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MICRO II Test 4 > MICRO II test 4 CSV > Flashcards

MICRO II test 4 CSV Flashcards

1
Q

What are the types of blood stream infections?

A

Intravascular (from within the CV system.)

Extravascular (Enter circulation from another site)

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2
Q

What is the most common portals of entry for extravascular infections.

A

Genitourinary tract, respiratory, abscesses, surgical wounds, bilary tract.

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3
Q

What are the common infections associated with the intravascular infections?

A

Mycotic aneurysm, infective endocarditis, suppurative thrombophlebitis.

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4
Q

How many culture bottles are recommended?

A

Two sets (4 bottles)

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5
Q

How much blood is to be used per culture?

A

10-20 ml of blood.

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6
Q

What are the steps for aseptic collection of blood cultures?

A

Find the vein before disinfection, below IV site, disinfect site, draw aerobic first.

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7
Q

What is contained in the blood culture bottle broth.

A

Nutrient broth and anticoagulant. (often trypticase soy, brain-heart infusion, supplemented peptone, thio broth

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8
Q

What is the BacT/ALERT method of detection for positive?

A

A sensor detects the increased CO2 with a colorimetric change.

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9
Q

What determines a BACTEC bottle positive?

A

With a fluorescence detector , fluorescent substrate reacts to increased CO2.

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10
Q

What are signs and symptoms of septicemia?

A

fever/chills, hyperventilation, skin lesions, altered mental status, diarrhea–more serious shock, hypotension, DIC, organ failure, septic shock.

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11
Q

What are some blood Cx results that suggest contamination?

A 
Bacillus spp.(non anthrax), 
Corynebacterium spp., 
Proprionibacterium acnes, 
Coagulase neg strep, 
* anything in only one bottle of several
Bug consistant with sepsis, different bug than that of primary infection site
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12
Q

What are some blood culture results that suggest a pathogen?

A

*Organism in repeated cultures,
Enterococci or Gram nen in endocarditis
Pathogens like Enterobacteriaceae
S. pneumono, Gram neg anaerobes or S. pyogenes
Commensals in immunocompromised patients

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13
Q

What is HACEK?

A

a group of fastidious G- bacilli (Aggregatibacter, Actinobacillus, Cardiobacterium, Eikenella, Kingella) usually indicate inf. endocarditis, May need longer incubation times.

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14
Q

What special requirements for Fungi?

A

bottles must be sufficiently vented and agitated for fungal growth, best to use lysis centrifugation methods.

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15
Q

What special requirements for mycobacteria?

A

often found as MAC in HIV patients, either use special media (ie midlebrook 7H9) or newer analyzers, good for mycobact.

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16
Q

What special considerations for Brucella?

A

slow growing, fastidious organisms, intracellular parasites., use brucella or trypticase soy broth,

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17
Q

What special considerations for mycoplasma?

A

in postpartum, post gyn procedure, post orbital proced, post urologic procdure, in immunocompromised. –not isolated well on systems (maybe in 7 days) may see pos culture, nothing on gram stain.

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18
Q

What are special considerations for campylobacter?

A

may be isolated w/in the 5 days, need special stain, AO, fastidious, use appropriate media/time/temp.

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19
Q

What is the “work up” for positive blood culture bottles from an instrument?

A

*Gram stain (maybe use Acridine orange, AO)
DO A SUBCULTURE on to appropriate plates for a gram stain (usually basic like CHOC and MAC, clood agar) parid tests like coagulase, bile solubility
The on to susceptibility tests

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20
Q

What are the types of respiratory infections?

A

Lower respiratory tract and Upper respiratory tract.

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21
Q

How are specimens collected to Dx Lower Resp infection?

A 
*expectorated sputum
induced sputum
bronchoscopy
Endotracheal/Tracheostomy suction (Leukin's Trap)
Transtracheal
Invasive, i.e thoracentesis, biopsy
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22
Q

Why do we perform a screening on sputum specimens before we culture?

A

We look at a stained smear on low power and determine how may epithelial cell are present, if too many (more than 10 / LPF) the the sputum is too much from upper resp/mouth and throat, not a deep lower sample.

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23
Q

What media do we use for Resporatpry samples?

A

SBA, CHOC, &Maconkey (if G-) most lower resp. infection pathogens isolate well on routine.

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24
Q

What is considered the conventional diagnostic method for resp. inf?

A

the Culture.

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25
Q

What is the rapid method for detecting resp pathogens,

A

the swabs, like flu and strep-a

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26
Q

What are some Lower Resp. microbes that are ALWAYS significant?

A 
Corynebacterium diptheriae
M. tuberculosis
M. pneumoniae
Chlamydia trachomatis
Chlamydohphilia pneumonia
Bortedella pertusis
Legionelle
Pmeumocystis carinii
Nocardia
Coccioides
Cryptococcus
Blastomyces
27
Q

Why is it so important for the bench tech to know what is normal flora of any body site?

A

So we don’t order a work up on something that is a normal colonizer, and also must recognize when we should if that pt is immunosupporessed.

28
Q

What is Acute Bronchitis?

A

Acute inflammation of tracheobronchial tree.cough, fever, sputum production, usually viral,

29
Q

What is Chroni(must have at least 3 consec months for 2 + uears>c Bronchitis

A

Excessive mucus, coughing, sputum,

30
Q

What is pneumonia?

A

inflammation of the Lower Resp tract, involving lungs airways and supporting structures.

31
Q

What are HCAP’s?

A

Health care associated pneumonias.

32
Q

What are common pathogens in HCAP?

A

MRSA, P. aeruginosa, K. peumoniae, E.coli (CRE, ESBL)

33
Q

What is CA pneumonia?

A

Community acquired.

34
Q

What are some common associated pathogenesis for community acquired pneumonia.

A

S. peumo, H. influenzae, M catarrhalis, M pneumo,C pneumoniae

35
Q

What causes a pleural infection

A

organism infecting the lungs gets into pleural space,

36
Q

What are kinds of specimens received for urine testing?

A

straight catheter, supra-pubic aspirate, kidney, clean catch(midstream),

37
Q

What is pyelonephritis?

A

inflammation of the kidney, usually bacterial, (fever and flank pain)

38
Q

What is urethritis?

A

Inflammation of the urethra, dysuria, frequency, common w/ UTI, should also check chlamydia/gonor.

39
Q

What is cystitis?

A

infection of the bladder, dysuria, frequency, urgency, due to inflammation & bacterial multiplication in urine and urethra

40
Q

What is the proper storage for a urine sample?

A

Either in fridge (4deg c) or in preservative tube.

41
Q

If using a .001 calibrated loop, how many CFU’/ml is each colony = to on the counting plate?

A

1000 cfu/ml

42
Q

What are the most commonly isolated organisms from urine?

A

E. coli, Klebsiella, Enterobacteriaceae, Staphylococcus saprophiticus,

43
Q

When should a urine be “worked up”?

A

*if greater than 10^4 cfu/ml (10k) of a single pathogen or for each of two pathogens from any kind of clean specimen on any patient = complete workup
If greater than 10^3 (1000) of single potential path on cCCMS on males or cath spec. = complete workup
Greater than 10^2 of any organism from a suprapubic aspirate= complete workup

44
Q

What are some sterile body fluid received in Micro?

A

pleural fluid, peritoneal fluid, peritoneal dialysis fluid, Pericardial fluid, Joint fluid, CSF.

45
Q

How long should a stool specimen sit before reaching the lab?

A

Should be tested in under 2 hours, or put in transport (preservative) media, ie Cary Blair

46
Q

What can be used to detect the 0157:H7 E coli?

A

Direct antigen detection. (EIA), also detects shiga toxin and C. diff toxins A and B.

47
Q

What is the role of toxins in the GI tract infections?

A

it is a microbial virulence factor, helps it to break down the host defenses,

48
Q

What is an enterotoxin?

A

a toxin that alter the metabolic activity of intestinal epithelial cells, results in loss of electrolytes and fluids out of cells.occurs in upper part where fluid absorption usually takes place.

49
Q

What is a cytotoxin?

A

disrupt the structure of epitheial cells, they then slough off and leave underlying mucosa unprotected. can’t secrete or absorb anymore.

50
Q

What is a neurotoxin?

A

occasionally ingested with food, Staph aureus, Bacillus cereus, C. botulinium, toxin affects CNS, may cause paralysis in extreme, or vomiting in minor.

51
Q

What selective media do you use with stool testing?

A

should use a supportive media (SBA), a differential media (, and a slightly/moderately selective agar (MacConkey, EMB, He or XLD),

52
Q

What are the three categories of transmission based precaution?

A

Airborne, Droplet, Contact

53
Q

What are some examples of agents requiring airborne precautions?

A

Measles, Varicella, Tuberculosis, Smallpox.

54
Q

What are some examples of agents requiring droplet precautions?

A

H. influenzae B, Mycoplasm pneumo, Strep in infants/young, Adenovirus, Mumps, Parvo, Rubella, N. Meningitidis

55
Q

What are some examples of agents requiring contact precautions?

A

GI, Resp, Skin, wound infections, C. diff, E. coli if incontinent, RSV, Herpes, scabies,

56
Q

What is LRN?

A

Laboratory Response Network,

57
Q

What is bioterrorism?

A

A biocrime, an intentional assault on a person, or group, using a pathogen or toxin.

58
Q

What is Select agent?

A

a list of specific pathogens or toxins that must be reported to the CDC, labs must have permission to have them at all.

59
Q

How would a sentinel level lab R/O Bacillus anthracis?

A

look at colony morphology, Check gram stain (large G+ rods), check catalase (+), Check motility (nonmotile), there is a rapid alert test also.

60
Q

What is the role of the sentinel lab?

A

to rule out and refer suspicious organisms.

61
Q

What is a class 1 BSC?

A

intermingling of room air in and out of cabinet area, most have HEPA filter.

62
Q

What is a class 2 BSC?

A

Self contained air, either by re circulation with a filter or exhaust to outside.

63
Q

What is a class 3 BSC

A

completely enclosed cabinet, negative pressure, air coming and going is sterilized, gloves attached to cabinet .

MICRO II Test 4 (1 decks)

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