Chapter 15 Flashcards Preview

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Flashcards in Chapter 15 Deck (197)
1

The traditional mode of bacterial identification is via ______ characteristics.

physiological/biochemical

2

Physiological/biochemcial characteristics look at the presence of specific enzymes and assesses _______ and _____ activities for bacterial identification.

nutritional and metabolic activities

3

Examples of physiological/biochemical characteristics

fermentation of different sugars
production of gas during fermentation/metabolism
presence of enzymes
sensitivity to different antimicrobial drugs

4

_____ analysis analyzes the types of specific structural substances that the microorganism contains.

chemical

5

Examples of chemical analysis of microbial diseases

Chemical composition of the cell wall
Different lipids present in the plasma membranes

6

______ methods analyze the cause of microbial disease by looking at the genome (DNA profile) of the microbe.

genotypic

7

_____ can be used to identify organisms and also to connect strains causing outbreaks.

genetics

8

_____ can be used to identify organisms and connect strains causing outbreaks. ____ contaminating apple juice is an example.

Genotypic methods
E. coli

9

Primary advantage over traditional methods of genotypic methods is that _____ is unnecessary.

culturing

10

Genotypic methods is an ____ process that offers quick results.

automated

11

______ is the study of blood serum and other bodily fluids.

serology

12

Diagnostic identification of antibody/antigen response can be found using a patients ____.

serum

13

The presence of _____ can indicate past exposure, vaccination or current infection.

antibodies

14

The presence of ______ usually indicates an active (or acute/chronic) infection (organism still present)

antigens

15

there are lab kits available for immediate identification of a number of _____.

pathogens

16

Laboratory tests are essential to diagnosis and ______ of the disease.

treatment/management

17

Success depends on how specimens are _____, ____, and stored.

collected, handled

18

STAT for lab results means short for _____, the Latin word for "immediately"

statim

19

During specimen collection care must be taken to avoid microflora and _______. You only want to collect specimens that may yield pathogens which are actually ____ the patient.

contamination
infecting

20

Specific rules for specimen collection vary depending on _____.

collection site.

21

_____ is when you wear gloves, gowns, masks, eye protection when appropriate.

aseptic technique

22

______ by the normal microflora (such as that of the skin or mucous membranes).

minimize contamination

23

Ways to minimize contamination is to gather a urine sample ______ or alcohol swab skin sites before a blood draw.

mid-stream

24

During specimen collection it is important to label well -- patient identifiers, _______, date and time of collection, etc.

specimen type/source

25

Specimen collection is best done prior to ____ therapy has begun (if possible).

antibiotic

26

Be aware of what is being ______, think of potentially dangerous pathogens.

collected

27

_____ specimen draw/collection when possible. The specimen can be divided later for multiple tests if needed.

single

28

Be aware of storage times, _____ and temperature for specimen collected.

containers

29

There is a contamination risk with ______ and it will be contaminated with some microflora. Higher levels of microflora occur in _____. The peri-urethral genital skin should be cleansed prior to collection

urine
women

30

Urine should be caught ______ to reduce the numbers of contaminating microflora from the peri-urethral area (much of which washes aware at start of urination)

mid stream

31

______ is the most concentrated and will contain larger numbers of organisms.

FMU - First morning urine

32

_____ collection has the lowest risk of microflora contamination and is typically does when the patient is unable to urinate independently.

catheter

33

Typically, the presence of a single type of bacteria growing at high number is considered a _____ UTI

positive

34

Greater too or equal too ______ CFU/mL indicates a single bacterial type.

100,000

35

______ up to 1000,000 CFU/mL indicates a single bacterial type in conjunction with symptoms of a UTI

1,000

36

1,000 CFU/mL or more indicates an infection from a ______ due to lower contamination.

catheter catch

37

If a urine culture shows growth of several different types of bacteria - likely due to _____.

contamination

38

Common contaminates of urine are _______ and E. coli.

lactobacillus

39

_____ is a measure of viable (living) bacteria.

colony forming unit (CFU)

40

CFU/mL (colony forming units per mililiter) is used for ____.

liquids

41

Plate 1/____ of a ml (small enough volume to plate)

100th

42

Multiply the number of resulting colonies by 100 to determine # of bacteria that was in ________.

the original 1ml volume.

43

1 ml of urine
colonies x 100 = CFU/ml
25 colonies

25 x 100 = CFU or 2500

44

_____ is normally sterile.

blood

45

Contamination risk of blood occurs if there is improper cleaning of the skin or handling of collection tubes and _____ (aseptic technique is important here)

needles

46

Origins of blood infection occurs when _____ can access the blood.

microbes

47

Blood infections can originate from surgery, dental work, catheters, or _____.

intestinal damage.

48

Occasionally bacteria can contaminate the blood during routine actives such as _____, minor injuries, etc. These small numbers are typically, but not always cleared by the immune system.

brushing teeth

49

______ fluid surrounds the brain and spinal cord.

cerebrospinal fluid (CSF)

50

CSF is normally _____ free.

microbe

51

Cerebrospinal fluid is collected via a ______.

lumbar puncture (spinal tap)

52

The most common purpose to collect CSF is to look for _____.

meningitis

53

The puncture site for CSF should be sterilized to avoid contamination of ____.

normal skin flora

54

______ can be performed on a sediment of CSF.

a gram stain

55

A _____ provides quick results for immediate treatment (time is important for meningitis diagnosis and treatment)

fast test

56

A gram stain shows ____ organisms in about 60% of cases of bacterial meningitis.

bacterial

57

Reasons no bacteria are found in CSF could be because the infection is viral, fungal, or non microbial, such as _____ or the bacterial species might be one that can't be grown in cultures.

cancer

58

______ culture is also performed for both aerobic and anaerobic bacteria. This takes a few days, not immediate with a gram stain.

bacterial

59

________ is when no organisms grow in cultures of CSF specimen, but clear symptoms are present.

Aseptic meningitis

60

Haemophilus influenzae is a form of ____ meningitis in which the infection spreads from respiratory tract to bloodstream, and then to the meninges.

bacterial meningitis

61

Neisseria meningitidis is the ______ form of bacterial meningitis in children and the second most common cause of bacterial meningitis in adults.

most common

62

Streptococcus pneumoniae is the most common cause of bacterial meningitis in ___.

adults

63

Skin microflora is the biggest challenge for contamination during collection of a ______.

skin specimen

64

Transportation conditions/timing is important to prevent _______ of any contaminants in specimen collection of skin.

overgrowth

65

When collecting skin specimens avoid skin _____ as this has high levels of microflora.

surface

66

When collecting a specimen of skin use ____ to collect specimen instead of swabs which are not precise and can drag in normal flora.

metal (scapel or syringe)

67

In lower respiratory specimens contamination from ____ is common.

microflora

68

Lower respiratory specimens collection can reduce contaminants by having patients _____ with sterile water or solution (or even brushing teeth)

gargle

69

A lower respiratory speciman can be collected via _______ to gather sputum or expectorated.

coughing deeply.

70

______ induced, uses a nebulizer, patient inhales sterile saline and coughs deeply to bring up samples for lower respiratory specimens.

sputum

71

Upper respiratory specimens can be collected three different ways: _____, _____, and _____.

oral, nasal, throat

72

During upper respiratory specimen collection from the oral cavity, targets lesions and avoid "normal" areas. ______ is hard to avoid from oral flora.

contamination

73

During upper respiratory specimen collection from the ____ cavity, by rotating the swab against the nasal mucosa with slight pressure (to prevent collecting only surface mucous).

nasal cavity

74

During upper respiratory specimen collection from the _____, the tonsils are swabbed as well as inflamed areas. Most commonly done to look for ________.

throat
Streptococcus

75

Several things can be done to analyze patients _____.

specimens

76

Direct testis using microscopic, immunologic, or ______ methods.

genetic

77

Cultivation, isolation, and _______ of pathogens using a wide variety of general and specific tests.

identification

78

Results of specimen analysis entered in a summary _______.

patient chart

79

_______ tests contain various biochemical tests that allow you to get a broad view of the metabolic profile of the organism.

rapid tests

80

Rapid tests can analyze carbohydrate _____.

fermentation

81

Rapid tests can analyze enzyme actions such as ______ and coagulase.

catalase

82

______ is a cytogenetic technique that uses fluorescent probes that bind to specific parts of DNA.

FISH (Fluorescent in situ hybridization)

83

FISH is used in _____ analysis.

nucleic acid (DNA, RNA)

84

The fluorescent probes can be designed to target DNA found only in the ______ of a specific species.

chromosome

85

The FISH technique can give results _____.

within hours

86

In mixed infections, only the _____ species will light up.

target

87

Immunological techniques are used to study the immune system and methods that use immunological _____ as experimental tools.

reagents

88

The most common immunological methods involve the production of _____ to detect specific proteins in a sample.

antibodies

89

Analyzing antibodies can reveal _____ of a patient's contact with microorganisms.

history

90

______ is the branch of immunology that traditionally deals with in vitro diagnostic testing of the serum.

serology

91

Important factors to consider hone using antibody/analysis is specificity and _____.

sensitivity

92

______ is how specific an antibody is for its corresponding antigen. Highly specific is desirable to avoid false positive results.

Specificity

93

_____ is the smallest amount of the antigen that can be detected by that antibody. This ensures that small amounts won't be missed by the antibody.

sensitivity

94

During serological diagnosis of disease a patient's sample is analyzed for the presence of _____. This will indicate disease exposure. This techniques uses a _____ mixed with an unknown sample.

antibody
known specific antigen

95

Binding of the known antigen with antibodies in the patient sample will only occur if the patient had previous exposure to the ______ during serological diagnosis.

antigen

96

A positive reaction of a blood sample is usually evident from a ______ sign, such as color change or clumping, that indicates a specific interaction between antibody and antigen.

visual

97

To identify an unknown organism, the unknown microbe is mixed with a ______ specific for particular organism.

known antibody

98

When trying to identify an unknown organism the test looks for microbe/antibody ____.

match

99

Microbe surface antigens will only bind the known antibody that is specific for it (__________)

equalling a poisitive identification

100

Agglutination and ______ reactions depend on the interaction of antibodies and antigens.

precipitation

101

Major differences between precipitation and agglutination is the _____ of antigens involved and if they are soluble or insoluble.

size

102

Antigens that are ______ cause precipitation.

soluble

103

Antigens that are _____ cause agglutination.

insoluble

104

______ is when an antigen-antibody reaction produces visible clumps

agglutination

105

______ reaction is an interaction of soluble antigens with antibodies leads to precipitation out of solution.

precipitation

106

Streptococcus pneumoniae capsule is _______, the reaction of the capsule to specific antibody results in precipitation of the antigen antibody complex out of solution.

insoluble

107

_____ is a technique which is used in conjunction with a fluorescence microscope.

immunofluorescense

108

Immunofluorescence uses the specificity of antibodies to their antigen to target fluorescent dyes to specific _______ or ______.

microbes or antigens

109

Immuofluorescense allows _____ of the sample when antibody binds with the target.

visualization

110

______ with fluorescent antibodies is when an unknown specimen or antigen is fixed to a slide and exposed to a fluorescent antibody solution (known antibody is specific for its target antigen)

direct testing

111

________ is used for syphilis spirochete.

direct testing

112

_______ with fluorescent antibodies are specific for the Fc portion of another antibody (and antibody already attached to an antigen - an indirect detection). In this case, identification of antibodies to sphyilis spirochete from patient serum. Parents antibodies won't be tagged so a fluorescent _____ antibody is needed.

indirect testing
second

113

_____ are extremely sensitive methods that permit rapid accurate measurement of trace antigen or antibody.

Immunoassays

114

Immunoassays examples

ELISA - enzyme linked immunosorbent assay
enzyme antibody complex used to detect antigen-antibody reactions.
poisitive reactions (binding of antigen-antibody) cause a visible color reaction to occur

115

Indirect ELISA detects ______ in a patients serum.

antibodies

116

Indirect Elisa testing steps

Known antigens are used to coat a plastic plate
patient serum is washed over the plate
patient serum is added, only antibodies specific to the antigen will "stick"
Detects antibodies in a patients serum

117

With indirect ELISA an antigen-antibody interaction indicates the person has been exposed and has ____.

made antibodies

118

HIV exposure leads to the production of HIV antibodies. Even when the person has no _____ symptoms of the disease.

overt

119

With indirect ELISA a second indicator antibody binds to the ______ antigen antibody complex which causes a color change that can be read in a ______ setting.

first
clinical lab

120

Direct ELISA (sandwhich) detects the presence of _____ in a patient sample.

antigen

121

With direct ELISA testing a plate is coated with a ______. Patients serum containing antigens are added and will bind only if specific for the _____.

known bound antibody
antibody

122

In direct ELISA (sandwich) testing a second enzyme linked antibody is ______ and will bind to the antigen which causes a colorimetric reaction to occur.

added

123

When looking for a measles antigen in a patient to diagnose active disease you use a ______ test.

direct ELISA test

124

Looking for measles antibodies would be a poor choice because of previous ______, because antibodies of measles are expected.

vaccinations

125

_____ diseases are commonly diagnosed with serological tests.

bacterial

126

____ phase is the initial phase of injury or disease. It is characterized by the influx of innate immune cells and inflammation (pain, tenderness, swelling, edema, bleeding)

acute

127

_____ is high IgM serum as the initial stages of adaptive immune response begin.

Acute phase serum

128

_____ phase is the recovery phase of an infection/disease. Adaptive immunity has completed its cycle by this point.

convalescent phase

129

______ is low IgM and high IgG in serum (for that particular antigen)

convalescent serum

130

Streptococcus pyogenes is a _____, found in Group A strep, and _____ hemolytic.

gram-positive cocci (chains)
beta hemolytic

131

Infections of ______ is typically begin in the throat or skin. Examples include strep throat (tonsils/throat), impetigo (skin infection), deep skin infection (such as cellulitis, necrotizing fasciitis (flesh eating disease).

streptococcus pyogenes

132

Autoimmune complications including Scarlet fever (joints and heart) and acute glomerulonephritis possible with the species _________.

streptococcus pyogenes

133

Routes of transmission for streptococcus pyogenes includes ______ , but the associated autoimmune disease is not transmissible.

person to person

134

Streptococcus progenies can be diagnosed via a _____ which uses antibodies in test strip to detect presence of GAS antigen. Also, a _____ are also used to confirm GAS pharyngitis.

rapid strep test
bacterial culture

135

A method of prevention for streptococcus progenies includes _____ and _____.

avoidance and hand washing

136

Treponema pallidum is a _____ bacterium, STD and can be transmitted from mother to fetus.

spirochete

137

To prevent transmission from mother to fetus ____ should be done in pregnant women

STD prevention/screening

138

There are ___ stages of syphilis symptoms.

4

139

The ____ stage of syphilis symptoms typically is a single chancre (skin ulceration).

primary

140

The ____ stage of syphilis symptoms is diffusion of a rash frequently onto palms of the hands and soles of the feet.

secondary

141

The ____- stage of syphilis symptoms show a serologic proof of infection present without symptoms of disease.

latent stage

142

The ___ stage of syphilis symptoms displays as gummas, neurological and/or cardiac symptoms begin.

tertiary

143

Treponema palladium cannot be _____ so serological tests are needed.

cultured

144

With Treponema pallidum a direct serological test detects antibodies to ______.

T. pallidum antigens

145

An indirect test of Treponema pallidum shows a syphilis infections because of the the production of nonspecific antibodies that react to _____.

cardiolipin.

146

Cardiolipin is a component of ______, which is present in all of your cells.

mitochondria

147

False positives in an ___ test are possible with Treponema pallidum.

indirect serological

148

Mycoplasma pneumoniae is an atypical ______.

bacterial pneumonia.

149

Mycoplasma pneumoniae can be transmitted with _____ with respiratory secretions of an infected individual.

close contact

150

Mycoplasma pneumoniae is a ____ bacteria with no cell wall, so gram staining cannot be used.

small

151

Symptoms of Mycoplasma pneumoniae has a _____ onset with a lower fever, and usually follows _____.

gradual
another illness

152

Mycoplasma pneumoniae is diagnosed by testing for the presence of ____ antibody to M. pneumonia in serum which indicates early/acute disease)

IgM

153

Mycoplasma pneumoniae is also diagnosed by testing for the presence of ______ (alone or with IgM) which indicates convalescent phase or previous exposure to Mycoplasma.

IgG

154

For prevention of Mycoplasma pneumoniae _____ with infected individuals should be avoided as well as anyone within close quarters.

close contact

155

_____ diseases are commonly diagnosed with serological tests.

viral

156

HIV is a result of _____.

acquired immunodeficiency syndrome (AIDS)

157

HIV is transmitted via infected blood, semen, vaginal fluid, Pre-ejaculate, or _____.

breast milk.

158

HIV is a virus, specifically a ______ in which the RNA genome is incorporated into host cell DNA. (lentivirus family)

retovirus

159

HIV ___ with the immune system.

interferes

160

Progression from HIV to AIDS increases the likelihood of infections, including opportunistic infections and tumors that do not affect people with _____.

healthy immune systems

161

HIV can be diagnosed serologically through the _____ test to detect HIV antibodies.

ELISA

162

Serological testing of HIV looks for antibodies which will not be present in _____ individuals. Secondary tests are used for confirmation.

uninfected

163

HIV methods of prevention includes screening of blood products, abstinence or ____ for sexual transmission, and HIV _____ to decrease the spread from mother to child.

barriers
antivirals

164

_____ viruses A, B, C, D, and E share the same disease symptoms, _____.

Hepatitis
liver inflammation

165

Hepatitis A, B, C, D, and E are not the same virus ____.

type

166

HAV is from the ____ genome.

RNA

167

HBV is from the ____ genome.

DNA

168

HCV is from the ____ genome.

RNA

169

HAV is _____.

acute hepatitis

170

HBV is ______.

acute/chronic hepatitis

171

HCV is ______.

chronic hepatitis.

172

HAV is in the ____ viral family.

picornaviridae

173

HBV is in the _____ viral family.

Hepadnaviridae

174

HCV is in the _____ viral family.

Flaviviridae

175

The onset of symptoms of HAV occurs in ____ weeks. The symptoms are _____ and can last months. It is a self limiting disease without long lasting infection.

2-6 weeks
flu-like symptoms

176

HAV is typically spread through the ____ route and transmitted person to person by ingestion of contaminated food or water (or via direct contact).

fecal-oral route

177

HAV can be prevented via a _____ and hygiene

vaccine

178

Detection of HAV specific ____ antibodies in the blood.

IgM

179

HAV - IgM is detectable from one to two weeks after the ______ and can last up to 14 weeks.

initial infection

180

HAV-IgG in the blood means the ____ stage is over.

acute

181

HBV is an inflammation of the ____ and can cause chronic infection.

liver

182

HBV is a ___ virus.

DNA

183

Exposure to infectious blood or body fluids - STD, transfusion, dialysis, acupuncture, tattooing are methods of transmission for _____.

HBV

184

Perinatal (just before or during birth) infection of HBV is a major route in ______.

endemic countries.

185

HBV is an acute illness that causes liver inflammation, vomiting ,and _____.

jaundice

186

Chronic HBV infection may lead to ____ and liver cancer.

cirrhosis.

187

HBV can be diagnosed via serum tests to detect either HBV antigens or IgM antibodies in the blood ____ in the infection.

early

188

HBV can be diagnosed via serum tests looking for IgG (antigens no longer present-except in chronic carriers) in the _____ stage of infection.

clearing (late infection)

189

Prevention of HBV can occur with vaccinations and by _____.

avoiding infected fluids

190

HCV is an inflammation of the liver. _____ may take years or even decades to develop.

cirrhosis

191

HCV spread via RNA viruses and _____.

blood to blood

192

HCV can be ______ for years.

asymptomatic

193

Acute HCV symptoms are _____ and often overlooked.

flu-like

194

Chronic HCV symptoms include inflammation leads to liver disease (cirrhosis) may take years or even ____ to develop.

decades

195

Acute phase of HCV can be diagnosed through HCV antibodies at ____ weeks after initial infection. ___% of people will clear the infection at this phase.

2-15 weeks
15-30?

196

Chronic HCV infection persists ____ or more.

6 months

197

HCV prevention currently does not have a ____ availability. In addition avoidance of infected blood contact (sexual transmission can happen, but is inefficient).

vaccination