SPECIMEN COLLECTION & PROCESSING Flashcards
1
Q
[sputum]
specimens needed for Mycobacterium
A
3 separate early morning specimens
2
Q
These media usually contain substances that do not promote multiplication of microorganisms but ensure their preservation and are available in swab collection systems
A
holding / transport media
3
Q
____________ to provide the larger iodine element to replace the smaller chloride in the stain molecule
A
gram’s iodine
4
Q
specimens needed for bacterial infection
A
3 specimens in 3 consecutive days
5
Q
[anticoagulants]
should not be used for microbiology specimens
A
- citrate
- ethylenediamine tetraacetic acid (EDTA)
6
Q
[stains]
________________ are directed toward coloring specific components of the elements present
A
differential stains
7
Q
bacteria with thinner walls containing lipopolysaccharides do not retain the dye complex
A
Gram-negative bacteria
8
Q
[Acid-Fast Staining of Mycobacteria]
results:
Mycobacteria stain bright orange
A
fluorescent stain
9
Q
[wounds/lesions after collection]
should be placed into a _________ or
____________
A
sterile tube or transport vial
10
Q
[isolation techniques]
- The specimen is applied by _________ or placing a ___________ onto a small area at the edge of the plate
- The ____________ is sterilized and allowed to cool thoroughly before streaking the agar
- The __________________ is useful for most specimen
- The relative number of organisms can be estimated based on the extent of ________ beyond the original area of inoculum
- Growth in the first quadrant can be graded as _____________; growth in the second or third quadrant can be graded as ______________; and growth in the third or fourth quadrant can be graded as ______________
A
- rolling the swab, drop of liquid specimen
- inoculating loop
- general-purpose isolation streak
- growth
- 1+ or light growth; 2+ to 3+ or moderate growth; 4+ or heavy growth
11
Q
Specimens for parasite microscopic studies should be collected ____________________
A
before any barium studies are done
12
Q
This system contains selective agar and a carbon dioxide (CO2)-generating tablet
A
JEMBEC system
13
Q
[anticoagulants]
The concentration must not exceed _______ (wt/vol) because some Neisseria spp. and certain anaerobes are inhibited by higher concentrations
A
0.025%
14
Q
[matching type|Gram-positive cocci]
Streptococcus, Peptostreptococcus spp.
a. pairs
b. tetrads
c. clusters
d. chains
e. encapsulated
f. gram-positive diplococci (lancet-shaped)
g. gram-negative diplococci pathogenic
A
d. chains
15
Q
[smears from thick, granular, or mucoid materials]
Granules within the material must be _________ so that their makeup can be assessed
A
crushed
16
Q
[Rapid Modified wright-Giemsa Stain]
The Wright-Giemsa stain is available in a modification that requires only _______ minutes
A
1-3 minutes
17
Q
[matching type|Gram-positive cocci]
Streptococcus pneumoniae, Streptococcus pyogenes (rarely), Stomatococcus mucilaginosus
a. pairs
b. tetrads
c. clusters
d. chains
e. encapsulated
f. gram-positive diplococci (lancet-shaped)
g. gram-negative diplococci pathogenic
A
e. encapsulated
18
Q
separates double-stranded DNA
A
denaturation
19
Q
[anticoagulants]
most common anticoagulant used for microbiology specimens
A
sodium polyanethol sulfonate (SPS)
20
Q
anneals primers to target DNA
A
primer annealing
21
Q
the exact anatomic site must be provided for?
A
wounds/lesions
22
Q
specimens commonly obtained by the patient
A
- urine
- sputum
- stool
23
Q
[preservatives]
used in commercial products to maintain accurate urine colony counts
A
boric acid
24
Q
Plates are inoculated using a ___________ to deliver a specified volume
A
calibrated loop
25
commonly used transport medium
Stuarts's or Amie's transport medium
26
[stains]
____________ are directed toward coloring the forms and shapes present
simple stains
27
[true or false]
Specimens received on swabs can be inoculated directly to culture media
true
28
When ethidium bromide is irradiated with UV light, it fluoresces _____________
bright orange
29
[stains]
_______________ are directed specifically at identification of an organism
DNA probe-mediated stains
(diagnostic antibody)
30
[search for microorganisms]
Organisms should be evaluated for _____, _____, and _____________
shape, size, gram reaction
31
[These specimens should be stored in what temperature?]
- abscess, lesion, wound
- body fluids
- CSF (bacteria)
- ear (inner)
- feces (preserved)
- genital
- nasal, throat, N/P
- urine (preserved)
Room temperature
32
[incubation]
_______ grow in ambient air, whereas _________ cannot grow in the presence of oxygen and require an anaerobic atmosphere
aerobes, anaerobes
33
[incubation]
Most bacteria cultures are incubated at _____ to ______
35° C, 37° C
34
used to prevent clotting of specimens, including blood, bone marrow, and synovial fluid
anticoagulants
35
specimens needed for parasitic infection
3 samples within 10 days
36
[catheter]
allow _______ to pass then collect the remainder urine
15 mL
37
[smears from thick, granular, or mucoid materials]
Granules that are too hard to crush between two glass slides probably _____________
do not represent infectious materials
38
[wounds/lesions]
collected by ____________ rather than by ________
needle aspiration, swab
39
The two single-stranded nucleic acid molecules used in hybridization techniques are referred to as _______ and _______
target, probe
40
[blood culture]
mL to collect for adults
20ml
(10mL aerobic & 10 mL anaerobic)
41
[blood culture]
mL to collect for children
10mL
(5mL aerobic & 5mL anaerobic)
42
smears from swabs are prepared by __________________ over contagious areas of the glass slide to deposit a thin layer of sample material
rolling the swab back and forth
43
[smears from thick, granular, or mucoid materials]
It is most desirable to have both _____ and _____ areas
thick, thin
44
[urine]
three methods in collecting urine
- clean catch midstream
- catheter
- suprapubic aspirate
45
not ideal method for urine collection
catheter
46
appropriate for specimens from the upper respiratory tract, external ear, eye, and genital tract
swabs
47
[stains]
four (4) stains
- gram
- acid-fast
- calcofluor white
- rapid modified Wright-Giemsa
48
[search for microorganisms]
A _____ or _____ lens is preferred for scanning, and a _______ lens is used for final evaluation
x40 or x60, x100
49
best specimen method for urine culture
clean catch midstream
50
[anticoagulants]
often used for viral cultures and for isolation of Mycobacterium spp. from blood
heparin
51
[matching type|Gram-positive cocci]
Neisseria spp., Moraxella catarrhalis
a. pairs
b. tetrads
c. clusters
d. chains
e. encapsulated
f. gram-positive diplococci (lancet-shaped)
g. gram-negative diplococci pathogenic
g. gram-negative diplococci
52
[matching type|Gram-positive cocci]
Staphylococcus, Streptococcus, Enterococcus spp.
a. pairs
b. tetrads
c. clusters
d. chains
e. encapsulated
f. gram-positive diplococci (lancet-shaped)
g. gram-negative diplococci pathogenic
a. pairs
53
not recommended for collection
swabs
54
gram stain was developed empirically by the Danish bacteriologist _____________ in ______
Christian Gram, 1884
55
[sputum]
collection methods for sputum
expectorated or induced
56
Tissues can be prepared for culture by ____________, in which the tissue is ground in a tissue grinder
homogenization
57
[incubation]
Some bacteria are capnophiles and require an increased concentration of CO2; this can be achieved by a ________, a __________, ____, or ______
candle jar, CO2 incubator, jar, bag
58
[smears from thin fluids]
The cytocentrifugation process deposits __________ and ____________ from the specimen onto the surface of a glass slide as a monolayer
cellular elements, microorganisms
59
a technique used to separate biological macromolecules, such as nucleic acids and proteins
electrophoresis
60
Urine specimens are inoculated using a __________________
quantitative isolation
61
[matching type|Gram-positive cocci]
Staphylococcus, Peptostreptococcus, Stomatococcus spp.
a. pairs
b. tetrads
c. clusters
d. chains
e. encapsulated
f. gram-positive diplococci (lancet-shaped)
g. gram-negative diplococci pathogenic
c. clusters
62
inoculated plates must be incubated anaerobically at ______ to _______
35°C to 37° C
63
[stains]
Stains can be categorized as _______, ________, __________
simple stains, differential stains, probe-mediated stains
64
Bacteria with thick cell walls containing teichoic acid retain the crystal violet–iodine complex dye after decolorization and appear deep blue
Gram-positive bacteria
65
[urethra]
Flexible swab inserted ______ for ________
2-4cm, 2-3 secs
66
[nasal]
insert premoistened swab ______ into nares
1 inch
67
[matching type|Gram-positive cocci]
Micrococcus, Staphylococcus, Peptostreptococcus spp.
a. pairs
b. tetrads
c. clusters
d. chains
e. encapsulated
f. gram-positive diplococci (lancet-shaped)
g. gram-negative diplococci pathogenic
b. tetrads
68
[Acid-fast Staining of Mycobacteria]
The primary stain binds to ____________ in the cell walls of the mycobacteria and is retained after the decolorizing step with __________
mycolic acid, acid alcohol
69
_____________ damages these thin lipid walls and allows the stain complex to wash out
decolorizer (alcohol-acetone)
70
most sterile method in urine collection
suprapubic aspirate
71
[levels of specimen prioritization]
level 3
- catheter tip
- urine
- tissue for quantitation
72
[Acid-Fast Staining of Mycobacteria]
different types of stains
- Fluorescent stain
- Kinyoun stain
- Modified Kinyoun stain (Partial Acid-Fast)
- Ziehl-Neelsen stain
73
[smears from thin fluids]
__________________ is preferred for this type of specimen, if available
cytocentrifugation
74
[body fluids]
mL to collect for CSF viral studies
>1mL
75
The tips of swabs may contain ______, _________, or __________
cotton, Dacron or calcium alginate
76
[levels of specimen prioritization]
level 1
- amniotic fluid
- blood
- brain
- cerebrospinal fluid
- heart valves
- pericardial fluid
77
[body fluids]
mL to collect
>1mL
78
[blood culture]
used to isolate anaerobic blood culture
anaerobic blood culture
79
[smears from thin fluids]
“Thin” specimens of fluids such as urine, cerebrospinal fluid (CSF), and transudates should be _________ but not ________ on the slide
drop, spread
80
synthesizes new strands of DNA
primer extension
81
__________ tend to have excessive fatty acids, which may be toxic to certain bacteria
cotton-tipped swabs
82
a compound made from seaweed
agarose
83
[eye: conjunctiva]
collect using ___________ moistened with ___________ on both eyes
separate swabs, sterile saline
84
[Acid-Fast Staining of Mycobacteria]
results:
Mycobacteria stain red, whereas the background material and non–acid-fast bacteria stain blue
Kinyoun & Ziehl-Neelsen stains
85
[Rapid Modified Wright-Giemsa Stain]
results:
- Blood cells stain as with Wright stain.
- The cytoplasm is __________.
- The chromatin of white cells is ________.
- Bacteria are _______.
- Parasitic protozoan nuclei are _______.
- basophilic
- purple
- blue
- red
86
four (4) levels of specimen prioritization
1. critical / invasive
2. unpreserved
3. quantitation required
4. preserved
87
[Nucleic Acid Hybridization Techniques]
_________________ is also called duplex formation
hybridization process
88
____________ to color all cells and background material a deep blue
crystal violet (hexamethyl-p-rosaline chloride)
89
sterile containers except for stool specimens, which can be collected in ______, _________ containers
clean, leakproof
90
[levels of specimen prioritization]
level 4
- feces in preservative
- urine in preservative
- swabs in holding medium (aerobic & anaerobic)
91
[incubation]
______________ grow with reduced oxygen and increased CO2 and can be isolated using jars or bags
microaerophiles
92
[other stains]
It binds to the nucleic acid of the cell and fluoresces as a bright orange when a fluorescent microscope is used
acridine orange
93
[other stains]
a fluorochrome dye that stains both gram-positive and gram-negative bacteria, living or dead
acridine orange
94
[matching type|Gram-positive cocci]
Streptococcus pneumoniae
a. pairs
b. tetrads
c. clusters
d. chains
e. encapsulated
f. gram-positive diplococci (lancet-shaped)
g. gram-negative diplococci pathogenic
f. gram-positive diplococci
95
[The routine primary plating media include the following items]
1. __________ agar plate
2. _______ medium for fastidious organisms for normally sterile body fluids or a site in which fastidious organisms are expected
3. ________ and ________ medium for enteric gram-negative bacilli for most routine bacterial cultures
4. _________ medium for gram-positive organisms for specimens in which mixed gram-positive and gram-negative bacteria are found
5. Additional _________ or ___________ for specific pathogens as needed
6. ___________ may be used as a supplement with specimens from sterile body fluids, tissues, lesions, wounds, and abscesses
1. nonselective
2. enriched medium
3. selective, differential
4. selective
5. selective media, enrichment broth
6. broth medium
96
aspirate fluid with ________ if eardrum is intact
needle
97
[blood culture]
used to isolate aerobic bacteria
aerobic blood culture
98
The most common nucleic acid stain used after separation by agarose gel electrophoresis is ________________
ethidium bromide
99
__________________ is used to separate RNA and DNA
agarose gel electrophoresis
100
[true or false]
stool specimens can be refrigerated
true
101
[body fluids]
mL to collect for CSF fungal studies
>2mL
102
[body fluids]
mL to collect for CSF bacterial culture
>1mL
103
[other stains]
appear green within pink-appearing or red-appearing bacterial cells
endospore stain: Schaeffer-Fulton
104
[smears from swabs]
smears should not be prepared from a _____ after it has been used to inoculate culture media
swab
105
Stools for Clostridium difficile toxin assay should be collected ______________ and can be refrigerated; if the delay is expected to be longer than 48 hours, the specimen should be frozen at _______
without a preservative, -70 degrees C
106
appears as a white chalky substance in the specimen and masks the appearance of parasites under the microscope
barium
107
[other stains]
used to locate bacteria in blood cultures and other specimens where discerning bacteria might otherwise be difficult
acridine orange
108
[other stains]
DNA stain
acridine orange
109
two (2) types of blood culture
- aerobic
- anaerobic
110
[Rapid Modified wright-Giemsa Stain]
This neutral dye is a combination of basic ___________ and ________that attach to oppositely charged sites on proteins. The results are ____________
thiazine dye, eosin, metachromatic
111
use _______ if eardrum is ruptured
swab
112
[smears from thick liquids / semisolids]
The swab is _________ in the specimen for several seconds and used to prepare a thin spread of material on the glass slide for staining and viewing.
immersed
113
[specimen preparation]
1. Specimens such as sterile body fluids, pus, urine, and sputum are ____________ onto selected media
2. Large volumes of sterile body fluids are __________ to increase the recovery of bacteria.
3. If the volume of fluid is greater than 1 mL, the specimen can be centrifuged for ________ at ________
4. If the specimen consistency is thin enough to avoid filter clogging, filtration with a _____________ can be performed
5. After filtration, the filter is removed and placed on the surface of an ________
1. inoculated directly
2. concentrated
3. 20 min, 3000 x g
4. Nalgene filter unit
5. agar plate
114
[incubation]
Most routine bacterial cultures are held for ___ to _______
48 to 71 hours
115
specimens that need to be refrigerate
- catheter tips (IV)
- CSF (viruses)
- ear (outer)
- feces (unpreserved)
- sputum
- urine (unpreserved)
116
used to isolate bacteria from blood
blood culture
117
If cerebrospinal fluid is not processed immediately, it can be stored in a _______ incubator for ________
35 degrees C, 6 hours
118
[blood culture]
disinfect using?
- alcohol
- iodine
119
[body fluids]
mL to collect for CSF AFB
>2mL
120
All unstained elements are subsequently counterstained red by ____________
safranin dye
121
The specimen should be submitted on two swabs; one is used for the ___________, and the other is used to make the __________
culture media, direct smear
122
[inner ear]
remove debris or crust with __________
saline moist swab
123
[incubation]
Cultures for anaerobes and broth cultures may be held for ___ to ______
5 to 7 days
124
[preservatives]
if the specimen is delayed longer than 2 hours, the specimen can be added to ______________
Cary-Blair transport media
125
[levels of specimen prioritization]
level 2
- body fluids
- bone
- drainage from wounds
- feces
- sputum
- tissue
