Specimens (general) Respiratory Org. – Flashcards
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What is the normal cut-off time for specimen collections? |
2 hours |
What should be indicated on the label of specimens? |
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What is the transport media Carey-Blair typically used for? |
| good for stool cultures or specimens that need to be held for extended period of time (mailing etc..) |
What is the transport media Amies typically used for? |
| Good for Neisseria gonorrhea |
What is the transport media Stuarts typically used for ? |
| supports transport of almost all pathogens |
What is the transport media JEMBEC typically used for? |
for genital cultures that cant get to the lab in a timely fashion
Specifically looking for N. gonorrhoeaa |
Mouth cultures are not routinely processed-will grow URF, what is the exception? |
Mycology cultures may be performed to rule out THRUSH (Candida albicans) |
What are you looking for in throat cultures? |
| Primarily used for the detection of Group A beta-hemolytic streptococci (cause of strep throat) |
If group A strep is left untreated...sequelae include... |
| Rheumatic Fever and Glomerulonephritis |
| What do type of agar do you plant throat cultures on? |
BAP - streak for isolation |
Group A rapid tests are commonly performed for throat cultures, but what is the problem with them? |
| Rapid tests are specific, but not sensitive...A Negative rapid test MUST be confirmed by culture |
Nasopharyngeal cultures are not routinely done, if performed they are by request and only to screen for carriers of..... |
S. aureus N. meningitidis H. influenzae |
| What are the steps to Nasopharyngeal cultures? |
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What is a Nares culture usually used for? |
| to rule out MRSA |
| What are the types of Lower Respiratory Specimens? |
Expectorated Sputum Suctioned Sputum (leukens tube) Bronchoscopy specimen or bronchial washing (BAL) Bronchial Brushing Transtracheal Aspirate Lung Aspirate Lung Biopsy |
| LRT specimen processing begins with... |
Gram Stain Calulate Q-Score If acceptable quality..process specimen |
| For the Q-score, sputum is evaluated at low power (10x) and neutrophils and squamous cells are graded...how many cells for a score of 0, 1, 2, or 3? |
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What plates do you innoculate when you have an acceptable quality Lower resp specimen?? |
| BAP, MAC, and CHOC |
After BAP and MAC cultures of Lower Resp specimens have grown....whats next? |
Add STAX to BAP
If both GN and GP appear in significant numbers...add CNA or PEA |
For Lower Resp Specimens...when do you report "Pneumo" |
when you see pairs of GP diplococci, sometimes lancet shaped, encapsulated, or with blotchy appearence, >25 pairs/oil immersion field (OIF) |
| For Lower Resp Specimens...when do you report "Staph" |
GP cocci in clusters >25/Oil immersion field |
| For Lower Resp Specimens....when do you report "yeasts" |
| at least one yeast cell with pseudohyphae/OIF |
| For Lower Resp Specimens..when do you report "Enteric/Psuedomonas" |
| GNB >10/OIF |
| For Lower Resp Specimens...when do you report "Bacteriodes/ Hemophilus" (B/H) |
| GN coccobacilli/pleomorphic > 10 /OIF |
| For Lower Resp Specimens...when do you report "Branhamella/Acinetobacter" |
| Plump GN diplococci >25/OIF |
| What are the most common pathogens of the Upper and Lower Respiratory Tract? |
Strep pneumoniae Haemophilus influenzae Klebsiella pneumoniae and other Enterobacteriaceae Pseudomonas aeruginosa and other "Pseudomonads" Legionella pneumophila Candida albicans (Thrush) Acinetobacter spp. Moraxella (Branhamella) catarrhalis Beta-hemolytic streptococci |
What are the "other" respiratory pathogens which require specialized media for isolation? |
Corynebacterium diphtheriae Mycobacterium tuberculosis and other Mycobacterium spp. Bordetella pertussis Nocardia asteriods Mycoplasma pneumoniae Chlamydia pneumoniae and other spp Pneumoncystis carinii Viruses ( CMV, HSV, Adeno, Influenza, etc) Fungi including Histoplasma capsulatum and others Anaerobes (Prevotella melaninogenicus, Fusobacterium nucleatum etc.) |
What are the organisms considered normal upper respiratory flora? (URF) |
Alpha and gamma hemolytic Streptococcus Staphylococcus spp (NOT aureus) Neisseria spp (NOT meingiditis) Corynebacterium spp (NOT diphtheriae) Many anaerobes Candida spp. |
What organisms are isolated in the URT of hospitalized patients and is usually not reported unless its a chemo patients? |
Klebs. pneumoniae Ps. aeruginosa Other Enterobacteriaceae |
What are the causative organisms of Vincents Angina (Trench Mouth) |
Borrelia vincentii (a.k.a. Bacteriodes denticola/Prevotella)
Fusobacterium nucleatum (now Fusobacterium necrophorum) |
In Vincents Angina (Trench mouth) what organisms predominate in the acute cases? Chronic cases? |
Acute: Spirochetes Chronic: Fusiform |
How are samples of Trench mouth tested in lab? |
Direct smear with Z/N or crystal violet
ALOT of Spirochetes and Fusiforms will be seen |
| What are the most likely organisms in otitis media infections? |
Stp pneumoniae (25-50%) Hem. influenzae (15-30%) Mor. cararralis (3-20%) Stp. pyogenes (2%) Sth. aureus (1%) Enterobacteriaceae (1%) |
| What are the most likely organisms in Otitis Externa infections? |
Ps. aeruginosa Sth. aureus Other aerobic bacteria |
What skin contaminants are not significant in otitis media samples? |
Sth. epidermidis Diphtheroids |
| A Nasopharyngeal swab is used in suscpected cases of... |
Neisseria meningitidis Bordetella pertussis |
| Chronic Granulomatus infection of nasal passages is due to the infection of what organism? |
| Klebs rhinoscleromatis |
| chronic mucopurulent nasal discharge, foul smelling, due to secondary low grade anaerobic infection of what organism? |
| Klebs. ozanae |
| What is the expected flora of the nasopharyngeal? |
Neisseria spp alpha/gamma strep Haemophilus spp Diphtheroids Anaerobic Bacteria Strep pneumoniae Staph small amounts of GNB (as hospitlization increase..so does GNB) small number of yeasts |
