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Infectious Disease > Intro > Flashcards

Intro Flashcards

1
Q

WBC tend to be ____ in the presence of an infection

A

elevated

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2
Q

What are the relative proportions of the WBC

A
  • Neutrophils (roughly 60 – 70%)
  • Lymphocytes (roughly 20 – 30%)
  • Monocytes (approximately 1 – 6%)
  • Eosinophils (approximately 1 – 3%)
  • Basophils (less than 1%)
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3
Q

____ are the most abundant WBC and act in defense in bacterial and fungal infections as well in times of physiologic stress

A

neutrophil

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4
Q

_____ Primary defense for viral infections
Elevations also in leukemias and lymphomas

A

Lymphocytes

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5
Q

_____ are the most common WBC in the lymph

A

lymphocytes

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6
Q

_____ are the largest WBC, becomes macrophages and are elevating in late or chronic infections

A

monocytes

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7
Q

____ defense mechanism in allergic reactions and parasitic infections

A

Eosinophils

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8
Q

_____ defense in hypersensitivity reactions and release inflammatory mediators

A

basophils

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9
Q

What does cloudy/turbid urine indicate?

A

pyuria (pus or WBC present in the urine)

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10
Q

What does an elevated leukocyte esterase in a urine dipstick analysis indicate?

A

increased WBC in urine, aka infection

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11
Q

Nitrites are produced by _____ bacteria

A

gram - bacteria

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12
Q

Wet prep is best to show ___ and _____

A

Clue cells (Bacterial Vaginosis)

Protozoans (Trichomonas)

looking for bacteria

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13
Q

KOH prep is best to show ___ cells

A

fungal cells

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14
Q

What will a clue cell look like under a microscope?

A

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

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15
Q

______ is used when collecting fluid in which opening pressure is needed

A

Lateral decubitus

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16
Q

_____ can be used if opening pressure isn’t needed

A

Upright position

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17
Q

How many tubes do you collect in a CSF? What goes in each?

A
  1. Cell Count and differential
  2. Glucose and protein levels
  3. Gram stain, C&S
  4. Other
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18
Q

What does increased CSF pressure indicate? decreased?

A

Increased pressure:
Infection, Tumors, Intracranial bleed

Decreased pressure:
Dehydration, CSF Leakage

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19
Q

What does cloudy/turbed CSF fluid indicate?

A

infection

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20
Q

What does xanthrochromia CSF fluid indicate?

A

bleeding

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21
Q

What is the normal viscosity for CSF fluid? What does thick mean?

A

same as water

infection or malignancy

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22
Q

What does decreased glucose in the CSF mean?

A

infection

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23
Q

What is normal for proteins and CSF?

A

normal is NONE to trace proteins

elevated proteins means infection, malignancy or autoimmune disease

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24
Q

What three additional CSF tests will be elevated in a bacterial infection?

A

lactic acid

lactate dehydrogenase

c-reactive protein

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25
Q

What are 3 contraindications for a lumbar puncture?

A
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26
Q

When would you order a brain CT before a lumbar puncture?

A

coma without cause
seizure
focal neurologic signs
immunosuppression

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27
Q

When would you order a brain MRI before a lumbar puncture?

A
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28
Q

Looking at normal pleural fluid under a microscope, what would you expect to find?

A

normal pleural fluid has small numbers of WBCs with no RBCs or microorganisms.

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29
Q

What is transudate?

A

An imbalance between the pressure within blood vessels (which drives fluid out) and the amount of protein in blood (which keeps fluid in), resulting in an abnormal accumulation of fluid. (talking about pleural fluid)

30
Q

What is exudate caused by?

A

Caused by injury or inflammation of the pleura resulting in pleural effusion.

31
Q

____ and ____ are the two most frequent causes of transudate

A

CHF or cirrhosis

32
Q

What 3 things are normal to find in transudate?

A

clear fluid
low protein/albumin/LDH
cell count = few

33
Q

What are some etiologies of exudate?

A

infectious diseases, bleeding, inflammatory conditions, malignancies, others

34
Q

What 3 things are normal to find in exudate?

A

fluid may appear cloudy
high protein/albumin/LDH
cell count is increased

35
Q

What does Light’s criteria signify? What are the 3 things?

A

Assists in the classification of pleural fluid being transudative or exudative
According to Light’s criteria, pleural effusion is likely exudative if at least one of the following exists

Pleural fluid protein:serum protein ratio >0.5
Pleural fluid LDH:serum LDH ratio >0.6
Pleural fluid LDH is >0.6 or >⅔ times the normal upper limit for serum LDH

36
Q

What does having a milky appearance to pleural fluid indicate?

A

to lymphatic system involvement

37
Q

Name some things you can test pleural fluid for

A

Glucose—typically about the same as blood glucose – ↓ in infection and if additional ↓ pH = malignancy
Lactate levels can ↑ with infectious pleuritis
Amylase levels ↑ with pancreatitis, esophageal rupture, or malignancy.
TG levels ↑ with lymphatic system involvement.
Tumor markers ↑ with some cancers

38
Q

What are some complications of pericardiocentesis?

A

Myocardial perforation
Bleeding
Pneumothorax
Arrhythmia
Acute pulmonary edema

39
Q

What is the water bottle sign?

A
40
Q

What is a paracentesis used for?

A

Used to help diagnose the cause of peritonitis or ascites (peritoneal fluid accumulation)

41
Q

What does milk-coloured (chylous) paracentesis fluid indicate?

A

malignant tumor, lymphoma, TB, parasitic infection, hepatic cirrhosis

42
Q

What does cloudy/turbid paracentesis fluid indicate?

A

peritonitis, primary bacterial infection, perforated bowel, appendicitis, pancreatitis, strangulated or infarcted bowel

43
Q

What does string-like viscosity of joint fluid indicate?

A

normal

44
Q

What does increased viscosity of joint fluid indicate?

A

septic arthritis

45
Q

What does decreased viscosity of joint fluid indicate?

A

inflammation

46
Q

A chest x-ray is used to screen the lungs for ????

A

Consolidation
Infiltrates
Cavitations
Nodules
Effusions

47
Q

_____ utilize radiation to produce images. Better for (bone/soft tissue)

A

CT Scan (computed tomography

bone

48
Q

_____ uses powerful magnetic fields and radio frequency pulses to produce images. Better for (bone/soft tissue)

A

MRI

soft tissue

49
Q

_____ retains the dye in a gram stain

A

peptidoglycan

50
Q

What is the process for a grain stain? short version at the end

A

Slide is stained with crystal violet dye - turning all cells purple

Gram’s iodine solution - causes dye to adhere more strongly to cell wall

Decolorization with ethyl alcohol and acetone

G+ cells - thick cell walls which retain the dye = stay purple

G- cells - thin cell walls, decolorizer easily penetrates and washes away dye

purple dye is applied

iodine is applied

alcohol wash

the counterstain, safranin is applied Gram + cells stay purple and gram - cells are pinkish red

51
Q

Name the gram + cocci clusters

A
52
Q

Name the gram + cocci chains

A
53
Q

Name the gram + rods

A
54
Q

Name the gram - cocci

A
55
Q

name some gram - rods

A
56
Q

Name some reasons your culture could be negative even if the patient does have an infection

A

Pathogen may not be present in sufficient quantity in the sample collected to be detected
Symptoms could be due to a viral infection
Patient could have been on previous antibiotics

57
Q

When ordering blood cultures, what is the protocol?

A

Typically order TWO or more samples from TWO locations

58
Q

How do you interpret blood culture results?

A

If both are positive for same organism = POSITIVE Culture
If one is (+) and one is (-) = possible contamination; may require re-testing
If both are negative for microorganisms (Reported as NO GROWTH) = NEGATIVE Culture

59
Q

____ is the most common pathogen on a urine culture

A

E. coli

60
Q

What is considered a positive urine culture?

A

Positive culture is ≥ 100,000 colonies of a single bacteria

61
Q

What does a rust colored sputum culture indicate?

A

strep pneu

62
Q

What does a yellowish/green sputum culture indicate?

A

H. influenzae

63
Q

What does a green sputum culture indicate?

A

pseudomonas

64
Q

What does a red, currant jelly sputum culture indicate?

A

klebsiella

65
Q

What does a bloody sputum culture indicate?

A

tuberculosis

66
Q

What does a foul smelling sputum culture indicate?

A

anaerobes

67
Q

What does a thin/scant sticky sputum culture indicate?

A

atypicals

68
Q

________, ______ and _____ do not grow on a basic sputum culture media

A

Atypical bacteria, mycobacterium (TB), and fungal infections

69
Q

What is the Centor criteria?

A
70
Q

What is MIC?

A

Minimum Inhibitory Concentration (MIC)
the lowest concentration of drug that inhibits the growth of the organism

71
Q

For sensitivity testing, you want the bacteria to be _____ to the abx in question at a (low/high) number

A

Susceptibility at the lowest MIC, (S with low number next to it)

Infectious Disease (16 decks)

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