Lesson 20: Smears and Cultures

What factors affect the physician's ability to identify, diagnose and treat infections?

Adequate specimen quantity; proper specimen transportation; speedy delivery to laboratory; proper labeling of specimen container; and proper inoculation and incubation.

Pasteurella multocida requires which type of environment? Dark Well-lit Aerobic Anaerobic

Anaerobic

Which environment lacks oxygen? Dry Wet Aerobic Anaerobic

Anaerobic

Wound cultures require special attention because the wound may contain this. Aerobic bacteria Anaerobic bacteria Pasteurella multocida Anaerobic and aerobic bacteria

Anaerobic and aerobic bacteria

Which is a sputum collection method that requires anesthesia? Suction Clean-catch Expectoration Bronchoscopy

Bronchoscopy

Daniel is seen about every three months so Dr. Barnes can keep an eye on a troubling heart arrhythmia. Today however, Daniel has a fever, congestion and a cough. Unfortunately, he can't produce enough sputum for a sample. What should you do next? You should use the suction method, so Daniel won't need anesthesia Bronchoscopy is the only alternative since Daniel has a heart condition Use the rapid strep test because it can test for many different types of infections Ask Daniel to drink a lot of water in the waiting room, then have him try the expectoration method again

Bronchoscopy is the only alternative since Daniel has a heart condition

Which is not a method of obtaining a sputum sample? Suction Clean-catch Expectoration Bronchoscopy

Clean-catch

These are nutrient-rich substances that promote pathogen growth. Flora Smears Seaweed plants Culture mediums

Culture mediums

_____ are body fluids that are tested for bacterial growth. Safety hoods Cultures Refrigerators Inoculating

Cultures

What do factors such as specimen quantity, specimen quality and proper inoculation determine? Results of the sensitivity test Doctor's success in diagnosis Number of colonies that will grow

Doctor's success in diagnosis

Which method is most comfortable for the patient to collect sputum? Suction Clean-catch Expectoration Bronchoscopy

Expectoration

A dry smear requires that the specimen cover one-fourth of the slide. True False

False

Bacteria with high lipid levels are Gram-positive. True False

False

Diffusion allows doctors to calculate the absolute lowest dose of antibiotic needed to inhibit bacterial growth. True False

False

For the suction method a sterile catheter passes through the patient's nose then sucks sputum directly from the lungs. True False

False

Most incubators maintain a temperature between 20 and 40 degrees Celsius. True False

False

Prior to an occult blood test, the patient should cut back on oatmeal or other high fiber cereals until after the test. True False

False

The culture is considered pure if more than one species or organism is present. True False

False

When collecting the strep swab, three samples should be collected. True False

False

Wound cultures require only anaerobic environments. True False

False

You should focus towards the lens to prevent the lens from coming in contact with the slide. True False

False

What can you do to ensure quality control in the lab?

Follow directions closely and note any deviation from the rules and regulations. Regular maintenance and daily checks of equipment will keep everything running smoothly. Check that all refrigerator temperatures are within the correct range and throw away any outdated items.

This term denotes the name of the paper surface used in the test. Occult Guaiac Sputum

Guaiac

What do sensitivity tests indicate? An allergy Colonies of bacteria How well and antibiotic will work Antibiotics the patient is allergic to

How well an antibiotic will work

_____ is the act of transferring a specimen to a plate containing a culture medium. Safety hoods Cultures Refrigerators Inoculating

Inoculating

Which procedure allows the bacteria to grow in a nutrient rich environment? Occult Incubated Inoculation Clean-catch

Inoculation

Outline the steps for viewing a slide with a microscope.

Place a cover slip over the specimen on the slide. Use the coarse adjustment to raise the nosepiece unit. Place the slide on the stage. Turn on the microscope light. Rotate the low-power (10x) objective into position. Look at the stage from the side and turn the coarse adjustment until the objective is as close to the slide as it will go. Stop turning when the objective no longer moves. Don't lower the objective while looking through the oculars. Look into the oculars and slowly turn the coarse adjustment to raise it until the object on the slide comes into view. Turn the fine adjustment to sharpen the image. If the stage is movable, use the knobs to survey the slide.

A low lipid bacterium will cause a Gram stain to be which color? pink black green purple

Purple

Strep testing can be most easily accomplished with which? Suction Clean-catch Bronchoscopy Rapid test and swabs

Rapid test and swabs

_____ must hold a temperature between 2 and 8 degrees Celsius. Safety hoods Cultures Refrigerators Inoculating

Refrigerators

Aerosols require the use of this type of equipment. Autoclaves Microscopes Refrigerators Safety hoods

Safety hoods

_____ are ventilators that suck out air and fumes created when samples with aerosols are being processed. Safety hoods Cultures Refrigerators Inoculating

Safety hoods

Scott collects a specimen and transplants into culture media so that the bacteria can grow in a nutrient-rich environment. He uses agar in a Petri dish for this portion of the procedure. Scott applies the specimen to the agar with his fingers and uses inoculating loops. The loop is moved across the plate in a sweeping motion, covering much of the surface area. Then the specimen, held in the agar in the Petri dish, is incubated for 24 to 48 hours. The colonies of bacteria that grow are then examined. What should Scott have done differently? Scott did everything correctly Scott should not have used a nutrient-rich environment Scott should have incubated the specimen for only 6-12 hours Scott should have used a swab instead of his fingers to apply the specimen to the agar

Scott should have used a swab instead of his fingers to apply the specimen to the agar

This determines how well certain antibiotics will work as a treatment for the infection. Rapid test Sensitivity test Developer test Stool guaiac test

Sensitivity test

In a microscope, light passes through a condenser and an iris diaphragm. The condenser controls the amount of light The condenser controls the intensity of the light The iris diaphragm controls the intensity of the light Both first and third statements are correct

The condenser controls the intensity of the light

Ten-year-old, Jenny is coughing uncontrollably as you lead her and her dad to an exam room. Her father confirms that she has not eaten or brushed her teeth. What will you use to obtain a sputum sample from Jenny? A rapid strep test, which is the fastest way to obtain a sputum sample The expectoration method, and you give Jenny a specimen cup to spit into The suction method and use a bulb to suction mucous from the child's nose A bronchoscopy without sedation, because you'd like to obtain a tissue sample as well

The expectoration method, and you give Jenny a specimen cup to spit into

Which is a true statement of the microscope? The fine adjustment is used to sharpen the image The course adjustment is used to sharpen the image The fine adjustment is used with the low power objective to bring the object into view Both first two statements are correct

The fine adjustment is used to sharpen the image

Why is it important to take two samples of sputum when performing the rapid strep test? One sample is used to test antibodies, the other to test antigens The first sample is used in the office and the second is sent to a lab for more accurate analysis Strep tests often give false positive results, so a second test is performed to confirm the diagnosis It takes very few streptococcal bacteria to cause strep throat, so two samples are necessary to make sure the bacteria isn't present

The first sample is used in the office and the second is sent to a lab for more accurate analysis

Why are stool cultures obtained?

They determine the cause of symptoms; identify bacterial, parasitic or protozoal infection; and determine if treatment is working as expected.

A clean-catch specimen is obtained when the patient urinates into a sterile container. True False

True

Bacteria with a low lipid content are gram-positive because they are stained and hold the first color, purple. True False

True

Carry the microscope with one hand under the base and other holding the arm. True False

True

Many cultures are collected with a sterile swab and need to be kept moist until testing. True False

True

Occult blood is blood in the feces that is not visible. True False

True

Personal protective equipment (PPE) is worn to minimize exposure to hazards that cause serious workplace injuries and illnesses. True False

True

Prior to an occult blood test, the patient may be asked to avoid vitamin C supplements, red meats and broccoli. True False

True

Prior to an occult blood test, the patient should talk to the doctor if he has hemorrhoids before beginning the test. True False

True

Sputum can be tested to diagnose diseases of the lungs and lower respiratory tract. True False

True

Swabs are often used in collecting specimens. True False

True

The compound microscope is used to view smaller specimens such as cell structures. True False

True

The eyepiece of a microscope may be single lens or binocular lens. True False

True

Wet mounts allow you to view the motility of specimens. True False

True

What are the seven steps to prepare a dry smear for staining?

Wash hands. Label slide with the patient's name. Put on gloves. Cover two-thirds of the slide with a thin layer of specimen. Hold the slide with forceps and dip into methanol, fixing the specimen in place. Let slide air dry, then proceed with staining procedure. Dispose of gloves and sanitize work area.

Outline the steps to obtain a sputum sample by expectoration.

Wash your hands. Identify the patient and explain the procedure. Put on personal protective equipment. The patient should breathe deeply 2 to 4 times and cough deeply to raise the sputum. Have the patient cough deeply again, expelling fluid into the center of the sputum container. Cover the container immediately. Dispose of PPE. Wash your hands. Document the procedure.

This allows you to view the natural color and motility patterns of live specimens. Smear Dry mount Wet mount

Wet mount

Today, Brett will prepare a bacteriological smear to be studied under a microscope. He properly transfers the specimen to a slide and fixes it in place. Then, the specimen is stained. With the microscope, the doctor will study the effects of the dye on the virus and use this information to identify the virus. Is there anything unusual or incorrect about this scenario? No, the scenario is accurate as is Yes, the dye will not allow the doctor to identify viruses or bacteria Yes, the procedure is not used to identify viruses. It should identify bacteria Yes, the doctor will study the effects of the dye on the virus and thus identify the bacteria

Yes, the procedure is not used to identify viruses. It should identify bacteria

You may think of a(n) _____ as a type of pressure cooker that you can use to sterilize instruments. culture medium autoclave

autoclave

Bacteriology is the study of _____. bacteria syphilis smears

bacteria

Flora is a type of _____. agar bacteria pathogen incubator

bacteria

A(n) _____ works by spinning the contents at a high speed, allowing the lighter components to float to the top while the heavier components sink to the bottom. centrifuge incinerator cover slip

centrifuge

A(n) _____ is a thin, flat piece of transparent material for viewing with the microscope. centrifuge incinerator cover slip

cover slip

Agar is a(n) _____ made from seaweed. culture medium autoclave

culture medium

A Bunsen burner is a type of _____ that uses heat to sterilize contaminated tools. centrifuge incinerator cover slip

incinerator

A negative Gram stain is _____. pink purple a confirmation of Streptococcus an indication of low-fat levels in the bacteria

pink

A(n) _____ is a thin layer of microorganism spread on a glass slide for identification purposes. bacteria syphilis smear

smear

T. pallidum is the cause of _____. bacteria syphilis smear

syphilis