Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Bacteriology > Specimen Collection, Handling, Transport and Preservation > Flashcards

Specimen Collection, Handling, Transport and Preservation Flashcards

1
Q

The validity of any test result is primarily dependent on______

A

Quality of specimens received

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

During time of collection, specimens should be collected during ____

A

Acute phase (early phase of illness) of infection

Before the application of antimicrobial therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

During specimen transport, specimens must be placed in a

A

leak-proof container

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

In some cases, within _______ of collection, samples must be transported

A

1-2 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

SPECIMEN STORAGE CONDITONS

A

a) ROOM (AMBIENT) TEMPERATURE - 22°C
b) REFRIGERATOR TEMPERATURE - 4°C
c) BODY TEMPERATURE (INCUBATOR) - 37°C
d) FREEZER TEMPERATURE - -20°C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the room (ambient) temperature?

A

22°C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the refrigerator temperature?

A

4°C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the body temperature (incubator)?

A

37°C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the freezer temperature?

A

-20°C;
-70°C if processing
will be delayed more than 4 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Specimens stored in ROOM (AMBIENT TEMPERATURE)?

A

 Abscess
 Lesion
 Wound
 Body fluid
 Inner ear sample
 Genital sample
 Throat sample
 Nasal sample
 Bone
 Tissue
 Preserved urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Specimens stored in REFRIGERATOR TEMPERATURE?

A

Catheter (IV) tips
CSF for VIRUSES
Outer ear samples
Feces (unpreserved)
Sputum
Urine (unpreserved)
Feces for (C. difficile toxin up to 3 days;
>3days store at -70°C)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Specimens stored in BODY TEMPERATURE (INCUBATOR)?

A

Cerebrospinal fluid for BACTERIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

AGENTS USED FOR SPECIMEN PRESERVATION:

A

 BORIC ACID
 POLYVINYL ALCOHOL (PVA) or BUFFERED FORMALIN
 STUART’S MEDIUM, AMIES MEDIUM, CARY AND BLAIR MEDIUM
 ANTICOAGULANTS (SPS and Heparin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Preserves urine and maintains the appropriate colony counts

A

Boric Acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Preserves stool and maintains the integrity of trophozoites and cysts of ova and parasites (O&P)

A

Polyvinyl Alcohol (PVA) or Buffered Formalin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Transport Media/ Holding Media

A

STUART’S MEDIUM
AMIES MEDIUM
CARY AND BLAIR MEDIUM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Maintain the viability of microorganism without supporting the growth of microorganism;
No death and no overgrowth

A

STUART’S MEDIUM
AMIES MEDIUM
CARY AND BLAIR MEDIUM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Prevents clotting of specimens (blood, bone marrow, synovial fluid)

A

ANTICOAGULANTS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

_______ and ______ of anticoagulant is important

A

Concentration and Type

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Many organisms are inhibited

A

ANTICOAGULANTS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

SPS

A

SODIUM POLYANETHOL SULFONATE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Concentration of SPS?

A

0.025%-0.03% (others up to 0.05%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Best anticoagulant for blood culture

A

SPS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Anti-complementary, antiphagocytic

A

SPS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Interferes with actions of antimicrobials

A

SPS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Inhibits growth of some strains of Neisseria

A

SPS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Addition of ______ counteract SPS inhibitory effect to some bacteria

A

1.2% gelatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Anticoagulant for viral cultures

A

Heparin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Inhibits growth of gram (+) bacteria and yeasts

A

Heparin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Use of the following anticoagulants are yet to be established in microbiology therefore, must not be used

A

Sodium Citrate (Blue Top)
EDTA (Lavender Top)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

A popular brand uses YELLOW TOP in two ways:

A
  1. SPS (Sodium Polyanethol Sulfonate)
  2. ACD (Trisodium Citrate Citric Acid Dextrose)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Not appropriate YELLOW TOP for microbiology

A

ACD (Trisodium Citrate Citric Acid Dextrose)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

General rule in using anticoagulants:

A

Do not refer to the use of tubes by color as different combination
of tube color and anticoagulant present

….always refer to a tube with respect to the anticoagulant it carries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

SPECIMEN LABELLING

A
  1. Patient’s Name
  2. Hospital Number
  3. Birth date
  4. Date and Time of Collection
  5. Specimen Source/Type
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

SPECIMEN REQUISITION

A
  1. Patient’s name
  2. Hospital number
  3. Birthdate/age
  4. Specimen source/type
  5. Date and time collected
  6. Date and time received
  7. Examination requested
  8. Address/telephone number
  9. Diagnosis
  10. Date of admission
  11. Current antimicrobial therapy
  12. Ordering physician
  13. Medico-legal cases: nature of incident, date and time of incident, place of incident
  14. Sexually transmitted infections: civil status, occupation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

SPECIMEN REJECTION

A
  • Sample data unmatched with request form data
    -Transported at wrong temperature and medium
  • Leaking specimens
  • Quantity is insufficient (QNS)
  • Specimen transport time exceeds 2 hours post collection time without any preservation done
  • Specimen received in formalin
  • Dried specimens
  • Specimen received for anaerobic culture from sites known to have anaerobes as part of the normal flora
  • Specimens contaminated with chemical dyes or oily chemicals
  • Foley catheter tips
  • Blood catheter tips from patients with no contaminant (+) blood cultures
  • Duplicate specimens in 24 hours period (except for blood culture)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Specimen received for anaerobic culture from sites known to have anaerobes as part of the normal flora

A

 Gastric washings
 Urine other than suprapubic aspiration
 Stool (except for C. Difficile – food poisoning)
 Vaginal secretions
 Oral/mouth/ oropharyngeal specimens (except for deep tissues obtained during surgical procedure)
 Swabs of ileostomy or colostomy sites
 Superficial skin specimens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

VEIN SELECTION

A

ante cubital fossa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Avoid vascular shunts or catheters;
Prosthetic devices are hard to decontaminate completely

A

BLOOD - VEIN SELECTION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

ANTISEPSIS

A

 70% alcohol
 Iodine (Betadine)
 Iodine tincture (iodine in alcohol)
 Chlorhexidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

BLOOD VOLUME
(for Pediatrics and Adults)

A

1-3 mL – Pediatrics
8-10 mL – Adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Periodicity of microorganism in bloodstream

A

NUMBER OF BLOOD COLLECTION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Random for some, continuous for some

A

NUMBER OF BLOOD COLLECTION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

In blood collection how many sets are preferred?

A

Two or three sets is preferred

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

As number of blood cultures is increased, pathogen recovery is _________

A

increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Not so important

A

TIMING OF COLLECTION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

In TIMING OF COLLECTION, Organisms are released into blood stream at

A

fairly constant rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

In TIMING OF COLLECTION, Intermittent bacteria is

A

unpredictable
So, 2 or 3 samples be spaced an hour apart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

TRUE OR FALSE:
No significant difference in the yield between multiple simultaneous blood cultures or those obtained at intervals

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

__________ collected is more critical than __________

A

Blood volume;
timing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

BLOOD CULTURE MEDIA

A

Trypticase Soy Broth Brain Heart Infusion Broth
Thioglycolate Broth (Supplemented peptone) Columbia or Brucella Broth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

BLOOD CULTURE TECHNIQUES

A

A. Commercially/Conventional

B. Instrument (Based System)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Instrument (Based System)

A

Bactec System (Becton Dickinson-Maryland)

Bact/Alert Microbial Detection System (Biometrieux-North Carolina)

Versa Trek Systems (Thermo Scientific-Ohio)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Growth of Bacillus spp., Corynebacterium spp., Propionibacterium acnes, Coagulase negative staphylococci

A

 Isolated in one of several cultures
 Bacillus anthracis must be ruled out before dismissing bacillus species as probable contaminant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Growth of multiple organisms from one of several cultures

A

Polymicrobial bacteremia is uncommon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

The clinical presentation or course is not consistent with sepsis

A

Physician-based not laboratory-based criteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

The organism causing the infection at a primary site of infection is not the same as that isolated from the blood culture

A

Isolated organism must be the same

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Growth of same organism in repeated cultures obtained either at different times or from different anatomic sites

A

Isolated organism is the same in all sites of collection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Growth of certain organisms in cultures obtained from patients suspected of endocarditis

A

Enterococci or gram (-) rods in patients with clinical gram (-) sepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Growth of the following:

A
  1. Enterobacteriaceae
  2. Streptococcus pneumonia
  3. Streptococcus pyogenes
  4. Haemophilus influenza
  5. Neisseria meningitidis
  6. Brucella spp.
  7. Bacteroides spp.
  8. Listeria monocytogenes
  9. Staphylococcus aureus
  10. Streptococci
  11. Gram (-) anaerobes
  12. Candida albicans
  13. Clostridium perfringens
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Isolation of commensal microbial flora obtained from patients suspected to be bacteremic

A

Immunocompromised patients

Those having prosthetic devices

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Functions of CSF

A

o Cushioning and buoyancy for the bulk of the brain
o Carries essential metabolites into the neural tissue and cleanses tissues of wastes as it circulates around the brain, ventricles and spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

CSF is produced by:

A

Choroid Plexus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Collection of CSF

A
  1. Skin antisepsis is applied before aspirating CSF
  2. Lumbar puncture done by physician
  3. Placed in sterile containers, screw-capped tube, without additives
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

In CSF collection, _____ sterile containers are numbered sequentially according to the order in which they were collected

A

3-4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Tube 1

A

chemistry studies; glucose and protein, and immunology studies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Tube 2

A

Culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Tube 3

A

cell count and differential count

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Tube 4

A

additional tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Volume of CSF

A

1 mL to 5 mL (up to 10 mL for mycobacteria and fungi)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

During transport, CSF should be ______ to the laboratory

A

hand-delivered immediately

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

During CSF transport, ________ will not be recovered after an hour or longer

A

Streptococcus pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

CSF must be transported in_____

A

<15 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

In preserving CSF, it should be placed in _______ at _______ temperature

A

incubator or at room temperature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Never refrigerate CSF if for_____

A

Bacterial culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

If for Hematology, CSF should be _____

A

refrigerated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

If for Chemistry and Serology, CSF should be _____

A

-20°C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

If for Viral Studies, CSF should be _____

A

refrigerated within 23 hours of collection and kept at 4°C up to 3 days

-70°C if longer delay is anticipated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

CSF pathogen

A
  1. Mycobacterium tuberculosis
  2. Treponema pallidum
  3. Streptococcus pneumonia
  4. Haemophilus influenza
  5. Streptococcus agalactiae
  6. Staphylococcus aureus
  7. Escherichia coli
  8. Naegleria or Acanthamoeba spp.
  9. Listeria monocytogenes
  10. Cryptococcus and other fungi
  11. Staphylococcus spp.
  12. Neisseria meningitidis
  13. Bacteriodes spp.
  14. Enteroviruses
  15. Staphylococcus epidermis
  16. Toxoplasma gondii
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

SPUTUM SAMPLES

A

EXPECTORATED SAMPLE

INDUCED SAMPLE

ENDOTRACHEAL SAMPLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

EXPECTORATED SAMPLE:
No food intake _______ hours ______ collection

A

1-2 hours before collection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

just before expectoration

A

Brush teeth or gargle with water or saline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Practice deep breathing, then cough off sputum secretions

A

SPUTUM:
EXPECTORATED SAMPLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Deep-coughed samples should be expelled directly in sterile container

A

SPUTUM:
EXPECTORATED SAMPLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Collection of Expectorated Sputum Sample is done in an area with ______ to avoid spread of infection

A

open air

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

SPUTUM
PMN = 10-25/LPF
EC = <10/LPF

SALIVA
PMN = <10/LPF
EC = >10/LPF
Should be rejected

A

BARTLETT’S SPUTUM SAMPLE CRITERIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

For patients unable to produce sputum

A

INDUCED SAMPLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

May be assisted by respiratory therapists who uses postural drainage and thoracic percussion to stimulate acceptable sputum

A

INDUCED SAMPLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Before specimen collection, patient should brush buccal mucosa, tongue and gums with wet toothbrush

A

INDUCED SAMPLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

INDUCED SAMPLE has high diagnostic yield of _______

A

Pneumocystis jiroveci pneumonia (PCP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

PCP is formerly

A

Pneumocystis carinii

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

causative agent for the rodent form of Pneumocystis

A

Pneumocystis carinii

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

An opportunistic, atypical fungus infecting immunocompromised hosts

A

Pneumocystis jiroveci pneumonia (PCP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

An alternative for INDUCED SAMPLE

A

AEROSOL-INDUCED specimen for mycobacterial and fungal agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

In AEROSOL-INDUCED, patient is allowed to breathe aerosolized droplets called _________ until a strong cough reflex is initiated

A

(NEBULIZATION containing 10% - 0.85% NaCl)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Secretions collected thru induction appear watery resembling saliva

A

INDUCED SAMPLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Contain materials directly from alveolar spaces

A

INDUCED SAMPLE

98
Q

INDUCED samples are adequate and acceptable for culture, therefore pre-screening is _________

A

eliminated

99
Q

May be obviate doing more invasive procedure such as bronchoscopy or needle aspiration

A

INDUCED SAMPLE

100
Q

Patients with ________ are unable to produce sputum in normal fashion

A

tracheostomies

101
Q

Specimens treated as SPUTUM

A

Tracheostomy aspirates
or
Tracheostomy suction

102
Q

In ENDOTRACHEAL SAMPLE, Lower respiratory secretions are easily collected using

A

Lukens Trap

103
Q

Patients are rapidly colonized by gram (-) bacilli and other nosocomial pathogens

A

ENDOTRACHEAL SAMPLE

104
Q

In ENDOTRACHEAL SAMPLE, colonization is not clinically relevant but these organisms may be aspirated into the lungs and can cause ___________

A

pneumonia

105
Q

Culture results are correlated with clinical signs and symptoms

A

ENDOTRACHEAL SAMPLE

106
Q

SPUTUM TRANSPORT AND STORAGE

A

<2 hours room temperature

24 hours at 4°C

107
Q

SPUTUM PATHOGENS

A

a. ß-hemolytic Streptococci
b. Bordetella pertussis
c. Streptococcus pneumonia
d. Pseudomonas spp.
e. Haemophilus influenza
f. Klebsiella spp.
g. Mycobacterium spp.
h. Yersinia pestis
i. Franciesella tularensis
j. Staphylococcus aureus
k. Mycoplasma spp.
l. Legionella spp.
m. Blastomyces dermatitidis
n. Candida albicans
o. Coccidiodis immitis
p. Histoplasma capsulatum
q. Influenza viruses

108
Q

GASTRIC ASPIRATE is exclusively for the isolation of

A

Acid Fast Bacilli (AFB)

109
Q

Collected from patients who are unable to produce sputum – young children

A

GASTRIC ASPIRATE

110
Q

Before patient wakes up in the morning, nasogastric tube is inserted into stomach and contents are withdrawn

A

GASTRIC ASPIRATE

111
Q

On the assumption that AFB from respiratory tract were swallowed at night and will be present in the stomach

A

GASTRIC ASPIRATE

112
Q

In Gastric Aspirate, relative resistance of Mycobacteria to _____ allows them viable for short period of time

A

acidity

113
Q

Must be delivered to laboratory at once to neutralize acidity

A

GASTRIC ASPIRATE

114
Q

Nasopharyngeal aspirates and washings are preferred over swabs except for

A

Chlamydia trahomatis

115
Q

are suitable for collecting most of the URT microorganisms

A

Sterile Dacron or Rayon

Calcium Alginate swabs with plastic shafts

116
Q

______ should never be used for culture of URT

A

Cotton swabs

117
Q

Fibers of Cotton swabs contain fatty acid on the surface killing some pathogens especially __________

A

Bordatella

118
Q

For culture

A

Calcium Alginate

119
Q

For PCR

A

Dacron or Rayon swabs in plastic shaft

120
Q

For B. pertussis

A

inoculated directly to fresh culture media at bedside

121
Q

If direct inoculation of B. pertussis (URT) is not possible, transport for
<2 hours in _______ at ______ temperature

A

1% Casamino medium;

room temperature

122
Q

Plated on the day of collection:

A

AMIES transport medium

123
Q

Plated more than 24 hours after collection:

A

Regan- Lowe
or
Jones-Kendrick transport medium

(contains charcoal, starch, and nutrients, as well as cephalexin)

124
Q

Lengthy delay in transport are expected:

A

Regan-Lowe Medium at 4°C

125
Q

If swab remains moist within _____ hours of collection before culture _____ further precautions need to be taken

A

4 hours;

no further precautions need to be taken

126
Q

highly resistant to desiccation and remains viable on a dry swab for as long as 48-72 hours

A

Streptococcus pyogenes

127
Q

URT PATHOGENS

A

1) ß-hemolytic Group A Streptococci
2) Corynebacterium diphtheria
3) Bordetella pertussis
4) Mycoplasma
5) Chlamydia
6) Candida albicans
7) Neisseria meningitidis
8) Neisseria gonorrheae
9) Haemophilus influenza
10) Moraxella catarhalis
11) Pseudomonas spp.
12) Streptococcus pneumoniae
13) Staphylococcus aureus
14) Cryptococcus neoformans
15) Herpes simplex virus (RSV)
16) Respiratory syncytial virus (RSV)
17) Influenza virus
18) Parainfluenza virus

128
Q

Purulent material from lower conjunctival sac and inner canthus of the eye (angle) is collected using sterile swab

A

EYE SWAB

129
Q

Both eye should be swabbed and cultured _______

A

separately

130
Q

dry calcium alginate swab placed in 2-SP (2-sucrose phosphate) transport medium, additional swab rolled across surface of slide, fixed with methanol for DFA (Direct Fluorescent Antibody)

A

Chlamydial culture

131
Q

EYE SWAB transport medium

A

2 - SP (2-sucrose phosphate) transport medium

132
Q

Bacterial Identification Method used in Eye Swab

A

Direct Fluorescent Antibody

133
Q

Ophthalmologist collects scrapings of the cornea using heat-sterilized platinum spatula

A

Keratitis

134
Q

Multiple inoculations of spatula in plated culture medium and thioglycolate broth

A

Keratitis

135
Q

placed in viral transport media

A

HSV and adenoviral culture

136
Q

2 corneal scrapes were determined to provide a simple method for diagnosis of bacterial keratitis

A

1 for gram stain
1 transported in brain heart infusion medium for culture and sensitivity testing

137
Q

RESIDENT FLORA OF EYES

A

1) Staphylococcus epidermis
2) Lactobacillus spp.
3) Propionibacterium acnes
4) Staphylococcus aureus (30%)
5) Haemophilus influenza (colonizes 0.4% - 25%)

138
Q

EYE SWABS - Very small percentage of individuals:

A

1) Moraxella catarrhalis
2) Various Enterobacteriacea
3) Streptococcus pyogenes
4) Streptococcus pneumonia
5) Other alpha haemolytic and gamma haemolytic streptococci

139
Q

PATHOGENS OF EYE SWABS

A

1) Staphylococcus aureus (blepharitis)
2) Streptococcus pneumoniae (conjunctivitis)
3) Staphylococcus epidermis (in children)
4) Haemophilus influenza (conjunctivitis)
5) Chlamydia trachomatis (keratoconjunctivitis)
6) Bacillus spp. (Post-surgical, post-traumatic endophthalmitis)
7) Neisseria gonorrheae (ophthalmia neonatorum)

140
Q

not diagnosed by culture

A

Middle ear infection or otitis media

141
Q

ideal for external otitis

A

Laboratory diagnosis

142
Q

External ear should be cleansed with a mild germicide such as:

A

1:1000 aqueous solution of benzalkonium chloride to reduce contaminating skin flora

143
Q

Done by Otolaryngologist to get sample

A

Tympancentesis

144
Q

RESIDENT FLORA - Sparse number of:

(EAR SAMPLES)

A

Streptococcus pneumoniae

Propionibacterium acnes

Staphylococcus aureus

Frequently: Enterobacteriaceae

Occasionally: Pseudomonas aeruginosa

Common: Non-Candida albicans

145
Q

PATHOGENS

Otitis externa

ACUTE:

A

 Staphylococcus aureus
 Streptococcus pyogenes
 Pseudomonas aeruginosa
 Other gram (-) bacilli

146
Q

PATHOGENS

Otitis externa

CHRONIC

A

Pseudomonas aeruginosa

Anaerobes

147
Q

PATHOGENS

Otitis media

ACUTE

A

 H.. influenza
 S. pneumoniae
 S. pyogenes
 M. catarrhalis
 RSV
 Influenza virus

148
Q

PATHOGENS

Otitis media

CHRONIC

A

Anaerobes

149
Q

Ultrafiltrate of blood consisting mostly of water but also contains nitrogenous wastes, sodium, potassium, chloride and other analytes collection

A

URINE

150
Q

TRUE OR FALSE: Urine samples from bedpans or urinals are not acceptable

A

TRUE

151
Q

TRUE OR FALSE: Urine culture samples should be collected directly into a sterile container

A

TRUE

152
Q

Urine is normally ______

A

SALINE

153
Q

Upper UTI

A

kidneys and ureters

154
Q

Lower UTI

A

bladder and urethra, prostate for males

155
Q

URINE COLLECTION

A
  1. CLEAN-CATCH MIDSTREAM URINE INSTRUCT PATIENT
  2. STRAIGHT CATHETER (IN AND OUT)
  3. INDWELLING CATHETER (FOLEY)
  4. SUPRAPUBIC ASPIRATION
156
Q

After several ml have passed, collect midstream

A

CLEAN-CATCH MIDSTREAM URINE INSTRUCT PATIENT

157
Q

Allow 15 mL to pass, then collect remainder

A

STRAIGHT CATHETER (IN AND OUT)

158
Q

Aspirates 5-10 mL of urine with needle and syringe

A

INDWELLING CATHETER (FOLEY)

159
Q

In SUPRAPUBIC ASPIRATION, needle aspiration is done ______ the symphysis pubis through the abdominal wall into the full bladder

A

above

160
Q

Place in screw cap container or anaerobic transporter

A

SUPRAPUBIC ASPIRATION

161
Q

 Immediately deliver to the laboratory at room temperature and plate as soon as received

A

SUPRAPUBIC ASPIRATION

162
Q

TRANSPORT OF URINE

A

Preserved urine: within 24 hours at room temperature

Unpreserved urine: <2 hours at room temperature, 24 hours at 4°C

163
Q

RESIDENT FLORA OF URETHRA

A

 Lactobacilli
 Corynebacterium
 Coagulase negative Staphylococci (CONS)
 Potential pathogens: Enterobacteriaceae and occasional yeasts are colonizers
 Quantitative cultures discriminate contamination, colonization and infection

164
Q

ETIOLOGICAL AGENT OF URINE

A

 Escherichia coli (UPEC- Uropathogenic E. coli)
 Klebsiella spp.
 Other Enterobacteriaceae
 Staphylococcus saprophyticus
 Enterococci
 Proteus
 Pseudomonas
 Enterobacter
 Mycobacterium tuberculosis
 Streptococcus agalactiae
 ß- Lactamase resistant E. coli
 Candida spp.
 Acinetobacter
 Alcaligenes
 Gardnerella vaginalis
 Citrobacter spp.
 Aerococcus urinae
 Salmonella and Shigella spp.
 Staphylococcus aureus
 Neisseria gonorrhoea
 Trichomonas vaginalis

165
Q

GENITAL TRACT SPECIMENS

Swab (transport time)

A

transport <2

166
Q

GENITAL TRACT SPECIMENS

Storage before processing

A

24 hours RT

167
Q

GENITAL TRACT SPECIMENS

Tube

A

transport as soon as possible and secretions are plated immediately

168
Q

GENITAL TRACT SPECIMENS

JEMBEC transport system:

A

placed at 37°C immediately on receipt in the laboratory

169
Q

FEMALE GENITAL TRACT SPECIMENS (Swab/Aspirates)

A
  1. BARTHOLIN’S cyst
  2. CUL-DE-SAC
  3. ENDOMETRIUM
  4. URETHRA
  5. VAGINA
  6. CERVIX
170
Q

 Skin antisepsis
 Aspirate fluid
 Use anaerobic transporter

A

BARTHOLIN’S cyst

171
Q

 Aspirate fluid
 Use anaerobic transporter

A

CUL-DE-SAC

172
Q

 Use anaerobic transporter

 Surgical biopsy or transcervical aspirate via sheathed catheter

A

ENDOMETRIUM

173
Q

 Use swab with Stuart’s or Amies Medium
 Remove exudates from urethral opening
 Insert flexible swab 2-4 cm and rotate for 2 seconds
 Or massage urethra against pubis symphysis to collect sample
 Collect an hour after patient has urinated

A

URETHRA

174
Q

 Use swab with Stuart’s or Amies Medium or JEMBEC transport system
 Remove exudates before collection
 Swab secretions and mucous membrane

A

VAGINA

175
Q

 Use swab with Stuart’s or Amies Medium
 Lubricants must not be used
 Remove mucus before collection
 Swab deeply into endocervical canal

A

CERVIX

176
Q

MALE GENITAL TRACT SPECIMENS

A
  1. PROSTATE
  2. URETHRA
177
Q

 Use swab with Stuart’s or Amies Medium or sterile screw cap tube
 Clean glans penis with soap and water
 Collect secretions on swab or in tube

A

PROSTATE

178
Q

 Use swab with Stuart’s or Amies Medium or JEMBEC transport system
 Insert flexible swab 2-4 cm and rotate for 2 seconds or collect discharge on JEMBEC transport system

A

URETHRA

179
Q

GENITAL TRACT SPECIMENS

RESIDENT MICROBIAL FLORA
o MALE

A

 CONS
 Corynebacterium
 Various anaerobes
 Mycobacterium smegmatis along with other gram (+) bacteria (prepuce or foreskin of uncircumcised)

180
Q

GENITAL TRACT SPECIMENS

RESIDENT MICROBIAL FLORA
o FEMALE

A

Prepubescent Age and
Post Menopausal Age:

Staphylococci Corynebacterium

Reproductive Age:

Enterobacteriaceae Streptococci Staphylococci Lactobacilli
Group B (ß-hemolytic) Streptococci Streptococcus agalactiae

181
Q

GENITAL TRACT SPECIMENS :
CAUSATIVE AGENTS

A

1) Neisseria gonorrhoea
2) Klebsiella granulomatis
3) Haemophilus ducreyi
4) Gardnerella vaginalis
5) Chlamydia trachomatis
6) ß-Hemolytic Streptococci
7) Listeria monocytogenes
8) Mycoplasma spp.
9) Candida albicans
10) Trichomonas vaginalis
11) Human Papilloma Virus (HPV)
12) Herpes Simplex Virus (HSV)
13) Ureaplasma urealyticum
14) Human Immunodeficiency Virus (HIV)
15) Adenovirus
16) Coxsackie virus
17) Molluscum contagiosum

182
Q

GENITAL TRACT SPECIMENS:
HOMOSEXUALS

A

1) Giargia lamblia
2) Entamoeba histolytica
3) Cryptosporidium spp.
4) Salmonella
5) Shigella
6) Campylobacter
7) Microsporidium
8) N. meningitides
9) Cytomegalovirus (CMV)
10) Hepatitis B, C, and E
11) HIV

183
Q

If submitted sample is initially negative, two additional samples must be submitted over the next few days

A

GASTROINTESTINAL TRACT SPECIMENS

184
Q

Organisms shed intermittently

A

GASTROINTESTINAL TRACT SPECIMENS

185
Q

Collection of samples at different times over several days enhances recovery

A

GASTROINTESTINAL TRACT SPECIMENS

186
Q

GASTROINTESTINAL TRACT SPECIMENS

A

STOOL
RECTAL SWAB
GASTRIC BIOPSY

187
Q

Stool must be placed in a

A

Sterile leak-proof container

188
Q

Liquid stool

A

1 teaspoon (5 mL)

189
Q

Formed stool

A

pea-sized

190
Q

Stool is placed in _______ if transport exceeds at 1 hour

A

enteric transport media (Cary & Blair)

191
Q

Stool can be transported within _____ hours at ______ temperature

A

24 hours at room temperature

192
Q

Stool can be stored at ____°C for ____ hours

A

4°C for 72 hours

193
Q

Routine culture not done for patients:

> 3 days hospital stay and whose admitting diagnosis was not diarrhea
…MUST BE TESTED for ____________

A

C. difficile

194
Q

If stool is unavailable, ______ can be submitted

A

RECTAL SWAB

195
Q

Insert rectal swab _____ cm post anal sphincter (Stool must be visible on swab)

A

2.5 cm

196
Q

Rectal Swab placed in ______ transport media

A

enteric transport media ( Cary & Blair)

197
Q

Rectal Swab can be transported within_____ hours at _____ temperature

A

24 hours at room temperature

198
Q

Rectal Swab can be stored _____ hours at ____ temperature or store at ___°C

A

<48 hours room temperature or store at 4°C

199
Q

Not as good as stool: parasites, toxins and viral antigens are not detected

A

RECTAL SWAB

200
Q

Sterile screw cap tube with Normal Saline

A

GASTRIC BIOPSY

201
Q

GASTRIC BIOPSY can be transported ___ hour/s at ____ temperature

A

<1 hour at room temperature

202
Q

GASTRIC BIOPSY can be stored ___ hours at __°C

A

24 hours at 4°C

203
Q

GASTRIC BIOPSY is used for recovery of

A

Helicobacter pylori

204
Q

GASTRIC BIOPSY PATHOGEN

A

1) Salmonella
2) Shigella
3) Campylobacter
4) Vibrio
5) Aeromonas
6) Plesiomonas
7) Yersinia enterocolitica
8) Escherichia coli 0157:H7
9) Helicobacter pylori
10) Clostridium spp.

205
Q

SKIN AND SOFT TISSUE SPECIMENS

Ideally how many swabs should be submitted to the laboratory?

A

2 or two
1 swab for culture
1 for gram staining

206
Q

SKIN AND SOFT TISSUE SPECIMENS

Better if can do ________ on the glass slide for gram stain

A

direct bedside swab

207
Q

MANIFESTATION OF SKIN INFECTION

A

Macule
Papule
Nodule
Pastule
Vesicle
Bulla
Scales
Ulcer

208
Q

a circumscribed (limited), flat discoloration of the skin

A

MACULE

209
Q

an elevated solid lesion ≤5 mm in diameter

A

PAPULE

210
Q

an raised solid lesion >5 mm in diameter

A

NODULE

211
Q

a circumscribed, raised, pus-filled (leukocytes and fluid) lesion

A

PASTULE

212
Q

A circumscribed, raised, fluid-filled (blister- like) lesion ≤5 mm in diameter

A

VESICLE

213
Q

a circumscribes, raised, fluid-filled (blister-like) lesion >5 mm in diameter

A

BULLA

214
Q

dry, horny, platelike lesions

A

SCALES

215
Q

lesion with loss of dermis and epidermis

A

ULCER

216
Q

 Wipe or irrigate area with sterile saline
 Use aerobic swab moistened with Stuart’s medium or Amies Medium
 Swab along leading edge of wound
 Transport in <2 hours
 Can be stored 24 hours at room temperature

A

SUPERFICIAL WOUND

217
Q

DEEP WOUND

Wipe area with

A

sterile saline or 70% alcohol

218
Q

Aspirate material from wall or excise tissue

A

DEEP WOUND

219
Q

DEEP WOUND
Lesions are unroofed if covered with scar tissue and swabbed at the periphery and base of lesion for optimal pathogen recovery use _______ swab

A

Rayon or Dacron-tipped swab

220
Q

To prepare smears, use scalpel blades to scrape base of lesion avoiding to macerate the cells, spread sample thinly in glass slide

A

DEEP WOUND

221
Q

DEEP WOUND Transport in _____ hours

A

<2 hours

222
Q

DEEP WOUND can be stored ___ hours at ____ temperature

A

24 hours at room temperature

223
Q

DEEP WOUND PATHOGENS

A

1) Bacteroides spp
2) Clostridium spp
3) Enterobacteriaceae
4) Staphylococcus aureus
5) Streptococcus pyogenes
6) Fungi
7) Varicella zoster virus
8) Viridans streptococci
9) Enterococci
10) Group A and other ß- haemolytic streptococci
11) Neisseria gonorrheae
12) Neisseria meningitidis
13) Haemophilus influenzeae
14) Pseudomonas aeruginosa
15) Pseudomonas mallei
16) Pseudomonas pseudomallei
17) Listeria monocytogenes
18) Vibrio vulnificus
19) Mycobacterium tuberculosis
20) Mycobacterium leprae
21) Treponema pallidum

224
Q

OTHER STERILE BODY FLUID

A

PLEURAL FLUID
PERITONEAL FLUID PERCARDIAL FLUID
SYNOVIAL FLUID
AMNIOTIC FLUID

225
Q

PLEURAL FLUID

A

lungs

226
Q

PERITONEAL FLUID

A

stomach

227
Q

PERCARDIAL FLUID

A

heart

228
Q

SYNOVIAL FLUID

A

joint

229
Q

AMNIOTIC FLUID

A

surrounds the baby

230
Q

Collected by aseptic aspiration with needle and syringe

A

OTHER STERILE BODY FLUID

231
Q

In OTHER STERILE BODY FLUID ____mL is sufficient for recovery of pathogen

A

1-5 ml

232
Q

In OTHER STERILE BODY FLUID ____mL is needed for fungi and mycobacteria that are present in low concentrations

A

10-15 ml

233
Q

Sterile screw cap tubes or anaerobic transporter or direct inoculation in blood culture bottles

A

OTHER STERILE BODY FLUID

234
Q

OTHER STERILE BODY FLUID is transported in _____ minutes and plate as soon as received

A

<15 minutes

235
Q

OTHER STERILE BODY FLUID

Blood cultures bottles with inoculated sterile fluids must be placed in _____

A

incubator

236
Q

OTHER STERILE BODY FLUID

May need to concentrate by centrifugation at _____ rpm at _____ minutes, discard supernatant and leave 0.5 mL of fluid to resuspend sediments for processing

A

3500 rpm at 5-10 minutes

237
Q

Any growth is considered pathogen since these fluids are normally sterile

A

OTHER STERILE BODY FLUID

238
Q

Done by physician during procedure

A

TISSUE AND BONE

239
Q

Samples immediately sent to laboratory or placed in an enrichment medium at bedside if samples are to be sent out to a reference laboratory

A

TISSUE AND BONE

240
Q

TISSUE AND BONE

As a general rule, always keep the sample ____ during transport (saline can be used in the absence of enrichment broth)

A

moist

241
Q

Always save a portion of the sample in a sterile broth (if enough sample was submitted)

A

TISSUE AND BONE

242
Q

TISSUE AND BONE

Store at the _____ and at ____°C for ___ weeks in case additional studies are needed

Or, if necessary, can also be stored at
___°C

A

refrigerator and at -70°C for 4 weeks

-20°C

Bacteriology (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions