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ASCP M Mometrix > URINE SAMPLES AND MOLECULAR TESTING > Flashcards

URINE SAMPLES AND MOLECULAR TESTING Flashcards

1
Q

Random samples

A

may be collected at any time, with no additional preparation or cleansing

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2
Q

random urine samples are used for

A

urine chemistry testing (creatinine, total protein,
electrolytes, microalbumin), but they are to be avoided for routine urinalysis or culture testing due
to the possibility of erroneous results and an increased chance of contamination

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3
Q

Midstream clean catch collection

A

comprises cleansing the skin near and around the urethra

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4
Q

Midstream clean catch is ideal for

A

urinalysis, bacterial culture,
and sensitivity testing

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5
Q

Catheterized specimens

A

collected by passing a hollow tube, or catheter, through the urethra
and into the bladder.

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6
Q

what are catheterized specimens useful for

A

bacterial culture testing, but it may
be used for other routine tests as well.

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7
Q

Suprapubic collection

A

a sterile environment when a needle is placed through the
abdomen and into the bladder.

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8
Q

Aspirated urine provides

A

a sterile sample that is free of outside
contamination and is ideal for bacterial cultures and cytologic examination

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9
Q

Nephrostomy tubes

A

catheters placed through the skin and directly into the kidney

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10
Q

What are nephrostomy catheters used for?

A

to drain or collect urine when output through the ureters in not possible. Samples may be
used for routine urinalysis testing or bacterial culture

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11
Q

The colony count is in colony forming units per mL

A

(number of colonies) × 100

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12
Q

No growth observed on media after 48 hours of incubation is

A

expected in normal clean-catch,
catheterized, suprapubic aspirate and in surgically obtained urine samples

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13
Q

Fewer than 10
colonies observed is

A

not considered a significant finding in clean-catch or catheterized specimens,
and no further workup is needed

**any bacterial growth of urine collected from sterile
sources is significant and requires further investigation

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14
Q

colony counts between 10
and 100 may be tested further if

A

a patient is having symptoms indicative of a urinary tract infection
(UTI)

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15
Q

> 100 colonies of mixed organisms exhibiting one
predominant organism is

A

a significant finding, and the predominant bacteria will be tested further

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16
Q

> 100 of a pure, single organism is

A

indicative of a UTI, and further workup is required to properly
identify the organism and perform antibiotic sensitivity testing for guide treatment options

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17
Q

Microscopic and macroscopic urinalysis findings are evaluated and correlated with

A

urine culture
findings in the determination of UTIs

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18
Q

which chemical reactions on a
urine dipstick indicate the presence or absence of bacteria in a sample?

A

Nitrite, pH, and leukocyte esterase

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19
Q

positive nitrite dipstick result indicates

A

infection is from common UTI-causing
bacteria, including E. coli, Klebsiella, Proteus, Pseudomonas, and Enterobacter species, as they will reduce
nitrate to nitrite

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20
Q

positive leukocyte esterase result indicates

A

UTI because WBCs are
commonly found in areas of infection

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21
Q

alkaline pH may indicate

A

the presence of infection-
causing bacteria in urine because some bacteria hydrolyze urea into the alkaline substance
ammonia

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22
Q

Macroscopic observations of WBCs and bacteria in urine sediment are

A

correlated
with urine culture results in the determination of a UTI

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23
Q

Colony morphology is evaluated by the following characteristics in urine cultures

A
  • Colony size
  • Form and margins
  • Elevation
  • Surface features, texture, and consistency
  • Color, transparency, and iridescence
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24
Q

Colony morphology is categorized by

A

size, form, margins, and elevation characteristics

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25
Colony size is categorized by diameter
o Pinpoint or punctiform < 1 mm o Small 1–2 mm o Medium 3–4 mm o Large > 5 mm
26
Morphological Forms are categorized as
o Circular, symmetrical circle o Irregular, lacking symmetry o Filamentous, exhibiting threadlike branching o Rhizoid, exhibiting a branching, rootlike shape
27
The margins, or edges, of a colony are most commonly evaluated as
o Entire, meaning smooth o Undulate, meaning wavy o Lobular, fingerlike growth spreading outward o Scalloped, rounded projections resembling a scallop shell o Filiform, thin and wavy layers spreading outward
28
Colony elevations are categorized by the following shapes:
o Flat o Raised o Convex, curved or rounded upward o Crateriform, sunken in the middle o Umbonate, with the middle protruding upward
29
Textures are described with the following terms:
o Smooth, o Wrinkled, shriveled o Rough, granular o Dull, no shine o Glistening, shining
30
The consistency of colonies is described as the following:
o Moist o Dry o Viscid, thick and sticky o Mucoid, moist and sticky o Butyrous, butter-like
31
Colony transparency is categorized as
o Transparent, clear, see-through o Translucent, semiclear, frosted-glass appearance o Opaque, unable to see through o Iridescent, color changing in reflective light
32
Sheep blood and chocolate agars often yield the following colony colors
o White o Cream o Yellow
33
Differential and selective medias can produce many colors based on the organism’s biochemical properties such as:
o Pink o Green o Blue o Black
34
Catalase positive
bubbling produced
35
catalase negative
no bubbling produced
36
coagulase positive
visible clumping
37
coagulase negative
no visible clumping or agglutination
38
oxidase test
is used for a presumptive identification of Neisseria species and P. aeruginosa
39
oxidase positive
development of a dark-purple color within 10 seconds
40
oxidase negative
colorless, or remains the original color of the colony
41
Indole test
used for a presumptive identification of E. coli and differentiation of swarming Proteus species
42
Indole positive
rapid development of a blue or green-blue color
43
Indole negative
no color change
44
PYR test
used to identify Enterococcus species and group A beta-hemolytic streptococci through the presence of the enzyme pyrrolidonyl
45
PYR positive
development of bright red color
46
PYR negative
No color change or a yellow-orange color
47
Urease test
used to detect C. neoformans in sputum samples and differentiate pathogenic Shigella and Salmonella species from nonpathogenic Proteus species in stool cultures
48
Urease positive
color change to magenta
49
Urease negative
no color change, pH paper remains yellow
50
Triple sugar iron slant (TSI)
used for presumptive identification of many Gram-negative bacilli, most commonly the enteric pathogens in the Enterobacteriaceae family.
51
TSI agar contains the following:
* Sugars — glucose, lactose, and sucrose * Nutrient source — peptone * Sulfur source — sodium thiosulfate * Indicator — ferric ammonium citrate * pH indicator — phenol red
52
TSI is inoculated using
a needle carrying a pure colony of the organism to be identified
53
K/K slant/butt
Slant, red; butt, red No sugars fermented, no reaction
54
K/A slant
Slant, red; butt, yellow Glucose fermented; lactose and sucrose not fermented
55
A/A slant
Slant, yellow; butt, yellow Glucose fermented; lactose, sucrose, or both fermented
56
G notation
Bubbles/splitting in the butt of the agar Gas production
57
H2S notation
Black precipitate H2S production
58
which testing method measures an organism’s ability to hydrolyze an amino acid to form an amine?
Decarboxylase testing, also called Moeller’s method
59
Decarboxylase positive
purple color change compared to orange in the control tube
60
Decarboxylase negative
No color change, or yellow color in the test and control tubes
61
what test is performed to definitively identify yeast species in clinical specimens
Carbohydrate utilization testing
62
Carbohydrate utilization positive
color change or growth around the disk
63
Carbohydrate utilization negative
no color change or growth around the disk
64
Motility testing is done to determine
if an organism is motile or not, allowing for further differentiation among organisms
65
what are the two methods for determining motility
the hanging drop method and the semisolid agar method
66
what objective is used to examine samples in the hanging drop method?
40x
67
what determines positive motility using the hanging drop method?
aka "true motility" organisms change position darting across field
68
what determines negative motility using the hanging drop method?
organisms may appear active remain in same position
69
what determines positive motility using the semisolid agar method?
organisms spread out into medium from initial inoculation site
70
what determines negative motility using the semisolid agar method?
organisms will remain in same site as inoculation
71
what testing determines the identification and differentiation of Haemophilus species?
X and V factor
72
what organism is the most important to identify in X and V factor testing?
H. influenzae
73
what conditions occur from H. influenzae?
meningitis and pneumonia
74
what indicates a positive X and V factor test?
X & V: growth around the XV disk only
75
what indicates a positive V factor?
-growth around the V disk -light growth around the XV disk -no growth around X disk
76
what indicates a positive X factor?
-growth around the X disk -light growth around the XV disk\ -no growth around the V disk
77
what indicates a negative XV factor?
growth on the entire surface of agar
78
what is latex agglutination testing used for?
qualitative and semiquantitative evaluations of virulent organisms
79
what organisms are used in latex agglutination testing?
Cryptococcus species
80
what is monoclonal antibody testing used for?
testing for antigens produced by H. pylori or toxigenic C. diff strains
81
what components comprise organism identification and susceptibility testing?
-incubator -automated reader -data terminal -printer -LIS connectivity
82
what methods are used to determine biochemical reactions to known isolates?
-turbidity -colorimetry -fluorescent -MALDI-TOF MS
83
what does MALDI-TOF MS stand for?
Matrix-assisted laser desorption ionization time-of-flight mass spectrometry
84
what are the two phases of MALDI-TOF?
-ionization -time-of-flight
85
what occurs during the ionization phase of the MALDI-TOF MS?
-sample is fixed to crystalline matrix -then is bombarded by a laser -laser vaporizes molecules into a vacuum and ionizes without destroying them
86
what occurs during the TOF MS phase of the MALDI-TOF MS?
-separates ions based on mass-to-charge ratio -determines the time each molecule takes to reach detector -patterns are compared to known patterns
87
what testing method allows for testing of multiple pathogens simultaneously?
multiplex molecular methods
88
what are multiplex systems used for the detection of?
respiratory or GI pathogens
89
what regions does genetic sequencing target?
16s ribosomal RNA in individual bacteria
90
what are the variable regions on the 16s gene?
V2, V3, V4, V6, V7, V8, V9
91
What is testing is used to find the correct agent and appropriate concentration to rid a bacterial infection?
antibiotic susceptibility and resistance testing
92
what are the most commonly used testing methods for antimicrobial susceptibility testing and resistance?
dilutions and disk diffusion
93
what method requires multiple tubes in varying concentrations of antibiotics with the test isolate?
broth dilution
94
what is considered the lowest concentration of drug necessary for inhibiting growth and multiplication?
MIC (minimum inhibitory concentration)
95
what is considered the lowest concentration of a drug resulting in death?
minimum bactericidal concentration
96
what method observes the zone size of bacterial growth inhibition?
disk diffusion
97
when is an organism considered susceptible?
when there is no bacterial growth around an antibiotic disk
98
when is an organism considered intermediate?
smaller zone, but not small enough to be considered resistant may need a higher dose of antibiotics
99
when is an organism considered resistant?
having no zone of inhibition
100

ASCP M Mometrix (18 decks)

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