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IUMICRO > Respiratory Cultures > Flashcards

Respiratory Cultures Flashcards

1
Q

Obj. 1: Diagram the anatomical areas of the respiratory tract including which areas are “upper”
and “lower.”

A

Upper
- Nasal Cavity
- Pharynx
- Larynx

Lower
- Trachea
- Primary Bronchi
- Lungs
- Bronchioles
- Alveoli

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2
Q

Obj. 2: Identify the areas of the respiratory tract that are considered sterile

A

Lower
- Trachea
- Primary Bronchi
- Lungs
- Bronchioles
- Alveoli

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3
Q

Obj. 3: Identify which specimens avoid exposure to usual flora of the upper respiratory tract

A
  • Lung aspirates or biopsies
  • Transtracheal aspirates
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4
Q

Obj. 4: Briefly describe the methods employed for collecting throat (oropharynx) and sinus infection specimens

A

Throat (oropharynx)
- Dacron or Rayon swabs
- Swab over both tonsils and posterior oropharynx (avoid contact with tongue, teeth, and gums)

Sinus infection
- Sinus puncture and aspiration

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5
Q

Obj. 5: Describe the various methods for collecting lower respiratory tract specimens (sputum vs.
BAL)

A

Sputum
- production from deep cough
- early a.m. preferred

BAL
- saline is injected into patient’s lung to fill alveolar
sacs — saline is removed and used for culturing

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6
Q

Obj. 5: Describe the various methods for collecting lower respiratory tract specimens (tracheal vs. transtracheal aspirate)

A

Tracheal
- manual induction of sputum and suction

Transtracheal
- catheter inserted directly into the trachea

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7
Q

Obj. 5: Describe the various methods for collecting lower respiratory tract specimens (open lung biopsy vs. Fine Needle Aspirate)

A

Open Lung Biopsy
- removal of lung tissue via surgery

Fine Needle Aspirate
- aspiration needle inserted into lung or lesion, less
invasive than a lung biopsy

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8
Q

Obj. 6: List the organisms most commonly found as “usual flora” in upper respiratory tract specimens

A
  • Corynebacterium spp.
  • Alpha and gamma hemolytic streptococci
  • Beta-hemolytic streptococci (not Grp. A)
  • Coagulase-negative Staphylococcus
  • Enterococcus spp.
  • Neisseria spp.
  • Eikenella corrodens
  • Capnocytophaga spp.
  • Anaerobes
    • Veillonella, Fustobacterium, Prevotella,
      Prophyromonas
  • Candida spp. (yeast)
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9
Q

Obj. 24: Identify the most following pathogens when observed in direct smears of Gram stained sputum

A

Klebsiella pneumoniae

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10
Q

Obj. 24: Identify the most following pathogens when observed in direct smears of Gram stained sputum

A

Pseudomonas

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11
Q

Obj. 25: Correlate the image with likely clinical scenario(s)

A

Pseudomonas
- Hospital-acquired (nosomical) pneumonia
- Folliculitis
- Eye infection (application of mascara, etc.)

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12
Q

Obj. 24: Identify the most following pathogens when observed in direct smears of Gram stained sputum

A

Fusobacterium nucleatum

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13
Q

Obj. 25: Correlate the image with likely clinical scenario(s)

A

Fusobacterium nucleatum
- Assoc. with infections of the mouth (human bites, lung abscesses, pleural
cavity, brain abscess)

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14
Q

Obj. 24: Identify the most following pathogens when observed in direct smears of Gram stained sputum

A

Haemophilus influenzae

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15
Q

Obj. 25: Correlate the image with likely clinical scenario(s)

A

Haemophilus influenzae
- Meningitis (esp. in young children)
- Pneumonia
- Epiglottitis

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16
Q

Obj. 24: Identify the most following pathogens when observed in direct smears of Gram stained sputum

A

Moraxella catarrhalis

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17
Q

Obj. 25: Correlate the image with likely clinical scenario(s)

A

Moraxella catarrhalis
- Ear and sinus infection in children

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18
Q

Obj. 24: Identify the most following pathogens when observed in direct smears of Gram stained sputum

A

Nocardia spp.

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19
Q

Obj. 25: Correlate the image with likely clinical scenario(s)

A

Nocardia spp.
- Tissue necrosis (lung, bone, etc.), Brain abscesses

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20
Q

Obj. 24: Identify the most following pathogens when observed in direct smears of Gram stained sputum

A

Streptococcus pneumoniae (GP)

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21
Q

Obj. 24: Identify the most following pathogens when observed in direct smears of Gram stained sputum

A

Streptococcus pneumoniae (decolorized)

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22
Q

Obj. 25: Correlate the image with likely clinical scenario(s)

A

Streptococcus pneumoniae
- Community acquired pneumonia

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23
Q

Obj. 7: Define pharyngitis, sinusitis, otitis media, epiglottitis, pertussis, and bronchitis

A

Pharyngitis: inflammation of pharynx, “sore throat”
Sinusitis: inflammation of sinus
Otitis media: middle ear infections
Epiglottitis: inflammation of the epiglottis
Pertussis: “whopping cough” caused by Bordetella pertussis
Bronchitis: inflammation of the bronchi

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24
Q

Obj. 8: Discuss the role of anaerobes in the cause of respiratory infections

A

Anaerobes can be the cause of respiratory infections when aspiration pneumonia occurs — inhaling oral contents, hence, upper respiratory normal flora. Requires specified antimicrobial therapy

25
Q

Obj. 9: List common general symptoms of pneumonia

A
  • Sudden increase of coughing
  • Wheezing
  • Hypoxia
  • Infiltration on imaging
  • Fevers
  • Night sweats
  • Malaise
26
Q

Obj. 10: Discuss the relationship of positive blood cultures and pneumonia

A

Occurs via secondary bacteremia from invasive pathogens (i.e. S. pneumoniae, PSA, Enterobacterales, etc.)

27
Q

Obj. 11: List 3 respiratory pathogen virulence factors and associated organisms

A
  1. Adherence: Streptococcus spp.
  2. Toxin Production: Corynebacterium diphtheriae, PSA, B. pertussis
  3. Evasion of host defenses: S. pneumo, H. flu, PSA, TB
28
Q

Obj. 12: Identify the significance (pathogenicity, organism identification) of polysaccharide capsules and intracellular growth for respiratory pathogens

A

Polysaccharide capsules: prevents phagocytosis by host cells
- S. pneumo, K. pneumo, H. flu, PSA
Intracellular pathogens: inhibits phagosome-lysosome fusion
- TB

29
Q

Obj. 25: Correlate the image with likely clinical scenario(s)

A

Klebsiella pneumoniae
- Hospital-acquired (nosomical) pneumonia

30
Q

Obj. 13: Identify the media (and specimen type) that is recommended for the setup of the following:
- “Strep screens”/Throat Culture

A

Specimen type: Throat swab
Media: BAP, CHOC, AnaBAP
(BAP w/ stabs, SXT agar)

31
Q

Obj. 14: Discuss the application (significance, sensitivity, specificity) of rapid antigen testing in diagnosis of strep throat.

A
  • Significance: ability to provide results in ~ 15 minutes
  • High specificity, low sensitivity
    • Conclusive for positive results
    • Inconclusive for negative results
32
Q

Obj. 13: Identify the media (and specimen type) that is recommended for the setup of the following:
- Routine Lower Respiratory Specimens:

A

Specimen Type: Sputum, BAL, Tracheal Aspirate, etc.
Media: BAP, CHOC, CNA, MAC

33
Q

Obj. 13: Identify the media (and specimen type) that is recommended for the setup of the following:
- Sterile Respiratory Specimens

A

Specimen Type: Lung biopsy, FNA, transtracheal aspirate
Media: BAP, CHOC, CNA, MAC, AnaBAP

34
Q

Obj. 15: Identify when is it appropriate to culture for anaerobes (correlate with usual flora in sputum)

A

Sterile Respiratory Specimens

35
Q

Obj. 16: Recognize the microscope objective that is used when screening sputum to determine if it is contaminated with saliva

A

10x Objective

36
Q

Obj. 17: Evaluate the adequacy of sputum specimens based on microscopic evaluation

A
  • Epi squamous cells = poor collection
  • WBCs, ciliated epi cells, macrophages = good collection
  • > 10 epis, < 25 WBCs: poor [reject, if sputum]
37
Q

Obj. 18: Discuss the reasoning for quantitation of organisms in respiratory tract specimens

A

Quantitating organisms helps distinguish colonization from infection

38
Q

Obj. 26: Identify the following cells commonly seen in direct smears of Gram stained sputum:

Obj. 27: Correlate the cell with an upper or lower respiratory sample

A

Ciliated pseudocolumnar epithelial

Lower respiratory sample

39
Q

Obj. 26: Identify the following cells commonly seen in direct smears of Gram stained sputum:

Obj. 27: Correlate the cell with an upper or lower respiratory sample

A

Ciliated pseudocolumnar epithelial

Lower respiratory sample

40
Q

Obj. 26: Identify the following cells commonly seen in direct smears of Gram stained sputum:

Obj. 27: Correlate the cell with an upper or lower respiratory sample

A

Dust Phagocytes (also called macrophage, pigmented alveolar)

Lower respiratory sample

41
Q

Obj. 26: Identify the following cells commonly seen in direct smears of Gram stained sputum:

Obj. 27: Correlate the cell with an upper or lower respiratory sample

A

Neutrophil

Lower respiratory sample

42
Q

Obj. 26: Identify the following cells commonly seen in direct smears of Gram stained sputum:

Obj. 27: Correlate the cell with an upper or lower respiratory sample

A

Squamous epithelial

Upper respiratory sample

43
Q

Obj. 26: Identify the following cells commonly seen in direct smears of Gram stained sputum:

Obj. 27: Correlate the cell with an upper or lower respiratory sample

A

Squamous epithelial

Upper respiratory sample

44
Q

Obj. 19: Identify appropriate media for special culture of non-routine respiratory pathogens
d. Diphtheria cultures

A
  • Tinsdale agar (black colonies with halos)
  • Loeffer agar slant (metachromatic granules)
    [Toxin Testing (Elek) requried]
45
Q

Obj. 19: Identify appropriate media for special culture of non-routine respiratory pathogens
b. Legionella cultures

A

BCYE (Buffered Charcoal Yeast Extract) - w or w/o antibiotics
- Opal/pearl white colonies

46
Q

Obj. 19: Identify appropriate media for special culture of non-routine respiratory pathogens
c. Pertussis cultures

A
  • Bordet gengou
  • Charcoal cephalexin
  • Regan Lowe
47
Q

Obj. 19 Identify appropriate media for special culture of non-routine respiratory pathogens
a. CF patients

A
  • MSA (Mannitol Salt Agar) - S. aureus
  • PC – Burkholderia cepacia
48
Q

Obj. 20: Outline the resistance issues that should be considered in light of the most common pathogens associated with pneumonia

A

Acroynm: ESKAPE
- Enterococcus faecium (VRE)
- S. aureus (MRSA)
- K. pneumoniae (ESBL & CRO)
- A. baumannii (Multi-drug resistant)
- P. aeruginosa (Multi-drug resistant)
- Enterobacter spp. (ESBL & CRO)

49
Q

Obj. 21: Discuss the vaccines which are available for the prevention of respiratory infections

A
  • H. influenza type b (Hib)
  • Influenza
  • MMR
  • DTaP/Tdap
  • Varicella
  • Pneumococcal
50
Q

Obj. 22: List the organisms that, if isolated from a respiratory specimen, should be considered as possible agents of bioterrorism

A
  • B. anthracis
  • Y. pestis
  • Francisella tularensis
51
Q

Obj. 23: List the most common bacterial pathogen(s) of the upper and lower respiratory tract:
- Pharyngitis

52
Q

Obj. 23: List the most common bacterial pathogen(s) of the upper and lower respiratory tract:
- Community acquired
- Hospital acquired
- Aspiration pneumonia
- Walking pneumonia

A
  • S. pneumo.
  • GNRs (Kleb., Enterobacter, PSA)
  • Polymicrobial (upper resp. tract flora)
  • M. pneumo.
53
Q

Obj. 23: List the most common bacterial pathogen(s) of the upper and lower respiratory tract:
Cystic fibrosis ( each “stage”)
- Early
- Middle
- Late

A
  • S. aureus
  • PSA
  • B. cepacia
54
Q

Obj. 23: List the most common bacterial pathogen(s) of the upper and lower respiratory tract:
- Diphtheria

A
  • C. diptheria
55
Q

Obj. 23: List the most common bacterial pathogen(s) of the upper and lower respiratory tract:
- Epiglottitis

A
  • Strep
  • Staph
  • H. influ.
56
Q

Obj. 23: List the most common bacterial pathogen(s) of the upper and lower respiratory tract:
- HIV patients

A
  • Mtb.
  • M. avium complex
57
Q

Obj. 23: List the most common bacterial pathogen(s) of the upper and lower respiratory tract
- Ear and sinus infections in children

A
  • S. pneumo.
  • H. influ.
  • M. catarrhalis
58
Q

Obj. 24: Identify the most following pathogens when observed in direct smears of Gram stained sputum

59
Q

Obj. 25: Correlate the image with likely clinical scenario(s)

A

E. coli
- UTI
- Diarrhea

IUMICRO (25 decks)

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