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NURS 2228 - Microbiology > Unit 5 - Diagnosis of infectious diseases > Flashcards

Unit 5 - Diagnosis of infectious diseases Flashcards

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1
Q

If the lab promptly and accurately identifies infectious agents, what does this do (3)?

A
  1. Provides patient with appropriate and effective therapy
  2. Avoids delay in providing therapy
  3. Helps reduce risk of further spread
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2
Q

When are most mistakes likely made in the diagnosis of infectious disease, in the post-analytic phase or the pre-analytic phase?

A

Pre-analytic phase

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3
Q

What is involved in the pre-analytic phase?

A
  • order placed
  • order transmitted to lab
  • identifying information entered
  • specimen obtained
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4
Q

What is involved in the post-analytic phase?

A
  • report generated
  • result conveyed to clinician
  • data interpreted
  • clinical response to result
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5
Q

What is a major decisive factor for successful identification of disease-causing agents?

A

Specimen collection

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6
Q

Who is responsible for collecting specimens (5)?

A
  • RNs
  • LPNs
  • Physicians
  • Registered medical lab technologists
  • med lab assistants
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7
Q

What are the five major steps of “I’s” for the identification of an infectious specimen?

A
  1. Inoculation
  2. Incubation
  3. Isolation
  4. Inspection
  5. Identification
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8
Q

True or False:

A nurse is likely to be the first health care worker to be aware of s/s of an infection in a patient

A

True

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9
Q

True or False:
One of the general principles of proper specimen collection and handling is … Taking the RIGHT specimen from the RIGHT patient

A

True

- check the physician’s orders and the patient’s ID

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10
Q

True or False:
One of the general principles of proper specimen collection and handling is … Taking the specimen first thing in the AM

A

False

  • Collect the specimen at the APPROPRIATE time
  • Ex: during the acute phase or the convalescent phase
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11
Q

Describe what serology (paired sera) is

A

Paired sera collected from a patient to detect a significant rise in ANTIBODY TITRE

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12
Q

True or False:

A paired sera serology measures the difference in level of infectious agent between one time and another

A

False

  • measure the levels of antibodies present in the body
  • minimum 4 fold increase
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13
Q

True or False:
One of the general principles of proper specimen collection and handling is …Collecting a specimen after the patient has started antimicrobials

A

False

- collect the specimen BEFORE patient receives antimicrobials

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14
Q

True or False:
One of the general principles of proper specimen collection and handling is … Using clean technique when collecting a specimen

A

False

- use ASEPTIC technique

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15
Q

True or False:
One of the general principles of proper specimen collection and handling is … Using the appropriate, sterile container and collection tools for the required specimen

A

True

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16
Q

True or False:
One of the general principles of proper specimen collection and handling is …Collecting an adequate amount of specimen (for various tests)

A

True

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17
Q

Why is it necessary to use the appropriate transport media when transporting a collected specimen?

A

To ensure the survival of the delicate disease-causing agents in the specimen during transport

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18
Q

Why is it important that the collected specimen has the appropriate label on it?

A

Ensures that the correct diagnosis goes to the CORRECT patient

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19
Q

Why is it important to communicate with the lab regarding special requires and possible etiology?

A

Because it gives the lab time to prepare

  • in the event of a lot of samples coming to the lab
  • ex. adequate staffing of lab
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20
Q

True or False:
One of the general principles of proper specimen collection and handling is … Transporting the specimens to the lab promptly

A

True

- different time limits may be applied to different specimens

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21
Q

What is the main role and responsibility of the clinical microbiology lab?

A

To accurately identify the disease-causing agent in a timely fashion

22
Q

What are the two major approaches that the clinical microbiology lab uses to identify disease-causing agents?

A
  1. Identify the pathogen and/or its products (through phenotypic, genotypic and immunological methods)
  2. Detect and often quantify antibodies made by the patient to the pathogen
23
Q

What are two other roles and responsibilities of the clinical microbiology lab?

A
  1. To quantify the disease-causing agent

2. To determine the susceptibility of the pathogen

24
Q

What does a culture and sensitivity test determine?

A

Whether the test organism is sensitive (susceptible) to antibiotics

25
Q

What are 3 common lab identification methods used to identify disease-causing agents?

A
  1. Phenotypic methods
  2. Genotypic methods
  3. Immunological methods
26
Q

True or False:

A phenotypic method usually involves a microscopic and macroscopic examination

A

True

27
Q

What are 3 examples of microscopic examinations in phenotypic testing?

A

Gram stain
Acid-fast stain
Electron microscopy

28
Q

True or False:

During macroscopic examination, the characteristics of bacterial colonies are examined

A

True

- such as growth patterns, texture, color, shape

29
Q

True or False:

Isolating the disease-causing specimen is often required using phenotypic methods

A

True

30
Q

Following isolation, what is required next during phenotypic methods of identification of disease-causing specimens?

A

Culturing (growing) of the microbes to sufficient numbers

31
Q

During phenotypic methods, selective media are used to grow/culture the microbes - what does selective media suppress and what does it promote?

A 
Suppress = growth of gram-positive and some fastidious bacteria
Promotes = growth of gram-negative bacteria
32
Q

What is an example of a selective OR differential media?

A

Mac Conkey agar

33
Q

What is used in enriched media to culture fastidious bacteria?

A

Blood or chocolate agars

34
Q

True or False:
When using phenotypic methods to identify a disease-causing microbe, a combination of phenotypic methods can be used to identify the agent

A

True

  • you can’t do just ONE test to find out what the agent is
  • you have to narrow it down, step by step
  • IT TAKES TIME!
35
Q

What does the biochemical method of phenotypic identification do?

A

Detects enzymes and/or metabolic products in a bacterial isolate

36
Q

True or False:

Using biochemical methods of identification, the tests comes out either positive or negative

A

True

- usually quite a few substrates are tested at the same time

37
Q

What is considered a definitive microbiological diagnosis of an infectious disease?

A

Culture and sensitivity

38
Q

What is a routine test for many bacterial and fungal infections?

A

Culture and sensitivity

39
Q

True or False:

Culture and sensitivity usually involves identifying the pathogens in culture

A

True

- they are isolated and grown in artificial media

40
Q

What is a classic qualitative approach for testing microbial susceptibility to antibiotics?

A

Culture and sensitivity

41
Q

What does the diameter around the antibiotic disk where no microbial growth is observed, tell us about the agent?

A

Whether the test organism is sensitive or susceptible or resistant to a particular antibiotic

42
Q

True or False:

The less space around an antibiotic disc, the more effective the antibiotic is

A

False

- more space = more effective

43
Q

What does it mean if an infectious agent is between the range of susceptible and resistant?

A

Means that the organism is on its way to becoming susceptible OR resistant

44
Q

What is a broth dilution test?

A

Tubes containing serial dilutions of an antibiotic inoculated with the test organism
- tubes incubated and then observed for the presence of growth

45
Q

What is minimum inhibitory concentration?

A

Smallest concentration of an antibiotic required to prevent microbial growth

46
Q

What is minimum bactericial concentration?

A

Lowest concentration of an antibiotic required to kill 100% of the microbes

47
Q

What is genotypic methods based on?

A

Identification of unique microbial DNA or RNA segments extracted from a patient’s clinical specimen

48
Q

What happens during genotyping of an infectious agent?

A

Gene probe binds to the complementary target sequence(s) detactable by color change, fluorescence or radioactivity

49
Q

True or False:

During genotyping, there is no need to culture the microbe

A

True

- therefore, it saves time

50
Q

What are some characteristics of genotyping?

A
  • sensitive (only small amount needed)
  • specific to the organism
  • quick
  • unaffected by the prior presence of antimicrobials

NURS 2228 - Microbiology (9 decks)

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