unit 4 Flashcards
(128 cards)
1
Q
what are the bloods stream infection
A
Intravascular
Extravascular
2
Q
where does Intravascular originate from
A
From the cardiovascular system
3
Q
????
A
?????
4
Q
Extravascular
A
bacteria enters the circulation through the lymphatics from another site of infection
5
Q
what are the common pots of entry in Extravascular in bloods stream infection
A
genitourinary tract, respiratory tract abscess surgical wounds infections biliary tract
6
Q
???
A
????
7
Q
????
A
????
8
Q
What is used to cleanse the site of venipuncture for blood culture collection
A
70% alcohol and another antiseptic (iodine)
9
Q
For adults how much blood should be collected in bloods stream infection
A
10 - 20 ml
10
Q
For children how much blood should be collected in bloods stream infection
A
1 - 5 ml
11
Q
Who have more bacteria per ml in blood
A
children
12
Q
How many cultures are sufficient bloods stream infection
A
4-6
13
Q
how long shoud be the second culture be collected for bloods culture
A
1 - 2 the longer the better
14
Q
the two set of bottles collected should be which type for blood culture
A
aerobic and anaerobic
15
Q
if you have only one bottle which type of bottle should you collect for blood cutlure
A
aerobic
16
Q
what are used to stop antibiotics in blood culture bottles
A
nutrient broth resins or charcoal and sps
17
Q
what are two systems that are used in blood culture
A
Bactec
Bact/Alert
18
Q
what Bactec system measure
A
The production of carbon dioxide
19
Q
In Bactec the production of carbon dioxide is produced by
A
by metabolizing organisms by using fluorescence
20
Q
what does BacT/Alert measure
A
Carbon dioxide and pH changes by a colorimeter
21
Q
what separat BacT/Alert the sensor
A
the sensor is separated from the broth by a membrane which is permeable to CO2
22
Q
what suggest contamination/ contaminate (which oraganisms) in blood culture
A
Growth of Bacillus spp(not anthracis) Corynebacterium spp Proprinibacterium acnes Coagulase negative staph in only one of several cultures
23
Q
what other suggest contamination/ contaminate in blood culture
A
Growth of multiple organisms form only one or several culture
24
Q
What suggest Pathogens in blood culture
A
1 Growth of the same organism in repeated culture
25
what are the organisms in certain culture obtained in from patients suggest a pathogen in blood culture
endocarditis (enterococci or gram negative rods)
26
what are the other organisms that suggest pathogen in blood culture
Enterobacteriaceae, S. pneumoniae, gram negative anaerobes, and S. pyogenes
27
Growth of commensal organism from what patient suggest pathogens in blood culture
immunocompromised patients
28
??????
??????
29
What are the possible pathogens with special requirements for blood stream infection
```
HACEK
Fungi
Mycobacteria
Brucella
Mycoplasma
Campylobacter
```
30
What are the types of samples of the urinary tract infections
uirne
31
what are type of infections in urinary tract infections
```
Urethritis
Cystitis
Acute urethral syndrome
Pyelonephritis
Asymptomatic Bacterium
```
32
what is Urethritis
infection of the urethra
33
organisms of the found in Urethritis infection
C. trachomatis,
N. gonorrhoeae,
T. vaginalis
34
what is Cystitis
infection on the bladder
35
what are the symptoms if Cystitis
dysuria,
frequency,
urgency
36
what is Acute urethral syndrome caused by and symptoms
```
STD
same as Cystitis
dysuria,
frequency,
urgency
but fewer bacteria
```
37
What is pyelonephritis
inflammation of the kidney parenchyma calices and pelvis
38
what is Asymptomatic bacteria significant to
pregnancy
39
what are the proper collection of urine
```
clean catch
straight catheterization
Suprapubic bladder aspiration
indwelling catheter
kidney urine
```
40
How is the clean catch done
this involves cleansing prior to urination. Sample collection does not begin until the urine starts to flow and collection should end before the flow stops
41
How is straight catheterization performed
a catheter is inserted into the urethra
42
How Suprapubic bladder aspiration done
urine is withdrawn directly from the bladder into a syringe through a percutaneously inserted needle
43
Explain how urine is got from an indwelling catheter
Urine may be aspirated from the catheter tubing using aseptic technique
44
when collected samples should be
transported as soon as possible
refrigerated or '
preserved
45
what is used to used to place the urine to the appropriate media
calibrated loop
46
What are the sizes of the calibrated loop
0.01 and 0.001
47
what will 0.001 loop equal to in CFU/ml
1000 CFU/ml
48
What is the interpretation of the colony
??????
49
Growth requirements of the urine cultures
Incubated for 24 hrs at 35C
50
What are the media used in urine (UTI)
5% sheep blood agar
| MacConkey agar
51
what is the commonly isolated organism
E.coli
52
What are the type of respiratory infection
lower respiratory tract infections
| upper respiratory infection
53
what is Bronchoscopy (specimen collection)
an invasive procedure which allows the physician to obtain bronchial washings or broncheoalveolar lavage samples.
Bronchial wash
54
what are the two ways of collecting sputum specimen
Expectorated
| Induced
55
Explain Expectorated
Expectorated – primary type of sample. Will be contaminated with upper respiratory secretions. Specimen should be the result of a deep cough.
56
Explain Induced in specimen collection
patients may need to be assisted by a respiratory therapist who can use postural drainage or thoracic percussion to stimulate production. May also use aerosol induction (breathe in a 15% sodium chloride – 10% glycerin mix for 10 minutes
57
explain how Tracheal Aspirates specimen are collected
Obtained by inserting a small plastic catheter into the trachea via a needle previously inserted through the skin
58
pharyngeal
/
59
name the types of Rapid Strep Testing for respiratory tract infection
latex agglutination
Enzyme immunoassay
Gene probe technology
60
Name the types of Rapid Viral Testing for respiratory tract infection
EIA-Enzyme Immunoassay
PCR--polymerase chain reaction
DFA direct immunofluorescence methods
61
What is the turn around time for EIA-Enzyme Immunoassay
10--30 mins
62
What is the turn around time for PCR--polymerase chain reaction
2 hrs
63
what is the turn around time for DFA direct immunofluorescence methods
2 hrs
64
Common causes, appropriate media????
????
65
appropriate media ????
??????
66
Sputum screening method and purpose ???
???????
67
Sputum screening method and purpose ?????
????
68
Sputum screening method and purpose
???????
69
Sputum screening method and purpose
????????
70
what are the sterile body fluids collected for culture
```
CFS
Pleural fluid
Peritoneal fluid
Pericardial fluid
Synovial fluid
Bone marrow
```
71
How are the Sterile Body fluids collected
Aspiration with syringe
72
How are the Sterile Body fluids transported
by sterile container
73
Should the Sterile Body fluids be refrigerated
NO
74
What are the media plates used for sterile body fluids
blood agar
chocolate
broth
75
How long should the sterile body fluids incubated
3 -- 7 days
76
what are the proper collection of the stool specimens
???
77
Name the toxins found Gastrointestinal infections
Enterotoxins
Cytotoxin
Neurotoxin
78
plates that are used for Gastrointestinal tract infections should be differential recovery selective or enrichment
selective
79
what does the enterotoxin do
it alters the metabolic activity of intestinal epithelial cells resulting in an outpouring of electrolytes and fluid into the lumen.
80
what does the cytotoxin do
it disrupts the structure of individual intestinal epithelial cells. When they are destroyed this cells slough from the surface of the mucosa leaving it raw and unprotected
81
what does the neurotoxins do
food poisoning or intoxication may occur as a result of ingesting toxins produced by micro organisms
82
what are the direct detection method of feces for GI infections
wet mount
stains
antigen detection
molecular biologic techniques
83
what method is used in antigen detection method in direct detection method
Enzyme immunoassay
antibody fluorescent stain
PCR
84
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85
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86
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87
what are the most common types of Nosocomial infections
```
UTI
Respiratory
Surgical
Blood stream
GI
```
88
UTI noscomial infection gram stain
gram neg rods
89
Respiratory noscomial gram stain and organisms and disease
pneumonia from gram negative rods
| S.aureus H. influenza
90
Surgical noscomial infection gram stain
gram pos rods
gram neg rods
yeast
(50% occur after discharge)
91
Blood stream noscomial infection organisms
CNS
| Enterococcus S.aureus
92
Blood stream noscomial infection gram stain
yeast
| gram negative
93
GI noscomial infection organism
C.difficile
94
Name five modes of spread in noscomial infections
```
Direct contact
Indirect conrtact
droplets
airbone
vectors
```
95
what is involved direct contact in modes of spread in noscomial infections
food and IV
96
what is involved indirect contact in modes of spread in noscomial infections
patient to patient
97
what disease is involved indirect contact in modes of spread in noscomial infections
MRSA
98
what is involved in droplets modes of spread in noscomial infections
B.pertussis,
N. menin
Mumps
99
what disease are spread in airborne modes of spread in noscomial infections
TB
| Measles
100
name a vector that is involved in the modes of spread in noscomoal infection
mosquito
101
What are the six preventive ways to stop the spread of infections
HANDWASHING
Segregation of infected patients
Appropriate PPE –masks , gloves and gowns
Bagging of contaminated items
Cleaning of rooms between patients
Signage for doors indicating isolation categories
102
what are the transmission based precautions in infection control
droplets
airborne
contact
103
what are the diseases involved in airborne
measles
varicella
TB
Smallpox
104
droplets
???
105
contact
??/
106
What type of labs do the laboratory response network have
```
federal
state and local public health
military
food testing
Environmental
Veterinary
international
```
107
what does the Federal lab do in LRN
These include labs at CDC, the US Department of Agriculture, the Food and Drug Administration (FDA), and other facilities run by federal agencies.
108
what does the state and local public health do LRN
hese are labs run by state and local departments of health. In addition to being able to test for Category A biological agents, a few LRN public health labs are able to measure human exposure to toxic chemicals through tests on clinical specimens.
109
what does the Military lab do with the LRN
Labs operated by the Department of Defense located both within the United States and abroad.
110
what does the food testing do with the LRN
The LRN includes FDA and USDA labs, and others that are responsible for ensuring the safety of the food supply.
111
what does the environmental do with the LRN
Includes labs that that are capable of testing water and other environmental samples.
112
what does the veterinary do with the LRN
Some LRN labs, such as those run by USDA, are responsible for animal testing. Some diseases can be shared by humans and animals, and animals often provide the first sign of disease outbreak.
113
what does the international do with LRN
The LRN has labs located in Canada, the United Kingdom, Australia, Mexico, and South Korea.
114
What are the three found in the pyramid from the top to the bottom. LRN.
national lab
reference lab
sentinel lab
115
what is the national lab designated to do by the LRN
have unique resources to handle highly infectious agents and the ability to identify specific agent strains.
116
what is the reference lab designated for by the LRN
can perform tests to detect and confirm the presence of a threat agent. These labs ensure a timely local response in the event of a threat incident. Rather than having to rely on confirmation from labs at CDC, many reference labs are capable of producing conclusive results. This allows local authorities to respond quickly to emergencies.
117
what is the sentinel lab designated to do by the LRN
represent the thousands of hospital-based labs that are on the front lines. Sentinel labs have direct contact with patients. Sentinel labs could be the first facility to spot a suspicious specimen. A sentinel laboratory’s responsibility is to refer a suspicious sample to the right reference lab.
118
what happens in level 3 laboratories in LRN
These laboratories work with hospitals and other first responders within their jurisdiction to maintain competency in clinical specimen collection, storage, and shipment.
119
what happens in level 2 laboratories
Chemists in these laboratories are trained to detect exposure to a number of toxic chemical agents. Analysis of cyanide, nerve agents, and toxic metals in human samples are examples of Level 2 activities.
120
what happens in leevel 1 laboratories
Using unique high-throughput analysis capabilities, they expand CDC’s ability to analyze large number of patient samples when responding to large-scale exposure incidents.
121
what does bioterrorism mean
???/
122
what is a select agent
???????
123
How to Rule out B. anthracis as a Sentinel lab `
??????
124
what is the methodology of the PCR
It amplifies a single copy nucleic acid target
125
Extraction in PCR means
releasing of Nucleic acid from the organisms by heat chemical or enzymatic methods
126
denaturation in PCR means
means heating at 94C the nucleic acid so that it can be a single strands
127
amplicon in PCR means
this the specific PCR amplification product containing the target nucleic acid of interest
128
thermal cyclers in PCR means
this minimizes the time lag required to alter the reaction temperature between denaturation, annealing and extension over several cycles
