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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
Obj. 9: List common general symptoms of pneumonia
- Sudden increase of coughing - Wheezing - Hypoxia - Infiltration on imaging - Fevers - Night sweats - Malaise
26
Obj. 10: Discuss the relationship of positive blood cultures and pneumonia
Occurs via secondary bacteremia from invasive pathogens (i.e. S. pneumoniae, PSA, Enterobacterales, etc.)
27
Obj. 11: List 3 respiratory pathogen virulence factors and associated organisms
1. Adherence: Streptococcus spp. 2. Toxin Production: Corynebacterium diphtheriae, PSA, B. pertussis 3. Evasion of host defenses: S. pneumo, H. flu, PSA, TB
28
Obj. 12: Identify the significance (pathogenicity, organism identification) of polysaccharide capsules and intracellular growth for respiratory pathogens
Polysaccharide capsules: prevents phagocytosis by host cells - S. pneumo, K. pneumo, H. flu, PSA Intracellular pathogens: inhibits phagosome-lysosome fusion - TB
29
Obj. 25: Correlate the image with likely clinical scenario(s)
Klebsiella pneumoniae - Hospital-acquired (nosomical) pneumonia
30
Obj. 13: Identify the media (and specimen type) that is recommended for the setup of the following: - “Strep screens”/Throat Culture
Specimen type: Throat swab Media: BAP, CHOC, AnaBAP (BAP w/ stabs, SXT agar)
31
Obj. 14: Discuss the application (significance, sensitivity, specificity) of rapid antigen testing in diagnosis of strep throat.
- Significance: ability to provide results in ~ 15 minutes - High specificity, low sensitivity - Conclusive for positive results - Inconclusive for negative results
32
Obj. 13: Identify the media (and specimen type) that is recommended for the setup of the following: - Routine Lower Respiratory Specimens:
Specimen Type: Sputum, BAL, Tracheal Aspirate, etc. Media: BAP, CHOC, CNA, MAC
33
Obj. 13: Identify the media (and specimen type) that is recommended for the setup of the following: - Sterile Respiratory Specimens
Specimen Type: Lung biopsy, FNA, transtracheal aspirate Media: BAP, CHOC, CNA, MAC, AnaBAP
34
Obj. 15: Identify when is it appropriate to culture for anaerobes (correlate with usual flora in sputum)
Sterile Respiratory Specimens
35
Obj. 16: Recognize the microscope objective that is used when screening sputum to determine if it is contaminated with saliva
10x Objective
36
Obj. 17: Evaluate the adequacy of sputum specimens based on microscopic evaluation
- Epi squamous cells = poor collection - WBCs, ciliated epi cells, macrophages = good collection - >10 epis, < 25 WBCs: poor [reject, if sputum]
37
Obj. 18: Discuss the reasoning for quantitation of organisms in respiratory tract specimens
Quantitating organisms helps distinguish colonization from infection
38
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
Ciliated pseudocolumnar epithelial Lower respiratory sample
39
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
Ciliated pseudocolumnar epithelial Lower respiratory sample
40
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
Dust Phagocytes (also called macrophage, pigmented alveolar) Lower respiratory sample
41
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
Neutrophil Lower respiratory sample
42
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
Squamous epithelial Upper respiratory sample
43
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
Squamous epithelial Upper respiratory sample
44
Obj. 19: Identify appropriate media for special culture of non-routine respiratory pathogens d. Diphtheria cultures
- Tinsdale agar (black colonies with halos) - Loeffer agar slant (metachromatic granules) [Toxin Testing (Elek) requried]
45
Obj. 19: Identify appropriate media for special culture of non-routine respiratory pathogens b. Legionella cultures
BCYE (Buffered Charcoal Yeast Extract) - w or w/o antibiotics - Opal/pearl white colonies
46
Obj. 19: Identify appropriate media for special culture of non-routine respiratory pathogens c. Pertussis cultures
- Bordet gengou - Charcoal cephalexin - Regan Lowe
47
Obj. 19 Identify appropriate media for special culture of non-routine respiratory pathogens a. CF patients
- MSA (Mannitol Salt Agar) - S. aureus - PC -- Burkholderia cepacia
48
Obj. 20: Outline the resistance issues that should be considered in light of the most common pathogens associated with pneumonia
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
Obj. 21: Discuss the vaccines which are available for the prevention of respiratory infections
- H. influenza type b (Hib) - Influenza - MMR - DTaP/Tdap - Varicella - Pneumococcal
50
Obj. 22: List the organisms that, if isolated from a respiratory specimen, should be considered as possible agents of bioterrorism
- B. anthracis - Y. pestis - Francisella tularensis
51
Obj. 23: List the most common bacterial pathogen(s) of the upper and lower respiratory tract: - Pharyngitis
GAS
52
Obj. 23: List the most common bacterial pathogen(s) of the upper and lower respiratory tract: - Community acquired - Hospital acquired - Aspiration pneumonia - Walking pneumonia
- S. pneumo. - GNRs (Kleb., Enterobacter, PSA) - Polymicrobial (upper resp. tract flora) - M. pneumo.
53
Obj. 23: List the most common bacterial pathogen(s) of the upper and lower respiratory tract: Cystic fibrosis ( each “stage”) - Early - Middle - Late
- S. aureus - PSA - B. cepacia
54
Obj. 23: List the most common bacterial pathogen(s) of the upper and lower respiratory tract: - Diphtheria
- C. diptheria
55
Obj. 23: List the most common bacterial pathogen(s) of the upper and lower respiratory tract: - Epiglottitis
- Strep - Staph - H. influ.
56
Obj. 23: List the most common bacterial pathogen(s) of the upper and lower respiratory tract: - HIV patients
- Mtb. - M. avium complex
57
Obj. 23: List the most common bacterial pathogen(s) of the upper and lower respiratory tract - Ear and sinus infections in children
- S. pneumo. - H. influ. - M. catarrhalis
58
Obj. 24: Identify the most following pathogens when observed in direct smears of Gram stained sputum
E. coli
59
Obj. 25: Correlate the image with likely clinical scenario(s)
E. coli - UTI - Diarrhea

IUMICRO (25 decks)

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