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Microbiology > Specimen collection and lab diagnosis > Flashcards

Specimen collection and lab diagnosis Flashcards

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1
Q

In what stage do most lab errors occur?

A

the pre-analytical stage

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2
Q

What joint would require longer incubation?

A

Shoulder aspirate

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3
Q

What sample requires prolonged incubation for Actinomyces?

A

jaw infection (wound or swab)

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4
Q

What is the death rate percentage from errors in patient identification?

A

50%

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5
Q

How many patient identifiers do you need to confirm?

A

two

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6
Q

What are four different patient identifers?

A
  • full name
  • OHIP number
  • DOB
  • Hospital accession number
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7
Q

What kind of precautions would you take in collecting a specimen sample from a patient with MRSA or VRE?

A

contact precautions (in addition to routine precautions)

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8
Q

What kind of precautions would you take for a patient with respiratory symptoms?

A

Droplet precautions

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9
Q

In what case would you don airborne precautions whilst collecting a specimen sample from patient?

A
  • SARs
  • avian influenza
  • TB
  • measles
  • chicken pox
  • disseminated herpes zoster
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10
Q

What 3 types of specimens MUST be stored at room temperature?

A
  • CSF for bacterial culture
  • anaerobic organisms
  • blood culture bottles
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11
Q

What kind of specimens MUST be stored between 2-8’C?

A

specimens for viral detection

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12
Q

What is the maximum amount of time a specimen being tested for a bacterial culture can be stored?

A

less than 24 hours

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13
Q

What organisms are negatively impacted from a delay in transport to lab?

A
  • Group A strep from throat swabs
  • N. gonorrhoeae (cervical culture)
  • N. meningitidis (CSF, blood culture)
  • anaerobes
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14
Q

viruses stable for about _ days in 2-8’C

A

2-3 days

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15
Q

Besides CSF specimens, what are some more examples of STAT specimens?

A
  • tissue or wound culture is suspecting necrotizing fasciitis
  • malaria
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16
Q

For blood culture, on average, how much blood do you collect?

A

8-10 ml per bottle

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17
Q

If there is a medical emergency, how much blood is taken for culture?

A

2 or more samples taken from different venipuncture sites, sequentially over a short period of time (minutes)

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18
Q

If endocarditis is suspected, how is blood taken differently?

A

collection happens over a period of time to show continuous bacteremia

  • at least 2 positive cultures of blood samples drawn >12 hours apart, OR
  • all 3 or a majority of >4 separate cultures of blood (first and last specimen drawn 1 hour apart)
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19
Q

A positive blood culture can reflect contamination not infection, when does contamination occur?

A

during the collection phase

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20
Q

Laboratory calculates contamination rate by counting the number of blood cultures with:

A
  • coagulase negative staphylococci
  • viridans streptococcus
  • micrococcus
  • propionibacterium spp
  • corynebacterium spp
  • bacillus spp (common in environment, survives as spore)
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21
Q

When using proviodine to disinfection site where blood will be drawn, how long must you wait after wiping area?

A

1.5-2 minutes

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22
Q

When using tincture of iodine to disinfection site where blood will be drawn, how long must you wait after wiping area?

A

30 seconds

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23
Q

When using chlorhexidine to disinfection site where blood will be drawn, how long must you wait after wiping area?

A

30 seconds

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24
Q

T/F: you do not need to disinfect the rubber septum of bottle because it is protected by cap

A

FALSE: not protected by cap MUST disinfect

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25
Q

Why is it uncommon to draw blood from catheter?

A

Because there is an increase in false positive cultures

26
Q

When is it appropriate to draw blood culture from a line?

A

When there is a suspected line-related infection or if very difficult to draw

27
Q

What does the continuous detection system look for in blood culture resulting in alarm sounds when detected?

A

increase in CO2 or decrease in O2

28
Q

What can be concluded from a positive gram stain?

A

the bacteria stains purple and it is gram-positive because the walls are thick it holds onto the color of the stain

29
Q

What type of bacteria soaks up the safranin stain?

A

gram-negative bacteria because of it’s thin walls

30
Q

Which identification system detects yeast and bacteria?

A

Vitek2

31
Q

What is the novel method for rapid identification (20 min) of microorganisms with laser pulses generating unique patterns for different types of microorganisms?

A

MALDI-TOF

32
Q

What are four non-invasive ways to collect a urine sample?

A
  1. clean-catch midstream specimens
  2. catheter
  3. ileal conduit
  4. bagged specimens in pediatrics
33
Q

What are four invasive ways to collect a urine sample?

A
  1. cystoscopic
  2. ureteral
  3. percutaneous nephrostomy
  4. supra-pubic aspirate
34
Q

When collecting urine sample from foley catheter what 2 things do you NEVER want to do?

A
  1. obtain sample from the catheter bag (highly contaminated)

2. never send the tip of the foley catheter

35
Q

For a wound culture what is the best type of specimen to collect?

A

either a tissue or fluid NOT swab when possible

36
Q

What drugs are CPEs resistant to?

A

almost all antibiotics including, all penicillins, cephalosporins, carbapenems, etc

37
Q

What are some detection methods of CPE?

A
  • screen for resistance using susceptibility testing methods
  • if MIC to ertapenem or meropenem is elevated, perform additional testing
  • immunoassay
38
Q

What are some bacterial causes of infectious diarrhea?

A

salmonella, shigella, campylobacter, yersinia enterocolitica, shiga-toxin producing E. coli, C diff

39
Q

What is the most common cause of diarrhea developed in the hospital?

A

clostridium difficile

40
Q

What are some common viral causes of diarrhea?

A

noravirus, adenovirus, astrovirus, enterovirus

41
Q

What are some parasites that cause diarrhea?

A

giardia, entamoeba histolytica/ dispar, dientamoeba fragilis, tapeworms, nematodes, cryptosporidium, cyclospora

42
Q

In what case would we send a rectal swab as a stool specimen?

A

for infants, other than that avoid sending rectal swab

43
Q

If you need to collect a stool sample but the client is unable to void, can you instruct them to use laxatives?

A

NO do not use laxatives

44
Q

When would a sample of stool be rejected for C diff?

A

formed stool or patient <1 year

45
Q

What is a frequent error that results in rejection of stool sample?

A

incorrect media transport

46
Q

What are some examples of irretrievable specimens?

A

CSF, pleural fluid, joint aspirate, pericardial fluid, vitreous fluid

47
Q

What is the order of tube collection?

A

Tube 1: cell count
Tube 2: chemistry (glucose and proteins)
Tube 3: microbiology (need large volumes if fungal or TB cultures requested 10 ml)
Tube 4: cell count

48
Q

How soon is the gram stain reported back from the lab?

A

within 1 hour

49
Q

For CSF, what are the most common bacterial pathogens?

A

S. pneumoniae, N. meningitidis, Haemophilus influenzae, listeria monocytogenes, Group B strep, E. coli

50
Q

Why is there a minimum of two blood samples taken?

A

one aerobic and one anaerobic

51
Q

What infection control measures must be taken for someone suspected of meningitidis?

A

droplet

52
Q

What is the sensitivity of cytospun gram stain of CSF?

A

56-86%

53
Q

What is the method of detection for respiratory specimens?

A

Nasopharyngeal swabs (NPS)

54
Q

What is the most commonly used method of respiratory viral detection?

A

molecular assays

55
Q

What causes acute pharyngitis?

A

S. pyogenes (Group A streptococcus)

56
Q

When collecting a sputum sample, when should the patient rinse their mouth?

A

First and then cough into container

57
Q

Mould detection require longer incubation around 3-6 weeks, and is mainly identified based on:

A
  • microscopy
  • colonial features
  • growth at different temperatures
  • some reagents
  • aspergillus
58
Q

In fungal detection methods, what is used to diagnosis acute or chronic infection?

A

serology

59
Q

What is the most common immunoassay method that is able to detect HIV antibody?

A

Enzyme immunoassay (EIA)

60
Q

What diagnostic method can be used for viruses, bacteria, parasitology and fungi?

A

molecular methods; nucleic acid is extracted from the specimen or isolate, different methods can be used to amplify the RNA or DNA

61
Q

What diagnostic method has increased sensitivity that t can detect organisms that have been delayed in transit, or cannot be cultured?

A

molecular method

Microbiology (17 decks)

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