonsil
Red throat

Swollen uvula
Gray furry tongue
White spots on tonsils

190
Q

S/Sx of Strep Pyogenes

A

Scarlet fever

Strawberry tongue

191
Q

How do you tell a Mycoplasma Pneumoniae pharyngitis from GAS infection?

A

Cough

192
Q

What are the 3 stages of pertussis?

A

Catarrhal- most infectious, common cold-like
Paroxysmal- whooping and mucus
Convalescent- reduced paroxysms and secondary complication

193
Q

Otitis media is always accompanied by ?

A

Viral URI

194
Q

What agents cause otitis media?

A 
Strep Pnemo
Pseudomonas Aeur.
H. Influenza
Moraxella Catarrhalis
RSV
Picornavirus
195
Q

What micrboes cause furunculosis in otitis externa?

A

GAS

196
Q

What type of bacterial pneumonia occurs in epidemics?

A

Staph A

197
Q

What type of bacterial pneumonia affects alcoholic, DM and nosocomial infections?

A

Klebsiella

198
Q

What type of bacterial pneumonia affects CF or ventilated PTs?

A

Pseudo. Aeurginosa

199
Q

What type of bacterial pneumonia affects young adults in summer or fall?

A

Mycoplasma pneumonia

200
Q

What type of bacterial pneumonia affects AIDS ans suppressive therapy PTs?

A

Pneumocystitis jiroveci

201
Q

Lab work ups for pneumonia include gram stain and UA for ? microbes?

A

Strep pneumo

Legionella

202
Q

What does rust color, currant jelly and foul smelling sputum mean?

A

Rust- S Pneumo
Currant- Klebsiella
Foul- anaerobic infection

203
Q

Fungal infection of bats and birds

A

Histoplasmosis

204
Q

Fungal infection of wood and soil

A

Bastomycosis

205
Q

Fungal infection of SW US, desert soil and rodent burrows?

A

Coccidioidomycosis

206
Q

What opportunistics infection can pass through milk, urine and feces?

A

Q fever

207
Q

What respiratory bacteria causes pharyngitis?

What bacteria causes epiglottitis

A

Strep Pyogenes

Haemophilus influenza

208
Q

What respiratory bacteria impacts adults, compromised and smokers?

A

Legionella

209
Q

What respiratory bacteria causes walking pneumonia

A

Mycoplasma

210
Q

What respiratory bacteria causes pharyngitis and conjunctivitis

A

N. Gonorrhea

211
Q

What respiratory bacteria causes ventilator pneumonia

A

Stenotropho Malto

Pseudo Aeruginosa

212
Q

What microbe is #1 for CAP

A

Strep pneumo

213
Q

What respiratory fungus is an invasive form of pneumonia

A

Aspergilloma

214
Q

What respiratory fungus causes meningitis in adults w/ cell mediated immunity defects like HIV?

A

Cryptococcus neoform

215
Q

What respiratory fungi causes invasive pneumonia in diabetics and neutropenic PTs?

A

Rhizopus

Mucor

216
Q

What respiratory parasite causes empyema and lung abscesses

A

Entamoeba histolytica

217
Q

What respiratory parasite causes hemoptysis and chronic bronchitis

A

Lung fluke

Paragonimus westermani

218
Q

What respiratory parasite causes wheezing, coughing pneumonia in compromised PTs?

A

Strongyloids Stercoralis from Rhabdo larva

219
Q

What respiratory virus causes conjunctivitis

A

Adeno virus

220
Q

What respiratory virus causespneumonia in compromised PTs?

A

Cytomega virus

221
Q

What respiratory virus causes ARDS

A

Hanta virus

222
Q

What respiratory virus causes Shifts and Drifts

A

Influenza

223
Q

What respiratory virus causes croup

A

Parainfluenza

224
Q

What respiratory virus causesbronchiolitis

A

Respiratory syncitial virus

225
Q

What are the most commonly encountered infections of primary care?

A

GI infections

226
Q

Characteristics of Secretory Diarrhea

A

Watery
No leukocytes
High vol, low freq
In small bowel of Viral origin, Giardia, Vibrio, ETEC

227
Q

Characteristics of Inflammatory Diarrhea

A

Mucus and PMNs
+ leukocytes
Low volume, high freq
Large bowel from Slamonella, shigella or Campylobacter

228
Q

Characteristics of hemorrhagic diarrhea?

A

Bloody w/ leukocytes
Low vol, high freq
In large bowel from H7

229
Q

What are dysenteric Sx of diarrhea?

A

Fever
Tenesmus
Blood/pus

230
Q

What can cause falst pos Guaiac tests?

What can cause false negatives?

A

Gum/GI bleeds
Foods

Vitamin C

231
Q

Where does Staph Aureus food poisoning come from?

A

Casserole/mayo/food handler

232
Q

What kind of foods cause poisoning from Clostridium Perfringens

A

High protein, gravy, meat dishes

233
Q

What kind of food causes salmonella poisoning?

A

Raw/undercooked meat, poultry or eggs (including reptile eggs)

234
Q

S/Sx of Salmonella Typhi

A 
Diarrhea/constipation
High fever
Rose spots
Mental confusion
Bradycardia
Hepatosplenomegaly
235
Q

What microbe causes pseudoappendicitis

A

Yersinia enterocolitica

236
Q

What microbe can cause an “ammonia cloud”?

A

H Pylori

237
Q

What bug made Milwaukee famous?

A

Crytpo Parvum

238
Q

What microbe is the Winter Vomit Dz and where does it come from?

A

Rotavirus- day care and diapers

239
Q

Who is primarily affected by hematogenous osteomyelitis

A

Children at metaphysis

If in adult- spine

240
Q

All lesions w/ ? characteristic need to be deeply excised for evaluation?

A

Pigmented

241
Q

What type of sample is used to dx fungal and scabie infections of the skin?

A

Skin scraping

242
Q

What instrument is used to Dx dermatological dz?

A 
Woods lamp
Capitis- blue green
Corpis- faint green
Erythrasma- coral red
Vittiligo- milky white
243
Q

Define Diascopy

A

Test of blanchability to determine lesion type

Inflammatory= no blanching

244
Q

Pink then brown/scaly sing patched are caused by?

A

Erythrasma

Corynebacterium

245
Q

Impetigo bollous = ?

Impetigo non-bollous =

A

Staph A

Staph P

246
Q

What skin issue feels like a water filled balloon?

A

Carbuncles= multiple furuncles from Staph A

247
Q

What is Risus Sardonicus and what causes it

A

Grinning muscle spasms

Clostridium

248
Q

Define Intertrigo

A

Inflammation rash of body folds from Candidiasis

249
Q

Define Malassezia Furfur and what causes it

A

Tan/brown/white scaly patches from Tinea Versicolor

250
Q

What type of derm issue is acquired from inhaling decaying vegetation?

A

Blastomycosis- painless sores that look like warts or ulcers

Dx w/ culture showing broad based budding

251
Q

What is Rose Handler’s Dz

A

Sporotrichosis- poorly healing skin lesions w/ secondary lesion on lymph vessels

252
Q

What form of herpes are nurses likely to get?

What form are wrestlers likely to get?

A

Whitlow

Gladiatorum

253
Q

What causes Slappped Cheek appearance?

A

5th Dz

Parvovirus B19

254
Q

What is 6th Dz?

A

Roseola

HHV6 or 7

255
Q

What causes ‘creeping eruption’?

A

Cutaneous larvae:
Ancylostoma duodenal
Necator americanus

256
Q

What disease does the Phlebotomine Sandfly carry?

A

L Donovani
Cutaneous sores w/ volcanic appearance
Visceral form- Kala Azar

257
Q

What causes Swimmer’s Itch?

A

Austrobilharzia Vargilandis- cercariae

Cercarial Dermatitis- Schistosome

258
Q

What is Myiasis

A

Derm. Hominis
Cordylobia anthropophaga
Botfly larva in skin

259
Q

Define Pleocytosis

A

Inc amount of CSF cells

260
Q

What microbes are most likely to cause bacterial meningitis across ages?

A

Elder- S. pneumo, E coli
Adult- S pneumo, N meningitis
Kids- S pneumo, N miningitis
Neonate- GBS, E coli

261
Q

Who and when does aseptic meningitis mostly affect?

A

Enterovirus in summer and fall in infants and kids

262
Q

Someone who raises pigeons may suffer from what form of meningitis?

A

Fungal

263
Q

What discovery is pathognomic for rabies?

A

Negri bodies

264
Q

What serologic Ab titer results indicates syphilis treatment?

A

1: 256 prior to treatment
1: 4 after

265
Q

What virus causes projectile vomit in kids?

A

Norovirus

266
Q

What type of media is used for stool sample transport for suspected OandP?
What is used for culture, EIA or virus?

A

Formalin and PVA
Cary-Blair
Viral- VTM

267
Q

What test for TB is not affected by BCG vaccine and results are available in 24-48hrs after one visit?

A

IGRA

268
Q

What two vulvovaginitis tests produce a positive amine test?

A

Trichomoniasis

Vaginitis

269
Q

PT presents w/ mucus/bloody diarrhea after 15 days of ABX treatment. What test would be best to ID the source of his infection?

A

EIA for Toxin A and B

270
Q

PT complains of watery, stinky diarrhea x 2wks after drinking untreated water while hiking. What test can ID the cause?

A

O and P

271
Q

Malaria fever cycles become highly synched causing which form to be difficult to Dx?

A

Falciparum

272
Q

S/Sx of pulmonary TB

A

Productive cough
Chest pain
Hemoptysis
F/C/Ns

273
Q

What is a more specific screening method for TB?

A

Interferon Gamma Release Assay

274
Q

Define Syndemic and what are the two?

A

Convergence of two or more diseases that act syngergistically to magnify the Dz burden
HIV is driver of TB infection and alters transmission dynamics

275
Q

What malarias synchronize at what time frames?

A

ViVae, Ovale- 48
Faciparum- 36-48hrs
Malariae- 72hrs

276
Q

What are the 3 phases of malarial paroxysms?

A

Cold 15-60min
Hot 2-6hrs
Sweat 2-4hrs

277
Q

What causes Blackwater Fever?

A

Hepatic malaria

Hyperbillirubinemia

278
Q

Acute Hepatitis panel will show?

A

IgM anti-HAV
IgM anti HBc
HBsAg
anti-HCV

279
Q

Most common form of anthrax?

A

Cutaneous

280
Q

How is a plague case in the SW US Dx’d?

A

Lymph node aspirate

281
Q

What are the categories of Tularemia

A 
Ulceroglandular- most common
Glandular
Oropharyngeal
Pneumonic
Typhoidal
282
Q

Slaughter house workers, farmer and vets are at increased risk of contracting?

A

Brucellosis

B Melitensis is most virulent but most preventable

283
Q

How is Brucellosis dx’d?

A

Culture of blood, clean catch urine, CSF and marrow

284
Q

What does Arenaviruses cause?

A 
Lassa
Junin
Machupo
Guanarito
Sabia
285
Q

What does Filovirus cause

A

Ebola

Marburg

286
Q

What does Bunyaviruses cause

A 
Crimean congo
Uukuniemi
Hanta
LaCrosse
Rift Valley
287
Q

What does Flaviviruses cause?

A

Dengue

Yellow fever

288
Q

What is the skin test for HSV and VZV?

A

Tzanck smear

289
Q

How is pyelonephritis Dx’d?

A

UA
CBC
Culture
Chemistry

290
Q

How is prostatitis and urethritis diagnosed?

A

UA
Culture
Pyuria but no bacteria= chlamydia

291
Q

N. Gonorrhea has what samples sent for Dx?

A

D/c for stain, culture and PCR

292
Q

What issue requires a sterile culture?

A

Male urethritis

293
Q

When is a culture for a UTI necessary?

A

Pyelonephritis or Complicated Cystitis- Culture for ABX

Quantitaive- 10^5 general rule

294
Q

Culture for Urethritis/Cervicitis has what amount of specificity and specifically for what microbe?

A

100%

Inc resistance of N Gonorrhoeae

295
Q

How is chancroid Dx?

A

Clinical and Culture

296
Q

What is the gold standard for HSV ID?

A

Viral culture

297
Q

How is PID Dx?

A

Clinically

Confirmed w/ nucleic acid test

298
Q

What is the difference of effect on the heart between endocarditis and staph a?

A

Endocarditis- Mitral and Aortic

Staph A/MRSA- tricuspid/right sided from IV drugs

299
Q

What are the Susceptibility tests?

A

Kirby Bauer- disc diffusion

Broth/agar- minimum inhib concentration

300
Q

What type of HPV is in Types 6 and 11

A

Condyloma Acuminatum

301
Q

What suspicions need lab alerts?

A

Dimorphic fungi
Epiglottitis
Diphtheria
Pertussis

302
Q

What microbes require extended stool cultures?

A

TCBS- Vibrio Cholerae
CIN- Yersinia Enterocolitica
MAC- E Coli EHEC

303
Q

How is Typhoid Fever diagnosed?

A

Stool culture- monocytes

Agglutination assay- Vi Ag

304
Q

What are the 3 stages of HIV CD4 counts?

A 
1= +500
2= 200-499
3= <200
4= unknown

IPAP (212 decks)

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