Respiratory Bench Flashcards

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1
Q

Classify the types of respiratory specimens that can be cultured as “non-sterile” relating to the normal flora content of the original site

A
Expectorated or induced sputum 
Endotracheal aspirates 
Bronchioalveolar lavage 
Bronchial washings
Bronch brushes
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2
Q

Classify the types of respiratory specimens that can be cultured as “sterile” relating to the normal flora content of the original site

A

Transtracheal aspirates
Lung aspirates
“steriles”
Pediatric BAL

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3
Q

Normal Flora of the respiratory tract

A
  1. Strep viridian’s group
  2. Corynebacterium
  3. Neisseria species
  4. Coag Negative Staph
  5. Rothia
  6. Group F streptococci
  7. Haemophilus spp other than influenzae
  8. Enterococcus species
  9. Candida
  10. Eikenella corrodens
  11. Capnocytophaga species
  12. Moraxella species
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4
Q

5 common “potential pathogens” of the lower respiratory tract

A
  1. Streptococcus pneumoniae
  2. Strep pyogenes
  3. Haemophilus influenae
  4. Staphylococcus aureus
  5. Cryptococcus neoformans
  6. Moraxella catarrhalis
  7. Neisseria meningitidis
  8. Gram Negative Rods
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5
Q

OSOM Ultra Strep A Test

  • time?
  • principle?
A
  • occurs in 7 minutes
  • color immunochromatographic assay using dual label technology
  • extraction, form complex with anti-group A strep antibody conjugated to color particles; complex will then bind to capture antibody and visible blue test line will appear.
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6
Q

OSOM Ultra Strep A Test

  • collect from where?
  • problems with it?
A

sterile swab from tonsils and or back of throat

- Rapid strep screen: rapid, but not sensitive but very specific

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7
Q

“Strep Throat” screen

- procedure

A

Swab of the tonsillar areas and posterior pharynx; BAP incubated in anaerobic glove box for 48 hours; screen BAP for beta strep group A only; strep latex test is performed on beta strep for identification.

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8
Q

What specimen types can receive a report of “normal flora”? and what specimen types require listing of all organisms isolated?

A

“normal flora” - non-sterile

All organisms - sterile

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9
Q

When are expectorated or induced sputums, and endotracheal or tracheostomy aspirates considered unsatisfactory for culture workup?

A

if there are > 10 squamous epithelial cells per low power field

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10
Q

How do you quantitate growth of organisms on respiratory culture media?

A

dependent on quadrant where organisms are growing (1+/few, first quad; 2+/moderate, second quad, 3+/many, third quad; 4+/many , fourth quad)

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11
Q

Pathogens commonly isolated from Cystic Fibrosis patients

A

Staphaureus or Haemophilus
Pseodomonas aeruginosa
Burkholderia cepacia
Stenotrophomonas maltophilia

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12
Q

Susceptibilities for Pseudomonas aeruginosa

A

colistin e-test

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13
Q

Susceptibilities for Stenotrophomonas maltophilia

A

Moxifloxacin and minocycline e-test

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14
Q

Cystic Fibrosis:

  • choice of selective media
  • length of incubation
  • purpose of selective media
A
  • PC and Mannitol Salt agar (MSA) plates
  • on day two incubated in ambient air incubator
  • PC agar for Burkholderia cepacia
  • MSA agar
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15
Q

Appropriate Media for:

- Throat strep screens

A

*

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16
Q

Appropriate Media for:

- Throat/Pharynx

A

BAP with stab

Special Request: choc, Mod Thayer Martin, Loeffler/Tellurite

17
Q

Appropriate Media for:

- Nose/nasopharynx

A

BAP, Chrom Agar

Special Request: Mod Thayer Martin, Bordet-Gengou or Regan Lowe

18
Q

Appropriate Media for:

- Routine Sputum (sputum, endotracheal suction, tracheal aspirate, Luken’s trap)

A

BAP with stab, Choc, Mac, and CNA

19
Q

Appropriate Media for:

- Bronchial wash/Unprotected brushing

A

BAP with stab, Choc, Mac, and CNA

20
Q

Appropriate Media for:

  • Bronchoaviolar lavage (BAL)
  • Protected brush
A

Quantitative cultures using calibrated loops

BAP with stab, Choc, Mac, CNA, Thio Broth

21
Q

Appropriate Media for:

-TransTrachial aspirate, “steriles”, Pediatric BAL

A

BAP with stab, Choc, Mac, and CNA

Thio Broth, anBAP, anPEA, anKV

22
Q

Appropriate Media for:

- Legionella Culture

A

BCYE with and without antibiotics after processing with 1:10 KCL:HCL
Routine Culture: BAP with stab, Choc, Mac, and CNA

23
Q

What media is kept at 35C in CO2 for 48 hours? Give purpose of each

A
  1. MAC - GNR, lactose reaction
  2. BAP - general purpose media, hemolysis
  3. Choc - enriched for Hemophilus and Neisseria sp.
  4. CNA - Gram positive organisms
24
Q

What media is kept at 35C in non CO2 incubator for 48 hours? Give purpose of each

A
  1. Chrom ID agar - for MRSA

2. Thio - general purpose media, enhances the growth of anaerobes

25
Q

What media is kept at 35C in anaerobic incubator for 48 hours

A
  1. anBAP - general purpose media, isolation of anaerobes, hemolysis
  2. anKV - isolate anaerobic GNR
  3. anPEA - isolate anaerobic GPC