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BACTE LAB > UNIT 1: Specimen Collection and Handling > Flashcards

UNIT 1: Specimen Collection and Handling Flashcards

1
Q

Types of UTIs (5)

A

Cystitis
Urethritis
Pyelonephritis
Pyelitis
Glomerulonephritis

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2
Q

Etiologic Agents

Enterics (3)

A

Proteus
Enterobacter
Klebsiella

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3
Q

Etiologic Agents in Urine (6)

A

E. coli
Enterics
Enterococcus faecalis
Pseudomonas aeruginosa
Staphylococcus aureus
S. saprophyticus

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4
Q

Preferred specimen used in Urine

A

Clean catch midstream

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5
Q

Other specimens used in urine (3)

A

Straight catheterized urine
Suprapubic aspirates
Collection during cystoscopy

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6
Q

Avoid collecting these 2 specimens in urine:

A

Random voided urine
Foley catheters

They are prone to contamination

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7
Q

T/F: The first portion of the urine stream in clean catch method is the most concentrated, thus it is the preferred portion

A

False

It contains organisms in the urethra; Midstream is preferred

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8
Q

UTIs

Inflammation of the bladder

A

Cystitis

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9
Q

UTIs

Inflammation of the kidney

A

Pyelonephritis

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10
Q

UTIs

Inflammation of the renal pelvis

A

Pyelitis

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11
Q

UTIs

Inflammation of the glomeruli

A

Glomerulonephritis

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12
Q

Specimens collected for urine (6)

A

First Morning
Random
Clean Catch Midstream Urine Specimen
Catheterized
Plastic Bag Collection
Suprapubic Aspiration

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13
Q

Urine specimen collection method for newborns

A

Plastic Bag Collection

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14
Q

T/F: First Morning Urine Specimen is the most concentrated

A

True

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15
Q

Urine

The direct collection of uncontaminated urine from the bladder with the use of a syringe

A

Suprapubic Aspiration

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16
Q

T/F: Suprapubic Aspiration is used for aerobic culture

A

False

Anaerobic culture

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17
Q

The amount of urine left in the bladder after urination

A

Residual urine

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18
Q

T/F: Females are less prone to bladder infections

A

False

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19
Q

Colony count that indicates UTI

A

100,000 CFU/ml and above

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20
Q

Urine culture

Incubation temperature and duration

A

35° for 18-24 hours

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21
Q

Specimen used for the diagnosis of lower respiratory tract infections

A

Sputum

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22
Q

Specimen used to diagnose bacterial pneumonia and pulmonary tuberculosis (PTB)

A

Sputum

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23
Q

Essential volume of collected sputum specime

A

5-10 ml

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24
Q

Sources of sputum sample (3)

A

Expectorated
Induced
Gastric contents

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25
Q

Source of sputum sample for children

A

Gastric contents

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26
Q

How many sputum samples should be collected for PTB?

A

2

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27
Q

Other specimens for PTB (3)

Besides sputum

A

Trastracheal aspirate
Bronchioalveolar Lavage (BAL)
Bronchial washings

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28
Q

Sputum sample for other infections

A

Early morning specimen

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29
Q

T/F: Prior to culture and sensitivity examination, pre-examine the submitted sputum

A

True

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30
Q

Stain used in th microscopic examination of sputum

A

Gram Stain

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31
Q

Used to assess the quality of sputum as it takes into account the ratio of WBCs to squamous epithelial cells as well as the presence of mucus in the specimen

A

Bartlett’s Classification

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32
Q

Bartlett’s Classification for sputum (2)

A

…> 25 leukocytes/LPF
…< 10 epithelial cells/LPF

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33
Q

The specimen of choice for the diagnosis of gastrointestinal pathogens

A

Stool

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34
Q

T/F: Rectal swabs may be used if stool is present on the swab during sample collection

A

True

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35
Q

Stool pathogens (9)

A

C. jejuni
Salmonella
Shigella
E. coli (EHEC, ETEC, EPEC, EIEC)
Vibrio
Y. enterolitica
L. monocytogenes
C. difficile
Mycobacterium Avium Complex (MAC)

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36
Q

Stool

EHEC stands for

A

Enterohemorrhagic Escherichia coli

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37
Q

Stool

ETEC stands for

A

Enterotoxigenic Escherichia coli

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38
Q

Stool

EPEC stands for

A

Enteropathogenic Escherichia coli

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39
Q

Stool

EIEC stands for

A

Enteroinvasive Escherichia coli

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40
Q

T/F: E. coli is a non-pathogenic normal flora

A

True

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41
Q

Stool pathogen detected in water analysis for fecal contamination

A

E. coli

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42
Q

Blood is used in the diagnosis of (5)

A

Fever of unknown origin (FUO)
Septicemia
Bacteremia
Typhoid Fever
Subacute Bacterial Endocarditis (SBE)

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43
Q

Blood should be collected before or after fever spike?

A

Both (before AND after)

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44
Q

T/F: Blood is used in both aerobic and anaerobic culture

A

True

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45
Q

Collection method for blood sample

A

Venipuncture

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46
Q

How many sites are used in blood collection?

A

2-3 different sites

Left and right hands/feet

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47
Q

Volume of blood that should be collected in adults

A

20 ml

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48
Q

Volume of blood that should be collected in pediatrics

A

1-20ml (1-5ml)

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49
Q

Blood:Media Ratio

A

1:10

1 blood:9 medium

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50
Q

Media of choice for blood samples (2)

A

Broth (Brain Heart Infusion, Biphasic Media, Thioglycollate Broth, Commercially available bottles)

Isolator system

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51
Q

Preferred anticoagulant for blood samples

A

Sodium polyanethole sulfonate (SPS)
(0.025-0.030%)

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52
Q

Other anticoagulants used for blood samples (3)

A

Heparin
Sodium amylosulfate
Sodium citrate

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53
Q

T/F: EDTA is antibacterial and should not be used in blood cultures

A

T

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54
Q

Body fluids include (7)

A

Abdominal fluid
Amniotic fluid
Ascitic fluid
Bile
Synovial fluid
Pleural fluid
Pericardial fluid

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55
Q

Body fluids are collected by?

A

Needle aspiration

(done by doctors only)

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56
Q

Gastric tubes used in collection of gastric specimens (2)

A

Levine Tubes
Rehfuss Tubes

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57
Q

Specimen used in the diagnosis of meningitis or meningoencephalitis

A

Cerebrospinal Fluid (CSF)

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58
Q

T/F: CSF specimen must be placed in a biosafety cabinet

A

T

Because meningitis can be airborne (in droplets)

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59
Q

T/F: CSF specimen must be processed ASAP

A

T

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60
Q

Causative agents of Meningitis (5)

A

H. influenzae
N. meningitidis
S. pneumoniae
S. agalactiae
Listeria

61
Q

Collection method for CSF specimen

A

Lumbar Tap

3rd-4th Lumbar Vertebra

62
Q

CSF is placed in how many sterile tubes?

A

3

63
Q

CSF

Which tube is used for microbiology if there are 3 sterile tubes?

A

2nd tube

64
Q

CSF

Which tube is used for microbiology if there are 4 sterile tubes?

A

4th tube

65
Q

Volume of CSF sample that should be collected

A

≥ 1 ml

66
Q

T/F: If there is only 1 sterile tube of CSF collected for testing, then the sample must be rejected.

A

F

67
Q

T/F: If there is 1 sterile tube of CSF collected for testing, you must use it for C&S first before other sections

A

T

68
Q

CSF

Accidental tapping of artery can lead to

A

RBC contamination

69
Q

Tissue Specimens

2 Types of biopsy

A

Excisional
Incisional

70
Q

Collection method for tissue specimens

A

Biopsy

71
Q

Tissue biopsy where the entire lesion is removed

A

Excisional biopsy

72
Q

Tissue biopsy where only a portion of the lesion is removed

A

Incisional biopsy

73
Q

T/F:
Aspirates - Anaerobic bacteria
Swabs - Aerobic bacteria

A

F

74
Q

Transport of specimen to the laboratory is ideally:

A

30 minutes

75
Q

Transport of specimens to the laboratory is preferably up to how many hours?

A

2 hours

Except for CSF specimens

76
Q

T/F: If specimens cannot be transported to the lab immediately, specimens must be added with preservatives, anticoagulants, or placed in transport/culture media

A

T

77
Q

2 preservatives for specimen preservation

A

Boric Acid
Refrigeration

78
Q

Preservatives

Boric Acid and Refrigeration are bacteriostatic/bactericidal

A

Bacteriostatic

79
Q

Maintains the viability of the specimen during transport to the lab

A

Transport Media/Holding Media

80
Q

Transport Mediums (4)

A

Cary Blair
Stuart’s or Amie’s
JEMBEC Media
Gonopak

81
Q

Antiphagocytic, anticomplementary anticoagulant that may inhibit some antimicrobials and certain bacteria

A

Sodium polyanethol sulfonate (SPS)

82
Q

Sodium polyanethol sulfonate (SPS) inhibits certain bacteria, such as: (4)

A

Neisseria
Gardnerella vaginalis
Streptobacillus moniliformis
Peptostreptococcus anaerobius

83
Q

2 anticoagulants used in preservation, storage, and transport of specimens

A

0.025%-0.03% Sodium polyanethol sulfonate (LIQUIOID)

Heparin

84
Q

Storage Temperature and Application

CSF for viruses

A

Refridgerator temperature

85
Q

Refridgerator temperature

A

4 degree Celcius

86
Q

Ambient/Room temperature

A

22 degree Celcius

87
Q

Body temperature

A

37 degree Celcius

88
Q

Freezer temperature

A

-20 or -70 degree Celcius

89
Q

Storage temperature and Application

Outer ear swab

A

Refridgerator temperature

90
Q

Storage temperature and Application

Feces for isolation of Clostridioides difficile toxin

A

Refridgerator temperature

91
Q

Storage temperature and Application

Sputum

A

Refridgerator temperature

92
Q

Storage temperature and Application

Catheter tips

A

Refridgerator temperature

93
Q

Storage temperature and Application

CSF for bacteria

A

Ambient/Room temperature

94
Q

Storage temperature and Application

Abcess, lesion, wounds

A

Ambient/Room temperature

95
Q

Storage temperature and Application

Body fluids

A

Ambient/Room temperature

96
Q

Storage temperature and Application

Preserved urine and stool

A

Ambient/Room temperature

97
Q

Storage temperature and Application urine and stool

Unpreserved urine and stool

A

Refridgerator temperature

98
Q

Storage temperature and Application urine and stool

Nasal specimens

A

Ambient/Room temperature

99
Q

Storage temperature and Application urine and stool

Tissue samples

A

Refridgerator temperature

100
Q

Storage temperature and Application urine and stool

CSF

A

Body temperature

101
Q

Storage temperature and Application urine and stool

Serum for Serology

A

Freezer temperature
(-20 C)

102
Q

Storage temperature and Application urine and stool

Long term storage

A

Freezer temperature
(-70 C)

103
Q

T/F: Difficult samples can be rejected

A

F

Confirm with the physician first

104
Q

Examples of difficult specimens (2)

A

CSF
Surgical biopsies

105
Q

Specimen Priority

Critical/Invasive

A

Level 1

106
Q

Specimen Priority

Unpreserved

A

Level 2

107
Q

Specimen Priority

Quantitation required

A

Level 3

108
Q

Specimen Priority

Preserved

A

Level 4

109
Q

Specimen Priority

Batch Processing

A

Level 5

110
Q

Specimen Priority

Level 1 (4)

A

CSF
Amniotic fluid
Blood
Pericardial fluid

111
Q

Specimen Priority

Level 2 (3)

A

Feces
Sputum
Tissue

112
Q

Specimen Priority

Level 3 (2)

A

Urine
Tissue for quantification

113
Q

Specimen Priority

Level 4 (3)

A

Feces in preservative
Urine in preservative
Swabs in holding/transport medium

114
Q

Specimen Priority

Level 5

A

Sputum/AFB culture

115
Q

Which specimen level should be the priority?

A

Level 1 - Critical/Invasive

116
Q

Selection of Appropriate Culture Medium

Isolation of gram-positive and gram-negative anaerobes

A

Anaerobic phenylethyl alcohol agar

117
Q

Selection of Appropriate Culture Medium

Isolation of gram-negative anaerobes

A

Anaerobic kanamycin-vancomycin agar

118
Q

Selection of Appropriate Culture Medium

Isolation of Bordetella pertussis (2)

A

Bordet-Gengou media
Regan-Lowe agar

119
Q

Selection of Appropriate Culture Medium

Enrichment used to isolate Legionella

A

Buffered charcoal yeast extract (BCYE)

120
Q

Selection of Appropriate Culture Medium

Isolation of Campylobacter

A

Campy blood agar

121
Q

Selection of Appropriate Culture Medium

Enriched, nonselective medium to isolate fastidious organisms

A

Chocolate agar

122
Q

Selection of Appropriate Culture Medium

Isolation of Neisseria and Haemophilus

A

Chocolate agar

123
Q

Selection of Appropriate Culture Medium

Isolation of Yersinia species

A

Cefsulodin-Irgasan-novobiocin agar (CIN agar)

124
Q

Selection of Appropriate Culture Medium

Isolation of gram-positive bacteria

A

Colistin-nalidixic acid agar

125
Q

Selection of Appropriate Culture Medium

Differential: isolation of gram-negative bacilli and differentiation of lactose fermenters from non-lactose fermenters (2)

A

Eosin-methylene blue agar
MacConkey agar

126
Q

Selection of Appropriate Culture Medium

Enrichment broth to enhance recovery of stool pathogens and inhibit normal flora coliforms (3)

A

Gram-negative broth
Selenite broth
Tetrathionate broth

127
Q

Selection of Appropriate Culture Medium

Selective: isolation of stool pathogens through inhibition of normal flora coliforms (2)

A

Hektoen enteric agar
Salmonella-Shigella agar

128
Q

Selection of Appropriate Culture Medium

Primary isolation medium for Mycobacterium

A

Löwenstein-Jensen medium
Middlebrook medium
Petragnani’s medium

129
Q

Incubation Conditions

Usual incubation time for most bacteria

A

18-24 hours
37 degrees C

130
Q

Incubation Conditions

Pseudomonas aeruginosa
Campylobacter jejuni

A

42 degrees C

131
Q

Listeria monocytogenes
Yersinia enterocolitica

A

4 degrees C
(Cold enrichment medium)

132
Q

Incubation Conditions

Aerobic bacteria e.g. P. aeruginosa

A

Ambient air
(21% oxygen)

133
Q

Incubation Conditions

Anaerobic bacteria e.g. Fusobacterium, Bacteroides, Clostridium

A

Use of anaerobic jars
(Gas-Pak, Brewer Jar, Glove Box method, Biobag System)

134
Q

Incubation Conditions

Enterics

A

Facultative anaerobes

135
Q

Incubation Conditions

Capnophiles

A

Candle Jar

136
Q

Incubation Conditions

Requires 5-10% carbon dioxide to grow

A

Capnophiles

137
Q

Incubation Conditions

Requires reduced oxygen (5-6%)

A

Microaerophiles eg. Campylobacter jejuni, Helicobacter pylori

138
Q

Incubation Conditions

21% Oxygen, 0.03% CO2

A

Aerobic Bacteria

139
Q

Incubation Conditions

0% oxygen

A

Anaerobe

140
Q

Incubation Conditions

5-10% CO2; 15% Oxygen

A

Capnophiles

141
Q

Incubation Conditions

5-6% or 5-10% Oxygen

A

Microaerophiles

142
Q

Critical results that should be reported immediately

A

Panic Values

143
Q

Enumeration

Panic Values

A

Positive:
Blood Culture
CSF Gram Stain or Culture
S. pyogenes in surgical wound
Gr Staining suggestive of gas gangrene
Blood Smear for Malaria
Cryptococcal Antigen Test
AFS
Detection of select agents such as Brucella or other significant pathogen

144
Q

A protein that can only be killed via incineration; causes CJD

A

Prions

145
Q

Selection of Appropriate Culture Medium

Isolation and differentiation of Vibrio

A

Thiosulfate-citrate-bile salts-sucrose agar

146
Q

Selection of Appropriate Culture Medium

Isolation of Neisseria gonorrhoeae (2)

A

Martin-Lewis medium
Modified Thayer-Martine agar

147
Q

Selection of Appropriate Culture Medium

All-purpose isolation media; subculture from primary plate

A

Trypticase soy agar

148
Q

Selection of Appropriate Culture Medium

Enriched broth that permits growth at various oxygen levels

A

Thioglycolate broth

BACTE LAB (5 decks)

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