RESP 111 Study Guide for Test 5

Question 1

What is a nosocomial infection, how often do patients acquire them, and how often do
nosocomial infections impact the respiratory system?

Answer 1

A nosocomial infection is one that is acquired after >48 hours in the hospital. 5-10% of patients
get these. Up to 40% of these affect the respiratory system.

Question 2

How are microorganisms named?

Answer 2

Each organism is given two names: First name→ genus name (always capitalized), Second
name→ species name (always lowercase)

Question 3

What KINGDOM does a fungus belong to and what are the qualities of a fungus?

Answer 3

Myceteae: Eukaryotic, ordinarily high resistance, hard to kill, and form spores.

Question 4

What type of organism is not included in the 5 kingdoms?

Answer 4

Viruses

Question 5

Why are viruses not considered cells and what do they need to function?

Answer 5

Viruses do not exhibit most of the life processes of cells…they must have a host cell to survive.

Question 6

How do we test for viruses and what are some common virus examples?

Answer 6

We test for viruses with an antibody check, history, and symptoms.
Examples: RSV, common cold, Influenza, and HIV

Question 7

What does the morphology of a bacterium tell us?

Answer 7

Morphology tells us the size, shape, and cell arrangement of the bacteria.

Question 8

What are the names of the three basic types of cell and what do they look like under a
microscope?

Answer 8

• Cocci – spherical or round shaped
• Bacilli – Rod or oval shaped
• Spirochete or Spirillum – Curved or spiral shaped

Question 9

What are the three types of stains that we perform on bacteria?

Answer 9

• Gram stain
• Acid fast bacilli
• Elisa

Question 10

How is the Gram stain performed and what does it tell us?

Answer 10

Apply crystal violet stain and rinse slide → all bacteria stain purple
Apply Gram’s iodine and rinse slide → All bacteria remain purple
Apply alcohol and rinse slide → purple stain removed from Gram negative cells
Apply safranin red and rinse slide → Gram negative cells appear pink-red; Gram positive cells
appear purple

Question 11

What are some common Gram+
and Gram– bacterium?

Answer 11

Positive:
Streptococcus pneumoniae– 80% of bacterial pneumonias
Staphylococcus aureus – Normal flora
Negative:
Pseudomonas aeruginosa– Vent dependency
Escherichia Coli – Intestinal flora

Question 12

Why is the Acid-Fast stain used and what is is the bacterium that we are usually looking for with it ?

Answer 12

It is a technique to identify bacteria that don’t take up dyes used in gram staining. Used
primarily to identify Mycobacterium Tuberculosis (Tb)

Question 13

What does ELISA stand for and how does the test work?

Answer 13

Enzyme Linked Immunosorbent Assay
Antigen (i.e. sample) is placed in a test well. An antibody with a linked enzyme is washed over
the surface of the well. Enzyme is stained to signal antigen – antibody reaction

Question 14

What are the three ways that respiratory therapists collect specimens?

Answer 14

• Patient cough up sputum
• Suction patient
• Bronchoscopy

Question 15

the guidelines for obtaining specimens.

Answer 15

• Collect in a sterile manner
• Collect before antimicrobial therapy is started
• Protect from heat and cold and delivered promptly to the lab
• Seal in a plastic bag to avoid exposing other health care practitioners
• Label properly to identify the patient, time of collection, date, source of specimen, and
  requested tests
• Perform collections with care and tact to avoid harming the patient or causing undue
  discomfort or embarrassment

Question 16

How can an expectorated specimen be contaminated and what can respiratory therapists do to
prevent it?

Answer 16

Expectorated sputum is contaminated with oral saliva containing epithelial cells.
If there are numerous epithelial cells the lab personnel will discard the sample.
Having patient thoroughly rinse or gargle with water before producing sputum may help
eliminate oral contamination.

Question 17

What are the names of the two devices that we can use to suction the airway and what type of
technique must we use? Sterile technique!

Answer 17

• Luken’s trap
• Delee suction catheter

Question 18

What is a bronchoscopy and when should we use it?

Answer 18

Bronchoscopy is when we use a fiber optic scope to collect specimens directly from lungs (it is the
best, most expensive, & most invasive technique)
Should be reserved for obtaining: Anaerobic specimens, specimens for cytology, to diagnose
pneumocystis pneumonia, and to identify bacterial, fungal & viral pathogens when simpler
methods fail.

Question 19

When performing a Gram stain, what other things do we discover besides negative or positive
groupings?

Answer 19

Shape of bacteria, groupings, and presence of spores.

Question 20

How long does a culture and sensitivity take and what two things do we discover from it?

Answer 20

Process takes several days. Determines the definite diagnosis of the organism. Determines
whether the organism is susceptible or resistant to anti-infective agents (antibiotics)

Question 21

What is endogenous and exogenous flora and what other names are used for these groups?

Answer 21

Endogenous micro-flora (aka normal or resident flora) → microorganisms that are normally
found in or on the body.
Exogenous (aka Transient flora) →microorganisms that are not normally found in or on the body

Question 22

What areas of the body are normally free of microorganisms?

Answer 22

Blood, lymph, spinal fluid & most internal organs including the lungs are normally free of
microorganisms

Question 23

What is an opportunistic infection and what is an example of one

Answer 23

A normally nonpathogenic microbe that has the potential to cause disease when the
physiological state of the host is altered
Example: Candida Albicans (yeast) that is normal flora in the mouth

Question 24

What are the three defense mechanisms that safeguard against microbial infections?

Answer 24

• Mucous membranes & skin
• Cellular & chemical responses
• Immune response

Question 25

What are the defense mechanisms of the respiratory system?

Answer 25

Vibrissae, nose, mucous membranes, cilia, coughing & sneezing, microflora, phagocytic WBC &
enzymes in sputum

Question 26

What are the two ways that a fever fights an infection?

Answer 26

• Stimulates WBC to increase their response to fight infection
• Fever raises the body temperature above the range of many bacterial strains causing
  them to die/inhibiting bacterial growth.

Question 27

What is phagocytosis and what cells perform this function in the body?

Answer 27

Process where certain WBC’s surround and ingest foreign materials

Question 28

What are the physiological reactions that occur with inflammation?

Answer 28

Edema at the site (increased capillary permeability), redness, heat, pain, and pus formation.

Question 29

How does the immune response function and what is natural and artificial immunity?

Answer 29

When antigens (intruders) are recognized in the body, the immune system stimulates antibody
production to protect against infection/reinfection.
* Natural immunity is acquired when initially exposed to a disease producing organism →
antibodies are produced that will protect in the event of reexposure.
* Artificial Immunity may be acquired artificially by administration of vaccines.

Question 30

What is another name for a leukocyte, what is the normal range, and when is the count
considered significant?

Answer 30

White Blood Cell
Normal range is 4,800 – 10,800
Considered significant if count is > 11,000

Question 31

What are the three types of granulocytes and what differentiates this type of cell?

Answer 31

Neutrophils, eosinophils, and basophils.
This classification of WBC contain membrane bound granulomas

Question 32

What percentage of the WBC differential are neutrophils

Answer 32

50-70% of all leukocytes

Question 33

What is another name for a neutrophil, what attracts them, and when do their numbers
increase?

Answer 33

Polymorphonuclear leukocytes
Attracted to sites of inflammation
Numbers will increase during a bacterial infection

Question 34

What is the normal percentage of eosinophils and when do their numbers increase?

Answer 34

2-4% of all leukocytes
Numbers will increase with allergic response

Question 35

What is the normal percentage of basophils, what do they attract, and what do they release?

Answer 35

0.5 – 1% of all leukocytes
Attract other white blood cells and release histamine

Question 36

What are the three types of agranulocytes and what differentiates this type of cell?

Answer 36

Lymphocytes, monocytes, and macrophages
This classification of WBC lack visible cytoplasmic granules

Question 37

What is the normal percentage of lymphocytes, where are they found, and what important
protein do they produce?

Answer 37

25% of all leukocytes
Most are found in lymphoid tissues
Produce antibodies

Question 38

What is the normal percentage of monocytes and what special immune function do they
perform?

Answer 38

3 – 8% of all leukocytes
Perform phagocytosis, but present a piece of the pathogen to the T cell

Question 39

What is the normal percentage of macrophages and what four immune functions do they
perform?

Answer 39

No normal percentage
Actively phagocytic, fight viruses, fight chronic infections, and activate the immune response.