Diagnosing Infection – Flashcards
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| What do you need to diagnose infectious diseases? |
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| complete patient history, physical exam, evaluate symptoms, proper selection, collection, transport and processing of clinical specimens |
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| What are clinical specimens? |
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| body fluids, secretions, tissues |
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| What is important of clinical specimens? |
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| that they are taken correctly because everything else relies on these collections |
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| What are needle sticks |
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| blood cultures, and are the biggest danger for occupational hazard |
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| how are clinical specimens protected? |
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| leakproof container and proper labeling |
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| What does garbage in garbage out mean? |
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| bad data in? bad data out |
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| What do high quality specimens give you? |
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| clinically relevant results |
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| What are the three components of specimen quality? |
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| proper selection, collection and transport |
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| what are the three consequences of poor-quality specimens? |
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| 1) etiologiv agent may be missed/destroyed 2) overgrowth of indigenous flora may mask etiologic agent 3) contaminants may interfere with recovery of etiologic agent |
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| What does the lab provide to lay out laws of specimen collection |
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| written guidelines |
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| what is the floor manual? |
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| what the lab is responsible for, it is required for certification and tells you how to handle each thing that could happen |
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| How are specimens properly collected? |
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| physician-specified collections and work with the MCB lab |
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| why is proper collection important? |
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| it minimizes contamination and protects sterile specimens |
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| what is a good way to prevent contamination |
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| collect speciment from site where pathogen is most likely to be found with the least contamination |
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| When undergoing antimicrobial therapy, when do you obtain the specimen? |
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| prior to the therapy |
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| When is the best stage to collect specimen? |
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| the acute stage (when showing symptoms) |
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| What are 4 points about collecting that would make it better? |
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| perform collection with care and tact, provide instructions for self-collections, obtain a sufficient quantity, and place in a sterile container. |
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| What do you have to protect the specimen from during transportation? |
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| heat and cold |
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| How are hazardous specimen handled? |
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| with more care to avoid contamination of personnel |
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| How do containers need to be? |
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| sterile |
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| What does a proper label include? |
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| name, ID, culture site, date/time |
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| What does an appropriate request slip include? |
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| requesting physician, collector, working diagnosis |
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| When should the collected specimens be brought to the MCB lab? |
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| ASAP |
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| TF urine usually is contaminated by microbes |
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| F |
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| How do you get a clean sample of urine? |
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| "clean catch, midstream urine" |
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| Cateterized urine |
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| use a straight cath - tap bladder and drain. don't take a sample from a full catheter bag |
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| Suprapubic needle aspiration urine |
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| taps urine through pelvic bone |
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| How does urine need to be treated in the context of lab stuff |
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| processed within 30 minutes, and refrigerate at 4C for up to 24 hours |
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| In urine samples, is bacteruria alone significant? |
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| No |
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| How do you tell if the bacteria in urine is due to contamination or not? |
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| you do a cell count and look for white blood cells in the urine |
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| bacteriaurea |
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| the presence of bacteria in urine not due to the contamination of the sample. |
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| What do WBC in the urine indicate? |
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| you know there is an infection (if there is just bacteria then you know it's just a colony from contamination) |
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| Bacteremia |
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| live bacteria in the blood that does not reproduce, easily cleared |
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| Septicemia |
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| live bacteria in blood that is multiplying and being sent to other organ systems, eventually kills patient |
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| What is in a blood culture set? |
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| 1 aerobic vial and 1 anaerobic vial |
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| What is the most sensitive to the volume of blood collected? |
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| 10 mL |
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| How do you disinfect blood? |
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| 70% alcohol, iodiphore, and chloro- |
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| How do you clean injection site? |
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| concentric swabbing motion outward from injection site |
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| Clinical specimens: cerebrospinal fluid: meningitis |
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| infection of the membrane that surrounds the brain |
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| Clinical specimens: cerebrospinal fluid: encephalitis |
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| inflammation of the brain |
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| Clinical specimens: cerebrospinal fluid: meningoencephalitis |
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| you have an infection and inflammation |
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| TF bacterial etiologies are rapidly fatal |
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| T |
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| Clinical specimens: cerebrospinal fluid: how is it collected |
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| lumbar puncture |
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| Clinical specimens: cerebrospinal fluid: how fast does the processing need to be? |
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| 30 minutes or less (STAT) |
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| Clinical specimens: cerebrospinal fluid: how are they read in the MCB lab |
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| gram stain and culture |
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| Clinical specimens: cerebrospinal fluid: how is the glucose count affected? |
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| it goes down |
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| Clinical specimens: cerebrospinal fluid: how is the preliminary report handled? |
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| it must be called into the lab, no fax |
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| TF many people die from viral meningitis |
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| F |
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| Clinical specimens: cerebrospinal fluid: what kind of test is bacterial antigen testing? |
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| latex test |
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| Sputum |
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| accumulation of pus within the lungs (where the bugs will be if there is pheumonia) |
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| TF sputum travels well |
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| T |
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| What is examined for quality control of sputum specimens? |
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| white blood cells, epithelial cells |
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| What is a bronchial aspiration? |
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| drawing fluid from the body |
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| What is the significance of first morning sputum? |
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| no idea |
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| Does sputum travel well? |
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| yes, it needs to be refrigerated though |
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| What bug do throat swabs usually test for? |
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| Group A strep; steptococcus pyogenes |
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| What do you have to do for testing throat swabs for anything besides type A strep |
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| make a special request |
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| What do you have to do with a wound? |
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| aspirates (removal of fluid) or biopsy |
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| What do you have to do with wounds? 4 things |
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| swab the specimen, indicate the type of wound, note the anatomic site, and see if it is aerobic or anaerobic |
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| What does a GC culture test? |
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| neisseria gonorrhoeae |
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| When should GC inoculation occur? |
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| immediately to the appropriate selective media |
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| What kinds of swabs do you have with GC cultures? |
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| vaginal, cervical, urethral, throat, rectal |
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| Should GC swabs be refrigerated during transport? |
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| No |
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| What kind of report do you get for males from GC cultures? |
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| preliminary gram stain report |
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| What kind of tests are used for GC and chlamydia trachomatis? |
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| nucleic acid-based tests |
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| What can a binary test test for? |
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| gonorrhoea and chlymydia |
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| If fecal specimens were not processed ASAP, what would happen? |
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| die off of bacterial pathogens |
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| What is cultured from a stool sample? |
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| salmonella, shigella, campylobacter |
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| What parasites are examined from stool specimens? |
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| protozoa and helminths |
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| If you want to look for other organisms in stool specimens, what do you need to do? |
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| make a special request |
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| pathology |
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| the study of the structural and functional manifestations of disease |
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| Who is the doctor's doctor? |
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| the pathologist |
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| What two types of pathology are there? |
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| anatomical and clinical |
