Unit 3 Exam Review Flashcards
1
Q
Organism that obtain food and shelter by living on or withing another organism
A
Parasite
2
Q
Parasite that can live only in a host
A
Obligate
3
Q
Parasite that can live both in or on a host, as well as free form
A
Facultative
4
Q
Parasites that live inside the body
A
Endoparasites
5
Q
Parasites that exist on the body surface
A
Ectoparasites
6
Q
Parasites that cause harm to the host
A
Pathogenic
7
Q
Parasites that benefit from the host, without causing harm
A
Commensals
8
Q
Organism that harbors the parasite and suffers a loss
A
Host
9
Q
A host that the parasite lives its adult and sexual stage
A
Definitive host
10
Q
A host that the parasite lives as the larval and asexual stage
A
Intermediate host
11
Q
Hosts that harbor the parasite to ensure continuity of the parasite’s life cycly
A
Reservoir host
12
Q
Organism that is responsible for transmitting the parasitic infection
A
Vector
13
Q
Specimens that parasites may be recovered from
A
Peripheral blood, CSF, GI tract, liver, lung, muscle, urine, ulcers, eyes
14
Q
What is the most common specimen parasites are found in?
A
Feces, fresh or preserved
15
Q
Feces must be free of what substances?
A
barium and antibiotics
16
Q
What 3 steps are in an O&P exam?
A
Wet mount, concentration, permanent smear
17
Q
What is a direct wet mount
A
detects motile organisms in duodenal drainage, with saline or iodine
18
Q
What chemicals can be used to concentration a specimen?
A
Formalin, ethyl acetate sedimentaiton or zinc flotation method, with saline or iodine
19
Q
What are the permanent stained smears
A
Trichrome or Iron hemotoxylin
20
Q
What is the Scotch tape prep for?
A
Diagnosis of Pinworm infection (eggs) from anus
21
Q
What specimen is needed for Trichomonas vaginalis or microfilaria
A
Urine
22
Q
Thick and thin blood films are used for what parasites?
A
Plasmodium, Babesia and Trypanosomes
23
Q
What percent of the population world wide harbors E. histolytica
A
0.5 to 50%
24
Q
Where are the higher rates of infectionn of E. histolytica?
A
underdeveloped countries
25
What percent of the USA population are infected with histolytica?
1 to 3$
26
What is associated with the infection of E. histolytica?
poor hygiene
27
Who is the principal host of E. histolytica?
Humans
28
How does E. histolytica infection occur?
Ingestion of cysts on fecally contaminated food or hands.
29
What is the E. histolyticac cyst resistant to?
The gastric environment
30
Where does E. histolytica decyst?
Small intestine
31
What is E. histolytica called when it decysts?
Metacyst
32
What does an E. histolytica metacyst divide into?
Divides into 4 and then 8 amoebae
33
Where do the E. histolytica amoebae move to?
Large intestine
34
How do a majority of E. histolytica leave the body?
Through feces
35
With a large E. histolytica infection, what happens to amebae that doesn't leave the body?
The amebae attach to and invade the mucosal tissue
36
What do E. histolytica amebae form?
Flask shaped lesions also called bomb craters
37
What can E. histolytica bomb craters lead to?
liver abscess
38
What is used to treat asymptomatic E. histolytica infections?
Iodoquinol
39
What is used to treat symptomatic and chronic E. histolytica amebiasis?
Metronidazole
40
How is E. histolytica usually diagnosed?
O&P Exam
41
What does En. Histolytica cause
Major cause of amebic dysentery
42
Describe the troph form of E. histolytica
Ameboid appearance, 15 to 20 micrometers in diameter. Single nucleus with small central karyosome.
43
What types of E. histolytica strains are larger than normal?
More invasive strains
44
What does the E. histolytica endoplasm look like?
Finely granular
45
What may the E. histolytica endoplasm contain?
Ingested erythrocytes
46
How is the nuclear chromatin distributed along the periphery of the nucleus?
Evenly distributed
47
What is diagnostic of E. histolytica?
Ingested RBC
48
Describe the Cyst form of E. histylotica
Spherical, with a refractle wall
49
In an E. histolytica cyst what does the cytoplasm contain?
Dark staining chromatoidal bodies
50
What does the nucleus of E. histolytica look like in cyst form?
1 to 4 nuclei with a central karyosome with peripheral chromatin
51
What are flagella?
Thin cytoplasmic extensions
52
What do flagellates contain?
locomotor organelles
53
What is the most frequent protozoan intestional disease in the US?
Giardia lamblia
54
How is G. lamblia transmitted?
water borne disease is most common, drinking from contaminated streams, travel to endemic areas, and day care centers. Also transmitted person to person
55
How does G. lamblia infection occur?
Ingestion of cysts, usually in contaminated water
56
Where does the Decystation of G. lamblia occur?
Duodenum
57
Where is the duodenum
First section of the small intesting
58
Where do G. limblia trophs colonize?
The upper small intestine where they may swim freely or attach to the sub-mucosal epithelium via the ventral suction disc.
59
What do free trophs do as they move down stream?
encyst
60
What takes place during encystment of G. lamblia?
Mistosis
61
How are G. lamblia cysts passed?
In stool
62
What are the G. lamblia reservoirs?
Man is primary, although beavers, pigs and monkeys are also infected
63
Describe G. lamblia cysts
9 to 12 m. eppisodial cells with a smooth defined wall
64
Describe G. lamblia cytoplasm
Four nuclei and mana structures are seen in the troph.
65
Describe G. lamblia troph
12 to 15 m, half pear shaped organism with 8 flagella and 2 axostyles
66
How are G. lamblia axostyles arranged?
bilateral symmetry
67
What does the G. lamblia troph cytoplasm contain?
Two nuclei and two parabasal bodi
68
What are early symptoms of G. lamblia?
flatulence, abdominal distension, nausea and foul-smelling bulky, explosive, often watery diarrhea.
69
What does G. lamblia stool contain?
Excessive lipids but very rarely any blood or necrotic tissue
70
What is a more chronic stage of G. lamblia associated with?
Vitamin B12 malabsorption and lactose intolerance
71
How is G. lamblia diagnosed?
O&P, ELISA, FA, or IFA stain
72
What is the drug of choice for G. lamblia?
Metronidazole
73
Cryptosporidium infects humans when they ingest __________.
Oocysts containing many sporozoites
74
What parasite is found in the GI tract of many animals and causes epidemics of diarrhea in humans
Cryptosporidium
75
Cryptosporidium contaminates what necessities
Food and water
76
Cryptosporidium is the likely cause when a community has _______
diarrhea
77
Severity of diarrhea and duration of Cryptosporidium symptoms are related to _______
Immuno-competence
78
In what types of patients will Cryptosporidium cause prolonged, severe diarrhea
AIDS patients
79
In AIDS patients the organisms may invade what areas of the body?
Gallbladded, biliary tract and lung epithelium
80
What is the treatment for cryptosporidias?
No approved effective treatment
81
What are the detection tests for Cryptosporidium??
Antibody tests, PCR, DFA
82
What is PCR?
Polymerase chain reaction
83
What is a sensitive method for detection of cryptosporidium?
FA/DFA
84
What are the two "areas" of Trypanosoma outbreaks?
African and American
85
What does African Trypanosoma cause?
African sleeping sickness
86
What is the vector for African Trypanosoma?
Tsetse fly
87
Trypanosoma invades which organs?
All organs including heart and CNS
88
What does African sleeping sickness lead to?
apathy, mental dullness, tremors, convulsions, sleepiness, coma
89
What are long term effects of African sleeping sickness?
Weith loss and death from malnutrition, heart failure, pneumonia or parasitic infection
90
What does American Trypanosoma cause?
Chagas disease
91
What is the vector for American Trypanosoma?
Reduvid bug or kissing bug
92
What is Chagas disease?
Chronic or acute infection characterized by neurological disorders
93
What neurological disorders are caused by Chagas disease?
Dementia, megacolon, megaesophagus and damage to the heart muscle
94
Is chagas disease fatal?
Yes unless its treated
95
What is responsible for human malaria?
Five Plasmodium species
96
What is the estimated amount of malaria cases?
200 million global cases
97
What is the mortality rate of malaria?
1 million people per year
98
What are the 2 most common species of malarial parasite?
P. falciparum and P. malariae
99
Where are malarial parasites most often found?
Asia and Africa
100
What species of malaria parasite is found in Latin America, India and Pakistan?
P. vivax
101
Where is P. ovale almost exclusively found?
Africa
102
How is the malaria parasite transmitted?
Female anopheline mosquito
103
How does the female anopheline mosquito transmit malaria parasites?
Injects sporozoites in the saliva.
104
What are alternate methods that malaria can be transmitted?
Transfusion and transplacentally
105
What symptoms will a patient with malaria develop?
headache, lassitude, vague pains in bones, and joints, chilly sensations and fever
106
What is a malaria fever associated with?
Severe headache, nausea, vomitin, and convulsions
107
What type of pattern do a malaria chill and fever follow?
Cyclic (paroxysm)
108
What type of malaria results in death?
P. falciparum which is more severe
109
Splenomegaly, hepatomegaly and nephritic syndromes are results from what disease?
Chronic malaria
110
How is Plasmodium diagnosed?
Detection of parasite in Giemsa stained blood smears
111
How is P. malariae treatment effective?
Various quinine derivatives and eradication of mosquitoes
112
Describe roundworms
Elongate and cylindric with a well developed digestive tract
113
How are roundworms diagnosed?
Eggs in feces
114
What type of infections are associated with Ascaris lumbricoides?
asymptomatic
115
How is A. lumbricoides infected?
Ingesting food or soil contaminated with infected eggs
116
Where do A. lumbricoides eggs hatch?
Upper small intestine
117
How long do A. lumbricoides female larvae life for?
12 to 18 months
118
How many eggs do female larvae produce?
25 million at a average daily output of 200,000 for life cycle
119
A. lumbricoides eggs are resistant to _____
Chemical disinfectant
120
How long can A. lumbricoides live for in sewage
survives for months
121
What type of infection is A. lumbricoides?
Man to man
122
How is A. lumbricoides diagnosed?
Eggs in stool
123
What is Enterobius vermicularis known as?
Pinworm
124
What is the most common helminthic infection?
Pinworm or E. vermicularis
125
What type of disease is pinworm?
Urban disease of children in a crowded environment (schools, day cares)
126
What is the most common symptom of pinworm?
Perianal, perineal and vaginal itching and irritation
127
How is pinworm diagnosed?
Finding the adult worm or eggs in the perianal area, particularly at night
128
How are pinworm eggs obtained?
scotch tape or pinworm paddle
129
What is the treatment for pinworm?
Two doeses of Pyrental Pamate two weeks apart.
130
What is an alternative treatement for pinworm?
Mebendazone
131
Who should be treated for pinworm?
The whole family, ,to avoide reinfection
132
What must be santized between pinworm treatments?
Bedding and underclothing
133
Trichuris trichuria causes what tropical disease?
Whipworm
134
What age group does whipworm effect?
5 to 15 years
135
Where is whipworm found?
Rural Asia and Africa, can also be seen in the Americas mostly south
136
How do you get infected with whipworm?
Ingestion of embryonated eggs in soil
137
How are heavy infections of T. trichuria characterized by?
Chronic profuse mucus and bloody diarrhea, associated with abdominal pains and prolapsed rectum
138
What does a T. trichuria infection result in?
Malnutrition, weight loss, and sometimes death
139
How is T. trichuria diagnosed?
Eggs in feces
140
What is the treatment for T. trichuria?
Abendazole
141
What is the most effective way to control T. trichuria?
Improved hygiene and sanitary eating habits
142
D. latum is also known as _______?
Fish tapeworm
143
What is D. latum associated with?
Eating raw or improperly cooked freshwater fish
144
How long can tapeworms get?
3-10 meters with more than 3000 proglottids
145
How are humans infected?
Eating uncooked fish that contains larvae
146
How long does it take for a tapeworm to mature?
3 to 5 weeks
147
What are symptoms of tapeworms?
abdominal discomfort, weight loss, loss of appetite and malenutrition
148
What are additional symptoms in heavily infected adults?
Anemia, neurological problems, vitamin B12 deficiency
149
How are tapeworms diagnosed?
Finding many typical eggs and empty proglottids in feces
150
What can help a tapeworm diagnosis?
History of raw fish consumption and residence in an endemic locality
151
What is the drug of choice for D. latum?
Praziquantel
152
How can D. latum be prevented?
Freezing for 24 hours, thorough cooking or pickling of fish will kill larvae
153
What species of Taenia is prevalent in cows?
T. saginata
154
What species of taenia is prevalent in pigs?
T. solium
155
What is the infection rate of Taenia?
As low as 1 per 1000 in North America and as high as 10% in third world
156
What tapeworm shows a higher infection?
Pork
157
How are tapeworms ingested?
A tapeworm larval cyst is ingested with poorly cooked infected meat
158
What are the symptoms of a light Taenia infection?
Asymptomatic
159
What are the symptoms of a heavy Taenia infection?
Abdominal discomfort, epigastric pain, vomiting and diarrhea
160
What type of Taenia eggs can infect humans?
T. solium
161
T. solium eggs can cause what disease in humans?
Cysticercosis
162
What is cysticercosis
Larval cysts in lung, liver, eye and brain
163
Cysticercosis can cause blindness and _____?
neurological disorders
164
Antibodies are produced in cysticercosis and are useful in _______?
Epidemiological tools
165
How is Taenia diagnosed?
Based upon recovery of eggs or proglottids in stool or perianal area
166
How is a cysticercosis infection confirmed?
Antibodies
167
What is the drug of choice for Taenia?
Praziquantel
168
What are effective precautions against Taenia?
Thorough inspection of beef and pork, adequate cooking or freezing
169
What temperatures can cysticerci not survive?
below 10C and above 50C
170
What is the best stain for Giardia lamblia?
Trichrome or Iron hemotoxylin
171
What is the best stain for Entamoeba histolytica?
Trichrome
172
What is the best stain for Trichuris trichuria?
Iodine wet mount
173
What is the best stain for Trypanasoma cruzi?
Blood smear
174
What is the best stain for Cryptosporidium parvae?
Modified acid fast staine
175
What is the best stain for Ascaris lumbricoides?
Iodine wet mount
176
What is the best stain for D. latum?
Iodine wet mount
177
What is the primary stain and function for Kinyoun?
Carbolfuchsin stains the mycobacteria bacilli
178
What is the Kinyoun counterstain and function?
Methylene blue stains background and other bacteria, not acid fast
179
What is present in the cell wall that contributes to acid fastness?
Mycolic acids
180
How will mycobacteria appear on a gram stain?
Poorly stained, beaded gram pos bacilli, gram neutral or ghosts
181
Which stain is more sensitive Kinyoun or Flurorchrome?
Fluorochrome
182
Why is the quantitation of the AFB important?
Indicates the extent of the patient's infectiousness
183
How many oil fields should be observed before calling a smear negative?
300 oil fields
184
What factors may contribute to a false positive smear?
Cross-contamination of slides, using tap water in staining, not wiping oil immersion between slides
185
What must be done to prepare a sputum or fluid specimens for AFB staining?
Decontamination, concentration by centrifugation, heatfixing
186
Name 2 stool fixatives that are appropriate if infections with Ascaris or Hookworm are suspected.
Formalin, SAF, MIF
187
What is the proper specimen and staining method for Plasmodium falciparum?
Blood, Giemsa/Wright stain
188
What is the proper specimen and staining method for Cryptosporidium parvae
Feces, MAF/IFA
189
What is the proper specimen and staining method for Giardia lamblia
Feces, Trichrome/wet pretp?IFA
190
What is the proper specimen and staining method for Trichomas vaginalis
Urine, genital, wet prep/Giemsa
191
What is the proper specimen and staining method for Trypanasoma cruzi?
Blood, Giemsa/Wright stain
192
Name 3 substances in a fecal specimen that may interfere with the detection of intestinal protozoa
Barium, mediations, mineral oil, bismuth
193
Which magnification is appropriate to examine stools that have been stained with trichrome?
Oil immersion 1000x
194
How will the background look on trichrome?
Green
195
How does cytoplasm look on trichrome?
trophs are blue green, cysts are blue green to purple
196
How does nuclei look with trichrome?
red, sometimes tinged with purple
197
How do cellular inclusions look with trichrome?
red, sometimes tinged with purple
198
What is the proper microscopic examination procedure for stools that have been concentrated by formalin ethyl-acetate?
Examine the sediment at low power (x100) and high power with saline and iodine
199
What is the purpose of Formalin in the concentration?
Formalin will preserve the parasite and render it non-infectious
200
What is the purpose of ethyl acetate in the concentration?
Ethyl acetate will trap debris and separate it from potential parasites contained in the sediment.
201
Why should stool specimens be preserved and concentrated?
Allows for the recovery of protozoa, helminths, coccidian, microspordia
202
If pinworm infection is suspeced, what type of specimen should be collected?
Scotch tape prep of perianal or perineum
203
Why is it necessary to do thick blood films for parasites?
allows exam of a larger volume of blood for parasites
204
Why is it necessary to do thin blood films for parasites?
used for parasite identification
205
Why is a calibrated microscope necessary for observation of parasitology slides?
Size is an important characteristic for ID of parasites
206
What are the 6 steps in viral replication?
Attachment, penetration, uncoating synthesis, maturation, release
207
How does Herpes infection occur?
Break in the mucus membranes of the mouth or throat, via the eye or genitals or directly via minor abrasions in the skin.
208
When are most individuals infected with HSV? And why?
By 1-2 years of age due to the universal distribution of the virus
209
Describe the initial symptoms of HSV infection.
Initially asymptomatic, however there may be minor local vesicular lesions
210
What are the stages of HSV infection?
Local multiplication, viremia, systemic infection, followed by life-long latent infection with periodic reactivation
211
Where can you find lesions of HSV1?
Oral and ocular lesions, increasing in genital lesions
212
Where can you find lesions of HSV2?
Genital and anal lesions
213
Is there a vaccine for HSV?
Not currently licensed but a number are under development.
214
Is HSV a DNA or RNA virus?
DNA
215
When does VZV normally occur?
Chicken pox - 90% in children, Shingles in the elderly
216
How does chicken pox infect humans?
Via respiratory tract or conjunctiva
217
How does the chicken pox spread?
After inoculation the virus spreads to bloodstream and reticuloendothelial system
218
Are there complications to chicken pox?
Complications are rare but may include CNS infection
219
How does Shingles infect humans?
Virus persists in CNS, either latently or a persistent infection. Reactivation leads to infection and tissue damage
220
What can Shingles lead to?
Blindness when cranial nerves are involved
221
What is the therapy for Shingles?
Acyclovir
222
What is the largest of the Herpes viruses?
Cytomegalovirus (CMV)
223
How common is CMV infection?
50-80% of US population are infected by age 40
224
What type of infection is CMV?
asymptomatic
225
What is the most common transmission of CMV?
During pregnancy to infants exposed in utero
226
What types of people are infected with CMV?
Immune deficient, specifically T-cell ex. AIDS and immunosuppressed transplant patients
227
How is CMV transmitted?
oral/respiratory route
228
Describe the systemic infection of CMV
Produces enlargement of cells and nuclear inclusion bodies in a wide range of tissues
229
What is RSV the cause of?
Respiratory infections in infants and children
230
What are some infections RSV causes?
Pneumonias, croup, upper respiratory
231
How is RSV transmitted?
Person to person, possibly nosocomial
232
When is RSV transmitted?
Usually in winter
233
What types of standard tests are avaliable for RSV?
cell culture, molecular (PCR or DNA) antibody detection
234
What special types of tests are avaliable for RSV?
Fluorescent antibody, enzyme immunoassay (EIA)
235
What are the 3 types of influenza?
Type A, B, and C
236
Name 3 types of Influenza A?
H1N1, H1N2, and H3N2 viruses
237
What is a host for Infuenza A?
Wild birds, however they do not become sick when infected. Domestic poultry (turkeys and chickens) can die from avian infuenza.
238
Who has recently become a factor in the spread of influenza?
Swine
239
Where is Influenza B normally found?
Humans
240
What can Influenze B cause?
Morbidity and mortality. Less sever epidemics than Type A. Type B can cause human epidemics, bout not pandemics
241
What type of disease does Infuenze C cause?
Mild illness which doesn't cause epidemics or pandemics
242
How can Influenza be prevented?
Vaccination
243
What is the death rate for Mycobacteria and who is subjected to it?
3 million people worldwide, normally over 50 years old or immune compromised/surpressed
244
How is mycobacteria transmitted?
Person to Person, or from contaminated fomites
245
How is M. tuberculosis spread?
P2P by inhalation of droplets (cough, sneeze) More prevalent in contained populations
246
How can tuberculosis spread in a lab?
Aerosols
247
What type of organism is tuberculosis?
Obligate, grows under reduced O2, survives for weeks in tutrifying or dried sputum
248
Name points of entry for tuberculosis.
Inhalation, food ingestion, milk born infections, puncture wounds, kidney involvement
249
Describe tuberculosis immune response
Cell mediated several weeks post infection, followed by tubercle development in lungs
250
What is the most common test for tuberculosis?
PPD purified protein derivative
251
Testing method for PPD
Inoculate PPD on skin and examine after 48 hours
252
Test results for PPD
>5mm indicates prior exposure
253
What are the PPD testing limitations?
Can't differentiate past exposure from active infection
254
Is there a vaccine for tuberculosis?
Yes but not administered in the US
255
Where is the tuberculosis vaccine used?
developing countries with high prevalence of disease
256
Why is the tuberculosis not used in US?
can't circumvent disease reactivation, doesn't prevent infection, may complicate current test methods, only 80% effective
257
Where is NTM (non tuberculosis mycobacteria) found?
soil, marshes, rivers, municipal ester supplies, marine and terrestrial life forms
258
How does NTM infect humans?
break in skin, trauma injections or surgery, animal contact
259
How many Runyon schemes are there?
4
260
What is Runyon scheme 1?
Photochromogens
261
What does Scheme 1 (Photochromogens) require?
Light for pigment production
262
What is Runyon scheme 2?
Scotochromogens
263
What does Scheme 2 (Schotochromogens) require?
form pigments in the presence or absence of light
264
What is Runyon scheme 3?
Nonphotochromogens
265
What does Scheme 3 (Nonphotochromogens) require?
no pigments produced
266
What is Runyon scheme 4?
Rapid Growers
267
What is unique about scheme 4?
growth in 3-5 days at 25 or 37 degrees
268
When is the best time to collect sputum samples?
Early morning from deep cough. Collect for 3 days
269
What chemicals can be used to decontaminate sputum samples?
Sodium hydroxide, benzalkonium chloride
270
What needs to be done to sputum samples to release mycobacteria from cells?
Liquify
271
Can mycobacteria be gram stained?
Does not gram stain well due to the high lipid content (mycolic or fatty acids)
272
What type of organism is mycobacteria?
pleomorphic rod
273
What do AFB gram stain as?
Gram invisible, negatively stained ghosts or as beaded gram pos rods
274
What is a flurochrome stain?
sensitive, useful for screening numerous specimens fast
275
What does a positive flurochrome look like?
bacilli will fluoresce yellow green
276
What is the minimum amount of fields that should be examined?
30 low power fields
277
How should flurochrome results be confirmed?
Two fuchsin acid fast stains
278
Name 2 acid fast stains
Ziehl Neelsen Hot or Kinyoun Cold
279
What do ZN and Kinyoun have in common?
Both employ carbol fuschin stain, destain with alcohol, counterstain methylene blue
280
Why are mycobacteria termed acid fast organisms
lipid rich walls are resistant to destaining with heated acid alcohol
281
What color does mycobacteria stain?
Red from the carbol fuschin, background appears blue/grean from the methylene blue counterstain
282
Name mycobacteria complex media
Lowenstein-Jensen and middlebrook
283
What does the Lowenstein-Jensen media contain?
potato, eggs, glycerol, citrate
284
Why do many labs use solid and liquid media for mycobacteria?
Maximum recovery
285
What is mycobacteria presumptive ID based upon?
growth rate, pigmentation, colonial appearance, optimal temperature
286
What test/smear can be used to confirm presence of mycobacteria?
MGIT
287
What are new ID strategies for M. tb complex and M. avium
Nucleic acid probes; tests performed from solid or liquid media, results within hours
288
What additional test methods are being developed for mycobacteria?
PCR - Polymerase chain reaction
289
What type of tests can be run to detect M. tuberculosis directly from clinical specimens?
Automated detection systems
290
What is the habitat of Nocardia?
Soil and water
291
What is the gram stain of Nocardia?
Aerobic, branching gram positive rods that may have a beaded appearance
292
How does Nocardia stain?
May stain as partially acid fast using a modified acid fast stain; not all isolates are partially acid fast
293
What type of infections does Nocardia cause?
Skin and respiratory infections
294
What are the Nocardia growth requirements?
30-35C in 48-72 hours
295
What types of agar will Nocardia grow on?
sheep bllod, chocolate, or fungal like Sab dex; may need selective agars for contaminated speicmens
296
How do colonies of Nocardia appear?
wrinkled, chalky white-orange pigment
