Clin Lab Med Micro #2 Exam 3

Front 1

first test for lyme disease

Back 1

Enzyme immunoassay

or

immunofluorescence assay

Front 2

2nd line test for lyme with s&s for less than 30 days?

Back 2

IgM, IgG and western blot.

Front 3

2nd line test for lyme with s&s for more than 30 days?

Back 3

IgG and western blot only.

Front 4

Lyme test interpretation

IgM antibodies positive.

IgG antibodies positive.

Western blot positive.

interpretation?

Back 4

likely lyme disease if consistent with S&S

Front 5

Lyme test interpretation

IgM antibodies positive.

IgG antibodies negative.

Western blot negative.

interpretation?

Back 5

early infection or false pos

Front 6

Lyme test interpretation

IgM antibodies negative.

IgG antibodies negative

Western blot not done because of 2 negatives

interpretation ?

Back 6

no infection present. Consider something else. or antibodies too low to read.

Front 7

Lyme test interpretation

IgM antibodies negative.

IgG antibodies positive.

Western blot positive.

interpretation ?

Back 7

late or previous infection

Front 8

Lyme test interpretation

IgM antibodies negative.

IgG antibodies positive.

Western blot negative.

interpretation ?

Back 8

patient has recovered from previous infection or false pos.

Front 9

IgG and IgM can be found in blood and what else?

Back 9

CSF

Front 10

gram negative coccobacilli (one tenth the size of regular bacteria)

Back 10

rickettsial disease

Front 11

how is rickettsial disease transmitted

Back 11

arthropod vector like lice, ticks or mites.

Front 12

gram positive bacteria are ?

Corny Actors Knock Back Listerine in the Closet

Back 12

Corny Actors Knock Back Listerine in the Closet - the gram positive bacteria are Corynebacteria,

Actinomyces,

Nocardia,

Bacillus

, Listeria,

and Clostridium. (plus Staph, and Strep -

the t looks like a + sign)

Front 13

Remeber... All bacilli are gram negative except "L DATTA"L -

Back 13

ListeriaD -

Diphtheria

Actinomycetes

Tetani Clostridium

TB Mycobacterium

Anthrax bacillus

Front 14

who gets rickettsia ricksttsii

Back 14

children 5 to 9 especially in NY.

Front 15

incubation period for rocky mountain spotted fever

Back 15

7 days or 2 to 14 days

Front 16

what are some interfereing factors with lyme disease diagnosis

Back 16

false pos from other spirochete infectino and rheumatoid factors.

Individuals in endemic areas may already have antibodies.

Front 17

tx for rockymountain spotted fever

Back 17

doxycycline

Front 18

white/brown coating on tongue

Back 18

RMSF

Front 19

rash begins at wrists and ankles and moves proximally

Back 19

RMSF

Front 20

–Acute and convalescent serum specimensare acquired. A 4-fold rise in serumantibody titer is preferable, but a single titer of 1:64 is highly suggestive.

Back 20

freebee. I don't know what to do with iths

Front 21

what tests would you use to dx RMSF

Back 21

latex agglutination and immunofluorescent

Front 22

Immunofluorescent test - Biopsy specimensof skin can be tested 3 to 4 days after symptoms appear. Require trained personnel and fluorescencemicroscope.

This method can be used for what disease?

Back 22

RMSF

Front 23

most common fungal pathogen in immunocomprimised patients

Back 23

candida

Front 24

how do I get vaginal candidiasis

Back 24

ABX or change in pH

Front 25

how do I get oral thrush

Back 25

diabetes.

corticosteroids.

HIV.

Dentures

Front 26

how do I get skin infection with candida

Back 26

get it in the intertriginous areas

Front 27

how do I get candida in my heart (endocarditis)

Back 27

IVDA

Front 28

how to tx candida

Back 28

nystatin, clotrimazole, fluconazole or ketoconazole

Front 29

If my patient has difficult swallowing and a candida infection what am I thinking?

Back 29

really bad infection and it is not just candida.

Front 30

how to dx candida

Back 30

gram stain or wet mount and see hyphae.

Front 31

where is Cryptococcosis from?

Back 31

pigeon poo

Front 32

who gets Cryptococcosis?

Back 32

AIDS, leukemia and lymphoma patients.

Front 33

dx of Cryptococcosis?

Back 33

CXR, culture, INDIA ink of CSF and latex agglutination.

India ink and latex agglutination are the important ones.

Front 34

tx of Cryptococcosis?

Back 34

fluconazole and itraconazole.

Front 35

How do antifungal meds effect the body?

Back 35

they are hepatotoxic so they need to be taken for a long time at low doses.

Front 36

India Ink stain

Back 36

Cryptococcosis

Front 37

Histoplasmosis from where

Back 37

soil contaminated with bats, chickens and starlings.

Front 38

dx of Histoplasmosis

Back 38

skin tests, test for antibodies, biopsy and culture.

Front 39

tx for Histoplasmosis?

Back 39

: Liposomal Amphotericin B (terribledrug) or Itraconazole

Front 40

how do I get Histoplasmosis

Back 40

mid west in the histo belt.

Also from parenteral feeding with upper GI perfs.

Front 41

what should you think if the patient has low calcitonin and they are not improving on ABX?

Back 41

maybe fungal or the ABX are not addressing the antigen.

Front 42

the most common seriours opportunistic infection with CD4 below 200?

Back 42

pneumcystic jeroveci

Front 43

dx of Pneumocystis jeroveci?

Back 43

Toluidine blue O stain of cyst wall and

Giemsa stain of intracystic bodies .

Get the specimen from bronchoalveolar lavage, lungbiopsy, special stains, PCR.

HIV patient – examine first morning sputumspecimen.

Front 44

special handling instruction with viral cultures

Back 44

specimens must be kept cool and moist in a holding medum.

requires inoculation on cell cultures.

specimen must be collected in the first few days of illness.

Front 45

how long to get viral cultures

Back 45

28 days

Front 46

does negative viral culture rule out the ds

Back 46

no.

Front 47

tx for PJC???

Back 47

TMP-SMX and pentalamine, which may cause hypoglycemia.

Front 48

CMV in pregnancy does what

Back 48

stillbirth, birth defects or brain damage.

Front 49

dx CMV

Back 49

culture confirms.

antibody titers.

CMV antigen aids in early detection.

TORCH test. (perinatal test)

Front 50

CMV risk factors?

Back 50

transplant, AIDS, immunosuppressed.

Front 51

I put 5% acetic acid on some bumps in the privates and they are what?

Back 51

condyloma acuminata

Front 52

condyloma lata vs condyloma acuminata

Back 52

lata is second stage syphilis.

acuminata is genital warts and they turn white when acetic acid is put on them.

Front 53

what should you do with genitcal warts to rule out a bad differential?

Back 53

biopsy to rule out squamous cell carcinoma.

Put acetic acid on them. Should turn white

Front 54

HSV 1 where?

HSV 2 where?

Back 54

1 - above waist

2 below waist.

Would be legit except anal oral vaginal and all kinds of sex.

Front 55

larger and fewer vesicles than HSV1?

Back 55

pharyngitis with ulcers.

Front 56

phryngitis with ulcers tx?

Back 56

acyclovir,

Front 57

vesicular lesions on skin of eyelids with dendritic corneal lesions with regional adenopathy.

Whats the tx?

Back 57

DO NOT give steroids. The can go BLIND!

refer to ophthalmologist.

they will tx with antivirals ending in ine or ir like : trifluridine, acyclovir, vidaribine,idoxuridine, no steroids

Front 58

tx for herppes simplex

Back 58

trifluridine, acyclovir, vidaribine, idoxuridine

Front 59

tzanck smear (non-secific) with multinucleated giant cells

Back 59

genital herpes

Front 60

peak incidence of gentital herpes

Back 60

15 to 29

Front 61

rapid method for dx of gential herpes

Back 61

fluorescent antigen and moncloncal antibody

Front 62

pharyngitis, edudates in half of patients, fever, painful nodes, fatigue, palatal petechiae in 25%. Enlarged speen and liver

Back 62

EBV virus in infectious mononucleosis

Front 63

atyplical lymphocytes on bood smear, then monospot test for what?

Back 63

EBV with infectious mono

Front 64

tx of EBV

Back 64

Ampicillin is contraindicated. avoid vigerous exercise.

Front 65

HIV dx

Back 65

ELISA, Western blot

Front 66

how to tell what the viral load is in HIV

Back 66

IFA and PCR

Front 67

dx of influenza

Back 67

Rapid culture for A & B using monoclonal antibodies and immunofluorescence.

Serology seldom practical, used for epidemiology, presence of IgM antibodyindicates acute infection.

Front 68

herpes zoster aka shingles dx

Back 68

culture.

serology.

fluorescent antibody detection.

fluorescent antigen detection are more sensitive.

PCR has greater sensitivity.

Front 69

erythema infectosum dx?

aka fith disease.

Back 69

serology of IgG antibodies not as valuable as IgM. PCR also used.

Front 70

slapped face apearance

Back 70

fifth disease

Front 71

fifth disease virus?

Back 71

parovirus B19

Front 72

dx for mumps and what virus?

Back 72

paramyxovirus.

serologic test for antibodies. Acute and convalescent antibodies increase 4 fold. Also can use fluorescent antibodies.

Front 73

rubella aka german measles dx

Back 73

cell culture of throat, blood urine, CSF serology which is an antibody titer.

Front 74

measles aka rubeola dx

Back 74

culture from blood and other secretion, serum antibodies 3 days after rash and peaks 2 to 4 weeks later

Front 75

koplicks spots with high fever, cough, rhinorhea, puffy red eyes, photophobia, conjunctivitis, malaise.

Back 75

measles or rubeola

Front 76

rash that starts over the face, neck, eyelids, then moves to armsm back chest abdomen, feet and things.

Back 76

measles

Front 77

roseola infantum is in what virus family

Back 77

herpes.

herpes 6 virus

Front 78

rash profuse on neck, arms and trunk with mild rash on face and legs.

Back 78

roseola infantum

Front 79

roseola dx is ?

Back 79

serology

Front 80

rabies dx

Back 80

•Virus isolation from patient’ssaliva or throat.

Fluorescent antibodyof blood, skin biopsy, Negri bodies(viral inclusions inneurons) are found in 90% of rabid animals.

Front 81

tx of rabies is?

Back 81

wound care.

antirabies serum with 5 IM infections over a month.

Front 82

Entamoeba histolytica, giardia lamblia, Cryptosporidium parvum, Toxoplasma gondii and malaria are all examples of what?

Back 82

protozoans

Front 83

malaria dx

Back 83

hx.

ID parasite in RBC's.

decreased HgB, protein, and WBC's in urine.

thrombocytopenia, increased PT and PTT.

Decreased fibrinogen.

Front 84

malaria tx

Back 84

oral chloroquine, atovaquone-proguanil.

Front 85

toxoplasma gondii dx

Back 85

tissue biosy and blody fluids. CT and MRI.

Front 86

when should antimicrobial susceptibility be performed?

Back 86

Isolateis not predictable based on the genus and species.

Organismis not part of the normal flora of the specimen site.

Organismis isolated from a transplant or immunocompromised patient.

Front 87

most popular method to determine microbila suceptibility ?

Back 87

microdilution method

Standardconcentration of bacteria is incubated in dilutions of common antibioticscommercially prepared on a 96-well plate.Lowest concentration of antibiotic thatinhibits visible growth of bacteria is theminimum inhibitory concentration(MIC).

That is the number at which an antibiotic will be bactericidal.

Front 88

with the microdilution methad what does it mean if there is a high reading?

Back 88

It takes more antibiotic to kill the bacteria

Front 89

what is the simplest and most reliable mothod for determining susceptibility?

Back 89

disc diffusion

Front 90

the antimicrobial gradient method or E-test is what?

Back 90

used for testing fastidious organisms that require special growing conditions.

MICs are determined by the intersectionof the elliptically–shaped zone of growth inhibition and the E-strip

Front 91

MIC is what

Back 91

minimum inhibitory concentration

Front 92

when would you see increased procalcitonin levels in an ICU?

Back 92

sepsis particularly in bacterial sepsis.

Front 93

what should happen to warfarin doses when on ABX?

Back 93

warfarin dose should decrease when on ABX

Front 94

most common cause of C dif?

Back 94

ampicillin