Flashcards in Chapter 15 Deck (197)
The traditional mode of bacterial identification is via ______ characteristics.
Physiological/biochemcial characteristics look at the presence of specific enzymes and assesses _______ and _____ activities for bacterial identification.
nutritional and metabolic activities
Examples of physiological/biochemical characteristics
fermentation of different sugars
production of gas during fermentation/metabolism
presence of enzymes
sensitivity to different antimicrobial drugs
_____ analysis analyzes the types of specific structural substances that the microorganism contains.
Examples of chemical analysis of microbial diseases
Chemical composition of the cell wall
Different lipids present in the plasma membranes
______ methods analyze the cause of microbial disease by looking at the genome (DNA profile) of the microbe.
_____ can be used to identify organisms and also to connect strains causing outbreaks.
_____ can be used to identify organisms and connect strains causing outbreaks. ____ contaminating apple juice is an example.
Primary advantage over traditional methods of genotypic methods is that _____ is unnecessary.
Genotypic methods is an ____ process that offers quick results.
______ is the study of blood serum and other bodily fluids.
Diagnostic identification of antibody/antigen response can be found using a patients ____.
The presence of _____ can indicate past exposure, vaccination or current infection.
The presence of ______ usually indicates an active (or acute/chronic) infection (organism still present)
there are lab kits available for immediate identification of a number of _____.
Laboratory tests are essential to diagnosis and ______ of the disease.
Success depends on how specimens are _____, ____, and stored.
STAT for lab results means short for _____, the Latin word for "immediately"
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.
Specific rules for specimen collection vary depending on _____.
_____ is when you wear gloves, gowns, masks, eye protection when appropriate.
______ by the normal microflora (such as that of the skin or mucous membranes).
Ways to minimize contamination is to gather a urine sample ______ or alcohol swab skin sites before a blood draw.
During specimen collection it is important to label well -- patient identifiers, _______, date and time of collection, etc.
Specimen collection is best done prior to ____ therapy has begun (if possible).
Be aware of what is being ______, think of potentially dangerous pathogens.
_____ specimen draw/collection when possible. The specimen can be divided later for multiple tests if needed.
Be aware of storage times, _____ and temperature for specimen collected.
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 should be caught ______ to reduce the numbers of contaminating microflora from the peri-urethral area (much of which washes aware at start of urination)
______ is the most concentrated and will contain larger numbers of organisms.
FMU - First morning urine
_____ collection has the lowest risk of microflora contamination and is typically does when the patient is unable to urinate independently.
Typically, the presence of a single type of bacteria growing at high number is considered a _____ UTI
Greater too or equal too ______ CFU/mL indicates a single bacterial type.
______ up to 1000,000 CFU/mL indicates a single bacterial type in conjunction with symptoms of a UTI
1,000 CFU/mL or more indicates an infection from a ______ due to lower contamination.
If a urine culture shows growth of several different types of bacteria - likely due to _____.
Common contaminates of urine are _______ and E. coli.
_____ is a measure of viable (living) bacteria.
colony forming unit (CFU)
CFU/mL (colony forming units per mililiter) is used for ____.
Plate 1/____ of a ml (small enough volume to plate)
Multiply the number of resulting colonies by 100 to determine # of bacteria that was in ________.
the original 1ml volume.
1 ml of urine
colonies x 100 = CFU/ml
25 x 100 = CFU or 2500
_____ is normally sterile.
Contamination risk of blood occurs if there is improper cleaning of the skin or handling of collection tubes and _____ (aseptic technique is important here)
Origins of blood infection occurs when _____ can access the blood.
Blood infections can originate from surgery, dental work, catheters, or _____.
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.
______ fluid surrounds the brain and spinal cord.
cerebrospinal fluid (CSF)
CSF is normally _____ free.
Cerebrospinal fluid is collected via a ______.
lumbar puncture (spinal tap)
The most common purpose to collect CSF is to look for _____.
The puncture site for CSF should be sterilized to avoid contamination of ____.
normal skin flora
______ can be performed on a sediment of CSF.
a gram stain
A _____ provides quick results for immediate treatment (time is important for meningitis diagnosis and treatment)
A gram stain shows ____ organisms in about 60% of cases of bacterial meningitis.
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.
______ culture is also performed for both aerobic and anaerobic bacteria. This takes a few days, not immediate with a gram stain.
________ is when no organisms grow in cultures of CSF specimen, but clear symptoms are present.
Haemophilus influenzae is a form of ____ meningitis in which the infection spreads from respiratory tract to bloodstream, and then to the meninges.
Neisseria meningitidis is the ______ form of bacterial meningitis in children and the second most common cause of bacterial meningitis in adults.
Streptococcus pneumoniae is the most common cause of bacterial meningitis in ___.
Skin microflora is the biggest challenge for contamination during collection of a ______.
Transportation conditions/timing is important to prevent _______ of any contaminants in specimen collection of skin.
When collecting skin specimens avoid skin _____ as this has high levels of microflora.
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)
In lower respiratory specimens contamination from ____ is common.
Lower respiratory specimens collection can reduce contaminants by having patients _____ with sterile water or solution (or even brushing teeth)
A lower respiratory speciman can be collected via _______ to gather sputum or expectorated.
______ induced, uses a nebulizer, patient inhales sterile saline and coughs deeply to bring up samples for lower respiratory specimens.
Upper respiratory specimens can be collected three different ways: _____, _____, and _____.
oral, nasal, throat
During upper respiratory specimen collection from the oral cavity, targets lesions and avoid "normal" areas. ______ is hard to avoid from oral flora.
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).
During upper respiratory specimen collection from the _____, the tonsils are swabbed as well as inflamed areas. Most commonly done to look for ________.
Several things can be done to analyze patients _____.
Direct testis using microscopic, immunologic, or ______ methods.
Cultivation, isolation, and _______ of pathogens using a wide variety of general and specific tests.
Results of specimen analysis entered in a summary _______.
_______ tests contain various biochemical tests that allow you to get a broad view of the metabolic profile of the organism.
Rapid tests can analyze carbohydrate _____.
Rapid tests can analyze enzyme actions such as ______ and coagulase.
______ is a cytogenetic technique that uses fluorescent probes that bind to specific parts of DNA.
FISH (Fluorescent in situ hybridization)
FISH is used in _____ analysis.
nucleic acid (DNA, RNA)
The fluorescent probes can be designed to target DNA found only in the ______ of a specific species.
The FISH technique can give results _____.
In mixed infections, only the _____ species will light up.
Immunological techniques are used to study the immune system and methods that use immunological _____ as experimental tools.
The most common immunological methods involve the production of _____ to detect specific proteins in a sample.
Analyzing antibodies can reveal _____ of a patient's contact with microorganisms.
______ is the branch of immunology that traditionally deals with in vitro diagnostic testing of the serum.
Important factors to consider hone using antibody/analysis is specificity and _____.
______ is how specific an antibody is for its corresponding antigen. Highly specific is desirable to avoid false positive results.
_____ 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.
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.
known specific antigen
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.
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.
To identify an unknown organism, the unknown microbe is mixed with a ______ specific for particular organism.
When trying to identify an unknown organism the test looks for microbe/antibody ____.
Microbe surface antigens will only bind the known antibody that is specific for it (__________)
equalling a poisitive identification
Agglutination and ______ reactions depend on the interaction of antibodies and antigens.
Major differences between precipitation and agglutination is the _____ of antigens involved and if they are soluble or insoluble.
Antigens that are ______ cause precipitation.
Antigens that are _____ cause agglutination.
______ is when an antigen-antibody reaction produces visible clumps
______ reaction is an interaction of soluble antigens with antibodies leads to precipitation out of solution.
Streptococcus pneumoniae capsule is _______, the reaction of the capsule to specific antibody results in precipitation of the antigen antibody complex out of solution.
_____ is a technique which is used in conjunction with a fluorescence microscope.
Immunofluorescence uses the specificity of antibodies to their antigen to target fluorescent dyes to specific _______ or ______.
microbes or antigens
Immuofluorescense allows _____ of the sample when antibody binds with the target.
______ 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)
________ is used for syphilis spirochete.
_______ 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.
_____ are extremely sensitive methods that permit rapid accurate measurement of trace antigen or antibody.
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
Indirect ELISA detects ______ in a patients serum.
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
With indirect ELISA an antigen-antibody interaction indicates the person has been exposed and has ____.
HIV exposure leads to the production of HIV antibodies. Even when the person has no _____ symptoms of the disease.
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.
Direct ELISA (sandwhich) detects the presence of _____ in a patient sample.
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
In direct ELISA (sandwich) testing a second enzyme linked antibody is ______ and will bind to the antigen which causes a colorimetric reaction to occur.
When looking for a measles antigen in a patient to diagnose active disease you use a ______ test.
direct ELISA test
Looking for measles antibodies would be a poor choice because of previous ______, because antibodies of measles are expected.
_____ diseases are commonly diagnosed with serological tests.
____ 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)
_____ is high IgM serum as the initial stages of adaptive immune response begin.
Acute phase serum
_____ phase is the recovery phase of an infection/disease. Adaptive immunity has completed its cycle by this point.
______ is low IgM and high IgG in serum (for that particular antigen)
Streptococcus pyogenes is a _____, found in Group A strep, and _____ hemolytic.
gram-positive cocci (chains)
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).
Autoimmune complications including Scarlet fever (joints and heart) and acute glomerulonephritis possible with the species _________.
Routes of transmission for streptococcus pyogenes includes ______ , but the associated autoimmune disease is not transmissible.
person to person
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
A method of prevention for streptococcus progenies includes _____ and _____.
avoidance and hand washing
Treponema pallidum is a _____ bacterium, STD and can be transmitted from mother to fetus.
To prevent transmission from mother to fetus ____ should be done in pregnant women
There are ___ stages of syphilis symptoms.
The ____ stage of syphilis symptoms typically is a single chancre (skin ulceration).
The ____ stage of syphilis symptoms is diffusion of a rash frequently onto palms of the hands and soles of the feet.
The ____- stage of syphilis symptoms show a serologic proof of infection present without symptoms of disease.
The ___ stage of syphilis symptoms displays as gummas, neurological and/or cardiac symptoms begin.
Treponema palladium cannot be _____ so serological tests are needed.
With Treponema pallidum a direct serological test detects antibodies to ______.
T. pallidum antigens
An indirect test of Treponema pallidum shows a syphilis infections because of the the production of nonspecific antibodies that react to _____.
Cardiolipin is a component of ______, which is present in all of your cells.
False positives in an ___ test are possible with Treponema pallidum.
Mycoplasma pneumoniae is an atypical ______.
Mycoplasma pneumoniae can be transmitted with _____ with respiratory secretions of an infected individual.
Mycoplasma pneumoniae is a ____ bacteria with no cell wall, so gram staining cannot be used.
Symptoms of Mycoplasma pneumoniae has a _____ onset with a lower fever, and usually follows _____.
Mycoplasma pneumoniae is diagnosed by testing for the presence of ____ antibody to M. pneumonia in serum which indicates early/acute disease)
Mycoplasma pneumoniae is also diagnosed by testing for the presence of ______ (alone or with IgM) which indicates convalescent phase or previous exposure to Mycoplasma.
For prevention of Mycoplasma pneumoniae _____ with infected individuals should be avoided as well as anyone within close quarters.
_____ diseases are commonly diagnosed with serological tests.
HIV is a result of _____.
acquired immunodeficiency syndrome (AIDS)
HIV is transmitted via infected blood, semen, vaginal fluid, Pre-ejaculate, or _____.
HIV is a virus, specifically a ______ in which the RNA genome is incorporated into host cell DNA. (lentivirus family)
HIV ___ with the immune system.
Progression from HIV to AIDS increases the likelihood of infections, including opportunistic infections and tumors that do not affect people with _____.
healthy immune systems
HIV can be diagnosed serologically through the _____ test to detect HIV antibodies.
Serological testing of HIV looks for antibodies which will not be present in _____ individuals. Secondary tests are used for confirmation.
HIV methods of prevention includes screening of blood products, abstinence or ____ for sexual transmission, and HIV _____ to decrease the spread from mother to child.
_____ viruses A, B, C, D, and E share the same disease symptoms, _____.
Hepatitis A, B, C, D, and E are not the same virus ____.
HAV is from the ____ genome.
HBV is from the ____ genome.
HCV is from the ____ genome.
HAV is _____.
HBV is ______.
HCV is ______.
HAV is in the ____ viral family.
HBV is in the _____ viral family.
HCV is in the _____ viral family.
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.
HAV is typically spread through the ____ route and transmitted person to person by ingestion of contaminated food or water (or via direct contact).
HAV can be prevented via a _____ and hygiene
Detection of HAV specific ____ antibodies in the blood.
HAV - IgM is detectable from one to two weeks after the ______ and can last up to 14 weeks.
HAV-IgG in the blood means the ____ stage is over.
HBV is an inflammation of the ____ and can cause chronic infection.
HBV is a ___ virus.
Exposure to infectious blood or body fluids - STD, transfusion, dialysis, acupuncture, tattooing are methods of transmission for _____.
Perinatal (just before or during birth) infection of HBV is a major route in ______.
HBV is an acute illness that causes liver inflammation, vomiting ,and _____.
Chronic HBV infection may lead to ____ and liver cancer.
HBV can be diagnosed via serum tests to detect either HBV antigens or IgM antibodies in the blood ____ in the infection.
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)
Prevention of HBV can occur with vaccinations and by _____.
avoiding infected fluids
HCV is an inflammation of the liver. _____ may take years or even decades to develop.
HCV spread via RNA viruses and _____.
blood to blood
HCV can be ______ for years.
Acute HCV symptoms are _____ and often overlooked.
Chronic HCV symptoms include inflammation leads to liver disease (cirrhosis) may take years or even ____ to develop.
Acute phase of HCV can be diagnosed through HCV antibodies at ____ weeks after initial infection. ___% of people will clear the infection at this phase.
Chronic HCV infection persists ____ or more.