Diagonosis Flashcards
What are symptoms?
Complete patient history
What are signs
Physical examination
High-quality specimen
3 components
Selection
Collection
Transport
What does selection indicate?
Location
4 aspects of collection?
Instructions to patient
Sufficient quantity
No antimicrobial beforehand
Proper labeling
3 Aspects of Transportation?
Completed request form
ASAP moved
Stored properly
What 3 things happens to the pathogen in a poor-quality specimen?
Destroyed
Masked
Contaminated
5 rejection criteria
Unlabeled & Mislabeled
Leak
QNS
Sent in Formalin (CML)
What should the specimen be put in if it’s sent to CML?
Saline
What does CCMS
Clean-catch mid-stream
When is a catheter used in urine collection?
Bedridden/Paralysis/ICU
(In situ)
&
Neurological bladder (intermittent)
Who is a urine bag used for?
Babies
What does SPA stand for
Suprapubic needle aspiration
What is the golden standard in urine collection?
SPA
When do we process urine sample?
Within 30 minutes
How long is a refrigerated urine sample valid for?
24h
The 2 sizes of calibrated loops
0.01 & 0.001 ml
What cultures can we use for urine?
Blood agar or MacConkey
What do we use CFU for?
Check urine for UTI
Equation of CFU
of bacterial colonies /ml
CFU of UTI in CCMS?
> 100,000
CFU of UTI in Catheter?
> 1000
CFU of UTI in SPA?
If any colonies appear = UTI
4 Criteria to determine clinical significance of a urine sample
Patient
Specimen type
Pyuria
Growth
Which 3 patients get the most UTI
Female & Elderly & Children
3 reasons for symptomatic sterile pyuria
Metallic wire loop got too hot
Patient took antibiotic
Atypical / fastidious MOs
What MOs cause Sterile pyuria?
……
5 causes of non symptomatic sterile pyuria ?
Pregnancy
Stones
DM
Interstitial nephritis
Vaginal discharge
Which is more indecative for a UTI? Bacteriuria or Pyuria?
Pyuria
What does Leukocyte esterase test indicate?
Pyuria
Which WBCs produce Leukocyte esterase enzyme?
Granulocyte WBCs & Monocytes
What does Nitrate test indicate?
Bacteriuria
Which MOs can nitrituria detect?
G- that (NO3 —> NO2)
Which 5 MOs have a negative nitrite test?
Staph saprophyticus
Enterococcus
P. Aeruginosa
Acinetobacter
Adenovirus
List 5 clinical pathology labs
Chemistry
Hematology
Microbiology
Immunology
Blood bank
The 4 major CML responsibilities
Processing clinical specimen
Isolation of potential pathogens
Identification of isolated ^^
AST
Which 2 sections of CML are only found in large hospitals?
Mycobacteriology
Virology
Which section of CML in small hospitals is dependent in large hospitals?
Immunology
What is the most common specimen sent to labs?
Urine
3 Indications of blood
Bacteremia
Septicemia
IV line infection with fever
Blood bacteremia 10 diseases
Pneumonia
UTI
Brucellosis
Tularemia
Anthrax
Plague
Meningitis
Endocarditis
Salmonella
Typhoid fever
What causes septicemia ?
G- bacteria and their toxins
What causes temporary bacteremia ?
Oral surgery (;Tooth extraction)
Aggressive brushing
How long is blood incubated before ruling out Endocarditis & fungi?
3 weeks
How long is blood incubated before ruling out Brucella?
6-8 weeks
3 causes of blood sample contamination
Pseudobacteremia (neonates)
Ward-based (Collection & flora)
Lab-based
3 Bacteria; G+ cocci that don’t grow in subculture
Anaerobic staph
Aerobic strep
Pyridoxine-dependent strep
Which G- cocci show no growth in subculture ?
Anaerobic Veillonella
Which G+ cocci show G- cocci in subculture ?
Acinetobacter
Which G+ bacilli show no growth in subculture ?
Anaerobic propionibacterium
6 G- bacilli that show no growth in subculture ?
(H)ameophilus
(A)ctinobacillus
(C)ardiobacterium hominis
(E)ikenella corrodens
(K)ingella
What 2.5 diseases is a CSF sample used for?
Meningitis
Encephalitis
Meningoencephalitis
[Life threat]
How is CSF sample collected?
Lumber puncture
Which sample require STAT processing?
CSF
Trauma vs Hemorrhage
1 difference
Trauma can have clotting
2 methods of blood sample processing
Microscopy & Centrifugation
What does blood centrifugation supernatant indicate?
MO capsule
In hematology what does increased Neutrophils & Lymphocytes indicate
Neutrophils = bacteria
Lymphocytes = Virus
How can the chemistry lab help in diagnosing bacterial infection in CSF sample?
Low Glucose + High protein
How many hours do we incubate CSF to before declaring the result negative?
48 hours
What are the major bacterial pathogens causing meningitis?
H. Influenza
Pneumococcus
Meningococcus
What are the 4 neonatal meningitis bacterial pathogens?
GNS
Enterococci
Listeria meningitis
E.Coli
What bacterias cause meningitis in VP shunt
Pseudomonas
S. Epidermis
S. Aureus
G- bacilli
Acinetobacter
Most common meningitis causing fungus?
Cryptococcus neoformans
Swab is not recommended in wounds and is rejected for these 2 pathogens:
MTB & fungi
What pathogen stems from a dog bite wound?
Pastuerella multocida
Which collection method should be avoided in Neisseria gonorrhoeae
Cotton swab
What bacteria do we use a throat swab for? & what antibiotic do we use for it?
(What is the gram stain & hemolysis type?)
Group A streptococcal
(S. Pyogenes) (G+) (B-hemolytic)
Sensitive to Bacitracin
What Pathogens do we use sputum specimen for in; ICU ?
MRSA
What Pathogens do we use sputum specimen for in; Pediatrics ?
Nasopharyngeal aspirates (NPA)
What Pathogens do we use sputum specimen for in; Lung needle biopsy ?
Fungus pneumonia in AIDS
When do we use anaerobic culture for stool sample?
C. Difficile & C. Perfringes
Pathogens found in stool sample
H)elminths
E).Coli
V)ibrio cholera
Y)ersinia
C)ampylobacter
S)almonella
S)higella
