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MDL 252 Microbiology 2 > Unit 1 > Flashcards

Unit 1 Flashcards

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1
Q

Validity

A

how accurate a test is

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2
Q

Reliability

A

how often the expected result shows

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3
Q

SOP

A

standard operating procedures

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4
Q

Reference organism

A

ATCC strains - behave like an actual specimen in both physical and chemical characteristics, utilized to confirm the validity and reliability of media, reagents and biochemical procedures

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5
Q

ATCC

A

American Type Culture Collection

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6
Q

Exempt media

A

Certain media will not require user testing, based on CLSI guidelines. Manufacturer certification provided

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7
Q

Non-exempt media

A

User-prepared. Keep records of sterility, testing with QC organisms of all new batches

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8
Q

Panic values

A

communicated immediately to an authorized clinician and documented. Have read back to you

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9
Q

Turnaround time

A

time to complete test from sample arrival to results reported

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10
Q

QC

A

Internal activities that ensure diagnostic test accuracy

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11
Q

QA

A

external activities that ensure diagnostic test accuracy

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12
Q

Patent outcomes

A

reduced length, cost of stay, TAT diagnosis, customer satisfaction

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13
Q

Benchmarking

A

compare your labs results to that of your peers

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14
Q

Qualitative AST

A

measured by the quality

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15
Q

Quantitative AST

A

measured by the quantity

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16
Q

MBC

A

Minimum bactericidal concentration

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17
Q

SBT

A

Serum Bactericidal Tests

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18
Q

Microdilution

A

technique used to measure antibiotic susceptibility in which the drug is diluted in a broth

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19
Q

Peak level

A

draw when the dosage is expected to be highest

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20
Q

Trough level

A

draw before patient’s next dose

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21
Q

Intrinsic resistance

A

results from the normal state of organism

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22
Q

Acquired resistance

A

altered physiology and structure changes in organism

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23
Q

Mode of Action

A

how an antimicrobial funtions

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24
Q

Synergy

A

activity greater than activity of single most active drug

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25
Q

Antagonism

A

activity less than activity of single most active drug

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26
Q

Drug of choice

A

antibiotic treatment that will normally work against organism class

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27
Q

McFarland Standard

A

reference to adjust the turbidity of bacterial suspensions so the number of bacteria will be within a given range to standardize testing

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28
Q

Zone of inhibition

A

area around antimicrobial which is lysed

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29
Q

Interpretative categories

A

Susceptible
Intermediate
Resistant

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30
Q

Supplemental tests

A

additional confirmatory tests

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31
Q

Beca lactamase

A

enzymes that destroy penicillins and/or caphalosporins and are produced by a variety of bacteria

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32
Q

Emperic therapy

A

beginning antibiotic treatment before confirmed test results

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33
Q

Bacteriostatic

A

inhibits but does not kill

Ex. Chloramphenicol, erythromycin, clindamycin, tetracycline

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34
Q

Bacteriocidal

A

kills the target organism

Ex. aminoglycosides, beta-lactams, vancomycin, quinolones

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35
Q

Susceptible

A

infection caused by the tested organism may be treated with a recommended dose of antimicrobial

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36
Q

Intermediate

A

isolate may be inhibited by attainable concentrations of certain drugs

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37
Q

Resistant

A

isolates are not inhibited by the concentration of antimicrobial achievable with a recommended dose

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38
Q

MIC - Minimal Inhibitory Concentration

A

quantitative monitoring drug dosage schedules in serum or when diffusion tests are equivocal or impractival

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39
Q

MBC testing

A

Minimal bactericidal concentration (continuation of MIC)

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40
Q

How to read and interpret disk diffusion zone sizes

A

measure lysed area in mm by ruler. Compare to CLSI standards of resistance

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41
Q

Reading dilutions to determine MIC value

A

After plate is incubated the tech checks growth with the control. If a dilution shows the bottom two wells but not the top two then the MIC value is the lowest number you DONT see growth in

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42
Q

significance of SBC

A

Modification of broth dilution method that measures the bactericidal activity from patients serum during therapy against the bacterial pathogen isolated from the patient

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43
Q

SBC sample

A

patient’s serum

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44
Q

When to perform AST testing

A

a. Isolate clinical significant?
b. chance of resistance
C. standard methods avaliable

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45
Q

Beta Lactam Spectrum

A

Both

46
Q

Beta Lactam Mode of Action

A

inhibit cell wall synthesis

47
Q

Beta Lactam Examples

A

Ampicillin
Piperacillin/Tazobactam
Cephazolin
Imipenem

48
Q

Beta Lactam Bacterio_____

A

Bacteriocidal

49
Q

Oxazolidinones spectrum

A

Gram +

50
Q

Oxazolidinones Mode of Action

A

initiates protein synthesis

51
Q

Oxazolidinones Examples

A

Linezolid

52
Q

Oxazolidinones Bacterio_____

A

Bacteriostatic

53
Q

Aminoglycosides Spectrum

A

Gram + and gram - not anaerobic

54
Q

Aminoglycosides Mode of Action

A

inhibit protein synthesis

55
Q

Aminoglycosides Examples

A

Gentamicin

56
Q

Aminoglycosides

Bacterio_____

A

Bacteriocidal

57
Q

Glycopeptides Spectrum

A

Gram + topical

58
Q

Glycopeptides Mode of Action

A

inhibit bacteria cell wall synthesis

59
Q

Glycopeptides Examples

A

Vancomycin

60
Q

Glycopeptides Bacterio_____

A

Bacteriocidal

61
Q

Macrolides Spectrum

A

Gram +

62
Q

Macrolides Mode of Action

A

Protein synthesis

63
Q

Macrolides Examples

A

Erythromycin

64
Q

Macrolides

Bacterio_____

A

Bacteriostatic

65
Q

Fluoroquinolones spectrum

A

Both

66
Q

Fluoroquinolones Mode of Action

A

inhibit DNA synthesis by binding DNA gyrases

67
Q

Fluoroquinolones Examples

A

Levofloxacin

68
Q

Fluoroquinolones

Bacterio_____

A

Bacteriocidal

69
Q

Azoles Spectrum

A

Fungi

70
Q

Azoles Mode of Action

A

disrupts fungal cell membrane

71
Q

Azoles Examples

A

Fluconazole

72
Q

Azoles Bacterio_____

A

Bacterostatic

73
Q

Supplemental AST testing - when

A

detect complicated resistance mechanisms not evident on routine AST testing

74
Q

Supplemental AST testing predictor drugs

A

oxacillin disk screen for penicillin resistance in strep pneumoniae

75
Q

Beta lactamase testing

A

Visual detection of beta lactamase hydrolysis - colormetric reaction
Enzyme will disrupt the beta lactam ring. Wont bind to PBP and inhibit cell wall synthesis

76
Q

Beta lactamase method

A

Chromogenic cephalosporin and acidometric - included on Neisseria test strip. Not useful for Enterobacteriaceae or Pseudomonas

77
Q

You have been asked to perform QC (quality control ) on a new kit of API20E strips. . Is this function preanalytic, analytic, or postanalytic

A

Analytic

78
Q

You have been asked to perform QC (quality control ) on a new kit of API20E strips. Name 3 possible organisms that would be appropriate for QC.

A

Gram negative rods from Enterobacteriaciae group or 2 from Entero and 1 non-Entero

79
Q

You have been asked to perform QC (quality control ) on a new kit of API20E strips. What criteria should determine the organisms to be used?

A

Organisms that represent positive and negative reactions for all 20 test wells.

80
Q

You have been asked to perform QC (quality control ) on a new kit of API20E strips. How can you be certain of the biochemical characteristics of the organisms used?

A

Using specific ATCC organisms recommended by the manufacturer

81
Q

You have been asked to perform QC (quality control ) on a new kit of API20E strips. What type of information should be documented in the QC record for this testing?

A 
Lot number
Expiration date
Test results
Tech performing test
Date
82
Q

You have been asked to perform QC (quality control ) on a new kit of API20E strips. If erroneous results are obtained, name 3 sources of error.

A

Tech error - inoculum too heavy/light
Mixed culture
Incubation time/temp
Problems with kit - manufacturer or transport

83
Q

A patient has been diagnosed with a UTI. A culture is sent to the lab and K. pneumonia has been identified. Name 2 testing methods that can be utilized to determine the susceptibility of various antimicrobials.

A

Disk diffusion and MIC

84
Q

A patient has been diagnosed with a UTI. A culture is sent to the lab and K. pneumonia has been identified. Name 2 bacteriocidal antimicrobials that may be effective.

A

Gentamycin
Ceftriaxone
Levofloxacin

85
Q

A patient has been diagnosed with a UTI. A culture is sent to the lab and K. pneumonia has been identified.. Name 2 bacteriostatic antimicrobials that may be effective

A

Tetracycline
Trimethoprim
Tigecycline

86
Q

A patient has been diagnosed with a UTI. A culture is sent to the lab and K. pneumonia has been identified. The lab did not test this organism for vancomycin, why?

A

Ineffective against gram neg organisms

87
Q

A patient has been diagnosed with a UTI. A culture is sent to the lab and K. pneumonia has been identified. Should levoflaxacin be tested?

A

Yes. Generally it is effective but acquired resistance is always possible.

88
Q

A patient has been diagnosed with a UTI. A culture is sent to the lab and K. pneumonia has been identified. Does this organism exhibit intrinsic resistance to any antimicrobials?

A

Yes. Ampicillin and other beta lactams

89
Q

Conditions for disk diffusion testing of S. aureus must come from which document?

A

CLSI

90
Q

What type of light source should be used to view a disk diffusion plate

A

Reflected light

91
Q

Supplemental AST testing is often required. What is the necessity for aminoglycoside screens

A

Detection of high-level resistance (HLAR) aminoglycoside

92
Q

What is the test method utilized when CRE type resistance is suspected?

A

Modified Hodge Test

93
Q

Name 2 methods for measuring the turbidity of the inoculum

A

McFarland Standard

Spectrophotometer

94
Q

Name 2 criteria for selection of antimicrobial agents to be tested

A

Site of infection
method
availability
known resistance patterns

95
Q

Class/spectrum of activity for:

Ampicillin

A

Beta lactam, both

96
Q

Class/spectrum of activity for:

Cefazolin

A

Beta lactam, both

97
Q

Class/spectrum of activity for:

Clindamycin

A

Lincosamide, gram pos (rarely gram neg)

98
Q

Class/spectrum of activity for:

Levofloxacin

A

quinolone, both

99
Q

Class/spectrum of activity for:

Piperacillin

A

Beta lactam, both

100
Q

Class/spectrum of activity for:

Ticarcillin/Clav acid

A

Beta lactam combo, both

101
Q

Class/spectrum of activity for:

Trime/Sulfa

A

combo, both

102
Q

What are the possible problems and what measures should be taking if the following are observed when performing QC? Several E. coli zones are too large

A

Check inoculum
medium depth
medium pH

103
Q

What are the possible problems and what measures should be taking if the following are observed when performing QC? Small colonies within the zone of tetracycline with S. aureus

A

Mixed culture
reisolate
resistant mutants

104
Q

What are the possible problems and what measures should be taking if the following are observed when performing QC? Gentamycin zone too small with P. aeruginosa

A

Ca and/or Mg level too high in medium

105
Q

What is the relationship between MIC and zone size?

A
  1. Regression graph

2. MIC breakpoints plotted against zone sizes, regression line is drawn. DD breakpoints are where lines intersect.

106
Q

An organism with an increased MIC value will be expected to have an increased or decrease zone size?

A

Decreased

107
Q

Name the 3 weekly QC organisms used for KB method

A

E. coli - 25922
P. aerug - 27853
S. aureus - 25923

108
Q

Describe the action of the amoxicillin or ticarcillin/clavulanic acid combo

A

2 beta lactams- lactam/lactamase inhibitor. Inhibitor renders B-lactamase incapable, beta lactam drug exerts its activity

109
Q

An oxacillin disk is used to test S. pneumoniae for penicillin. Why?

A

Due to increased resistance observed with penicillin, OX is more sensitive and reliable indicator.

110
Q

Define empiric antimicrobial therapy

A

therapy that is started before knowing organism or susc. profile

MDL 252 Microbiology 2 (7 decks)

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