Meningitis and Body Fluids Quiz
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Questions and Answers

What is the primary function of cerebrospinal fluid (CSF)?

  • To transport oxygen to brain cells
  • To supply nutrients to the brain
  • To provide a cushioning effect for the brain (correct)
  • To clear toxins from the brain

    • Which type of meningitis is characterized by the presence of pus in the meninges?

  • Viral meningitis
  • Purulent meningitis (correct)
  • Aseptic meningitis
  • Encephalitis

    • What is the most common route for infection leading to meningitis?

  • Hematogenous spread through the bloodstream (correct)
  • Trauma to the skull
  • Contiguous spread from another infection
  • Post-surgery microbial contamination

    • Which of the following symptoms is NOT typically associated with acute bacterial meningitis?

    <p>Rash development (B)</p> Signup and view all the answers

    Which organism is a common causative agent of meningitis in neonates?

    <p>Escherichia coli (C)</p> Signup and view all the answers

    What is the purpose of a lumbar puncture in the context of meningitis?

    <p>To collect cerebrospinal fluid for analysis (C)</p> Signup and view all the answers

    In which populations are pneumococci commonly identified as causative agents of meningitis?

    <p>In older children and adults (D)</p> Signup and view all the answers

    What is the medical procedure used to collect pleural fluid?

    <p>Thoracentesis (A)</p> Signup and view all the answers

    What is the recommended method to transport specimens collected for meningitis testing?

    <p>Transport at room temperature within 15 minutes (A)</p> Signup and view all the answers

    Which organism is most commonly associated with infectious arthritis in synovial fluid?

    <p>Staphylococcus aureus (C)</p> Signup and view all the answers

    What condition describes excess fluid in the pleural cavity?

    <p>Pleural effusion (A)</p> Signup and view all the answers

    In primary peritonitis, what is the typical source of infection?

    <p>Spontaneous bacterial infection (B)</p> Signup and view all the answers

    Which of the following is a common cause of secondary peritonitis?

    <p>Bacteroides spp. (A)</p> Signup and view all the answers

    What is the typical causative agent of pericarditis?

    <p>Viruses (A)</p> Signup and view all the answers

    What is the main risk associated with amnionitis?

    <p>Rupture of the fetal membranes (A)</p> Signup and view all the answers

    Which of the following fluids surrounds the fetus during pregnancy?

    <p>Amniotic fluid (A)</p> Signup and view all the answers

    Which tube in the specimen collection is designated for hematology testing?

    <p>Tube #3 (C)</p> Signup and view all the answers

    What percentage range indicates the sensitivity of gram stain smears?

    <p>75-90% (D)</p> Signup and view all the answers

    Which media are the most common for culturing specimens?

    <p>BAP and CHOC (B)</p> Signup and view all the answers

    In cases of viral meningitis, what type of growth is typically seen from bacterial cultures?

    <p>No Growth (A)</p> Signup and view all the answers

    What type of meningitis can be confirmed through PCR or staining methods?

    <p>TB (D)</p> Signup and view all the answers

    What kind of organisms primarily cause brain abscesses?

    <p>Anaerobic bacteria, staphylococci, and viridans (D)</p> Signup and view all the answers

    Antigen detection tests are available for which of the following organisms?

    <p>Group B streptococci, Hib, meningococci, and pneumococci (C)</p> Signup and view all the answers

    Which cell type is typically associated with fungal meningitis based on CSF findings?

    <p>Lymphocytes (D)</p> Signup and view all the answers

    What is the most common cause of urinary tract infections (UTIs)?

    <p>E. coli (A)</p> Signup and view all the answers

    Which of the following is classified as a lower urinary tract infection?

    <p>Cystitis (A)</p> Signup and view all the answers

    Which specimen collection method is not associated with percutaneous aspiration?

    <p>Cystoscopy (C)</p> Signup and view all the answers

    What should be noted regarding the physical state of the fluid during specimen processing?

    <p>Physical appearance (B)</p> Signup and view all the answers

    What is a symptom of acute urethral syndrome (AUS)?

    <p>Frequent urination (B)</p> Signup and view all the answers

    What transport method is recommended for specimen collection?

    <p>Transported at room temperature (D)</p> Signup and view all the answers

    Which bacteria are typically considered normal flora in the urethra?

    <p>Corynebacterium and Micrococcus (B)</p> Signup and view all the answers

    What is the common route of infection for UTIs?

    <p>Ascending route (C)</p> Signup and view all the answers

    What is the most common predisposing factor for urinary tract infections in men over 60 years of age?

    <p>Enlarged prostate (C)</p> Signup and view all the answers

    Which method should be used for collecting a clean-catch midstream urine specimen?

    <p>Clean the periurethral area, then collect midstream (C)</p> Signup and view all the answers

    What is the specified timeframe for transporting urine specimens to prevent contamination?

    <p>Within 2 hours (D)</p> Signup and view all the answers

    What is the purpose of the leukocyte esterase test in urinalysis?

    <p>To detect the presence of white blood cells (A)</p> Signup and view all the answers

    Which of the following specimens is not considered acceptable for culture?

    <p>Urine catheter tips (A)</p> Signup and view all the answers

    When collecting a urine specimen from an indwelling catheter, which approach is correct?

    <p>Clean the collection port with ethanol (A)</p> Signup and view all the answers

    Why is the first morning urine specimen preferred for culture?

    <p>It has the highest concentration of bacteria (A)</p> Signup and view all the answers

    What does a colony count of 100,000 CFU/mL in a urine culture indicate?

    <p>Probable infection (A)</p> Signup and view all the answers

    What does a positive nitrite test result in urine signify?

    <p>Presence of bacteria that reduce nitrate (D)</p> Signup and view all the answers

    What type of specimen collection is characterized by inserting a needle through the abdominal wall into a full bladder?

    <p>Suprapubic aspirate (C)</p> Signup and view all the answers

    Which of the following is NOT a common guideline for interpreting urine culture results?

    <p>One organism &gt;10^3 CFU/mL is always significant (A)</p> Signup and view all the answers

    In urine culture media, which agar is primarily used for the growth of common urinary pathogens?

    <p>Blood agar plate (A)</p> Signup and view all the answers

    What should be done if a urine specimen shows no growth after culture?

    <p>Report no growth and disregard the specimen (A)</p> Signup and view all the answers

    Flashcards

    Cerebrospinal fluid (CSF)

    A clear, colorless fluid found in the brain and spinal cord.

    Meningitis

    Inflammation of the meninges, the membranes surrounding the brain and spinal cord. Often caused by bacterial or viral infections.

    Purulent meningitis

    Meningitis caused by bacteria, resulting in pus formation in the meninges.

    Aseptic meningitis

    Meningitis caused by viruses, typically without pus formation.

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    Encephalitis

    Inflammation of the brain, often caused by viruses.

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    Meningoencephalitis

    Inflammation of both the brain and meninges, frequently caused by a combined infection.

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    Hematogenous spread

    The main route of infection spread through the bloodstream, carrying organisms from a colonized or infected site to the meninges.

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    Contiguous spread

    Infection spreading from an infected site directly adjacent to the central nervous system.

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    Amniotic Fluid

    Fluid surrounding the fetus, sterile in healthy pregnancies.

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    Pleural Effusion

    Excess fluid in the space between the lungs and chest wall.

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    Empyema

    Infection of the pleural space, often spreading from pneumonia, leads to pus formation.

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    Pericarditis

    Infection of the pericardium, the protective tissue around the heart. Usually caused by a VIRUS.

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    Septic Arthritis

    Infection of the synovial fluid, causing joint pain and inflammation.

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    Secondary Peritonitis

    Infection of the peritoneal cavity, often caused by ruptured appendix or perforated bowel.

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    Primary Peritonitis

    Infection of the peritoneal cavity, occurring spontaneously without a known source of infection.

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    Amnionitis

    Infection of the amniotic membrane, can occur even if the membrane is intact.

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    CSF Collection Tubes

    A sample of cerebrospinal fluid (CSF) collected in three tubes for different tests: chemistry, microbiology, and hematology. Each tube has a specific purpose, e.g., Tube 1 analyzes protein and glucose while Tube 2 checks for microbes.

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    Thick Smear

    A type of Gram stain smear used for CSF microbiology analysis. It helps identify potential bacterial invaders by their shape and color. Though relatively sensitive, it can sometimes miss certain bacteria.

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    BAP and CHOC Agar

    A type of culture medium used for growing bacteria from CSF in a CO2 incubator. This is the most common media, chosen because it helps bacteria flourish.

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    MAC or EMB Agar

    A specialized agar used for isolating and identifying Gram-negative bacteria (GNR) from CSF cultures. This is helpful if GNR are spotted on a Gram stain smear.

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    Hib Meningitis

    A specific type of meningitis caused by the bacteria Haemophilus influenzae.

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    Bacterial Meningitis

    A specific type of meningitis caused by the bacterial invasion of the meninges, often leading to inflammation and pus formation. This is usually detected through bacterial cultures and antigen tests.

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    Fungal Meningitis

    A specific type of meningitis caused by fungal infection, usually happening in people with weakened immune systems. This is often characterized by chronic inflammation.

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    Encephalitis/ Meningoencephalitis

    A type of brain inflammation frequently caused by viruses, sometimes accompanied by inflammation of the meninges (meningoencephalitis).

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    Urinary Tract Infection (UTI)

    Infection of the urinary system, a common condition.

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    Bacteriuria

    Presence of bacteria in the urine, doesn't always mean an infection.

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    Pyuria

    Presence of white blood cells in urine, a sign of inflammation or infection.

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    Cystitis (Lower UTI)

    Infection of the bladder, causing painful urination and frequent trips to the bathroom.

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    Pyelonephritis (Upper UTI)

    Infection of the kidneys, causing fever, pain, and urinary symptoms.

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    Acute Urethral Syndrome (AUS)

    Urinary tract infection in young women, often with dysuria, pyuria, and bacteriuria.

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    Urethritis

    Infection of the urethra, often sexually transmitted.

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    E. coli

    The most common cause of UTIs, a type of bacteria often found in the gut.

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    Suprapubic Aspirate

    A sterile urine collection method where a needle is inserted through the abdominal wall into the bladder.

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    Indwelling Catheter Urine

    The type of urine specimen collected from a catheter inserted and left in the bladder.

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    Clean-Catch Midstream Urine

    The preferred urine specimen type for UTI diagnosis, collected after cleaning the periurethral area.

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    Straight Catheter Urine

    A urine collection method where a catheter is inserted into the bladder, urine collected, and then the catheter is removed.

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    Nitrite Test

    A test that detects nitrate reductase activity in bacteria, indicating their presence in the urine.

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    Leukocyte Esterase Test

    A test that detects leukocyte esterase, an enzyme present in white blood cells, suggesting pyuria.

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    Colony Count

    The number of bacteria in a sample of urine, typically measured in colony-forming units (CFU) per milliliter.

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    BAP (Blood Agar Plate)

    A type of agar used for culturing bacteria, particularly helpful in identifying different bacterial species.

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    Enteric Agar

    A type of agar that inhibits the growth of gram-positive bacteria while promoting the growth of gram-negative bacteria, useful in identifying potential UTI pathogens.

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    Identification and Sensitivity

    A test that identifies the specific type of bacteria causing an infection and determines its susceptibility to various antibiotics.

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    Inoculation

    The process of transferring a urine sample onto a culture plate to promote bacterial growth and identification.

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    UTI (Urinary Tract Infection)

    The most common nosocomial infection in the United States, often associated with catheterization and instrumentation.

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    Suprapubic Aspirate

    A type of specimen often used for anaerobic bacterial culture, collected by inserting a needle through the abdominal wall into the bladder.

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    Study Notes

    Central Nervous System - Chapter 35

    • The central nervous system includes the brain, spinal cord, and meninges.
    • The meninges are sterile membranes that surround the brain and spinal cord.
    • Cerebrospinal fluid (CSF) bathes the brain and spinal cord. CSF is clear and colorless. Tests on CSF include culture, cell count, glucose, and protein levels.
    • Meningitis is inflammation of the meninges. Purulent meningitis, also known as pyogenic meningitis, involves pus in the meninges and is usually caused by bacteria. Aseptic meningitis is caused by viruses, rather than bacteria.
    • Encephalitis is inflammation of the brain, often caused by viruses. Meningoencephalitis is inflammation of both the brain and the meninges.
    • Routes of infection include hematogenous spread (bloodstream), contiguous spread (from adjacent sites like sinusitis), and trauma (breaching the CNS protective barrier). Surgical procedures can also introduce microbes.

    Body Fluids - Chapter 61

    • Body fluids often used in diagnostics include those from the pleural cavity (pleural fluid), peritoneal cavity (peritoneal fluid), pericardial cavity (pericardial fluid), joints (synovial fluid), and amniotic fluid. All are typically sterile.
    • Pleural fluid: Thoracentesis involves collecting pleural fluid from the space between the lungs and chest wall. Possible infections include empyema, a purulent pleural fluid infection caused by bacteria similar to pneumonia causing organisms.
    • Peritoneal fluid: Paracentesis is a procedure where peritoneal fluid is collected from the abdominal cavity. Infections can be spontaneous (no known source) or secondary (caused by ruptured appendix, perforated bowel) and can be caused by many organisms, but common causes include Enterobacteriaceae, staphylococci, S. pneumoniae, viridans strep, S. pyogenes.
    • Peritoneal dialysis fluid: Used in chronic dialysis for end-stage renal failure, peritoneal dialysis fluid (dialysate) is introduced into the peritoneal cavity to filter metabolic waste. Bacteria can come from skin flora (Staph, strep, GNR, Corynebacterium).
    • Pericardial fluid: Pericardiocentesis involves collecting pericardial fluid from the space around the heart. Pericarditis is usually caused by viruses.
    • Synovial fluid: Infectious arthritis, often caused by S. aureus, involves the inflammation of joint fluid. Other potential pathogens include streptococci, N. gonorrhoeae, H. influenzae, and Bacteroides.
    • Amniotic fluid: Amniocentesis involves collecting amniotic fluid surrounding the fetus. Amnionitis is the infection of the amniotic membrane and can occur even if the fetal membrane is intact. Possible pathogens include group B streptococci, anaerobes, E. coli, Gardnerella vaginalis, Ureaplasma urealyticum.

    Urinary Tract - Chapter 37

    • The urinary tract consists of the kidneys, ureters, urinary bladder, urethra, and prostate.
    • Normal flora in the urethra includes coag-neg staph, Corynebacterium, Micrococcus, Streptococci, Enterobacteriaceae, anaerobic bacteria, yeast and Mycoplasma. The upper parts of the tract are generally sterile.
    • Urinary tract infection (UTI) is microbial invasion of the urinary system. This is a common condition. Symptoms include bacteriuria (bacteria in urine), and pyuria (WBC in urine).
    • UTI types include: Cystitis (bladder infection), Pyelonephritis (kidney infection), Acute urethral syndrome (in young women and includes dysuria, pyuria, bacteriuria), and Urethritis (symptoms similar to UTIs).
    • Causative organisms for UTIs include E. coli (most common), other Enterobacteriaceae (Klebsiella), S. saprophyticus in young women, S. aureus, enterococci, and Pseudomonas.
    • Routes of infection include ascending (urethra to bladder/kidneys), and descending (bloodstream).
    • Factors predisposing to UTIs include urinary tract abnormalities, enlarged prostate, kidney stones, instrumentation (catheterization), and underlying medical conditions (diabetes).
    • In women, short urethra, hormonal changes, sexual activity and pregnancy can be predisposing factors. In men, over 60 years of age and an enlarged prostate can be factors.
    • Nosocomial infections: UTIs are a common cause of nosocomial infection in hospitals. These are often linked with instrumentation or catheterization.

    Genital Tract Infections and STDs - Chapter 38

    • Sexually transmitted diseases (STDs), also known as venereal diseases, involve infections transmitted through sexual contact.
    • Genital tract infections include urethritis (inflammation of the urethra), gonococcal urethritis (caused by N. gonorrhoeae), non-gonococcal urethritis (caused by C. trachomatis, or U. urealyticum), and more.
    • Urethritis symptoms often mimic UTI symptoms but are sometimes considered sexually transmitted.
    • Common causative organisms for urethritis include N. gonnorrhoeae, C. trachomatis, Enterobacteriaceae, S. saprophyticus, U. urealyticum, and Haemophilus.
    • The female genital tract consists of ovaries, fallopian tubes, uterus, cervix, vagina, and vulva. Indigenous microbes include, but are not limited to, Lactobacillus, Staphylococcus, Streptococcus (group B), Enterobacteriaceae, Corynebacterium, Gardnerella, Mycoplasma, and Ureaplasma, and anaerobic microorganisms. The composition of indigenous microbiota changes with age and other factors.
    • Genital tract infections can be exogenous (caused by STDs) or endogenous (caused by normal flora, rare). Most are sexually transmitted. Examples of common vaginal infections are candidal and trichomonas infections.
    • Bacterial vaginosis involves reduced lactobacilli and has clue cells that can be identified using a wet prep technique. A whiff test using KOH may help diagnose.
    • Cervicitis is an infection of the cervix, and is typically caused by N. gonorrheae or C. trachomatis.
    • Bartholinitis is an infection and abscess of the Bartholin's gland.
    • Group B streptococci can cause meningitis in newborns. Pregnant women are screened for group B strep.
    • Pelvic inflammatory disease (PID) includes conditions like salpingitis (fallopian tube), endometritis (uterus lining), tubo-ovarian abscesses, and peritonitis. PID is often caused by N. gonorrhoeae or C. trachomatis and can be related to childbirth, surgery, or IUD insertion, as those procedures can cause certain normal flora to ascend.
    • Male genital tract includes the urethra, prostate, epididymis, and testicles. Conditions such as epididymitis, prostatitis, and orchitis are upper tract infections in males, with similar microorganisms possibly causing UTIs.
    • Genital ulcer diseases include chancroid (caused by Haemophilus ducreyi), syphilis (caused by T. pallidum), genital herpes (caused by Herpes simplex virus type 2), donovanosis (caused by K. granulomatis), and lymphogranuloma venereum (caused by C. trachomatis).
    • Genital infections can also include HPV and warts.

    Specimen Collection and Culture Considerations

    • Specimen collection methods for various sites (urethra, cervix, vagina, etc.) are required. The collection method often influences the type of specimen collection. Appropriate specimens are key to obtaining accurate results to diagnose.
    • Swabs: Urogenital swabs are frequently made of cotton or rayon treated with charcoal. Collection from the urethral or vaginal area is generally done during a period where the patient has voided within the preceding 1-2 hours. Removal of mucus or discharge at the collection site is critical to avoid contamination.
    • Culture media requirements: Routine cultures may include (but are not limited to) Blood agar plates (BAP), Enteric agar plates (MAC, EMB), and Chocolate agar plates (CHOC) for identifying different microorganisms.
    • Incubation: Following the correct incubation time/conditions is necessary for growth and proper identification of organisms. This may vary by culture and organism and include standard temperatures (35°C) and/or use of CO2 concentration.
    • Colony count and identification procedures: Following culture, colony count and isolation procedures result in a CFU/ml value. This count gives insight into the severity and type of infection and the types and numbers of the organisms observed in culture.
    • Follow the guidelines and protocol to obtain the most informative specimens possible to correctly identify and treat infections.

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    Description

    Test your knowledge on meningitis, its causes, and related medical procedures. This quiz covers the characteristics of meningitis and the role of cerebrospinal fluid, along with concepts related to infection and fluid collection. Ideal for medical students and healthcare professionals.

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