Background 3

Question 1

what makes up the upper respiratory tract

Answer 1

nasal cavity, pharynx, larynx

Question 2

what makes up the lower respiratory tract

Answer 2

trachea, primary bronchi, lungs

Question 3

list some acute upper respiratory tract infections

Answer 3

rhinitis, pharyngitis/tonsillitis and laryngitis - or the common cold

Question 4

how long is the onset of symptoms for URTIs

Answer 4

1-3 days

Question 5

how long do URTIs tend to last

Answer 5

7-10 days

Question 6

What can pharyngitis/tonsillitis (strep throat) be caused by - where theres a sudden onset, fever, etc

Answer 6

beta haemolytic streptococcus group a

Question 7

what symptoms dont present with strep throat

Answer 7

a runny nose, voice changes or cough

Question 8

in unvaccinated patients what are some pathogens for URTIs?

Answer 8

bordetella pertussis or corynebacterium diphtheriae

Question 9

what does bordetella pertussis cause

Answer 9

whooping cough

Question 10

what does corynebacterium diphtheriae cause

Answer 10

diphtheria

Question 11

how is a throat swab collected

Answer 11

sterile swap up and down the back of throat

Question 12

once in the lab what is done with the throat swab

Answer 12

plated on blood agar, disc with antimicrobial agent (bacitracin) placed on surface of agar, incubate overnight @ 37

Question 13

if the organisms causing diptheria are suspected where is the throat swab placed and for how long?

Answer 13

media containing tellurite, incubated in air for 48 hours at 37 degrees

Question 14

if whooping cough is suspected as the URTI, what type of swab is taken

Answer 14

pernasal swab

Question 15

where is a pernasal swab placed

Answer 15

on media containing charcoal

Question 16

how long is a pernasal swab placed on charcoal and with what

Answer 16

it is incubated for 3-5 days in humid co2 at 37 degrees

Question 17

after incubation of a URTI bacteria, the blood plate is observed for

Answer 17

beta haemolytic colonies

Question 18

which type of bacteria is sensitive to bacitracin and doesnt grow close to the paper disc

Answer 18

streptococcus pyogenes

Question 19

normal throat flora includes other haemolytic organisms but these are not sensitive to

Answer 19

bacitracin

Question 20

the possible URTI bacteria can be serogrouped using

Answer 20

Lancefield streptococcal grouping kit

Question 21

If a beta haemolytic streptocccus group a is isolated the clinicial is informed due to

Answer 21

potentially hazardous seleque and infectiousness of the organism

Question 22

what can beta haemolytic streptococcus group a result in

Answer 22

rheumatic fever, glomerulonepheritis

Question 23

what is diphtheria characterised by

Answer 23

sore throat, low fever, adherent membrane (pseudomembrane) on tonsils, pharynx

Question 24

what can a pseudomembrane do

Answer 24

form across the airway and cause obstruction

Question 25

what causes diptheria

Answer 25

coynebacterium diphtheriae

Question 26

is a vaccination available for diphtheria?

Answer 26

yes

Question 27

what type of bacteria is corynebacterium diphtheria

Answer 27

short gram positive rod

Question 28

the toxin from corynebacterium diphtheria is detected using what type of test?

Answer 28

elek test

Question 29

for lower respiratory tract infections what is the best sample to use

Answer 29

sputum

Question 30

what are sputum samples placed on due to potential contamination with normal flora or upper resp

Answer 30

blood agar, choc agar, indicator agar and sabourauds agar

Question 31

specimens for the isolation of mycobacterium tuberculosis and other mycobacteria are inoculated on which type of media

Answer 31

lowenstein jensen media

Question 32

why are sputum samples diluted prior to routine culture or decontaminated prior to mycobacterial culture

Answer 32

because they are usually contaminated with normal resp tract flora

Question 33

a sputum culture is mixed with what to digest the mucins in the specimens thus making it a homogeneous suspension

Answer 33

sputalysin

Question 34

where is digested sputum placed

Answer 34

onto various agars

Question 35

what type of disc is placed on chocolate agar with the sputum

Answer 35

optochin disc

Question 36

the plates are exmamined the next day and what is picked off for appropriate biochemical and sensitivity testing

Answer 36

potential pathogens

Question 37

what is an aid to the presumptive identification of streptococcus pneumoniae?

Answer 37

optochin

Question 38

why is optochin a presumtpive identification for streptococcus pneumoniae?

Answer 38

s. pneumonia is sensitive to optochin and therefore has a zone of inhibition around the disc

Question 39

what colour is streptococcus pneumoniae on blood agar or chocolate agar

Answer 39

it is green alpha haemolytic

Question 40

is streptococcus pneumoniae gram pos or gram neg

Answer 40

gram pos

Question 41

describe the morphology of streptococcus pneumoniae

Answer 41

it is diplococci

Question 42

is streptococcus pneumoniae sensitive to optochin

Answer 42

yes

Question 43

what colour is haemophilus influenzae on chocolate agar

Answer 43

grey colonies with a distinctive smell

Question 44

does haemophilus influenzae grow on blood agar

Answer 44

no fam

Question 45

is haemophilus influenzae oxidase pos or oxidase neg

Answer 45

slowly oxidase pos

Question 46

what is haemophilus influenzae dependent upon

Answer 46

x and v dependent on x and v factors plate

Question 47

what is legionella caused by

Answer 47

legionella pneumophila

Question 48

how is legionella transmitted

Answer 48

by contaminated water from shower heads and air conditioning units

Question 49

how many types of influenza virus are there

Answer 49

three virus a , b and c

Question 50

what does influenza virus a cause

Answer 50

epidemic type

Question 51

what does influenza type b cause

Answer 51

a miler disease usually in the winter

Question 52

what does influenza type c cause

Answer 52

nothing, unlikely to be a human pathogen

Question 53

what does the influenza virus envelope contain that can be used to type infleuzna

Answer 53

neuraminidase and haemagglutinin

Question 54

how is influenza transmitted

Answer 54

through respiratory secretions

Question 55

is vaccination possible with influenza

Answer 55

yes

Question 56

the influenza vaccine contains inactivated virus from

Answer 56

two currently circulating strains of influenza a and a strain of influenza b

Question 57

the influenza vaccine is a short lived vaccine and does not cover

Answer 57

all strains of influenza a

Question 58

pre processing of sputum for mycobacterial culture involves decontaminating it with

Answer 58

sodium hydroxide and then buffered in distilled water

Question 59

the solution for mycobacterial sputum cultures is centrigued at

Answer 59

300rpm for 30 minutes

Question 60

what are the two main methods for culturing mycobacteria

Answer 60

culture on solid media - lowenstein jensen slopes, culture in liquid - similar to blood culture

Question 61

what is the mycobacterial culture stained with once heat fixed

Answer 61

ziehl neelson (cold)

Question 62

after 4-10 weeks of incubation of mycobacterial culture it becomes

Answer 62

positive

Question 63

what is the growth of mycobacterial stained with to ensure it is acid alcohol fast?

Answer 63

ziehl neelson

Question 64

a few weeks after the mycobacterial positive result what happens

Answer 64

sensitivity pattern and final identification of the species is confirmed

Question 65

what is tuberculosis caused by

Answer 65

mycobacterium tuberculosis

Question 66

what do symptoms of tuberculosis include

Answer 66

night sweats and coughing blood (haemoptysis)

Question 67

what is the treatment for tuberculosis

Answer 67

multiple drug therapy for up to 12 months

Question 68

why does mycobacterium tuberculosis not stain using gram stain

Answer 68

has a waxy cell wall

Question 69

describe mycobacterium tubercolusos

Answer 69

acid alcohol fast rods

Question 70

mycobacterium is slow growing, how long does it take

Answer 70

6-10 weeks

Question 71

what specialist media is mycobacterium tuberculosis grown on

Answer 71

lowenstein-jensen