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Infectious disease > diagnostic & therapeutic techniques > Flashcards

diagnostic & therapeutic techniques Flashcards

1
Q

general symptoms of infection

A

fatigue, fever, chills

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2
Q

symptoms of skin/wound infection

A

redness, swelling, discharge, tenderness

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3
Q

lower rsp tract infection symptoms

A

productive cough, SOB, pleuritic chest pain

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4
Q

upper rsp tract infection symptoms

A

congestion, discharge/drainage, HA/pain/pressure

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5
Q

GI infection symptoms

A

abd pain, N/V/D

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6
Q

genitourinary infection symptoms

A

pain/burning while urinating, vaginal/urethral discharge

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7
Q

neuro infection symptoms

A

HA, confusion, altered mental status

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8
Q

MSK infection symptoms

A

joint pain, swelling, redness, warmth

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9
Q

WBC is typically elevated in the presence of ?

A

infection
leukocytosis

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10
Q

what are 5 types measured in differential WBC

A
  1. neutrophil
  2. lymphocyte
  3. monocyte
  4. eosinophil
  5. basophil
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11
Q

what WBC are granulocytes and what are agranulocytes

A

granulocyte - neutrophil, eosinophil, basophil
agranulocyte - lymphocyte, monocyte

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12
Q

what is the most abundant and least abundant WBC

A

most - neutrophil
least - basophil
“Never Let Monkeys Eat Bananas”

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13
Q

what is the primary defense in bacterial infections and first to arrive at site of infection

A

neutrophil
also active in fungal infections and physiologic stress

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14
Q

when bone marrow is signaled to make more neutrophils due to presence of infection

A

immature neutrophils (bands)
“left shift”

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15
Q

primary defense for viral infections

A

lymphocytes
“clean up” cells

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16
Q

what is the most common WBC in lymph

A

lymphocytes

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17
Q

what is the largest WBC and is elevated in late/chronic infection

A

monocytes
can migrate into tissue/organs and become macrophages

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18
Q

what WBC is seen in allergic reactions and parasitic infections

A

eosinophils

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19
Q

what is seen in hypersensitivity reactions and releases inflammatory mediators

A

basophils

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20
Q

for a “clean catch,” collect the urine sample when urine has only been in the bladder for ?

A

2-3h

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21
Q

urinalysis symptoms of a UTI

A

color - cloud/turbid - has pyuria
odor - strong/fishy odor
chemical dipstick - leukocyte esterase, nitrites, blood
microscopic examination - WBC, RBC, microorganisms, casts

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22
Q

leukocyte esterase in a dipstick analysis shows

A

enzymes made by WBC
increased WBC in urine

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23
Q

nitrites are produced by ___ in a dipstick analysis

A

g-

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24
Q

blood in a dipstick analysis suggests ?

A

infection/inflammation/injury in urinary tract

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25
Q

RBC present in a dipstick analysis is indicative of

A

infection/inflammation/injury

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26
Q

Casts in dipstick analysis is indicative of

A

kidney infection

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27
Q

wet prep/KOH prep is indicated for

A

vaginal/cervical/urethral discharge

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28
Q

difference between wet and KOH prep

A

wet
- specimen placed on slide with saline solution
- clue cells (BV), protozoans (trichomonas)
KOH
- with KOH
- fungal cells

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29
Q

epithelial cells of the vagina that get their distinctive stippled appearance by being covered with bacteria

A

clue cells

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30
Q

difference between lateral decubitis vs upright positions during LP positioning

A

lateral decubitis - opening pressure is needed
upright - opening pressure isn’t needed

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31
Q

normal physical/lab characteristics of CSF

A

clear and colorless
almost same viscosity of water
No RBC
< 5 WBC present
glucose - 50 - 75 mg/dL
No protein

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32
Q

increased pressure of CSF is indicative of

A

infection, tumor, intracranial bleed

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33
Q

decreased pressure of CSF is indicative of

A

dehydration, CSF leakage

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34
Q

cloudy/turbid CSF color is indicative of

A

infection

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35
Q

xanthochromia in CSF is indicative of

A

bleeding

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36
Q

thick CSF is indicative of

A

infection or malignancy

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37
Q

what is the main complication from lumbar punctures

A

headache*

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38
Q

normal pleural fluid has ____ number of WBC with ___ RBC or microorganisms

A

small
no

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39
Q

RBC present in pleural fluid analysis is indicative of

A

trauma or malignancy

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40
Q

imbalance between pressure within blood vessels and the amount of protein in blood

A

transudate

41
Q

fluid caused by injury or inflammation of the pleura resulting in pleural effusion

A

exudate

42
Q

2 pleural fluid analysis

A
  1. microscopic exam
    - total cell counts
    - cytology
  2. infectious disease test
    - gram stain
    - bacterial C&S
    - individualized testing
43
Q

milky pleural fluid is indicative of

A

lymphatic system involvement

44
Q

reddish pleural fluid may indicate presence of

A

blood

45
Q

cloudy, thick pleural fluid may indicate

A

presence of microorganisms and/or WBC

46
Q

chemical tests for pleural fluid analysis

A
  1. glucose - decrease in infection, additional decrease pH in malignancy
  2. lactate levels - increase with infectious pleuritis
  3. amylase - increase in pancreatitis, esophageal rupture, malignancy
  4. TG levels - increase with lymphatic system
  5. tumor markers - increase
47
Q

what is used to help diagnose the cause of peritonitis or ascites (peritoneal fluid accumulation)

A

paracentesis
causes:
- new onset ascites
- large or refractory ascites
- suspected spontaneous or secondary bacterial peritonitis

48
Q

what is used to diagnose the cause of joint effusions? s/s?

A

arthrocentesis
s/s: joint pain, joint swelling, erythema, warmth

49
Q

obtain chest x-ray when there are s/s of pulmonary infection:

A
  1. dyspnea, SOB
  2. cough
  3. fever, chills
  4. pleuritic chest pain
50
Q

used to screen pulmonary infection, masses, trauma and other pathologies

A

CXR

51
Q

uses radiation to produce images

A

CT scan

52
Q

uses powerful magnetic fields and radio frequency pulses to produce images

A

MRI

53
Q

cells stained purple are

A

G+ cells
thick cell walls

54
Q

cells stained blue are

A

G- cells
thin cell wall

55
Q

cell turns pinkish red with safranin red is

A

g-

56
Q

cell is purple with safranin red is

A

g+

57
Q

G+ staphylococcus

A

s. aureus
s. epidermidis

58
Q

G+ streptococci a-hemolytic

A
  1. s. pneumonaie
  2. s. viridans
59
Q

G+ streptococci B-hemolytic

A
  1. S. pyogenes
  2. S. agalactiae
  3. s. Bovis
60
Q

G+ steptococci y-hemolytic

A

s. enterococcus

61
Q

g+ rods

A
  1. corynebacterium
    - c. diphtheriae
  2. clostridium
    - c. difficiles
  3. bacillus
    - b. anthracis
    - b. cereus
  4. lactobacillus
    - l. acidophilus
  5. listeria
    - l. monocytogenes
62
Q

G- cocci (3)

A
  1. acinetobacter
  2. moraxella
    - m. cat
  3. neisseria
    - n. gonorrhea
    - n. meningitidis
63
Q

g- rods (16)

A
  1. bacteroides - B. fragilis
  2. campylobacter
  3. enterobacter
  4. escherichia - E. coli
  5. klebsiella
  6. proteus
  7. helicobacter - H. pylori
  8. pseudomonas
  9. salmonella
  10. serratia
  11. shigella
  12. vibrio - V. cholera
  13. yersinia - Y. pestis
  14. haemophilus - H. flu
  15. legionella - L. pneumonphila
  16. bordetella - B. pertussis
64
Q

why is gram stain important in clinical medicine

A
  1. aids in selection of culture media
  2. initial selection of abx
  3. establish preliminary dx
65
Q

if a culture is negative for bacteria, it does not rule out an infection bc:

A
  1. pathogen may not be present in large quantities
  2. symptoms could be due to a viral infection
  3. pt could have been on previous abx
66
Q

for blood cultures are ordered ___ or more samples from ___ locations

A

two, two

67
Q

stool culture labs evaluate for most common intestinal ____ pathogens

A

bacterial

68
Q

to test for parasites, you must order:

A

stool for ova and parasites

69
Q

a urine culture is positive when ?

A

+100k colonies of a single bacteria
men and some cath specimens = 1k>

70
Q

rust colored sputum is caused by what organism

A

s. pneumoniae

71
Q

yellowish/green sputum is caused by what organism

A

H. flu

72
Q

green sputum is caused by what organism

A

pseudomonas

73
Q

red, currant-jelly sputum is caused by what organism

A

klebsiella

74
Q

bloody sputum is caused by what organism

A

tuberculosis

75
Q

foul-smelling/bad tasting sputum is caused by what organism

A

anerobe

76
Q

thin/scant sticky sputum is caused by what organism

A

atypicals - mycoplasma pneumoniae, c. pneumonaie

77
Q

used to determine whether a person with pharyngitis has a group A streptococcal infection

A

rapid strep test

78
Q

when do you perform a throat culture

A

when a strep test is negative

79
Q

avoid strep throat testing in children how old

A

< 3

80
Q

avoid routine rapid strep testing of what type of pt

A

asx
children <3y/o

81
Q

4 criteria for throat culture

A
  1. hx of fever
  2. tonsillar exudate
  3. tender anterior cervical adenopathy
  4. absence of cough

<15y/o +1
>44y/o -1

82
Q

negative throat culture is a sore throat caused by ?

A

viral infection

83
Q

most common cause of viral sore throat

A

adenovirus

84
Q

sensitivity testing is not necessary when…

A

most common pathogens are known and are known to be susceptible to first line tx

85
Q

when is sensitivity testing indicated (4)

A
  1. pathogens are unknown or mixed pathogens
  2. known resistance
  3. severe infection
  4. infection is not responding to typical first line tx
86
Q

what are the 4 CSF tubes

A
  1. WBC w/diff
  2. glucose and protein
  3. gram stain, C&S
  4. other - ordered if initial tests are abnormal
    - lactic acids
    - lactate dehydrogenase (LDH)
    - C-reactive protein
    - (all will increase if infection present)
87
Q

clear fluid
low protein/albumin/LDH
few cell count
what type of fluid?

A

transudate

88
Q

fluid can appear cloudy
high protein/albumin/LDH
increased cell count
what type of fluid?

A

exudate

89
Q

according to Light’s criteria, pleural effusion is likely exudative if at least one of the following exists:

A
  1. pleural fluid protein:serum protein ratio >5.0
  2. pleural fluid LDH:serum LDH ratio >0.6
  3. pleural fluid LDH is >0.6 or >2/3 times the normal upper limit for serum LDH
90
Q

increased viscosity from an arthrocentesis is indicative of ? decreased viscosity?

A

increased = sepsis
decreased = inflammation
string-like = normal

91
Q

lobar consolidation is usually seen in ? while patchy nodular infiltrates is usually seen in ?

A

pneumonia
pulmonary edema (CHF)

92
Q

process of gram stain illustration

A
  1. stain with crystal violet dye
  2. grams iodine solution (causes dye to stick more onto cell wall)
  3. decolorize with alcohol and acetone
  4. counterstain with safranin red
93
Q

what is the most common pathogen in urine cx

A

e. coli

94
Q

when do you order a sputum cx?

A

when you suspect a bacterial infection in the lungs (pneumonia)
may be ordered after tx of an infection to see effectiveness

95
Q

what are the most common bacterial pathogens in sputum cx

A
  1. strep
  2. staph
  3. haemophilus
  4. klebsiella
96
Q

lowest concentration of drug that inhibits the growth of the organism

A

minimum inhibitory concentration (MIC)

97
Q

what is the zone of inhibition

A

abxx is effective against the bacteria, leaving a clear ring

98
Q

how long does sensitivity testing take?

A

24-48 h AFTER organisms have been identified on culture

99
Q

how are sensitivity tests reported?

A

susceptible
intermediate
resistant

Infectious disease (15 decks)

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