Unit 1 Flashcards

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1
Q

To survive, microbial inhabitants have learned to adapt by varying all of the following, except

A

Bacterial shape

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2
Q

Who has considered the father of protozoology and bacteriology?

A

Anton van Leeuwenhoek

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3
Q

Prokaryotic cells have which of the following structures in their cytoplasm?

A

Ribosomes

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4
Q

The form of DNA is commonly found in eukaryotic cells

A

Linear

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5
Q

The nuclear membrane in prokaryotes is

A

Missing

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6
Q

A microorganism that is a unicellular organism and lacks a nuclear membrane and true nucleus belongs to which classification?

A

Bactria

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7
Q

In the laboratory, the clinical microbiologist is responsible for all the following, except

A

Selecting treatment for patients

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8
Q

What enables the microbiologist to select the correct media for primary culture and optimize the chance of isolating a pathogenic organism?

A

Understanding the growth requirements of potential pathogens at specific body site

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9
Q

A clinical laboratory scientist is working on the bench, reading plates, and notices that a culture has both a unicellular form and a filamentous form. What type of organism exhibits these forms?

A

Fungi

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10
Q

All of the following statements are true viruses, except

A

Viruses do not need host cells to survive and grow

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11
Q

Diagnostic microbiologists apply placement and naming bacterial organisms into all the following categories, except

A

Order

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12
Q

Bacterial species that exhibit phenotypic differences are considered

A

Subspecies

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13
Q

What structure is described as a phospholipid bilayer embedded with proteins and sterols that regulates the type and amount of chemicals that pass in and out of a cell?

A

Plasma membrane

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14
Q

What makes the interior of the plasma membrane potentially impermeable to water-soluble molecules?

A

The hydrophobic tails of the phospholipids molecules are found there

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15
Q

The function of a cell wall is to

A

Provide rigidity and strength to the exterior of the cell

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16
Q

Name the numerous short (3-10 um) projections that extend from the cell surface and are used for cellular locomotion

A

Cilia

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17
Q

A microbiology technologist performs a traditional bacterial stain on a colony from a wound culture that is suspected to contain bacteria from the genus clostridium. The unstained areas in the bacterial cell observed by the technologist are called

A

Endospores

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18
Q

This constituent of gram-positive cell walls absorbs crystal violet but is to dissolved by alcohol, thus giving the gram-positive cell its characteristic purple color

A

Peptidoglycan

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19
Q

Mycobacteria have a gram-positive cell wall structure with a waxy layer containing these two compounds

A

Glycolipids and mycolic acid

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20
Q

When performing a Gram stain on a gram-negative organism, the crystal violet is absorbed into this outer cell wall layer, and then washed away with the acetone alcohol. What is the main component of the outer layer of the cell wall?

A

Lipopolyaccharide

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21
Q

The three region of the lipopolysaccharide include all of the following except,

A

Myocolic acid

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22
Q

The outer cell wall of the gram-negative bacteria serves three important functions, which includes all the following except

A

It provides an attachment site for flagella, which will act in locomotion

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23
Q

Mycoplasma and Ureaplasma spp. must have media supplemented with serum or sugar as nutrients and because

A

The lack cell walls

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24
Q

Whaat is the purpose of a capsule?

A

Act as a virulence factor in helping the pathogen evade phagocytosis

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25
Q

The three basic shapes of bacteria include all the following except

A

Cell wall deficient

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26
Q

The gram stain is a routine stain used in bacteriology to determine gram-positive and gran-negative based on the

A

Composition of the bacterial cell wall

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27
Q

In what staining procedures does carbofuchsin penetrate the bacterial cell wall through heat or detergent treatment?

A

Acid-fast stain

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28
Q

What stain is used for medically important fungi?

A

Lactophenol cotton blue

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29
Q

All of the following are types of media, excerpt

A

Fastidious

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30
Q

Which of the following environmental factors influence the growth of bacteria in the laboratory?

A

All of the above
* pH
* temperature
* Gaseous composition of the atmosphere

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31
Q

Some bacteria grow at 25-42 C, but diagnostic laboratories routinely grow pathogenic bacteria at what temperature?

A

35C

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32
Q

Which of these bacteria cannot grow in the presence of oxygen?

A

Obligate anaerobe

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33
Q

What class of organisms, such as the Streptococcus sp., can survive in the presence of oxygen but do not use oxygen in its metabolic processes?

A

Aerotolerant anaerobe

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34
Q

The laboratory receives a specimen in which the doctor suspects that the infecting organism is carbon dioxide. It is therefore classified as what type of bacteria?

A

Capnophilic

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35
Q

The following describes the log phase of bacterial growth

A

Bacteria doubling with each generation time

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36
Q

Diagnostic schemes is the microbiology laboratory typically analyze each unknown bacterium’s metabolic processes for all the following, except

A

Energy utilization for metabolic processes

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37
Q

Which is a biochemical process carries out by both obligate and facultative anaerobes?

A

Fermentation

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38
Q

What type of fermentation produces lactic, acetic, succinic, and formic acids as the end products?

A

Mixed acid

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39
Q

If bacteria utilize various carbohydrates for growth, they are usually detected by

A

Acid production and change of color from the pH indicator

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40
Q

In the medical microbiology laboratory, the ability of gram-negative bacterium to ferment this sugar is the first step in its ID

A

Lactose

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41
Q

A ________ is a single, closed, circular piece of DNA that is supercoilded to fit inside a bacterial cell

A

Chromosome

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42
Q

Genes that code for antibiotic resistance are often found on small, circular pieces of DNA. The DNA pieces are called

A

Plasmids

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43
Q

What process involves transferring or exchanging genes between similar regions on two separate DNA molecules?

A

Recombination

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44
Q

A microbiologist is working with two separate cultures of the same organism. The bacteria in one culture are resistant to penicillin, whereas the bacteria in the other culture are susceptible to penicillin. The bacteria from both cultures are mixed together, and all the resulting bacteria are resistant to penicillin. What caused this phenomenon?

A

The plasmid carrying the resistance gene was transferred to the susceptible population of bacteria

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45
Q

Diphtheria is a disease produced by corynebacterium diphtheria. However, not all C. Diphtheriae bacteria produce the toxin that causes this disease. To produce the toxin, the bacteria must first become infected with a bacteriophage. The process by which bacterial genes are transferred to new bacteria by the bacteriophage is called

A

Transduction

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46
Q

Lysogeny occur when

A

Genes present in the bacteriophage DNA are incorporated into the bacteria’s genome

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47
Q

These are enzymes that cut the bacterial DNA at specific locations

A

Restriction enzymes

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48
Q

Organisms that participate in a biological relationship where both benefit from one another are called

A

Symbionts

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49
Q

Parasitism is

A

A biological relationship in which one species gains benefits at the expense of the host

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50
Q

This bacterial state occurs when a host harbors a disease-causing organism, but does not show signs of disease

A

Carrier

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51
Q

Healthy people are colonized by many different sites. These bacteria are referred to as

A

Indigenous flora

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52
Q

Diabetics may sometimes be infected with their own resident flora. This type of infection is called

A

An opportunistic infection

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53
Q

Mechanism used b the skin to prevent infection and protect the underlying tissue from invasion by potential pathogens include all the following, except

A

Antibiotics that inhibit many microorganisms

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54
Q

A laboratory professional is testing a new antimicrobial soap. The tech washes her forearm then does a culture of the skin. Which organisms should she most likely expect to find growing in the culture?

A

Staphylococcus epidermis and propionbacterium

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55
Q

What mechanism allows strict anaerobes to grow in the cervices and areas between the teeth when plaque is present?

A

A low oxidation-reduction potential occurs at the tooth surface under the plaque

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56
Q

The stomach can be considered a first line of defense against microbial infections because

A

Most microorganisms are susceptible to to the acid pH of the stomach

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57
Q

This type of bacteria is able to live in the colon with little to no oxygen and is the predominant organisms

A

Anaerobes

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58
Q

After perforation of the colon, surgeons must guard against infection in the _________ because of leakage of the contents of the colon

A

Peritoneal cavity

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59
Q

The human body is constantly challenged by pathogens in the environment. It is not infected by every pathogen it encounters because the microbial flora

A

Produce conditions at the microenvironmental level that block colonization

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60
Q

The ability of an organism to produce disease in an individual is called

A

Pathogenicity

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61
Q

A patient with a n indwelling catheter develops a fever and lethargy. In addition, the urine in the catheter bag has turned a brownish color and smells foul, which suggests an infection is present. What type of infection does this describe?

A

Iatrogenic

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62
Q

The smaller the number of microorganism necessary to cause infection in competent Host, the more _______ ad the microorganism

A

Virulent

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63
Q

Factors the determine the pathogenicity and increase the virulence of organism include all the following, except

A

An organisms ability to produce infection when host conditions change

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64
Q

The most common bacterial characteristic that allows for evasion of phagocytosis by the host is called

A

Polysaccharide capsule

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65
Q

This is a leukocidin that is lethal to leukocytes and produces by staphylococci

A

Panton-valentine

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66
Q

Changes in these host structures can result in lower virulence of microorganism

A

Adhesion receptors

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67
Q

After attachment to host cells, a pathogen may use the following mechanisms to establish itself and cause disease, except

A

Produces lysozyme to kill the host cell

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68
Q

Dissemination of a pathogen is

A

When infection with a pathogen spreads from the initial infection site to distant site such as organs and tissues

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69
Q

A physician notices that several patients are infected with clostridium difficile, but only a few of the patients are symptomatic for disease. The reason for this discrepancy is

A

Only those strains of the organsisms carrying the extrachromosomal DNA coding for the toxin gene will produce ten and cause the individuals to be symptomatic

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70
Q

The effects of endotoxins consist of dramatic changes in all the following, except

A

Fluid imbalance

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71
Q

A patient is brought to the emergency room with the following symptom: body temperature of 102 F, low blood pressure, elevated WBC, and disseminated intravascular coagulation. This person has gram-negative rods growing in the blood. What is responsible for these symptoms?

A

Endotoxin

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72
Q

Healthy skin secretes these substances to help prevent colonization by transient and possibly pathogenic organisms

A

Long-chain fatty acids

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73
Q

Lysozyme is

A

A low-molecular-weight enzyme that hydrolyzes the Peptidoglycan layer of bacterial wall

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74
Q

Interferon is a substance produced by the body that inhibits viral replication. Interferon accomplishes this task by

A

Binding to surface receptors that stimulate the cell to synthesize enzymes that inhibit viral replication over several days

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75
Q

All of the following activities must occur for phagocytosis to take place and be effective in host defense, except

A

Migration of lymphocytes to the area of infection (chemotaxis)

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76
Q

This process results in enhanced phagocytosis by neutrophils

A

Opsonization

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77
Q

One of the most effective defenses bacteria have against phagocytosis is

A

The capsule

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78
Q

Innate immunity consists of which of the following components?

A

All of the above are part of the innate immune system

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79
Q

The major constituents of the adapative of specific immune response are

A

Lymphocytes

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80
Q

The class of antibodies is usually found as a pentameter

A

IgM

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81
Q

A subsequent exposure to the same antigen elicits a(n) ________, characterized by a rapid increase in IgG antibody associated with higher levels, a prolonged elevation, and a more gradual decline in antibody levels

A

Anmnestic immune response

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82
Q

These are low-molecular-weight proteins secreted by T cells

A

Lymphokines

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83
Q

Immunity to intracellular bacterial pathogens, such as mycotoxins bacterium tuberculosis, is primarily cell mediated, through the activities of

A

T lymphocytes, lymphokines, and a macrophages

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84
Q

Pathogens can be transmitted through all the following routes, except

A

Handwashing

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85
Q

Because infections can be encountered via the air, _______can cause transmission of some pathogens

A

Coughing

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86
Q

The resulting disease from this route of transmission is a disease of animals that is transmitted to humans

A

Zoonotic

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87
Q

The chemical or physical method that destroy all forms of life is called

A

Sterilization

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88
Q

Organisms that are the most resistant to heat, chemicals, and radiation are

A

Prions

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89
Q

After using the phone, the laboratory tech sprayed the receiver with a chemical spray. This process will kill a defined scope of microorganisms. What is this process called?

A

Disinfection

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90
Q

before performing a phlebotomy, the phlebotomist will clean the area on a patients arm with a substance before inserting needle. This substance is called an

A

Antiseptic

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91
Q

All of the following factors play a significant role in the selection and implementation of the appropriate method of disinfection, except

A

Humidity

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92
Q

When eliminating organisms from inanimate objects, higher numbers of organisms require longer exposure time because

A

It takes longer to eliminate 99% of microorganisms

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93
Q

If this is present on a surface to be disinfected, it can shield microorganisms from the disinfectant or inactivate the disinfectant. What is this substance?

A

Organic material

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94
Q

Disinfectants are usually used at this temperature

A

20-22 C

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95
Q

Pasteurization achieves______?

A

Disinfection

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96
Q

Chemosterilizers exert their killing effect through all the following mechanisms, except

A

Inactivating enzyme substrates

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97
Q

Alcohol use this mechanism to inactivate microorganisms

A

Denature proteins

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98
Q

The tech needs to sterilize a piece of equipment that cannot be autoclaved or gas sterilized because the equipment contains lenses, metal, and rubber components. What solution should be used to sterilize this piece of equipment?

A

Glutaraldehyde

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99
Q

For the most effective microbial killing, all iodophors must be properly diluted because

A

There must be enough free iodine to kill the microorganisms

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100
Q

Even though hypochlorites are inexpensive and have broad range of microbes that they kill, they are not used as sterilants because of

A

Long exposure time for sporicidal action

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101
Q

Many materials in hospitals that must be sterilized cannot withstand steam sterilization. Gas sterilization is used instead, using this gas

A

Ethylene oxide

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102
Q

Why should health care workers wash their hands after coming into contact with a patient?

A

To reduce the spread of pathogenic bacteria from one individual to another

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103
Q

High-level disinfectants are active against all the following, except

A

Parasites

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104
Q

This agency regulates the use, sale, and distribution of antimicrobial pesticide products from certian inanimate, hard, nonporous surfaces, or incorporates into substances under the pesticide law

A

Antimicrobial division of environmental protection agency (EPA)

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105
Q

These two alcohols are effective in killing enveloped viruses such as Hepatitis B virus (HBV)

A

70% isopropyl and 95% ethanol

106
Q

This chemical is a saturated 5-carbon dialdehyde that has broad-spectrum activity, rapid killing action, and remains active in the presence of organic matter

A

Glutaraldehyde

107
Q

These disinfectants are cationic, surface-activated agents that work by reducing the surface tension of molecules in a liquid, resulting in the disruption of the cellular membrane of microbes

A

Quaternary ammonium compounds

108
Q

This organization regulates chemical skin antiseptics

A

FDA

109
Q

The main goal of handwashing is to

A

Eliminate transient floras

110
Q

Routine handwashing in health care settings mandates washing as all the following times, except

A

When gloves become soiled during a procedure or dressing change on the same patient

111
Q

The purpose of surgical hand scrubs and waterless hand rubs is to

A

Eliminate the transient flora and most of the resident flora on the skin

112
Q

The most common iodophor used in the US for pre operative skin preparation is

A

Povidone-iodine

113
Q

This topical antiseptic disrupts the microbial cell membrane and precipitates the cellular contents

A

Chlorhexidine gluconate

114
Q

This compound is a diphenhydramine ether and it exerts its bactericidal effects by disrupting the cell wall. It has good activity against gram-positive cocci, but poor activity against fungi. What is its name?

A

Triclosan

115
Q

Laboratory safety includes all the following areas, except

A

Isolation

116
Q

Why is laboratory-acquired infection an obvious hazard for personnel working in a microbiology laboratory?

A

Personnel deal with a variety of infectious agents: viral, fungal, parasitic, and bacterial

117
Q

The comprehensive safety program from the microbiology laboratory needs to fulfill all the following provision, except

A

It is specific to the hospital and does not need to conform to state, local, and federal regulations

118
Q

Processing of patient specimens and handling of actively growing cultures of microorganisms put an employee at risk of potential contact with the infection agent through all the following routes, except

A

Blood splashed onto intact skin

119
Q

All of the following organisms can typically cause infection from aerosolization of specimens, except

A

Staphylococcus aureus

120
Q

What protective measures can a laboratory worker take when working with actively growing cultures to ensure that they do not become infected?

A

Ensure that fungal cultures are sealed and worked in bio safety cabinet

121
Q

The laboratory exposure control plan should contain all the following, except

A

Review of control plan every 5 years

122
Q

Universal/standard precautions require that

A

Blood and body fluids from all patient be considered infectious and capable of transmitting disease

123
Q

Engineering controls and work practice controls to ensure standard precautions are followed include all the following except

A

Fire blankets

124
Q

Standard precautions do not address which of the following

A

Respirators

125
Q

Safety program and work practice controls consist of all of the following except

A

Allowing workers to eat at the bench if it gets busy and they do not have time to take a lunch break

126
Q

All of following are examples of PPE, except

A

Prescription glasses

127
Q

Technicians are doing the morning chemistry run. Once they load the specimens onto the instrument, they remove their gloves to do paperwork in a clean area of the laboratory. What should the technicians do after removing their gloves?

A

Wash their hands

128
Q

The biosafety levels were categorized using all the following criteria, except

A

The bacterial load necessary to cause infection

129
Q

A biosafety level 1(BSL-1) level of containment is used for organisms that

A

Are well classified and not known to cause disease in healthy people

130
Q

A biosafety level 2 (BSL-2) level of containment is used for organisms that

A

Create a moderate potential hazard for employees and the environment

131
Q

Because biosafety level 3 (BSL-3) organisms have the potential for aerosol transmission, and disease with these agents may have serious lethal consequences, all of the following guidelines apply to BSL-3 laboratories, except

A

BSL-3 laboratories should have positive air pressure

132
Q

Biosafety level 4 (BSL-4) organisms are dangerous, exotic and pose an increased risk of aerosol-transmitted infections and life-threatening disease. Two examples of BSL-4 organisms are

A

Marburg and Congo-Crimean hemorrhagic fever

133
Q

OSHA requires laboratories to have this document to ensure that laboratory personnel have a thorough working knowledge of the hazards of the chemicals with which they work

A

Chemical hygiene plan

134
Q

A material safety data sheet (MSDS) contains all the following information, except

A

Classification of a chemical (acid, base, protein)

135
Q

If a laboratory uses hazardous chemicals, it must

A

Keep a chemical inventory and MSDSs on hand

136
Q

Laboratory safety for hazardous chemicals includes

A

Using fume hoods to prevent inhalation of fumes

137
Q

Most institutions use the RACE acronym to respond to a fire emergency. RACE stands for

A

Rescue, alarm, contain, extinguish

138
Q

The best way to care for your back is to prevent back injuries. All of the following are some ways to prevent back injuries, except

A

Carefully lifting heavy objects overhead

139
Q

Three levels of laboratories outlined in the laboratory response network (LRN) include all the following, except

A

First responder

140
Q

In the LRN programs, hospital based microbiology laboratories are classified as this type of laboratory

A

Sentinel

141
Q

Category A bioterrorism agents

A

Pose the highest threat because they are easily transmitted and highly infectious

142
Q

Once bioterrosim is suspected, a sentinel laboratory should perform all culture manipulation using these safety guidelines

A

BSL-3

143
Q

Quality control is designed to

A

Ensure the medical reliability of laboratory data

144
Q

Actual laboratory testing is called an

A

Analytic activity

145
Q

All of the following activities will directly affect the quality of laboratory test, except

A

Accreditation

146
Q

In January 2004, The Joint commission (TJC) implemented performance measurements for organizational systems that are critical to patient safety, quality of care, treatment, and services. This new initiative is called

A

Shared visions new pathway

147
Q

All of the following activities are included in a laboratory quantity control program except

A

Air quality

148
Q

The morning technician arrives at the microbiology laboratory and goes around checking daily temperatures. This person will check temperatures daily on all of the following equipment, except

A

Centrifuges

149
Q

Thermometers used in the laboratory must be calibrated before the are put into use. This is accomplished by

A

Checking against an NIST thermometer

150
Q

Preventive maintenance on an instrument includes all the following except

A

Disinfecting the surface of the instrument

151
Q

Commercial media must have quality control testing performed by the manufacturers. Because of high failure rates, all of the following media must be retested by the hospital laboratory, except

A

Trypticase soy agar with 5% sheep blood

152
Q

Media that do not need to be retested by the hospital laboratory must still undergo observation for all of the following except

A

Organism colony characteristics

153
Q

When a medium needs to be quality controlled because it was prepared in house or because it is complex, all the following rules must be followed except

A

Only media not specified in clinical and laboratory standards institute (CLSI) guidelines should be tested

154
Q

Reagents that should undergo quality control in the microbiology laboratory include all the following except

A

Immersion oil

155
Q

In any susceptibility system, variables that can affect the results the following:

A

*antibiotic potency
*incoculum concentration
*pH

156
Q

Susceptibility testing of control organisms is usually conducted daily until precision can be demonstrated with ______ or _______ days of susceptibility testing using CLS guidelines

A

20; 30; consecutive

157
Q

How can personnel competency be determined?

A

Proficiency testing

158
Q

The following are provisions of CLIA 88 except

A

Revering the employees competency monthly

159
Q

Quality control stock cultures are available from all of the following, except

A

CDC

160
Q

Popular media choices for maintaining stock cultures include

A

Tryptic soy agar deeps

161
Q

Which of the following is an example of a mission statement for an institution?

A

“Working together for a healthy America”

162
Q

All of the following are components of TJC recommendations for establishing performance monitors, except

A

Do

163
Q

Customers of a laboratory include all of the following except

A

Accrediting organizations

164
Q

Multiple unlabeled specimen have been sent to the laboratory from multiple in-patient locations. The laboratory mangager decides corrective action needs to occur. What should be constructed to evaluate and correct the problem?

A

Make a cross-functional team

165
Q

When a broken process fixed?

A

When the problem is prevented from happening again

166
Q

What is benchmarking?

A

Seeking an industry’s or profession’s best practices to imitate and improve

167
Q

When performing tests in the microbiology laboratory, the detection limit of a test refers to the ______ of that test

A

Analytic sensitivity

168
Q

A technician is performing a chemistry test on a control sample. The technician gets the following values for the control: 4.3, 4.3, 4.3, 4.2, 4.4, 4.3, 4.2 and 4.4. The actual value is 4.3. These results are said to be

A

Accurate

169
Q

A test is performed on a group of 10 patients. Six patients have a disease, and four are free or the disease. If six, patients (all known to have to the disease) of this group test positive for the disease, we say that the clinical sensitivity of this test is

A

100%

170
Q

A group of 10 patients are to be tested: six are known to have a disease and four are disease free. if the four disease-free patients tested negative for this disease, what would the clinical specificity of this test be?

A

100%

171
Q

Incidence is

A

The number of new cases of disease over a period of time

172
Q

A test can have a positive and a negative predicative value (NPV). All of the following elements are needed to compute the positive and NPV of a test, except

A

Type of disease being tested

173
Q

Assume that a certian test for group A streptococcus has reported sensitivity and specificity of 90-98%, respectively, and the estimated prevalence for group A streptococcus infection in acute pharyngitis is 5%. What is the PPV of this test?

A

70.3%

174
Q

Usually, negative test results are more reliable in predicting

A

The absence of disease

175
Q

The efficiency of a test indicates

A

The % of patients who are correctly identified as having or not having the disease

176
Q

Screening is

A

Used for testing large population of patients

177
Q

Confirmation is used after

A

Obtaining a positive screening result

178
Q

When choosing a test to perform in your laboratory, an in-house verification is always performed. Verification of a test

A

Serves to establish that the performance parameters of the test are satisfactory

179
Q

Test validation is the ongoing process of providing information that a test is performing correctly. The components of validation include all the following, except

A

Specimen requirements

180
Q

All of the following provide guidelines to ensure the continual correct performance of tests, except

A

CDC

181
Q

Data generated by the laboratory is directly influenced by

A

The quality of the specimen and its condition when received

182
Q

To assist hospital personnel in collecting the highest quality specimen, the laboratory should q

A

Develop a well-written handbook and make it available at every patient care unit

183
Q

The goal of the specimen collector when collecting specimens for culture should be to

A

Maintain the viability of the living organism at the site with minimal contamination

184
Q

All of the following principles of specimen collection are fundamental to ensuring appropriate specimen management, except

A

It is acceptable to delay transport of the specimen to the laboratory if it is in transport media

185
Q

Why is it acceptable for a fecal sample to be collected in a nonsterile container?

A

Manu types of bacteria call the intestinal tract home; the specimen cannot become contaminated

186
Q

Swabs are appropriate for specimens collected from all the following sites, except

A

Urine

187
Q

How should specimen collection instruction be given to the patient to ensure collection of a good specimen for culture?

A

Both verbal and written instruction in simple language

188
Q

Why is clean-catch midstream urine used for a urine culture as opposed a clean catch urine?

A

The first portion of the urine flow washes contaminants from the urethra and the next portion of urine is more representative of the bladder

189
Q

Sputum specimens are often collected for the diagnosis of q

A

Bacterial pneumonia

190
Q

The best way to minimize the amount of upper respiratory flora in a sputum specimen is to follow which of these procedures??

A

Have the patient rinse the mouth with water and expectorate with the aid of a really deep cough directly into a sterile container

191
Q

The specimen of choice for detecting GI pathogens is

A

A stool specimen

192
Q

Proper ID of each specimen includes a label firmly attached to the container with all the following information except

A

Diagnosis

193
Q

To perform a quality laboratory analysis, the laboratory needs specific information regarding the patient and the specimen. What can be critical weak link in the specimen management process?

A

Incomplete information on the requisition

194
Q

The requisition form should provide all the following information, except

A

Patient home address

195
Q

If a test is not considered appropriate for the specimen, the following should happen

A

The laboratory needs to communicate with the physician to determine exactly what needs to be done

196
Q

All specimens must be transported

A

In leakproof secondary containers

197
Q

A safe method of transporting aspirated wound material would be in

A

An anaerobic transport system

198
Q

What is the primary goal in the transportation of specimens to the laboratory?

A

The maintain the specimen as near its original state as possible with minimal deterioration

199
Q

If transport of the specimen is delayed, the specimen can be maintained by all of the following, except

A

Saltwater

200
Q

A night technician is working in microbiology when a CSF specimen comes in. Almost simultaneously, the technician is called to the emergency department to draw blood on seriously injured car crash victims. How would the technician store the CSF until time permits to work on the CSF specimen?

A

Place the specimen in a 35C incubator whee it is good for up to 6 hours

201
Q

Two types of specimens can use preservatives to maintain them until they can be delivered to the laboratory. They are

A

Urine, stool

202
Q

Specimens such as blood, bone marrow, and synovium are mixed with anticoagulants right after collection. Why should this occur?q

A

Organisms become bound up in the clotted material and are difficult to isolate

203
Q

The purpose of transport media is to

A

Ensure the preservation of microorganisms in the specimen

204
Q

In certain instances, it is desirable for specimens to be inoculated directly onto culture media. Specimens for this pathogen can be placed onto a commercial transport system called a James E. Martin Biological Environment Chamber (JEMBEC) system. What pathogen is this?

A

Neisseria gonorrhoeae

205
Q

The shipment of clinical specimens and cultures of microorganisms is governed by a complex set of national and international guidelines issued by

A

The Department of Transportation (DOT) and the U.S. Postal Service

206
Q

How does the DOT define an infectious substance ?

A

A metrical known to contain or is suspected of containing a pathogen that causes disease in humans or animals

207
Q

A technician receives a package from a supplier of quality control microorganisms. The package has a small watertight vial in a larger watertight tube. The larger tube has some bubble wrap around it, but the larger tube is just placed in the fiberboard box. All of the following was right with this packaging, except

A

The primary receptacle was placed into the secondary container with no absorbent material

208
Q

All of the four levels represents a possible scheme for prioritizing the handling of specimens, except

A

Level 4: anticoagulated

209
Q

Types of specimens that can be batch processed, including all the following except

A

Specimens for fastidious organisms

210
Q

All of the following are examples of suboptimal specimens that must be rejected, except

A

The specimen is for a Neisseria gonorrhoeae (GC) culture and submitted in a JEMBEC system

211
Q

The technician in the laboratory has received a specimen that is rejected. The technician calls the physician and tells the physician the specimen is unacceptable and the reason why. The physician insists that the culture needs to be performed on this unacceptable culture. What should the technician do?

A

Plate the culture, but include a comment explaining the potentially compromised test results

212
Q

Notations from the macroscopic (gross) examination of a specimen should include all the following except

A

What type of container the specimen was collected in

213
Q

The direct microscopic examination is a useful tool for all the following reasons, except

A

It can tell the physician what type of normal Flora is present on the smear and if it is anaerobic or aerobic

214
Q

Direct microscopic examinations are not recommended for all the following specimen sources except

A

Urethral discharge from a male

215
Q

Nonselective media supports

A

The growth of most non-fastidious microbes

216
Q

selective media

A

Support the growth of one type or group of microbes, but not another

217
Q

Differential media

A

Support the grouping of microbes based on different characteristics demonstrated in the media

218
Q

Enriched media

A

Allow the growth of fastidious microbes through the addition of certain growth enhancers

219
Q

An enrichment broth is

A

A liquid medium designed too encourage the growth of small numbers of a particular organism while suppressing other flora

220
Q

How is culture media selected for specimen plating?

A

The selection of media to inoculate is based on the type of specimen submitted for culture and the organisms likely to be involved in the infectious process

221
Q

Routine primary plating media include all of the following items, except

A

Special biochemical media

222
Q

What method is used to concentrate specimens to increase recovery of pathogens in the microbiology laboratory?

A

Centrifugation

223
Q

What technique is used to isolate bacterial colonies when inoculating organisms onto an agar plate?

A

Isolation streaking

224
Q

When using the isolation streaking technique, the greatest concentration of organisms (if present) will be in which quadrant??

A

First

225
Q

When using the isolation streaking technique, the most isolated forms of the organism should be in which quadrant?

A

Fourth

226
Q

If a 0.001 mL quantitative loop is used to inoculate plate media for a urine culture, each colony of growth represents how many organisms per mLs in the original sample?

A

1000 organisms

227
Q

Most bacterial cultures are incubated at this temperature range

A

35-37C

228
Q

Aerobes are bacteria that grow

A

In ambient air

229
Q

Microaeorphiles are bacteria that grow

A

In reduced oxygen concentration but increased carbon dioxide concentrations

230
Q

Capnophiles are bacteria that grow

A

An increased carbon dioxide concentrations

231
Q

Anaerobes are bacteria that grow

A

Where little or no oxygen is present

232
Q

Cultures for anaerobes and broth cultures may be incubated for

A

5-7 days

233
Q

All of the following are questions that microbiology technologist will ask while reading and interpreting the growth of cultures, except

A

How long has this culture been incubated?

234
Q

What woke practice have microbiologists incorporated to keep laboratory testing cost-effective while providing optimum patient care?

A

Limited ID procedures

235
Q

When plating a nonroutine culture on primary culture media, the technician should ask all the following questions, except

A

What anaerobic bacteria will be present in this specimen?

236
Q

Nonroutine specimens can include all the following specimen types, except

A

Syringe needles

237
Q

To help the microbiologist report microbiology results to the physician in a timely fashion to ensure the appropriate treatment, the technician may use this report

A

Preliminary

238
Q

Culture results

A

Confirm the correctness of the therapeutic choices already made and implemented

239
Q

All of the following steps should be used to prepare a smear from thick, granular, or mucoid materials, except

A

Take an additional swab and rub it back and forth on the two glass slides to ensure the material is thin enough to read once it is stained

240
Q

When making slides of this materials such as urine and CSF

A

Mark the area of the sample drop on the reverse side with a wax pencil and then place drop of the specimen into the marked area

241
Q

A cytocentrifuge is an excellent method of preparing non viscous fluids, because

A

It deposits cellular elements and microorganisms from the specimen onto the surface of a glass slide a monolayer

242
Q

The purpose of a simple stain is to

A

Color the forms and shapes present

243
Q

In the microbiology laboratory, this instrument is routinely used to examine smears for structures that are too small to be seen with the unaided eye

A

Compound microscope

244
Q

Polymicrobial presentations in smears require more interpretation and must take into account all the following except

A

Method used to make the smear

245
Q

Commonly encountered polymicrobial infections are common in

A

Perirectal abscesses

246
Q

When a laboratory proffessional examines a specimen smear, he or she should be looking for all the following except

A

Mucus

247
Q

Why should laboratory professionals look for contamination of a specimen by normal microbial flora?

A

Contamination of specimens with normal flora that are not collected from sterile sites diminishes the value of the culture studies

248
Q

When examining specimen smears for pathogenic bacteria, this is important to note

A

Intracellular and extracellular forms

249
Q

Because cell wall-damaged bacteria, antibiotic-treated bacteria, or dead bacteria may appear falsely gram-negative, the following are considered “critical cocharactristics” that assist in the interpretation of the smear include

A

Shape size

250
Q

If a symptomatic patient presents to a physician with and infection, the physician will treat the patient with antibiotics. What role does the laboratory play in antibiotic selection if the physician has already treated the patient before receiving the culture results?

A

The physician expects the laboratory to affirm or reject the antibiotic choice made after the presumptive diagnosis

251
Q

All of the following are signs of acute inflammation on a bacterial smear, except

A

Mucus

252
Q

All of the following cell reflect chronic inflammation except

A

Neutrophils

253
Q

A bacterial smear may indicate a polymicrobial infection when

A

More than one morphologic type of bacteria is present on the smear

254
Q

The direct microscopic examination of infected materials, along with specimen site historical information, may suggest modifications in routine culture techniques to allow the isolation of a suspected pathogen. Common modifications include all of the following except

A

Changing the amount of humidity in the incubator

255
Q

Bartletts method for scoring sputum and the Murray-Washington method for contamination assessment associate what with unacceptable sputum specimens?

A

10-20 Squamous epithelial cells/ 10x field

256
Q

Contaminating materials include all of the following except

A

Crystallized Gram stain

257
Q

the most bothersome contaminating materials for the laboratory professional are those that

A

Contain microorganisms that will grow in culture and confuse the culture evaluation

258
Q

Local material that may be added in the criteria for accepting or rejecting a respiratory specimen include all the following except

A

Bacterial ropes

259
Q

To assist the physician and the laboratory professional in interpreting sputum smears, all of the following local materials are quantitated except

A

Mucus

260
Q

What elements should be included in the direct examination of a microbial smear?

A

Only these elements useful in characterizing the specimen

261
Q

You are working in a microbiology laboratory and receive a sputum culture. You perform a Gram stain on the sputum, and get the following results: 3+ gram-positive cocci, greater than 25 epithelial cells/ 10x field, less than 10 neutrophils/10x field, and heavy mucus. What do these results indicate

A

An unacceptable specimen and work up that should be limited to basic ID of bacteria