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Questions and Answers
Which department in a hospital is responsible for processing clinical specimens?
Which department in a hospital is responsible for processing clinical specimens?
Clinical Pathology department
What is the primary mission of the Clinical Microbiology Lab?
What is the primary mission of the Clinical Microbiology Lab?
What are the four major responsibilities of a Clinical Microbiology Lab?
What are the four major responsibilities of a Clinical Microbiology Lab?
Processing of Clinical Specimens, Isolation of potential Pathogens, Identification of isolated Pathogens, and Antimicrobial susceptibility testing.
Which of the following is NOT considered a rejection criteria for a clinical specimen?
Which of the following is NOT considered a rejection criteria for a clinical specimen?
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What is the purpose of a direct staining technique?
What is the purpose of a direct staining technique?
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Which of the following is considered the most common clinical specimen sent to the Clinical Microbiology Lab (CML)?
Which of the following is considered the most common clinical specimen sent to the Clinical Microbiology Lab (CML)?
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Which type of urine collection method is considered superior for testing?
Which type of urine collection method is considered superior for testing?
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What is the optimal temperature for storing urine specimens for up to 24 hours?
What is the optimal temperature for storing urine specimens for up to 24 hours?
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In the context of urine analysis, what does pyuria indicate?
In the context of urine analysis, what does pyuria indicate?
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Bacteriuria without pyuria is considered a significant finding, indicating a potential urinary tract infection.
Bacteriuria without pyuria is considered a significant finding, indicating a potential urinary tract infection.
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What enzyme is detected in the urine by the leukocyte esterase test?
What enzyme is detected in the urine by the leukocyte esterase test?
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Which of the following is NOT a reason why blood should always be considered significant until proven otherwise?
Which of the following is NOT a reason why blood should always be considered significant until proven otherwise?
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What is the main indication for blood culture?
What is the main indication for blood culture?
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What is the recommended temperature for incubating blood cultures?
What is the recommended temperature for incubating blood cultures?
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Refrigerating blood culture bottles is recommended to preserve the viability of the microorganisms.
Refrigerating blood culture bottles is recommended to preserve the viability of the microorganisms.
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What is the most common cause of endocarditis in individuals who do not use intravenous drugs?
What is the most common cause of endocarditis in individuals who do not use intravenous drugs?
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What are the three sterile tubes that cerebrospinal fluid (CSF) is typically collected into, and what labs are they sent to?
What are the three sterile tubes that cerebrospinal fluid (CSF) is typically collected into, and what labs are they sent to?
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Which of the following is NOT a common sign of increased intracranial pressure (ICP) in the context of cerebrospinal fluid analysis?
Which of the following is NOT a common sign of increased intracranial pressure (ICP) in the context of cerebrospinal fluid analysis?
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What is the most likely cause of meningitis in a neonate?
What is the most likely cause of meningitis in a neonate?
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Which type of specimen is preferred for wound culture?
Which type of specimen is preferred for wound culture?
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Which of the following is a common cause of postsurgical wound infection?
Which of the following is a common cause of postsurgical wound infection?
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What type of bacteria is responsible for causing gonorrhea?
What type of bacteria is responsible for causing gonorrhea?
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What type of media is recommended for culturing Neisseria gonorrhoeae?
What type of media is recommended for culturing Neisseria gonorrhoeae?
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Which of the following is NOT a common complication of Group A streptococcal infection?
Which of the following is NOT a common complication of Group A streptococcal infection?
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Sputum culture is routinely performed for diagnosing upper respiratory tract infections.
Sputum culture is routinely performed for diagnosing upper respiratory tract infections.
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What is the most common cause of community-acquired pneumonia?
What is the most common cause of community-acquired pneumonia?
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Feces specimens for Salmonella and Shigella cultures should be processed immediately to avoid death of these bacteria.
Feces specimens for Salmonella and Shigella cultures should be processed immediately to avoid death of these bacteria.
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Which of the following is the recommended media for enriching Salmonella and Shigella cultures?
Which of the following is the recommended media for enriching Salmonella and Shigella cultures?
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What are the two common types of media used for the selective isolation of Salmonella and Shigella?
What are the two common types of media used for the selective isolation of Salmonella and Shigella?
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Feces specimens are not routinely used for the detection of parasites.
Feces specimens are not routinely used for the detection of parasites.
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Study Notes
Microbiology Course - Diagnosis of Infectious Diseases - Fifth Sheet
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Pathology Department Organization: Includes Anatomical Pathology (Morgue, Histopathology, Cytology, Cytogenetics, Electron Microscopy Labs), Clinical Pathology (Clinical Microbiology, Clinical Immunology, Hematology, Blood Transfusion, Clinical Chemistry Labs).
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Clinical Microbiology Lab (CML) Mission: Active participation in managing and treating patients with infectious diseases.
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Patient Approach with Infectious Disease: Includes patient history, physical examination, differential diagnosis, investigations (laboratory and radiological), and final diagnosis and treatment plan.
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CML Responsibilities: Processing clinical specimens, isolating pathogens, identifying pathogens, and performing antimicrobial susceptibility testing (AST).
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Hospital Outbreak Responsibilities: Recognition, notification, source identification, environmental sample processing, and healthcare provider screening.
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CML Sections: Bacteriology, Mycobacteriology, Virology, Immunology, Mycology, Parasitology. Note these are sometimes sectioned differently depending on hospital size.
Clinical Specimens (Samples)
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High Quality Specimen Components: Specimen selection (appropriate type), collection (clear instructions, sufficient quantity, appropriate containers), and transport (immediate or storage if delayed, proper documentation). Incorrect specimens will be rejected.
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Rejection Criteria: include unlabeled or mislabeled samples, leaked containers, insufficient quantity, potential pathogen destruction or masking by contamination.
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Specimen Processing: Steps vary, depending on specimen type, and include macroscopic and microscopic examinations, inoculation of appropriate culture media, identification, and antimicrobial susceptibility testing.
Urine Specimens
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Collection Methods: Clean-Catch Mid-Stream (CCMS), catheterized urine, urine bag, and suprapubic needle aspiration (SPA). CCMS is preferred when possible.
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Processing Time: within 30 minutes of collection or 24 hours with refrigeration. Urine samples should be processed as soon as possible.
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Specimen volumes: Specific volumes of urine are needed for testing.
Blood Specimens
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Blood Specimens Importance: Blood is typically sterile and any isolate should be tested in case of infection.
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Collection and Processing: Instructions for appropriate collection, transport, and processing of blood specimens using aseptic technique and proper sterilization.
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Transport and Delivery: Blood specimens must be transported and delivered as soon as possible; do not refrigerate unless instructed.
CSF Specimens
- Collection Requirements: CSF collection for diagnosis of life-threatening diseases is to be performed by a physician under strict surgical asepsis, using three sterile tubes, with appropriate documentation.
Wound Specimens
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Collection and Handling: Specify that samples should ideally be aspirated using a needle and syringe, and contain pus.
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Important Information of Rejection: Specimens liable for frequent contamination (e.g., swabs for MTB, and fungi) are rejected.
Throat Swabs
- Collection and Testing: Throat swab testing often looks for streptococcal bacteria/Group A streptococci. Tests include use of gram stains, bacitracin sensitivity, Lancefield grouping, and specific testing. Use a slide agglutination test.
Sputum Specimens
- Collection: Sputum specimens are usually used in the diagnosis of lung disease, such as pneumonia or tuberculosis. Specimens are collected from the lungs and usually handled according to hospital procedure.
Stool Specimens
- Collection and Labwork: Stool specimens are commonly used for gastrointestinal infections or illnesses. Several specialized media, and different test methods, are used to detect pathogens.
Additional Note
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Immune-compromised patients: Infections may present differently in patients with weakened immune systems.
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Significance of Results: Results and interpretation focus on clinical significance - are the symptoms consistent with an infection and are the results from the test results significant?
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Description
This quiz covers the key aspects of diagnosing infectious diseases in the context of microbiology. It includes the organization of the Pathology Department, the role of Clinical Microbiology Labs, and the approach to patient care regarding infectious diseases. Test your knowledge on sample processing, pathogen identification, and outbreak management.
