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Prism lab results basic, advanced, common infective agents

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quickster2008's version from 2016-11-12 21:09

Section 1

Question Answer
generalized term for any WBC including neutrophils/granulocytes, monocytes, lymphocytes, eosinophils and basophils. Leukocyte
Why is important to differentiate what type of leukocyte is increased with an infectionbecause a rise an leukocyte count can indicate a rise in any or all of the different types of WBCs which all mean different things
Neutrophils/Granulocytes part of what immune systemPart of the humoral system.
Phagocytic cells in the inflammatory process.Neutrophils/Granulocytes(PMNs and band cells)
Neutrophils/Granulocytes(PMNs and band cells) take ? days to matureNormally take 8-14 days to mature.
Neutrophils/Granulocytes(PMNs and band cells) functionally last ? daysFunctionally last 1-2 days.
Neutrophils/Granulocytes(PMNs and band cells) half life is ? hrsHalf-life 6 hrs
when would Neutrophils/Granulocytes(PMNs and band cells) be increased iWould be increased in an inflammatory state.
Mature neutrophils that you would expect to see in an infection.PMNs
Immature neutrophils. Presence indicates active, ongoing infectionBand cells:
left shift indicates increased neutrophil percentage in the presence of band cells.
Cells that become Phagocytic, bacteriocidal macrophages in the humoral systemmonocytes
Accumulate after neutrophils in acute infection and Presence indicates post-inflammatory state or chronic infection.Monocytes or macrophages
Part of the cellular system.lymphocytes, eosinophils, basophils
part of humoral systemneutrophils and monocytes(macrophages0
Produce immunoglobulins and express cellular immunity (T and B cells), Possibly increased in a foreign body reaction, but not normally increased in bone/soft tissue infectionsLymphocytes
Generally involved in allergic and immune responses and acronym NAACP eosinophils NAACP -(Neoplasm, Allergy, Addison’s, Collagen vascular disorder, Parasites)
Involved with acute allergic responses and histamine release.Basophils
increased WBC.Leukocytosis
An increased leukocyte count indicatesan increased level of inflammation, not necessarily infection.
other causes of leukocytosis besides infection.Lithium, Corticosteroids
a decreased WBC. This could lead to a normal WBC in the presence of infection.Leukopenia
other causes of leukopenia besides infection.Drugs: Methotrexate, Phenybutase, Dilantin, Salicylates
Basic DM infection labsCBC with diff, chem-7/metabolic panel, minerals(Ca, Mg, P), Glucose, HbA1c, H&H, Coags
advanced DM infection labsESR, CRP, nutrition analysis(albumin, pre-albumin) wound culture & sensitivity, blood cultures, bone biopsy, EKG, CXR
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Section 2

Question Answer
Is acidosis or aklosis a Non-descript finding in infectionacidosis
indicate Abnormal in renal dysfunction with long term vascular consequences.Minerals (Ca, Mg, P)
tress of infection will probably cause a hypo or hyperglycemic state.hyperglycemic
Measure of glycosylated hemoglobin and long-term glucose controlHgA1C
7 % HgA1C indicates ? mg/dl blood sugar1% equals approximately 20 glucose points (7% equals ~140ug/ul)
labs that are Essential to know if you are planning surgery.H&H, Coags
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Section 3

Question Answer
Erythrocyte Sedimentation Rate (ESR) normal<20mm/hr
Erythrocyte Sedimentation Rate (ESR) Moderate elevation20-60mm/hr
Erythrocyte Sedimentation Rate (ESR) severe elevation>60mm/hr
(ESR) measured usingWestergren method
measures the distance erythrocytes fall in one hour in a vertical column of anti-coagulated blood under the influence of gravity.Westergren method
which is more specific CRP or ESRCRP, ESR is Sensitive, but not specific for infection as it is increased in any inflammatory state with increased fibrinogen.
Besides infection ESR is also elevated with ?Pregnancy, DM, ESRD, CAD, CVD, Malignancy, Age
Normal CRP0-0.6mg/dl
CRP measuresMeasures a liver protein only present in acute inflammation (not normally found at all).
Besides infection CRP also elevated in RA, Malignancy, MI, SLE, Pregnancy, etc.
Is CRP specific for infection?Sensitive, but not specific for infection(but better than ESR)
Why dont some hospitals use CRPMore expensive and technically difficult to perform.
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Section 4

Question Answer
Albumin normal value3.6-5g/dl
what is albuminTransport protein in liver with important functions in catabolism
Will albumin be increased or decreased in infection?Value decreased with inflammation and malnutrition.
When would you order albuminfor infection & malnutrition. Will decr with inflammation & malnutrition
Pre-albumin normal value19-36 mg/dL
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Section 5

Question Answer
You should expect Gram Stain results to come back in ? hrsresults usually within 24 hours
Preliminary Wound Culture and Sensitivity results to come back in ? hrsresults usually within 48 hours
Expect final Wound Culture and Sensitivity results to come back in ? hrsresults usually within 72 hours
Presence of ? cell in gram stain indicates inflammation.PMNs
What does a gram stain tell youif there is an organism present-essentially irrelevant bc doesnt tell u which one
Gram stain nature (positive/negative) and shape (cocci/bacillus) of any organism, Clues you into organism so you know what antibiotic to orderPreliminary wound & sensitivity
Should always get sensitivities with this and Allows for conclusive Abx planning.final wound & sensitivity
ideal situation for wound & sensitiivitydeep wound specimen (not just a swab) following incision and drainage with pulse lavage before beginning antibiotic therapy.
test that Indicates bacteremia/septicemiaBlood Cultures
how should blood cultures be drawnShould be drawn from 2 sites; 20 minutes apart.
Gold standard for diagnosis of osteomyelitisBone Biopsy
Chest xray or EKG for what type of pts> 40 and smoker or cardiac issues
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Section 6

Question Answer
gram stain shows Anaerobic Gram Positive CocciPeptostreptococcus
Aerobic Gram Positive RodsBacillus anthracis Corynebacterium diphtheriae Listeria Monocytogenes
-Anaerobic Gram Positive RodsClostridium perfringens Clostridium difficile Clostridium tetani
-Aerobic Gram Negative RodsPseudomonas, E. coli, Enterobacter, Proteus, Vibrio, Y. pestis, Shigella, Salmonella, Klebsiella, Serratia, E. Corrodens, P. multicide
Anaerobic Gram Negative RodsBacteroides fragilis
Aerobic Gram Negative CocciNeisseria
spirochetesTreponium pallidum Borrelia burgdorferi
Aerobic Gram Positive CocciStaph aureus, MRSA, Staph epi, MRSE, Enterococcus, VRE, Strept pyogenes (Group A), Strept agalactiae (Group B), Strept bovis (Group D), Strept Viridans
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Section 7

Question Answer
Staph aureusAerobic Gram Positive Cocci
MRSAAerobic Gram Positive Cocci
Staph epiAerobic Gram Positive Cocci
MRSEAerobic Gram Positive Cocci
EnterococcusAerobic Gram Positive Cocci
VREAerobic Gram Positive Cocci
Strept pyogenes (Group A)Aerobic Gram Positive Cocci
Strept agalactiae (Group B)Aerobic Gram Positive Cocci
Strept bovis (Group D)Aerobic Gram Positive Cocci
Strept ViridansAerobic Gram Positive Cocci
PeptostreptococcusAnaerobic Gram Positive Cocci
Bacillus anthracisAerobic Gram Positive Rods
Corynebacterium diphtheriaeAerobic Gram Positive Rods
Listeria MonocytogenesAerobic Gram Positive Rods
Clostridium perfringensAnaerobic Gram Positive Rods
Clostridium difficileAnaerobic Gram Positive Rods
Clostridium tetaniAnaerobic Gram Positive Rods
pseudomonasAerobic Gram Negative Rods
e. coliAerobic Gram Negative Rods
enterobacterAerobic Gram Negative Rods
proteusAerobic Gram Negative Rods
vibrioAerobic Gram Negative Rods
y. pestisAerobic Gram Negative Rods
shigellaAerobic Gram Negative Rods
salmonellaAerobic Gram Negative Rods
klebsiellaAerobic Gram Negative Rods
serratiaAerobic Gram Negative Rods
e.corrodensAerobic Gram Negative Rods
p.multicideAerobic Gram Negative Rods
Bacteroides fragilisAnaerobic Gram Negative Rods
NeisseriaAerobic Gram Negative Cocci
Treponium pallidumSpirochetes
Borrelia burgdorferiSpirochetes
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