MPL 202 midterm review 4

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Questions and Answers

In a diagnostic microbiology laboratory, which activity primarily falls under the clinical service aspect?

  • Developing new methods for identifying microbial species.
  • Providing routine diagnostic testing for patient samples. (correct)
  • Training new laboratory staff in advanced techniques.
  • Conducting research on emerging infectious diseases.

A researcher is investigating the effectiveness of a new antiviral drug. Which section of the diagnostic microbiology laboratory would most likely be involved in this research?

  • Bacteriology
  • Mycology
  • Parasitology
  • Virology (correct)

A patient is suspected of having a chronic parasitic infection, but initial tests are inconclusive. Which type of sample analysis would be most useful in determining the duration and extent of the patient's immune response?

  • Bacterial Culture
  • Serology (correct)
  • Fungal Stain
  • Viral Load

A microbiology lab is investigating an outbreak of a new fungal infection. To accurately identify the causative agent, which characteristic is MOST critical to analyze?

<p>Whether it's a single-celled yeast or multi-cellular filamentous fungi. (A)</p> Signup and view all the answers

In optimizing the pre-analytic phase of diagnostic microbiology, what is the MOST critical step to ensure accurate test results?

<p>Accurate and timely specimen collection. (B)</p> Signup and view all the answers

A technologist notices a delay in reporting test results due to inefficient data entry. Which action would MOST effectively optimize the post-analytical process?

<p>Implementing an automated system for result entry and transmission. (D)</p> Signup and view all the answers

During a lab tour, you observe separate rooms for different types of analyses. Which organizational layout BEST minimizes the risk of cross-contamination?

<p>Separate, dedicated rooms for bacteriology, mycology, virology, and parasitology. (A)</p> Signup and view all the answers

In a Gram stain procedure, if the alcohol decolorizer is skipped, what would be the likely appearance of both Gram-positive and Gram-negative bacteria under the microscope?

<p>Both Gram-positive and Gram-negative bacteria would appear purple. (C)</p> Signup and view all the answers

Why is culture considered more sensitive than direct detection methods like Gram staining?

<p>Culture methods involve amplification of the microorganism, allowing detection even with a low initial quantity. (A)</p> Signup and view all the answers

In the context of laboratory testing, which of the following best describes the 'pre-analytical' phase?

<p>The phase that includes specimen collection, transport, receipt, and processing prior to testing. (C)</p> Signup and view all the answers

In MALDI-TOF mass spectrometry, what is the primary role of the 'matrix' chemical?

<p>To ionize the bacterial proteins, allowing them to be accelerated in an electric field. (A)</p> Signup and view all the answers

Which step in the MALDI-TOF process directly results in the creation of a unique 'fingerprint' for bacterial identification?

<p>Acceleration of ionized particles through a vacuum tube. (B)</p> Signup and view all the answers

A microbiologist observes a bacterial sample under a microscope after performing a Gram stain. The bacteria appear purple. Which of the following conclusions can be accurately drawn?

<p>The bacteria are Gram-positive. (B)</p> Signup and view all the answers

A lab technician is tasked with rapidly identifying a fungal infection from a patient sample. Which direct detection method would be most appropriate for this purpose?

<p>Calcofluor white staining (D)</p> Signup and view all the answers

Why is the 'Time of Flight' component important in MALDI-TOF mass spectrometry?

<p>It separates particles based on their mass-to-charge ratio, allowing for identification. (A)</p> Signup and view all the answers

Why is electron microscopy particularly useful in virology for direct detection of viruses?

<p>It allows visualization of viruses based on their shape and structure without prior amplification. (D)</p> Signup and view all the answers

What is a primary disadvantage of using syndromic testing as a rapid diagnostic method?

<p>It tends to be more expensive than other diagnostic approaches. (D)</p> Signup and view all the answers

What characteristic of PCR tests makes them particularly useful for diagnosing C. difficile infections?

<p>Their sensitivity in detecting even small quantities of bacterial DNA. (D)</p> Signup and view all the answers

Which of the following statements is correct regarding the turnaround time (TAT) and sensitivity of direct detection methods versus culture methods?

<p>Direct detection methods have a shorter TAT and are less sensitive than culture methods. (A)</p> Signup and view all the answers

In the context of PCR testing, what is the role of primers?

<p>To initiate the DNA replication process by binding to specific sequences. (B)</p> Signup and view all the answers

A microbiologist performs a Gram stain on a sample from a patient suspected of having a bacterial infection, but no organisms are seen on the smear. According to protocol, what is the next appropriate step?

<p>Inoculate a culture medium and wait for culture results before declaring a negative result. (C)</p> Signup and view all the answers

In biochemical identification of bacteria, what principle is used to identify the specific type of bacteria?

<p>The bacterium's metabolic activities and the products they produce. (C)</p> Signup and view all the answers

What is a significant risk associated with performing PCR tests?

<p>Significant risk of sample contamination leading to inaccurate results. (A)</p> Signup and view all the answers

How does MALDI-TOF differentiate between different species of bacteria?

<p>By comparing the protein profiles to known bacterial protein profiles. (C)</p> Signup and view all the answers

What is the significance of using rapid diagnostic methods in clinical settings?

<p>They allow for quicker and more appropriate treatment decisions. (D)</p> Signup and view all the answers

Prior to placing the target plate inside the MALDI-TOF machine, what is the last preparatory step?

<p>Applying a chemical 'matrix' to the bacterial sample. (B)</p> Signup and view all the answers

A physician orders a third set of blood cultures (total of six bottles) for a patient to rule out bacteremia. Which of the following statements BEST reflects the appropriateness of this order, considering resource utilization and diagnostic yield?

<p>This is inappropriate, as the increase in sensitivity from two to three sets does not justify the additional resource consumption. (D)</p> Signup and view all the answers

A patient without urinary tract symptoms has a urine dipstick test ordered as part of a routine check-up, prior to a more extensive examination. According to recommendations for avoiding unnecessary resource consumption, what is the MOST appropriate course of action?

<p>Omit the urine dipstick test unless the patient presents with specific urinary tract symptoms. (A)</p> Signup and view all the answers

A doctor preemptively orders several lab tests, including a complete blood count and metabolic panel, anticipating that their supervising physician would want them. What principle of avoiding unnecessary resource consumption does this violate?

<p>Performing tests to anticipate a supervisor's wishes. (A)</p> Signup and view all the answers

When collecting blood cultures to diagnose a bloodstream infection, what is the MOST critical factor to ensure accurate results?

<p>The total volume of blood collected across all culture bottles. (B)</p> Signup and view all the answers

What is the MOST important instruction to give a patient who needs to provide a sputum sample for laboratory analysis?

<p>Cough up sputum from deep in your lungs rather than just spitting. (D)</p> Signup and view all the answers

Which of the following methods directly identifies the type of bacteria present in a sample using fluorescent markers?

<p>Amplified DNA detection (D)</p> Signup and view all the answers

In a laboratory setting, during which phase does specimen collection take place?

<p>Pre-analytical phase (D)</p> Signup and view all the answers

If a lab technician receives a poorly collected specimen, which of the following is the most likely consequence based on the principle of 'garbage in, garbage out'?

<p>Inaccurate or unreliable test results. (A)</p> Signup and view all the answers

Resource stewardship in healthcare aims primarily to reduce which of the following?

<p>Wasteful spending on tests/treatments that do not benefit patients. (A)</p> Signup and view all the answers

A doctor is considering ordering an expensive and invasive diagnostic test before exploring less invasive options. According to resource stewardship principles, what should a lab professional do?

<p>Suggest less invasive options to the doctor. (A)</p> Signup and view all the answers

How does unnecessary testing impact access to healthcare for other patients?

<p>It can limit access by consuming resources that could be used for other patients. (A)</p> Signup and view all the answers

During which of the following phases of laboratory testing does the interpretation of test results occur?

<p>Only in the analytical phase (C)</p> Signup and view all the answers

After analysis of the specimen is complete, in which phase does the lab report become available?

<p>Post-analytical Phase (A)</p> Signup and view all the answers

Which action exemplifies resource stewardship by a clinical lab professional?

<p>Confirming a test's necessity with the ordering physician. (C)</p> Signup and view all the answers

A lab technician notices an unusual test request that seems inappropriate for the patient's condition. What is the BEST course of action?

<p>Contact the ordering physician to clarify the test's rationale. (A)</p> Signup and view all the answers

Flashcards

Diagnostic Microbiology

The in vitro diagnosis of diseases caused by microorganisms (bacteria, fungi, viruses, parasites, and mycobacteria).

Diagnostic Microbiology Lab Roles

Routine diagnostics, infection control, and reference testing.

Bacteriology

The study of bacteria, which are prokaryotic, single-celled organisms divided into Gram-positive and Gram-negative types.

Mycology

The study of fungi, which are eukaryotic, single, and multi-cellular organisms divided into yeast and filamentous fungi.

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Virology

The study of viruses, which are acellular infectious particles that need a host to replicate.

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Serology

The study of serum, especially with regard to the immune system's response to pathogens, which is mainly the detection of antibodies.

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Parasitology

Study of eukaryotic, single and multi-cellular organisms, which are divided into protozoa (e.g. Giardia lamblia) and nematodes.

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Mycobacteriology

The study of mycobacteria, which are prokaryotic, single-celled organisms.

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Acid-Fast Bacteria (AFB)

Bacteria that retain dye when treated with acid during staining. This is due to high mycolic acid content in their cell walls.

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Gram Stain Steps

Crystal violet stains all cells purple, iodine fixes the stain, alcohol decolorizes gram-negative cells, and safranin counterstains gram-negative cells pink/red.

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Calcofluor White

A fluorescent dye used in mycology to directly visualize fungi in patient samples under a microscope, rapidly identifying fungal infections by binding to chitin.

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Electron Microscopy

A method using an electron microscope to magnify, visualize, and identify viruses based on their shape and structure without prior amplification.

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Culture (Microbiology)

Growing microorganisms on a nutrient-rich medium like agar to amplify them for identification and testing.

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Agar Plate Streaking

Spreading bacteria from a sample across an agar plate in a streaking pattern to isolate individual bacterial cells and allow them to grow into distinct colonies.

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Biochemical Identification (Bacteria)

Identifying bacteria by observing their metabolic activities in test mediums, indicated by color changes.

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Direct Detection vs. Culture

Direct detection gives rapid results but may miss organisms. Culture is more sensitive but takes longer.

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Unnecessary Resource Use

Avoid tests, treatments, or procedures that won't alter the patient's clinical course.

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Eliminate Low-Value Healthcare

Aim to eliminate healthcare practices that provide minimal benefit relative to their cost.

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Blood Culture Volume

Collect ~40 ml of blood to achieve ~95% sensitivity for bacteremia detection.

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Blood Culture Sets

Two bottles per set, with two sets per sepsis episode, help distinguish true infection from contamination.

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Quality Sputum Sample

Ensure it's from the lungs, not saliva, for accurate respiratory results; collect from deep cough.

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Virus Identification (clear = 0)

A biochemical key ID that signifies the type of virus.

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MALDI-TOF Mass Spectrometry

A method using MALDI-TOF to analyze protein profiles for bacterial identification.

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Steps of MALDI-TOF

Prepare sample, add matrix, laser vaporizes/ionizes, time of flight measurement, mass spectrum creation, database matching.

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Rapid Diagnostics Characteristics

Short turnaround time, high sensitivity, but can be expensive.

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Syndromic Testing

A diagnostic approach testing for multiple pathogens causing similar symptoms simultaneously.

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Downside of Syndromic Testing

Useful in detection, but can be expensive.

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PCR Test

Processed in real time, results in ~60 min. High risk of contamination.

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PCR as Point of Care

Point of care testing method.

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PCR Sensitivity and Specificity

Detects small amounts of bacterial DNA by amplifying specific sequences.

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PCR Amplification

Repeated heating and cooling cycles to create millions of copies of target DNA.

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Amplified DNA Detection

Detecting amplified DNA using fluorescent markers to identify bacteria type.

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Susceptibility Testing

Testing to determine a microbe's vulnerability to specific antimicrobial agents.

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Pre-analytical Phase

The phase encompassing specimen collection, transport, receipt, and processing.

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Analytical Phase

The stage where the actual testing and interpretation of results occur.

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Post-analytical Phase

Involves the reporting of test results.

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Critical Role in Pre-analytics

Ensuring high-quality specimens for accurate test results.

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"Garbage In, Garbage Out"

Emphasizes that poor specimens lead to poor results. Avoid sending or accepting questionable specimens.

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Resource Stewardship

Avoiding unnecessary tests/treatments to reduce healthcare waste.

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Unnecessary Harm

Unnecessary tests/treatments leading to potential harm for the patient.

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Limitation of Access

Unnecessary tests/treatments limit resources and delay care for other patients.

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