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421 - Micro Lab > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Lower resp. tract GS acceptilibity

A

Less than 10 squamous epithelial cells + more than 25 PMN cells

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2
Q

Upper resp. tract

A

Throat, nasopharynx, ear, sinus
Normal flora
Pathogens

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3
Q

Pharyngitis

A

S. pyogenes (Group A)
Less common: Group C beta, group G beta, and Arcanobacterium, Fusobacterium necrophorum.
Required R/O: C. diphtheriae, N. gonorrhoeae

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4
Q

Sinusitis & Otitis

A

S. pneumonia, H. influenzae, M. catarrhalis, S. aureus, S. pyogenes, GN bacteria

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5
Q

Epiglottitis

A

H. influenzae

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6
Q

Lower resp. tract

A

Shouldn’t have normal flora (may be contaminants)

Pathogens: S. pneumonia, H. influenzae, Group B strep in neonates, GNR, S. aureus, Legionella

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7
Q

Nosocomial pathogen

A

Pseudomonas, Klebsiella, other Enterobcteriae, S. aureus, M. catarrhalis, Anaerobic

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8
Q

Rapid antigen test for throat

A
  • Detect Group A Strep: PDX test
  • Sensitivity: 83%, high specificity: 100%
  • Negative RADT should be confirmed by culture
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9
Q

Acute pharyngitis pathogens

A
  1. Strep beta-hem Group A, C (large colon), G (food-borne):
  2. Arcanobacterium
  3. Neisseria gonorrhoeae
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10
Q

Arcanobacterium

A 
GPR
Pharyngitis assoc. with rash. 
Extracellular toxin: phospholipase D, hemolysis
Catalase,  Urease: neg
Inhibit hemolysis of S. aureus
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11
Q

Strep beta-hem group

A

Pharyngitis
Group A, C (large colon), G (food-borne)
GPC in pair, cat: neg, latex agglu.

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12
Q

Neisseria gonorrhoeae

A

Pharyngitis + tonsillitis: mostly asymptomatic
Transport system: Amies gel (org. very sensitive to dry and temp)
Culture: selective media, e.g. Thayer-Martin, Martin-Lewis, or CA

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13
Q

N. meningitidis

A

Flora of nasopharynx and oropharynx
Required report when: abundance or special request (epidemic)
Work up in a BSC

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14
Q

Throat normal flora

A

S. aureus, H. influenzae, S. pneumoniae, M. catarrhalis, enteric GNR (when they’re low level)

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15
Q

Corynebacterium diphtheriae

A
  • Tinsdale agar: black colonies with brown halo
  • Cystine-tellurite: gray to black
  • Loeffler’s: produce metachromatic granules
  • ID test: GPR, methylene blue stain from Loeffer’s (metachromatic look like granules)
    Urease: neg, Nitrate reduction; pos, Sugar fermenter.
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16
Q

Sputum & Endotracheal suction culture

A 
GS: columnar epithelial cells
Pathogen: when predominant
R/O: S. pneumonia
R/O Cryptococcus neoformans
Only ID when predominant: S. aureaus, GNR
Always ID: Mycobacterium, Nocardia, mold
17
Q

Saprophytic Neisseria

A

Colonies: beige to yellow, opaque
Oxidase: pos

18
Q

Moraxella catarrhalis

A 
CTA: all neg
Catalase: pos
Oxidase: pos
Butyrate: pos
Nitrate: pos
DNAse: pos
19
Q

Normal flora oropharyngeal

A 
Anaerobes, 
Beta-hem strep (except A, C, G)
Coagulase-neg Staph
Diphtheroids
Lactobacillus 
Micrococcus 
Neisseria spp.
Rothia mucilaginous
Viridian strep. 
(more)
20
Q

M. tuberculosis condition & media

A

Primary nutrient required: Lipid
Egg-based: Lowenstein-Jensen
Serum-based
Broth media incubated and read by instruments
Temp: 35-37C (30-42C)
5-10% CO2
Time: 6-8 weeks –> Read twice per week for 1st 2 weeks and once per week

21
Q

Direct detection of M. tuberculosis

A

NAAT: amplify and detect DNA or rRNA, no distinguish live or dead bacilli, no following therapy.

22
Q

Photochromogen

A

Produce pigment when light exposure

M. kansassi

23
Q

Scotochromogen

A

Produce pigment w/o light exposure

M. avium complex

24
Q

Non-chromogen

A

No pigment, M. tuberculosis, M. abscessus (rapid grower)

25
Q

Acid-Fast stain

A

Resist with GS,
Require physical, chemical to take up dye
E.g.: Auramine stain (observed at low mag and fluorochrome), Ziehl-Neelsen stain (observed at high mag)
Org: Mycobacterium, Legionella micdadei

26
Q

Modified Acid Fast stain

A

Actinomycetes contains mycolic acids

Org: Nocardia, Rhodococcus, Tsukamurella

27
Q

Bordetella pertussis

A 
GNR
Media: 
- Transport: Regan Lowe at 35C in O2, high humidity.
- Hemolytic on Bordet-Gengou medium
Test: PCR, DFA
28
Q

Legionella spp.

A 
GNR, tiny, 
Media: BCYE: gray-white, glistening, ground-glass
Test: 
- L. micdadei MAF
- L. pneumophila: urine test 
Serology, DFA, NAAT
29
Q

Serology is useful when

A
  • Organism: cant be cultured, slow growth, hazardous, other tests easily negative
  • Serology: distinguish 1st and 2nd response
  • Fast, high test-volume
  • Highly sensitive, specific
30
Q

Neonatal testing

A
  • IgG crosses placenta, IgM does not.
  • IgM: utero (baby) infection
  • IgG only: passive maternal transfer –> baby is fine
31
Q

Acute & Convalescent

A
  • Testing for Abs during acute phase or convalescence (2 weeks after recovery)
  • 4-fold increase titer –> current infection
  • Important: unclear time exposure, unclear Abs response, low initial Abs response, false positive IgM

421 - Micro Lab (6 decks)

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