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CSMLS > MICRO Respiratory/ Genital > Flashcards

MICRO Respiratory/ Genital Flashcards

1
Q

Normal flora of the Upper Resp Tract

A
  • alpha and non-hem Streptococci
  • Haemophilus sp
  • Coryneforms/ diphtheroids
  • Staphylococcus sp
  • Micrococcus sp
  • Anaerobes
  • Enterobacteriaceae
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2
Q

Only 10-20% of all resp tract infections can be treated by antibiotics. Why ?

A

Viruses cause >80% of acute upper resp tract infections

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3
Q

Pathogens of the mouth

A
  • Candida sp
  • S. pyogenes (if in wound)
  • Treponema
  • Fusobacterium
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4
Q

Define Thrush

A

candidiasis in mouth characterized by white patches of exudate on an acutely inflamed mucosa

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5
Q

Pathogens of the nose

A
  • S. aureus
  • S. pyogenes (if pure)
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6
Q

Pathogens of the throat

A
  • S. pyogenes
  • Corynebacterium dipththeriae (toxigenic)
  • N. gonorrhoeae
  • H. influenzae
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7
Q

the lower resp tract should have what organisms in healthy individuals ?

A

NONE; LRT should be sterile in healthy individuals

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8
Q

T or F: lower resp specimens are often contaminated

A

TRUE; organisms from mouth/ throat often contaminate lower resp specimens

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9
Q

What maintains the pH of the vagina ?

A
  • Lactobacillus acidophilus
  • produces lactic acid from glycogen

NOTE: at pH of 4.4 to 4.6

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10
Q

Normal pH of the vagina. Why is that ?

A

acidic; 4.4 to 4.6
- inhibits growth of E. coli (Enterobacteriaceae)

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11
Q

Which organisms can grow despite acidic pH of vagina ?

A
  • Anaerobes
  • Enterococci
  • C. albicans
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12
Q

The cervix is generally sterile because of __.

A

The cervix is generally sterile because of its ALKALINE pH.

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13
Q

Normal Flora of Genital Tract

A
  • non-hem Streptococci
  • CNS
  • viridans group Strep
  • Diphteroids/ coryneforms
  • Lactobacillus sp
  • Neisseria sp

NOTE: similar to urine/ skin

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14
Q

Pathogens of the Genital Tract

A
  • N. gonorrhoeae
  • S. aureus
  • P. aeruginosa
  • Haemophilus ducreyii
  • Candida sp
  • Group A & B Strep
  • Chlamydia trachomatis
  • Trichomonas vaginalis
  • Gardnerella vaginalis
  • Treponema pallidum
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15
Q

Define Bacterial Vaginosis

A

imbalance of normal flora; decreased Lacto, increased Gardnerella sp./ anaerobes

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16
Q

Define Cervicitis. What is it caused by ?

A
  • inflammation of the cervix/ external uterine opening
  • Neisseria gonorrhoeae, anaerobic organisms, Chlamydia or Herpes virus
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17
Q

Define Endometritis. What is it caused by ?

A
  • inflammation of the endometrium or the mucus membrane lining the uterus
  • C. perfringens, Bacteroides sp., Enterobacteriaceae, Group A & B Strep, Mycoplasma sp
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18
Q

Define Epididymitis. What causes it ?

A
  • inflammation of the epididymis/ coiled duct (on anterior surface of testes)
  • blockage due to complication with N. gonorrhoeae = sterility in males
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19
Q

Define Genital Ulcers

A

ulcers caused by Treponema pallidum, Haemophilus ducreyii, Chlamydia trachomatis

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20
Q

Define Non-gonococcal urethritis

A
  • usually in men
  • Chlamydia, Trichomonas, Herpes, Ureaplasma urealyticum
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21
Q

Which of the following statements is / are true of Corynebacterium diphtheriae?

Select all that apply:

a.
Epsilon-test is used to test for toxin production

b.
All strains of Corynebacterium diphtheriae are toxigenic

c.
Can be part of normal flora

d.
Colonies look dry on BAP

A

c.
Can be part of normal flora

d.
Colonies look dry on BAP

NOTE: ELEK test is used to test for toxin production

22
Q

Which of the following media is suitable for primary isolation of Legionella sp?

a.
Chocolate agar

b.
Regan Lowe agar

c.
Buffered charcoal yeast extract agar

d.
Lowenstein Jensen agar

A

c.
Buffered charcoal yeast extract agar

23
Q

Which of the following organism(s) is / are included in the Pseudomonas fluorescent group?

Select all that apply:

a.
Pseudomonas putida

b.
Pseudomonas stutzeri

c.
Pseudomonas aeruginosa

d.
Pseudomonas diminuta

A

a.
Pseudomonas putida

c.
Pseudomonas aeruginosa

24
Q

Which of the following statements best describes Streptococcus pneumoniae?

a.
Bile soluble, catalase positive, optochin resistant

b.
Bile soluble, catalase negative, optochin sensitive

c.
Bile soluble, catalase positive, optochin sensitive

d.
Bile soluble, catalase negative, optochin resistant

A

b.
Bile soluble, catalase negative, optochin sensitive

25
Q

Col morph: M. catarrhalis

A

gy

26
Q

Col morph: Viridans group Strep

A

fgn

27
Q

Col morph: S. pneumoniae

A

wet α

28
Q

Which of the following sputum specimens can be rejected based on a poor Q-score?

a.
Specimen is the 3rd in a series with two prior unacceptable

b.
Patient has 2+ RBC present

c.
Patient has decreased neutrophils in their blood

d.
Patient is immunosuppressed

A

b.
Patient has 2+ RBC present

29
Q

Which of the following specimens is best for isolation of Bordetella pertussis?

a.
“Cough” plate

b.
Expectorated sputum

c.
Pleural fluid

d.
Nasopharyngeal swab

A

d.
Nasopharyngeal swab

30
Q

Which of the following respiratory pathogens require manual susceptibility testing?

Select all that apply:

a.
Haemophilus influenzae

b.
Staphylococcus aureus

c.
Streptococcus pneumoniae

d.
Moraxella catarrhalis

A

a.
Haemophilus influenzae
- fastidious

c.
Streptococcus pneumoniae
- wet consistency interferes with instrument

31
Q

Which of the following characteristic(s) describes both Haemophilus influenzae and Bordetella pertussis?

Select all that apply:

a.
Infect animals of many species

b.
Cause invasive disease

c.
Grow well on simple media

d.
Small gram negative bacilli

A

d.
Small gram negative bacilli

32
Q

Which of the following organism and test result pairings is correct?

a.
Neisseria mucosa: oxidase negative / butyrate esterase positive

b.
Neisseria meningitidis: oxidase positive / gram negative coccobacilli

c.
Neisseria gonorrhoeae: oxidase positive / ONPG positive

d.
Moraxella catarrhalis: oxidase positive / DNase positive

A

d.
Moraxella catarrhalis: oxidase positive / DNase positive

33
Q

Which of the following organisms is a pathogen of the oropharynx?

a.
Staphylococcus aureus

b.
Streptococcus pyogenes

c.
Streptococcus viridans

d.
Streptococcus pneumoniae

A

b.
Streptococcus pyogenes

  • strep throat
34
Q

Which of the following organisms play an important role in protecting the female genital tract against pathogens?

a.
Diphtheroids

b.
Gardnerella vaginalis

c.
Escherichia coli

d.
Lactobacilli

A

d.
Lactobacilli

35
Q

What is the most common vaginal infection in women of childbearing age?

a.
Neisseria gonorrhoeae

b.
Trichomonas vaginalis

c.
Bacterial vaginosis

d.
Chlamydia trachomatis

A

c.
Bacterial vaginosis

36
Q

Which of the following statements is true about Neisseria gonorrhoeae?

a.
Serologic diagnosis is more reliable than culture

b.
Penicillins are no longer recommended for treatment

c.
Bacteremia is common

d.
Men are frequently asymptomatic carriers

A

b.
Penicillins are no longer recommended for treatment

37
Q

Which of the following specimens is acceptable for Treponema pallidum identification?

a.
Lesion swab

b.
Cervical swab

c.
Urethral swab

d.
Urine

A

a.
Lesion swab

38
Q

Which of the following direct smear results from a vaginal specimen would be reported as NEGATIVE for bacterial vaginosis?

a.
4+ WBC 2+ EPI 4+ GNB* 4+ GPBL

b.
4+ WBC 2+ EPI 4+ GPCCL 4+ GPBL

c.
4+ WBC 2+ EPI NBS

d.
4+ WBC 2+ EPI 4+ GNB* 4+ GNB colif

A

b.
4+ WBC 2+ EPI 4+ GPCCL 4+ GPBL

39
Q

The following results are recorded for a vaginal direct smear:

1+ WBC
4+ EPI
3+ GPBL
1+ GPB dips
1+ GNDC
1+ GPC cl
1+ GNB *

a.
Negative for bacterial vaginosis

b.
Indeterminate for bacterial vaginosis

c.
Positive for bacterial vaginosis

d.
Positive for N. gonorrhoeae

A

a.
Negative for bacterial vaginosis

  • No Gardnerella (GVB) or MOB
40
Q

Which of the following reagents is used for the whiff test for bacterial vaginosis?

a.
H2O2

b.
MgO2

c.
KOH

d.
HCl

A

c.
KOH

41
Q

The following results are recorded from vaginal direct smears. Which of the following results require further work up?

Select all that apply:

a.
4+ WBC 2+ EPI 4+ GNB* 4+ GPBL

b.
4+ WBC 2+ EPI 4+GPCCL

c.
4+ WBC 2+ EPI 4+GNB colif I/E

d.
4+ WBC 2+ EPI 4+ GPBL

A

b.
4+ WBC 2+ EPI 4+GPCCL

c.
4+ WBC 2+ EPI 4+GNB colif I/E

42
Q

Which of the following characteristics is true of pathogenic Neisseria?

Select all that apply:

a.
35-37°C for growth

b.
Fastidious growth requirements

c.
Wetgy / shgy colonial morphology

d.
Grows in O2 and CO2

A

a.
35-37°C for growth

b.
Fastidious growth requirements

c.
Wetgy / shgy colonial morphology

43
Q

ALA Test Principle and possible results ?

A

ALA = Delta-aminolevulinic acid = tests organism’s ability to synthesize their own hemin (X factor) from an ALA supply

Results:
Red fluorescence (+) = no hemin requirement/ produces own X factor

No fluorescence (-) = requires exogenous hemin for growth/ does not produce X factor

44
Q

What is the principle of the oxidase test ? What is a positive result ?

A

Principle: TMPD (tetramethyl-p-phenylene diamine) reagent interacts with cytochrome c oxidase in electron transport chain

Positive (+): non-fermenters produces dark purple indophenol

45
Q

Principle of Plate Bile Solubility. What is a positive result ?

A

Principle: presence of bile salts accelerate activity of autolytic enzyme

Positive: flattened/ dissolved colonies after 15 min

46
Q

Media for C. diphtheriae

A
  • Loeffler’s media
  • Modified Tinsdale
47
Q

Media for Bordetella pertussis (3)

A

Charcoal
Reagan-Lowe agar
Bordet-Gengou agar

48
Q

Principle of ELEK test. What is a positive result ?

A

Principle:

Differentiates atoxigenic and toxin-producing C. diphtheriae

Positive:
Neutralization b/w toxin + antitoxin-impregnated filter paper= precipitation lines (X)

49
Q

Fluorescent stain for Mycobacteria tuberculosis

A

Auramine-rhodamine stain

50
Q

Why do acid-fast organisms stain differently using Ziehl-Neelsten stain ?

A
  • Since acid-fast properties of mycolic acids do not bind simple stains:

Use Ziehl-Neelsten= carbol fuchsin (basic) + acid alcohol decolorizer + methylene blue counterstain

  • LIPOID CAPSULE stains with carbol-fuchsin and resists decolorization by acid alcohol

CSMLS (39 decks)

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