chapter 78 Flashcards by paul theuri

Q

Quality control

A

internal activities that ensure diagnostic accuracy

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Q

Quality Assurance

A

external activities that ensure positive patient outcomes

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Q

performance improvement

A

improve patient care by note making mistakes in the first place; advocate continuous training to guard against having to correct deficiencies.

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Q

proficiency testing

A

maintain an average score of 80% in every area. Will evaluate procedures, reagents equipment and personnel. Should be treated as a real patient specimens.

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Q

Patient outcomes

A

????

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Q

benchmarking

A

compare your lab results with those of your peers

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Q

validity

A

how accurate is the results compared to the ATCC is concerned with the study’s success at measuring what the researchers set out to measure.

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Q

Reliability

A

the instrument should be 100% leaning to the exact valueis concerned with the accuracy of the actual measuring instrument or procedure

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Q

SOP

A

Standard operating procedures.

requirements for specimen collection and transport
daily or routine QC
procedure for processing specimens
procedure for direct examination of specimens and rapid testing
procedure for culture identification and susceptibility testing

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Q

Reference Organisms

A

a strain collection comprising bacteria, fungi, and algae, which can be used in standardized testing procedures as reference organisms

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Q

ATCC

A

American Type culture collection. They behave like an actual specimen in both physical and biochemical characteristics and are utilized and are utilized to confirm the validity and reliability of media, reagents and biochemical procedures.
reference organism. the number following the ATCC indicates the strain

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Q

CLSI

A

specimen collection, SOP manual, personnel: requires documentation of qualifications, continuing education, on the job training and competency.

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Q

Exempt vs non exempt media

A

commercially prepared media should be exempted form QC apart from chocolate. Personal prepared media should be always be QC and are non-exempted

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Q

panic values

A

must be communicated immediaetly to an authorized clinician and documented

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Q

turn around time

A

how quick the result can atoned or diagnosed

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Q

Qualitative vs Quantitative

A

Qualitative test does not you give the results in numbers(susceptible, intermediate, resistant )
Quantitative test give you results in numbers/count

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Q

MIC

A

Minimal Inhibitory concentration. Dilution testing methods are used to determine the minimal concentration of an antimicrobial agent required to inhibit or kill a microorganism..

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Q

MBC

A

minimum bacterial concentration ??????

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Q

SBT

A

serum bacterial test

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Q

Microdilution

A

technique used to measure antibiotic susceptibity in which the drug is diluted in a broth

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Q

peak and trough

A

peak is the highest point of the drug after intake

trough is the lowest level of the drug in the body before intake of the drug

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Q

Intrinsic and acquired resistant

A

intrinsic normal genetic structural or phsylogiacal state of an organism
acquired results from altered cellular physiology and structure changes in the organism usual genetic makeup. unpredictable

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Q

modes of action

A

how an antimicrobial functions

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Q

Synergy

A

activity of combination substantially greater than activity of single most active drug alone.

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Antagosim

activity of the combination is substantially less than the activity of the single most active drug alone.

Drug of choice

This is predicting which isolate of bacteria is susceptible to the antimicrobial agent that is commonly used against them.

Erythromycin

class : Macrolides spectrum: gram positive bacteria mode of action: protein synthesis is inhibited Bactriostatic

Gentamicin

class: Aminoglycosides spectrum:gram pos & gram neg mode of action: inhibits protein synthesis bactericidal

Vancomycin

class: Glycopeptides spectrum: gram pos mode of action: inhibit bacterial wall synthesis bactericidal

Levoflaxin

class: Quinolones spectrum: gram pos and gram neg mode of action: inhibits DNA synthesis bactericidal

Cefazolin Ampicilin piperacillin Imipenem

class: Beta Lactams spectrum: gram pos % gram neg mode of action: inhibit cell wall synthesis bactericidal

Cefazolin

class: Beta Lactams spectrum: gram pos % gram neg mode of action: inhibit cell wall synthesis bactericidal

Ampicilin

class: Beta Lactams spectrum: gram pos % gram neg mode of action: inhibit cell wall synthesis bactericidal

piperacillin

class: Beta Lactams spectrum: gram pos % gram neg mode of action: inhibit cell wall synthesis bactericidal

Imipenem

class: Beta Lactams spectrum: gram pos % gram neg mode of action: inhibit cell wall synthesis bactericidal

Fluconazole

class: Azole spectrum: Fungi(yeast) modes of action: disrupt the fungal cells membrane

Linezolid

class:Oxazolidinones spectrum: gram pos mode of action: interfere with initiation of protein synthesis bacteriostatic

predictor drugs for Strep.pneumoniae

Oxacillin disk for penicillin resistance in Strep.pneimoniae

What are the 2 tests for beta-lactamases

chromogenic cephalosporin and acidometric

what is bacterias are the beta-lactamase tests routinely used for

H.Influenza, N.gonorrhea, Strap. species. Moraxella.sp

what is extended spectrum Beta-Lactamase

ESBL's are enzymes that mediate resistance to extended-spectrum (third generation) cephalosporins and monobactams but do not affect cephamycins or carbapenems.

what organisms are routinely tested for ESBL

K,pneumoniae, E.coli K.oytoca

what is CRE

a family of bacteria that are hard to treat because they have a high resistant to antibiotics. aka KPC are plasmid borne resistant mechanisms and are capable of crossing genetic elements, from one organism to another and across genus and species lines

CRE

Carbapenem-resistant Enterobacteriaceae

Two organisms that can be carbapenem resistant and are normal flora to the gut bacteria

Klebsiella and E.coli

what antibiotics are MRSA resistant

oxacillin, Methicillin, Penicillin, amoxicillin

Name 3 examples of natural intrinsic resistant to antibacterial agents

1: gram negative bacteria VRS vancomycin 2: klebsiella spp versus ampicillin (a B-lactam) target 3: Enterococci versus aminoglycosides

Mechanism of gram negative bacteria vrs vancomycin

lack of uptake resulting form inability of vancomycin to penetrate outer membrane

mechanism of klebsiella spp versus ampicillin(B-lactam)

production of enzymes that destroy ampicillin before the drug can reach the PBP (penicillin binding proteins)

Mechanism of Enterococci versus aminoglycosides

lack of sufficient oxidative metabolism to drive uptake of aminoglycosides

what is the benefits of E-test

it combines the mic with disk diffusion

ESBLs

Enzymes that mediate(brings out) resistance to extended-spectrum cephalosporins and monobactams but do not affect cephamycins or carbapenems

CQI

continuous quality improvement

name 4 criteria of antimicrobials to be tested

site of infections availability known strain resistant method

beta lactamase testing methods

chromogenic cephalosporin | acodometric

what does natural selection mean in the subject of resistant strains

will kill of susceptible strains and leave resistant strains

what 3 factors influence resistant?

biological, clinical and environmental

???????

Due to increased resistance observed with penicillin, OX is more sensitive and reliable indicator Perform MIC for confirmation

what does the beta-lactamase enzyme do

it disrupts the beta-lactam ring. It can not bind to PBP and inhibits cell wall synthesis

Describe the action of the (amoxicillin or ticarcillin)/clavulanic acid combination.

2 beta lactams beta lactam/ beta lactamase inhibitor. Inhibitor renders B-lactamase incapable , beta lactam drug (b-lact sens.) exerts it's activity

How does MRSA resist antibiotics

it produces altered PBP's that the antimicrobial cannot inhibit cell wall synthesis

what is MRSA

a strain of Staphylococcus aureus that is resistant to beta-lactam antibiotic.

what is vancomycin screening agar used to detect

resistant enterococcus (VRE) or resistant or intermediate staphylococcus (VRSA, VISA)

mechanism of gram neg bacteria vrs vancomycin

lack of uptake of vancomycin resulting to inability of the drug to penetrate the bacteria

klebsiella spp vrs ampicillin

production of enzyme that destroys the drug before it reaches the penicillin binding protein.

enterococci vrs aminoglycosides

lack of sufficient oxidation metabolism for the uptake of the aminoglycosides

what is used to detect/screen MRSA

Oxacillin salt agar

TQM

total quality management: | activity to improve total care by monitoring the lab work to detect deficiencies and correct them.

``` Preanalytical analytical postanalytical patient preparation sample collection sample handling and storage information dissemination to medical staff ```

preanalytical

Preanalytical analytical postanalytical preventive maintenance on equipment instrumentation function checks and calibrations quality control and management of media and reagents

analytical

Preanalytical analytical postanalytical recording of results transmission of results within an acceptable interval

post analytical

JCAHO

It monitors the quality of the care given by healthcare professionals, most often in hosptials, but they also over see nursing homes and such as well.

CAP

give accreditation for the lab