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Clinical Medicine LAB - Professor Sample > Respiratory - Blood gas > Flashcards

Respiratory - Blood gas Flashcards

1
Q

Gm+ diplococci

A

purulent and rusty hemoptysis = strep

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2
Q

Gm+ cocci in clusters

A

purulent, staph

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3
Q

Gm- bacilli (rods)

A

purulent bright streaks hemoptysis - pseudomonas

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4
Q

Pre-Procedure: of sputum collection

A

Saliva is NOT sputum!

Rinse mouth with water before sputum collection

No antiseptic mouth wash

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5
Q

Procedure: of sputum collection

A

Morning samples are best (upon awakening)

1 tsp of sputum in sterile container

Cough after several deep breaths

Stimulate coughing by warm aerosol treatment

Adequate specimen= <10 epithelial cells per low-power field - is a contaminated specimen (seen with microscopy)

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6
Q

virus Nasopharyngeal (NP) swab antigen tests

A

influenza A

RSV

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7
Q

NP swab procedure ?

A

Dacron swab is gently inserted into the nostril until resistance is met

Rotated several times and then withdrawn

Proper technique is key

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8
Q

what is the direct exam for sputum testing Legionella (atypical)

A

Fluorescent Ab stain

Allows rapid ID of Legionella

Bacteria concentration is often not high enough to ID from sputum

Sensitivity 25-75% - a lot of false negatives
Specificity >95%

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9
Q

Legionella Culture (best one?)

A

Legionella media
Difficult to grow
↑ false negatives

Sensitivity 20-80%
Specificity 100%

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10
Q

Legionella Urine antigen

A

Performed from a clean catch urine specimen

Transport in a sterile container

Positive findings = Legionella

+ after 2-3 days of infection ( so we don’t really have to wait for ABS to develop)

Sensitivity ~70%
Specificity ~100%

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11
Q

Legionella ABS tests

A

Single titer of >1:256

Paired titers with fourfold rise to titer of 1:128 between week 1 and week 3

May take 4-6 weeks for titers to become positive

Sensitivity 80-90%
Specificity >99%

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12
Q

Pneumocystis jiroveci is a culture useful?

A

NO

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13
Q

Pneumocystis jiroveci Direct tests?

A

DFA (main)
Giemsa stain
Methenamine silver

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14
Q

TB tests?

A 
Direct (AFB Microscopy)
Culture
Nucleic Acid testing
Quantiferon
PPD
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15
Q

What will TB show on AFB microscopy?

A

acid-fast bacilli

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16
Q

TB definitive diagnosis?

A

Mycobacterial Culture

3 morning samples

17
Q

TB Nucleic Acid Amplification:?

A

Not as sensitive as culture

Performed on one respiratory
specimen

Expensive

18
Q

Tuberculosis:

PPD (purified protein derivative)

A

Most used to screen for latent TB infxn

Not specific to TB (could detect other mycobacterium infxns)

19
Q

Tuberculosis:

Quantiferon-TB Gold:

A

Blood is mixed with antigens and then interferon (released by WBC) is measured

Increased in those with active or latent TB

20
Q

Indications to use Quantiferon-TB Gold?

A

Used to dx active TB in patients recently exposed to or suspected to have TB infection

Pts with previous BCG vaccination

21
Q

Indications for thoracentesis?

A

Determine cause of unexplained pleural effusion

Relieve intrathoracic pressure from large volume of fluid

22
Q

Transudate effusion (fluid is coming from another part of the body)

A

CHF
Cirrhosis
Nephrotic syndrome
hypoproteinemia

23
Q

Exudates effusion (exudate coming from right in the like like a pneumonia )

A

Inflammatory
Infectious
Neoplastic

> 1000

24
Q

Cloudy fluid from Thoracentesis

A

Infectious

Inflammatory

25
Q

Bloody fluid from Thoracentesis

A

Traumatic tap

Tumor - vascular and bleeding

Intrathoracic bleeding

26
Q

> 50% small lymphocytes = ?

A

TB or tumor

27
Q

PMNs found in thoracentesis fluid = ?

A

acute inflammatory condition (pneumonia, TB, infarction)

28
Q

Exudate protein level?

A

> 3 g/dL

29
Q

Transudate protein level?

A

< 3 g/dL

30
Q

Exudate Glucose level?

A

<60 mg/dL

it is low cause the bacteria is eating it all if we have an infection

31
Q

serum albumin minus effusion albumin levels and indications?

A

Transudate = > 1.1

Exudate = < 1.1 (0.5 ratio)

32
Q

Contraindications to Thoracentesis?

A

Thrombocytopenia
Anticoagulation
Rash in area of tap

Clinical Medicine LAB - Professor Sample (36 decks)

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