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Infectious disease > diagnostic & therapeutic techniques > Flashcards

diagnostic & therapeutic techniques Flashcards

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1
Q

general symptoms of infection

A

fatigue, fever, chills

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2
Q

symptoms of skin/wound infection

A

redness, swelling, discharge, tenderness

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3
Q

lower rsp tract infection symptoms

A

productive cough, SOB, pleuritic chest pain

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4
Q

upper rsp tract infection symptoms

A

congestion, discharge/drainage, HA/pain/pressure

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5
Q

GI infection symptoms

A

abd pain, N/V/D

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6
Q

genitourinary infection symptoms

A

pain/burning while urinating, vaginal/urethral discharge

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7
Q

neuro infection symptoms

A

HA, confusion, altered mental status

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8
Q

MSK infection symptoms

A

joint pain, swelling, redness, warmth

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9
Q

WBC is typically elevated in the presence of ?

A

infection
leukocytosis

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10
Q

what are 5 types measured in differential WBC

A
  1. neutrophil
  2. lymphocyte
  3. monocyte
  4. eosinophil
  5. basophil
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11
Q

what WBC are granulocytes and what are agranulocytes

A

granulocyte - neutrophil, eosinophil, basophil
agranulocyte - lymphocyte, monocyte

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12
Q

what is the most abundant and least abundant WBC

A

most - neutrophil
least - basophil
“Never Let Monkeys Eat Bananas”

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13
Q

what is the primary defense in bacterial infections and first to arrive at site of infection

A

neutrophil
also active in fungal infections and physiologic stress

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14
Q

when bone marrow is signaled to make more neutrophils due to presence of infection

A

immature neutrophils (bands)
“left shift”

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15
Q

primary defense for viral infections

A

lymphocytes
“clean up” cells

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16
Q

what is the most common WBC in lymph

A

lymphocytes

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17
Q

what is the largest WBC and is elevated in late/chronic infection

A

monocytes
can migrate into tissue/organs and become macrophages

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18
Q

what WBC is seen in allergic reactions and parasitic infections

A

eosinophils

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19
Q

what is seen in hypersensitivity reactions and releases inflammatory mediators

A

basophils

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20
Q

for a “clean catch,” collect the urine sample when urine has only been in the bladder for ?

A

2-3h

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21
Q

urinalysis symptoms of a UTI

A

color - cloud/turbid - has pyuria
odor - strong/fishy odor
chemical dipstick - leukocyte esterase, nitrites, blood
microscopic examination - WBC, RBC, microorganisms, casts

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22
Q

leukocyte esterase in a dipstick analysis shows

A

enzymes made by WBC
increased WBC in urine

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23
Q

nitrites are produced by ___ in a dipstick analysis

A

g-

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24
Q

blood in a dipstick analysis suggests ?

A

infection/inflammation/injury in urinary tract

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25
RBC present in a dipstick analysis is indicative of
infection/inflammation/injury
26
Casts in dipstick analysis is indicative of
kidney infection
27
wet prep/KOH prep is indicated for
vaginal/cervical/urethral discharge
28
difference between wet and KOH prep
wet - specimen placed on slide with saline solution - clue cells (BV), protozoans (trichomonas) KOH - with KOH - fungal cells
29
epithelial cells of the vagina that get their distinctive stippled appearance by being covered with bacteria
clue cells
30
difference between lateral decubitis vs upright positions during LP positioning
lateral decubitis - opening pressure is needed upright - opening pressure isn't needed
31
normal physical/lab characteristics of CSF
clear and colorless almost same viscosity of water No RBC < 5 WBC present glucose - 50 - 75 mg/dL No protein
32
increased pressure of CSF is indicative of
infection, tumor, intracranial bleed
33
decreased pressure of CSF is indicative of
dehydration, CSF leakage
34
cloudy/turbid CSF color is indicative of
infection
35
xanthochromia in CSF is indicative of
bleeding
36
thick CSF is indicative of
infection or malignancy
37
what is the main complication from lumbar punctures
headache*
38
normal pleural fluid has ____ number of WBC with ___ RBC or microorganisms
small no
39
RBC present in pleural fluid analysis is indicative of
trauma or malignancy
40
imbalance between pressure within blood vessels and the amount of protein in blood
transudate
41
fluid caused by injury or inflammation of the pleura resulting in pleural effusion
exudate
42
2 pleural fluid analysis
1. microscopic exam - total cell counts - cytology 2. infectious disease test - gram stain - bacterial C&S - individualized testing
43
milky pleural fluid is indicative of
lymphatic system involvement
44
reddish pleural fluid may indicate presence of
blood
45
cloudy, thick pleural fluid may indicate
presence of microorganisms and/or WBC
46
chemical tests for pleural fluid analysis
1. glucose - decrease in infection, additional decrease pH in malignancy 2. lactate levels - increase with infectious pleuritis 3. amylase - increase in pancreatitis, esophageal rupture, malignancy 4. TG levels - increase with lymphatic system 5. tumor markers - increase
47
what is used to help diagnose the cause of peritonitis or ascites (peritoneal fluid accumulation)
paracentesis causes: - new onset ascites - large or refractory ascites - suspected spontaneous or secondary bacterial peritonitis
48
what is used to diagnose the cause of joint effusions? s/s?
arthrocentesis s/s: joint pain, joint swelling, erythema, warmth
49
obtain chest x-ray when there are s/s of pulmonary infection:
1. dyspnea, SOB 2. cough 3. fever, chills 4. pleuritic chest pain
50
used to screen pulmonary infection, masses, trauma and other pathologies
CXR
51
uses radiation to produce images
CT scan
52
uses powerful magnetic fields and radio frequency pulses to produce images
MRI
53
cells stained purple are
G+ cells thick cell walls
54
cells stained blue are
G- cells thin cell wall
55
cell turns pinkish red with safranin red is
g-
56
cell is purple with safranin red is
g+
57
G+ staphylococcus
s. aureus s. epidermidis
58
G+ streptococci a-hemolytic
1. s. pneumonaie 2. s. viridans
59
G+ streptococci B-hemolytic
1. S. pyogenes 2. S. agalactiae 3. s. Bovis
60
G+ steptococci y-hemolytic
s. enterococcus
61
g+ rods
1. corynebacterium - c. diphtheriae 2. clostridium - c. difficiles 3. bacillus - b. anthracis - b. cereus 4. lactobacillus - l. acidophilus 5. listeria - l. monocytogenes
62
G- cocci (3)
1. acinetobacter 2. moraxella - m. cat 3. neisseria - n. gonorrhea - n. meningitidis
63
g- rods (16)
1. bacteroides - B. fragilis 2. campylobacter 3. enterobacter 4. escherichia - E. coli 5. klebsiella 6. proteus 7. helicobacter - H. pylori 8. pseudomonas 9. salmonella 10. serratia 11. shigella 12. vibrio - V. cholera 13. yersinia - Y. pestis 14. haemophilus - H. flu 15. legionella - L. pneumonphila 16. bordetella - B. pertussis
64
why is gram stain important in clinical medicine
1. aids in selection of culture media 2. initial selection of abx 3. establish preliminary dx
65
if a culture is negative for bacteria, it does not rule out an infection bc:
1. pathogen may not be present in large quantities 2. symptoms could be due to a viral infection 3. pt could have been on previous abx
66
for blood cultures are ordered ___ or more samples from ___ locations
two, two
67
stool culture labs evaluate for most common intestinal ____ pathogens
bacterial
68
to test for parasites, you must order:
stool for ova and parasites
69
a urine culture is positive when ?
+100k colonies of a single bacteria men and some cath specimens = 1k>
70
rust colored sputum is caused by what organism
s. pneumoniae
71
yellowish/green sputum is caused by what organism
H. flu
72
green sputum is caused by what organism
pseudomonas
73
red, currant-jelly sputum is caused by what organism
klebsiella
74
bloody sputum is caused by what organism
tuberculosis
75
foul-smelling/bad tasting sputum is caused by what organism
anerobe
76
thin/scant sticky sputum is caused by what organism
atypicals - mycoplasma pneumoniae, c. pneumonaie
77
used to determine whether a person with pharyngitis has a group A streptococcal infection
rapid strep test
78
when do you perform a throat culture
when a strep test is negative
79
avoid strep throat testing in children how old
< 3
80
avoid routine rapid strep testing of what type of pt
asx children <3y/o
81
4 criteria for throat culture
1. hx of fever 2. tonsillar exudate 3. tender anterior cervical adenopathy 4. absence of cough <15y/o +1 >44y/o -1
82
negative throat culture is a sore throat caused by ?
viral infection
83
most common cause of viral sore throat
adenovirus
84
sensitivity testing is not necessary when...
most common pathogens are known and are known to be susceptible to first line tx
85
when is sensitivity testing indicated (4)
1. pathogens are unknown or mixed pathogens 2. known resistance 3. severe infection 4. infection is not responding to typical first line tx
86
what are the 4 CSF tubes
1. WBC w/diff 2. glucose and protein 3. gram stain, C&S 4. other - ordered if initial tests are abnormal - lactic acids - lactate dehydrogenase (LDH) - C-reactive protein - (all will increase if infection present)
87
clear fluid low protein/albumin/LDH few cell count what type of fluid?
transudate
88
fluid can appear cloudy high protein/albumin/LDH increased cell count what type of fluid?
exudate
89
according to Light's criteria, pleural effusion is likely exudative if at least one of the following exists:
1. pleural fluid protein:serum protein ratio >5.0 2. pleural fluid LDH:serum LDH ratio >0.6 3. pleural fluid LDH is >0.6 or >2/3 times the normal upper limit for serum LDH
90
increased viscosity from an arthrocentesis is indicative of ? decreased viscosity?
increased = sepsis decreased = inflammation string-like = normal
91
lobar consolidation is usually seen in ? while patchy nodular infiltrates is usually seen in ?
pneumonia pulmonary edema (CHF)
92
process of gram stain illustration
1. stain with crystal violet dye 2. grams iodine solution (causes dye to stick more onto cell wall) 3. decolorize with alcohol and acetone 4. counterstain with safranin red
93
what is the most common pathogen in urine cx
e. coli
94
when do you order a sputum cx?
when you suspect a bacterial infection in the lungs (pneumonia) may be ordered after tx of an infection to see effectiveness
95
what are the most common bacterial pathogens in sputum cx
1. strep 2. staph 3. haemophilus 4. klebsiella
96
lowest concentration of drug that *inhibits* the growth of the organism
minimum inhibitory concentration (MIC)
97
what is the zone of inhibition
abxx is effective against the bacteria, leaving a clear ring
98
how long does sensitivity testing take?
24-48 h AFTER organisms have been identified on culture
99
how are sensitivity tests reported?
susceptible intermediate resistant

Infectious disease (15 decks)

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