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421 - Micro Lab > Genital & Blood > Flashcards

Genital & Blood Flashcards

1
Q

Gardnerella vaginalis

Colony & GS & Spot test

A

Tiny on BA and CA
Pleomorphic gram variable rods
Cat: Neg

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2
Q

Lactobacillus spp

Colony, GS, spot test

A

Pin-point to med, alpha-hem
GS: Long, thin, GPR in pair, chain
Cat: Neg

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3
Q

TMI (Thayer Martin Improved)

A

Vancomycin
Colistin
Trimethoprim
Anisomycin

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4
Q

TM media

A

Vancomycin
Nystatin
Colistin

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5
Q

MTM (Modified TM)

A

Vancomycin
Nystatin
Colistin
Trimethoprim

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6
Q

N. gonorrhoeae

Colony & GS & Spot test

A

Grow on TMI
GNDC
Oxidase: Pos

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7
Q

Specimen transport

A

RT within 4 hrs
Never refrigerate
Selective media: TMI
Incre CO2, moisture, 35C in 72hrs

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8
Q

Compare N. gon and N. men on CA

A

N.men is bigger and more isolated

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9
Q

GNDC source

A

N. gonorrhoeae: Genital, respiratory
N. meningitidis: CSF, respiratory
M. catarrhalis: Respiratory
Saprophytic Neisseria: Respiratory

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10
Q

N. gonorrhoeae biochem test

A

CTA slant: Glu pos, Mal neg, Lac neg, Suc neg
Enzyme test
Resistant to Colistin

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11
Q

N. meningitidis

A

CTA: Glu pos, Mal pos, Lac neg, Suc neg
Enzyme test
Maldi-TOF

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12
Q

M. catarrhalis

A

CTA: All neg
Nitrate: pos
DNAse: pos
Maldi-TOF

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13
Q

GC GenProbe test

A 
Ribosomal RNA is released
Probes target rRNA --> Chemiluminescent labled DNA probes hybridize with rRNA of GC --> measured by luminometer
Pos: >50,000 relative light unit
Neg: < 40,00 relative light unit
Between: repeat the test
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14
Q

R/O Group B beta hemolytic Strep.

A

Carrot broth: turn orange
Todd Hewitt Broth:
Lim Broth: Todd Hewitt with colistin and nalidixic acid

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15
Q

Genital tract flora

A 
Staph. epidemidis
C. diphthroids
Streptococcus
Peptococcus, Lactobacillus, Bacteroides (Anaerobe)
Mycoplasma homonis
Gardnerella vaginalis
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16
Q

Bacterial vaginosis

A

Non-inflammatory
Amine odor, yellowish discharge
pH > 5.0
GS: Many GNCB, clue cells, absence of Lactobacillus
Overgrowth of vaginal flora: Gardnerella and anaerobes
Treatment: Metronidazole

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17
Q

Catheter vs peripheral infection on BA

A

Paired two site blood culture drawn
Extra blood from each site sent in SPS tube
“Human blood plate”: 1ml pt sample + 10ml Columbia Agar
Examines for 3 days
If count on catheter > 10 times peripheral => Catheter-associated infection

18
Q

Catheter vs peripheral infection in bottle

A

Bottle drawn from a catheter goes Pos 4 or more hours before peripheral –> Line infection

19
Q

Acridine orange stain

A

Used when a false positive bottle

May see poorly staining organisms: Campylobacter, Brucella, Francisella, Mycoplasma

20
Q

Transient bacteremia

A

Bacteria enter the bloodstream during a common event: brushing teeth, eating hard, dental procedure, etc.

21
Q

Continuous bacteremia

A

Constant release of bacteria into the bloodstream: endocarditis & other endovascular infections

22
Q

Intermittent bacteremia

A

Bacteria released in burst, cleared, and released again

30-60 min before a febrile episode

23
Q

Venereal Syphilis

A

Treponema pallidum subsp. pallidum

  • Spirochete
  • Poor antigenicity –> survival in the host
24
Q

Treponema pallidum

A
  • 3 stages: chancre/ulcer –> rash –> gummas
  • Dx: Reverse serologies, darkfield microscopy
  • Treatment: Penicillin-G
25
Q

Primary syphilis

A
  • Acquired: less than 10 org, 3 weeks incubation
  • Primary lesion: chancre, painless, develops 10-70d after
  • 5% can be extra-genital (can be mistaken for Herpes)
26
Q

Secondary syphilis (systemic)

A
  • Develops 6-8w after 1st
  • Spirochaetemic disease: rash extend to palms and soles. Resolves after 2-8w
  • Systemic: meningitis, arthritis, arthralgia (40% neuro)
  • Great imitator (symptoms are similar to other infections)
27
Q

Latent & Late syphilis

A
  • Latent: 30% develop to 3rd, 70% latent
  • Late (3rd):
    + Only vertical infection
    + Gumma (15%) can occur in any body tissue
    + Cardiovascular (10%)
    + Neurosyphilis (8%)
    + Tabes dorsalis: slow degeneration of lower spinal cord
28
Q

Congenital syphilis

A
  • Infection acquired transplacentally from mother with 2nd syphilis
  • Symptom: Fever, 2nd syphilis, persistent rhinitis, hydrops, hepatosplenomegaly, thrombocytopenia
  • Dz can occur 12-20 years later if left untreated.
29
Q

Direct detection of T. pallidum

A
  • No in vitro growth, no GS
  • Direct on darkfield microscopy: 1st, 2nd syphilis, check motility, examine in 20 min
  • DFA-TP: does not require viability, labeled polyclonal or monoclonal anti-T.pallidum
30
Q

Serologic test

A 
Humoral Abs in response to T. pallidum
- Detect 1st stage
- Increase conc. in 2nd stage
- Decline in latent stage
Two types: Non-treponemal and Treponemal
31
Q

Treponemal test

A
  • Highly sensitive
  • Confirmation with non-trep test
  • Reactive result on treponemal test + Reactive result on non-trep test = highly specific for trep infection.
  • EIA: IgG + IgM or IgM + WB for congenital syphilis
  • TP-PA: particle agglutination
  • FTA-ABS: historically for VDRL confirmation
32
Q

Non-treponemal test

A
  • Detect Abs to “reagin”: cardiolipin & other lipids from damaged cells
  • Used screening
  • Low sensitivity in 1st syphilis
  • RPR (Rapid Plasma Reagin):
    + Serum/plasma
    + Use colored particle
  • VDRL: requires microscopic readout
33
Q

Cause “Drips”

A 
GC
Non-GC urethritis
Chlamydia
Bacterial vaginosis
Trichomonas vaginitis/urethritis
Candidiasis
34
Q

Cause “Sore”

A

Venereal Syphilis
Herpes: HSV2, HSV1
Other pathogens (uncommon in the US)

35
Q

Non-gonococcal Urethritis

A

40% Chlamydia trachomatis
30% genital mycoplasmas
Occasional: Trichonas

36
Q

GC Confirmation test

A
  • CTA
  • NET (enzyme)
  • Immunologic test: Coagulation, Fluorescent Abs
  • Maldi-TOF
  • Gen-Probe test (non-amplified)
  • NAAT (Nu. Acid Amplification Test): extremely sensitive & not required viable org.
37
Q

Pelvic Inflammation Disease (PID)

A
  • Ascending infection from CT, GC and flora
  • 5-10% higher with IUD
  • Complication: Infertility, ectopic pregnancy, chronic pelvic
  • Dx: culture peritoneal aspirate
38
Q

Viruses cause genital infection

A
  • Herpes (HSV-1, HSV-2): cause genital ulcer. dsDNA, infect squamous epi cells, neonatal concern, cervical cancer. Treat with Acyclovir.
  • HPV: most common viral STD. Cause wart or cancer (16, 18, 31)
  • Dx: Culture, PCR, Hybrid capture2 DNA
  • Vaccine: Gardasil, Cervarix
39
Q

Agents of infective Endocarditis

A
  • Oral flora: viridians Strep.
  • Skin flora: assoc. with lines, IV devices (S. epidermidis, S. aureus)
  • HACEK
  • Abiotrophia
  • Enterococcus
40
Q

Chlamydia trachomatis (CT)

A 
Serovars D-K
Incubation time: 7-14 days
Less than 50% of male (even less for females) show symptoms
Dx: Aptima Combo 2, NAAT
Treatment: Azithromycin, Doxycycline

421 - Micro Lab (6 decks)

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