Misc body sites (Eye and Body Fluids)

Question 1

What are the three syndromes associated with eye infection?

Answer 1

Conjunctivitis, bacterial keratitis, bacterial endopthalmitis

Question 2

Source is usually direct inoculation of exogenous organism from fomites, hands, environment or hematogenous spread

Answer 2

Conjunctivitis

Question 3

Corneal infections include prior ocular disease, contact lens wearers, and topical corticosteroids.

Answer 3

Bacterial keratitis

Question 4

Most serious; from trauma (including surgery) to the eye

Answer 4

Bacterial endophthalmitis

Question 5

What are the specimen types for eye cultures?

Answer 5

swab, corneal scrapings, conjunctival scrapings, and vitreous fluid

Question 6

Potential Pathogens for bacterial endophthalmitis?

Answer 6

All isolates should be considered significant

Question 7

What is common contaminating flora for all eye cultures?

Answer 7

Coagulase negative staph
Diphtheroid bacilli
Viridans strep

Question 8

What is the rule to determine the workup flow for eye cultures?

Answer 8

Rule of 3

Question 9

An oddball organism that is considered on the rise for causes of eye infections?

Answer 9

Acanthamoeba sp (parasite)

Question 10

T or F. Drainages are sterile fluids.

Answer 10

False

Question 11

When is a critical value reported for a body fluid culture?

Answer 11

Any time an organism is seen in a gram stain

Question 12

Of the collection tubes for CSF, which tubes go to micro for testing?

Answer 12

2 and 3

Question 13

What kind of body fluids culture do we use thioglycolate broth for?

Answer 13

peritoneal dialysis fluids, bone marrows, and CSF shunt fluid

Question 14

What method do we use for a direct gram stain of body fluids?

Answer 14

CYTOSPIN

Question 15

T or F? You can refrigerate CSF.

Answer 15

False

Question 16

What plate do we use for culture of Non-CSF fluid, that we don’t use for CSF fluid?

Answer 16

MAC

Question 17

If one organism is observed per oil immersion field, then at least how many organisms are there per mL or specimen?

Answer 17

10^5

Question 18

If you want to submit a body fluid culture in a blood culture bottle, what extra things will you need to do?

Answer 18

Ensure anticoagulant is added to the bottles, and submit extra fluid for gram stain

Question 19

What are the cons of sending body fluids in blood culture bottles?

Answer 19

No quantitation, certain organisms require blood to grow, and lab must validate

Question 20

What are the pros of sending body fluids in blood culture bottles?

Answer 20

Bottles w/ additives that neutralize antimicrobials, better recovery using larger inoculum, recommended by ASM, JMC, and numerous studies

Question 21

What are potential contaminants of non-CSF body fluid culture?

Answer 21

Coag negative staph, Diptheroid bacilli, and Viridans strep

Question 22

What rule is followed when working up pathogens from a non-CSF body fluid?

Answer 22

Rule of 3; > 3 semiquantitate all and list descriptive IDs

Question 23

Where is CSF found?

Answer 23

Around the brain in the subarachnoid space and in the spinal cord

Question 24

Minimizes the passage of infectious agents into CSF.

Answer 24

Blood brain barrier

Question 25

Infection in the subarachnoid space

Answer 25

Meningitis

Question 26

Many PMNs (neutrophils) in CSF

Answer 26

Purulent

Question 27

What kind of infection is purulence indicative of?

Answer 27

Bacterial infection

Question 28

Usually viral | Increase in CSF lymphocytes

Answer 28

Aseptic

Question 29

What does a low glucose indicate?

Answer 29

Infection is present and bacteria are feeding on glucose

Question 30

Potential pathogens of the CSF in neonates and infants?

Answer 30

S. agalactiae (Group B Strep), E. coli, and Listeria monocytogenes

Question 31

Potential pathogens of the CSF in children?

Answer 31

H. influenzae, S. pneumoniae, N. meningitidis

Question 32

Potential pathogens of the CSF in young adults?

Answer 32

N. meningitidis

Question 33

Potential pathogens of the CSF in adults?

Answer 33

S. pneumoniae, N. meningitidis

Question 34

Potential pathogens of the CSF in elderly?

Answer 34

S. pneumoniae, L. monocytogenes, GNB

Question 35

Potential pathogens of the CSF in AIDS patients?

Answer 35

Cryptococcus neoformans

Question 36

Fever Stiff neck Change in mental status

Answer 36

Symptoms of acute meningitis

Question 37

Increased PMN leukocytes Decreased glucose in CSF Increased protein in CSF

Answer 37

Findings in bacterial meningitis

Question 38

Often occurs in | patients who are immunocompromised.

Answer 38

Chronic meningitis

Question 39

What are the symptoms of chronic meningitis?

Answer 39

The same as acute meningitis

Question 40

Increase in lymphocytes Elevated protein Decreased glucose

Answer 40

Findings in chronic meningitis

Question 41

Inflammation of the peritoneum membrane

Answer 41

Peritonitis

Question 42

What patients are particularly susceptible to peritonitis?

Answer 42

End stage renal patients

Question 43

What are common agents of peritonitis?

Answer 43

Bowel flora/anaerobes, often polymicrobial

Question 44

What other complication may occur along with pericarditis?

Answer 44

Myocarditis

Question 45

What is pericarditis usually caused by?

Answer 45

Viral agents

Question 46

Inflammation of the joint space

Answer 46

Arthritis

Question 47

Common causes of septic arthritis?

Answer 47

- N. gonorrhoeae – most common in young adults - Haemophilus influenzae in young children - Streptococci - Anaerobic bacteria (Bacteroides)

Question 48

When might it be necessary to culture a bone marrow aspiration or biopsy?

Answer 48

To diagnose brucellosis, histoplasmosis, blastomycosis, tuberculosis, and leishmaniasis

Question 49

Where is bone marrow aspirated from?

Answer 49

Interstitium of the iliac crest

Question 50

What do we collect bone marrow in for culture?

Answer 50

Sodium Polyethanol Sulfonate (SPS)

Question 51

What are the potential contaminants of all body fluids?

Answer 51

Coag negative Staph, Diptheroid bacilli and Viridans strep