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Clinical Microbiology Chapters 36-38
Terms in this set (86)
A microbiologist is reading a vaginal culture. She sees the very white colonies are gamma hemolytic on blood agar but appear to have feet. What organism could this possibly be?
PID is a complication occasionally seen following infections caused by:
What is the most common method of testing used to identify Neisseria gonorrhoeae and Chlamydia trachomatis in the lab?
Nucleic acid amplification test (NAAT)
Penicillin-resistant Neisseria gonorrhoeae produces:
Beta-lactamase and nitrocefin
Name the three bacteria that cause the most cases of bacteria STI.
Chlamydia trachomatis, Neisseria gonorrhea, Treponema pallidum
What is the advantage over cultures of performing nucleic acid amplification tests (NAATs) for cases of gonococcal urethritis?
The test is highly sensitive and specific
What is required for culturing Chlamydia?
The greatest risk for cervical cancer is genital infections by:
What organisms can be mistaken for Neisseria gonorrhoeae in a Gram stained smear of a cervical exudate?
What cells are found in BV?
What condition is characterized by an overgrowth of anaerobic bacteria and a decrease in lactobacilli in the vagina?
Many women who have BV complain of a fishy odor from vaginal secretions. What causes the odor?
Explain the procedure to prepare a wet prep. What are we typically looking for on a wet prep from a cervical swab?
Mix swab with saline and place a drop of fluid on the slide and use the cover slip and look under high power for clue cells and look for Gardnerella vaginalisis and BV
Can we identify Neisseria gonorrhoeae off of a gram stain from a urethral swab from a male?
Yes, gram negative diplococci from a male urethra with symptoms and WBC's seen. Nothing else present that will look like
What is the main symptom of primary syphilis?
Which of the following is a symptom for secondary syphilis?
Perianal condyloma lata
Which of the following is a symptom of tertiary syphilis?
Which of the following is the most common causative agent of urethritis?
During childbearing years the normal flora of the vagina maintain a low pH, thus encouraging colonization with all the following types of organisms EXCEPT:
Enteric Gram-negative rods
What organism causes chancroid?
List 3 different test/ways we can speciate Neisseria.
NAT/serology, Carbohydrate utilization, Bacticard Neisseria
Why are there so many cases of genital herpes in the US?
Lesions shed virus when asymptomatic
Nongonococcal urethritis is most commonly caused by which of the following organisms?
What part of the urinary tract is most susceptible to infection?
What characteristics of urine inhibits growth of many pathogens?
Urinary tract infection (UTI) in children is associated with significant morbidity and long-term medical problems, including all of the following EXCEPT:
A gram-negative bacilli isolated on MAC has the following biochemical test results: TSI-K/A H2S; indole-negative; urease-positive; TDA-positive. What is the most likely identification of this microbe?
The atypical clinical presentation of a geriatric patient with a UTI includes all the following EXCEPT:
Burning upon urination
A young women goes to her physician complaining of dysuria, frequency, urgency, and suprapubic pain. A urinalysis shows hematuria, positive protein, positive leukocytes esterase, and a positive nitrite. What is a probable diagnosis?
What is the most common cause of uncomplicated UTI's?
What group has the most UTIs caused by Staphylococcus saprophyticus?
Symptomatic sexually active young women
What organisms usually cause UTIs in older men in conjugation with prostatic hypertrophy?
Why don't we set up chocolate agar for urine cultures?
Fastidious microbes don't grow in the urinary tract
What is one factor that can contribute to the incidence of candiduria in hospitalized pateints?
Increased use of broad-spectrum antimicrobials agents
The criteria used to determine the presence of a UTI include all of the following:
Presence or absence of symptoms, the type of organism/ organisms isolated, predisposing factors
How must urine specimens be handled after collection?
What is the definitive method for collecting uncontaminated urine specimens?
What do specimens with multiple uropathogens indicate?
What additive can maintain urine sample integrity for up to 48 hours at room temperature?
What is the minimum colony count for the following specimens:
Suprapubic aspiration: Catheter: Midstream clean catch:
>10^2 CFU/mL, >10^2 CFU/mL, 10^5 CFU/mL
Which of the following specimens is acceptable for a urine culture:
A clean catch midstream sample, collected in a sterile container 30 minutes ago submitted for urine culture
Which of the following is an example of a primary bacteremia source?
An infected heart valve
Which of the following is an example of a secondary bacteremia source?
What organism is the most common cause of community acquired bacteremia?
What condition results when there is a procedural manipulation of a body site containing normal microbiota, causing those bacteria to enter the bloodstream?
What is the most common clinical manifestation associated with continuous bacteremia?
All of the following underlying conditions would predispose a person to a polymicrobial bacteremia EXCPET:
Urinary tract infections
A vaccine is available to prevent septicemia and invasive infections, particularly in children, caused by this organism:
Bacteremia with this organism often leads to endocarditis, osteomyelitis, septic arthritis, or hepatic abscess:
What organism is primarily found in septicemia originated from an upper urinary tract infection?
Common sites associated with bacteremia and sepsis include all the following EXCEPT:
All of the following organisms are noted colonizers of indwelling catheters EXCEPT:
Meningitis following bacteremia and septicemia are often associated with Neisseria meningitidis and:
What condition leads to most cases of bacteremia arising from intraabdominal infections?
Which of the following descriptions best matches an organism that would be more likely to go from sepsis to septic shock:
A lactose-fermenting gram-negative rod that is beta-hemolytic and indole positve
A gram-positive cocci that is catalase positive and coagulase positive.
A gram-positive cocci that is catalase negative, esculin and PYR positive.
What type of medical implant device is commonly associated with osteomyelitis, which will then lead to bacteremia?
Abnormal conditions that may indicate the presence of bacteremia include all the following EXCEPT:
The recommendation of three sets of blood cultures drawn at 1 hour intervals is recommended to diagnose which of the following conditions?
You pull a blood culture from the analyzer after it is flagged as positive. A direct gram stain is performed and the results reveal a curved gram-negative rod that resembles "gull wings". The bottle is subcultured to SBA and CA and incubated aerobically at 37 C. After 24 hours, no growth is seen. The next step would be to:
Subculture the bottle again and incubate in microaerophilic conditions
Sodium polyanetholsulfonate (SPS) performs all of the following functions in the blood culture bottles EXCEPT:
Act as a bacterial nutrient
Septi-Check is which type of blood culture system?
Biphasic broth-slide system
What is the correct blood: broth ration for blood cultures to reduce the antibacterial effect of serum in adults?
1:5 - 1:10
What is the principle of a continuous monitoring blood culture system?
The amount of CO2 produced is measured as a growth index and compared with a threshold Se
Separate venipunctures were performed to collect three sets of blood cultures from a patient with an artificial heart valve. The first and third sets grew a gram-positive pleomorphic rod in 1 of 2 bottles while the second set had no growth in either bottle. What is the most likely explanation for these findings?
The blood cultures were contaminated with skin biota
The primary isolation of Neisseria gonorrhoeae requires:
An organism from a urine culture grows as pinpoint, translucent, beta-hemolytic, gray colonies on SBA. The gram-stain shows gram-positive cocci in chains. The microbe is catalase negative and PYR negative. What is the next step?
An organism from a urine culture grows as pinpoint, translucent, beta-hemolytic, gray colonies on SBA. The gram-stain shows gram-positive cocci in chains. The catalase test is negative. What rapid test should you do next?
>100,000 CFU/ml of a gram-negative bacilli were isolated on MAC from a urine specimen. Glucose: acid, gas production; Indole: negative; Urea: positive; TDA: positive; H2S: positive. The organism is most likely?
Definitive identification of Neisseria gonorrhoeae is made with:
Hydrolysis of carbohydrates
What organism fails to grow on artificial media or in cell cultures:
All members of the Enterobacteriaceae are:
Which of the following microbes is the most common cause of bacteremia:
Which of the following clean-catch urine culture colony counts indicates the patient has a UTI?
How should the plates be incubates for a urine culture?
37 C, both plates in the incubator
An unknown organism isolated from a urine culture grows as large, irregular, gray colonies on SBA with beta-hemolytic. The organism grows as bright-pink on MAC. The gram stain reveals a GNR in singles. What is the next step?
The RPR test can be used to monitor the course of treatment in a patient diagnosed with syphilis.
Which of the following organisms may be mistaken for Neisseria gonorrhoeae in a cervical exudate?
Infection of the urinary tract is MOST frequently associated with:
An unknown organism isolated from a urine culture grows as large, irregular, gray colonies on SBA with beta-hemolysis. The organism grows bright pink on MAC. What is the next step?
Isolates identified as Neisseria gonorrhoeae should have the Nitrocefin test performed?
A urine gram-stain shows gram-positive ccci in clusters. The organism
What culture plates should be set up for a urine culture?
SBA and MAC
Klebsiella species characteristically are:
Chlamydial infections have been implicated in:
Urethritis and conjunctivitis
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