Clinical Pathology Nicoprieto

Front 1

Name the test and what it is for

Back 1

Catalase test
Differentiate:
- Staphylococcus (+) from Streptococcus (-)
- Among small non-branching, non-spore forming aerobic gram positive bacilli:
( + ) Listeria spp. Corynebacterium spp.
( - ) Erysipelothrix rhusiopathiae (H2S+), Arcanobacterium haemolyticum

Front 2

Name the test and what it is for

Back 2

Coagulase tube test: detects free coagulase producing organisms
Coagulase-positive staphylococci:
Staphylococcus aureus subsp. anaerobius
S. a. aureus
S. a. delphini
S. hyicus
S. intermedius (dog bite)
S. lutrae
Staphylococcus schleiferi subsp. coagulans

Coagulase-negative staphylococci:
S. saprophyticus
S.cohnii subsp. cohnii
S. cohnii subsp. urealyticum
S. captitus subsp. captitus
S. warneri
S.hominis
S.epidermidis
S. caprae
S. lugdunensis (+ with bound/slide coagulase test and PYR+)
Coagulase test = Rabbit plasma + organism incubated at 35*C and checked at 4 hr and 24 hr

Front 3

Name the test and what it is for

Back 3

Coagulase slide test: detects bound (clumping factor) coagulase producing organisms

S. aureus group and S. lugdunensis ( - coagulase tube test)

Front 4

Name the test and what it is for

Back 4

Coagulase latex agglutination test: detects bound (clumping factor) coagulase producing organisms

S. aureus group and S. lugdunensis ( - coagulase tube test)

Front 5

Name the test

Back 5

Kirby-Bauer disk diffusion antibiotic sensitivity testing showing nosocomial MRSA

Front 6

Name the test

Back 6

Kirby-Bauer disk diffusion antibiotic sensitivity testing showing community acquired MRSA with positive D-test

Front 7

Novobiocin disk/gram stain, name the organism on the right side

Back 7

Staphylococcus saprophyticus

Coagulase - Staph. involved in approximately 10-20% of UTI (young females)

Front 8

Name the probable organism

Back 8

Clostridium perfringens showing double zone of Beta hemolysis on SBA

Front 9

Lecithin Lactose Agar

Back 9

Clostridium perfringens precipitates lecithin around colonies (opaque halo)

Front 10

thioglycolate broth

Back 10

Clostridium perfringens in thioglycolate broth, showing gas production

Front 11

Name organism

Back 11

Pseudomonas aeruginosa on BAP showing metallic haze colonies

Front 12

Mac Conkey agar

Back 12

Pseudomonas aeruginosa on MAC
Glucose non-fermenter, oxidase positive

Front 13

KIA/TSI tube, organism?

Back 13

K/K:
non-glucose, non-lactose, non-sucrose fermenter
No H2S

Pseudomonas

Front 14

Type of hemolysis, possible organisms

Back 14

Beta-hemolysis

Groups
A (pyogenes)
C (S. dysgalactiae Subs. equisimilis)
G (S. equi Subs. zooepidermicus)

B (pyogenes)
β-hemolytic enterococci

Front 15

Bacitracin test

Back 15

Group A Streptococcus (pyogenes) is susceptible to Bacitracin

Bacitracin resistant Beta-Hemolytics
S. milleri group (F)
S. dysgalactiae Subs. equisimilis (C)
S. equi Subs. zooepidermicus (G)
β-hemolytic enterococci

Front 16

PYR test

Back 16

Positive in Streptococcus pyogenes (GAS)

AND Beta-hemolytic Enterococci

Front 17

Lancefield testing caveat

Back 17

Does not distinguish between large-colonyforming,
pyogenic streptococci of groups A, C and G and
small-colony-forming group A, C and G strains of the
anginosus or “S. milleri” group

Front 18

This bacterium grew in Regan-Lowe medium forming round, domed, mercury-silver, colored, shiny colonies

Back 18

Bordetella pertussis

Culture sensitivity:

• If ≥14 days from onset of cough, sensitivity is
lower, so serology is sent instead of culture

• Caveat: Serology is uninterpretable in immunized
or unimmunized patients <11 years of age
– These patients are cultured regardless of duration of
symptoms

Front 19

Name organism

Back 19

Corynebacterium diphtheriae

Non-motile
Catalase +

Front 20

Name organism and medium

Back 20

Tellurite-containing medium, black colonies of Corynebacterium diphtheriae

Front 21

Optochin Susceptibility Test, name organism

Back 21

Streptococcus pneumoniae

Optichin sensitive, > 14 mm. inhibition

Front 22

BHI agar, what is preferable for this organisms?
Name organisms:
Green arrow
Red arrow
Blue arrow

Back 22

Preferable medium for Haemophilus spp.:
Chocolate agar or Horse blood agar with free X (hemin) and V (NAD)
Red (X and V)
H. influenzae
H. haemolyticus
Green (V only) - ("The P's like the V")
H. parainfluenzae
H. paraheamolyticus
Blue (X only) - ("X-Rated")
H. ducreyi

Front 23

S. aureus streak

Back 23

Haemophilus spp. satellitism

S. aureus produces V and if Beta-hemolytic releases X from SBA

Front 24

Gram + methylene blue: name organism

Back 24

Corynebacterium diphteriae

Metachromatic granules with methylene blue

Front 25

BYCE medium, name organism

Back 25

Legionella pneumophila

Buffered Charcoal Yeast Extract agar

Legionella won't stain with gram on direct specimens, it will from subculture specimens

Front 26

Facultative anaerobes, Acid Fast negative, organism group?

Back 26

Actinomyces spp.

Front 27

Molar tooth colonies

Back 27

Actinomyces israelii

Front 28

Acid fast stain

Back 28

Nocardia spp

Front 29

Chalky-white colonies when young then yellow/orange colonies

Back 29

Nocardia asteroides

Front 30

Medusa-head colonies

Back 30

Bacillus anthracis

Front 31

Name organism

Back 31

Bacillus anthracis

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Name organism

Back 32

Bacillus anthracis

Front 33

Optichin disks

Back 33

Resistant

PYR positive, Bile esculin positive: Enterococcus spp.

PYR negative:

Bile esculin positive: S. bovis (D)
Bile esculin negative: Viridans

Front 34

Ampicillin Resistant
Vanco Sensitive

Back 34

Enterococcus faecium non-VRE

Front 35

Ampicillin Vancomycin Resistant

Back 35

Enterococcus faecium VRE

Front 36

Ampicillin, Vancomycin susceptible

Back 36

Enterococcus faecalis

Front 37

Quad plate

Back 37

Test for synergy of aminoglycosides with vancomycin for Enterococci causing bacterial endocarditis

Front 38

Urease test, gram and tissue, name organism

Back 38

Brucella melitensis

Castaneda biphasic blood culture held for 21 days historically used for culture

Front 39

Common-antigen test (glutamate
dehydrogenase or GDH test)

Back 39

Used as a screening test for C. diff. to decide which
specimens to evaluate using another assay (e.g.,
cytotoxicity assay or toxin EIA)

Front 40

Glucose fermenting
Nitrate to nitrite
Oxidase negative

Possible organisms with this colony type in Mac Conkey

Back 40

Lactose fermenting

E. coli (indole+)
Enterobacter spp. (VP test +, catalase+, citrate+)
Klebsiella spp. (VP test +, non-motile, mucoid colonies)

Front 41

Hektoen enteric agar

Back 41

E. coli

Front 42

Hektoen enteric agar

Back 42

Salmonella spp.

H2S production

Front 43

KIA-TSI

Back 43

E. coli
Enterobacter
Klebsiella
Acid Slant/Acid Butt (A/A)

Shigella
Vibrio
Alkaline Slant/Acid Butt (K/A)


Salmonella
Citrobacter
Proteus
Alkaline Slant/Acid Butt (K/A) + H2S

Pseudomonas
Alkaline Slant/Alkaline Butt (K/K)

Front 44

CIN agar

Back 44

Yersinia enterocolitica

•Septicemia in iron overload syndromes
•Mesenteric adenitis – RLQ pain mimics appendicitis
•Grows well at 4*C (like Listeria)
•CIN agar (Cefsulodin-irgasan-novobiocin)

Front 45

Safety pin morphology

Back 45

Yersinia pestis

Front 46

TBCS agar

Back 46

Vibrio cholerae

Oxidase positive/glucose fermenter
KIA: K/A

TCBS (Sucrose)
Yellow: V. cholerae
Green: V. vulnificus, V. parahaemolyticus

Front 47

Gram, identify organism group

Back 47

Vibrio spp

Front 48

Special BAP medium, at 42°C and @ 5% O2, 10% CO2, 85% nitrogen
• Catalase positive
• Oxidase positive

Back 48

Campylobacter spp

• Hippurate hydrolysis test
– If positive, identifies isolate as C. jejuni
– Of Campy species, only jejuni is positive

Front 49

Name organism
Motile

Back 49

E. coli

Front 50

MUG test positive (β-glucuronidase activity)

Back 50

E. coli

Front 51

Name organism
Non-motile
VP+

Back 51

Klebsiella spp

Indole:

+ K. pneumoniae

- K. oxytoca

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Name organism

Back 52

Proteus spp

Indole:

+ P. vulgaris

- P. mirabilis

Front 53

Name organism
Coagulase -
Novobiocin resistant

Back 53

Staphylococcus saprophyticus

Front 54

Name organism
Thayer Martin
Glucose fermenting

Back 54

Neisseria gonorrheae

Molecular amplification methods
– Permit concurrent detection of CT in single specimen
– Allow use of urine as a specimen (non-invasive)
– Do not require viable organisms (transport not an issue)
– Highly sensitive
– Rapid
• Disadvantages:
– GC DNA may be present up to 3 weeks after successful
treatment, so NAATs should not be used as test of cure
– Isolates not available for susceptibility testing if treatment
difficulties arise
– Results inadmissible evidence in medicolegal cases

Front 55

Blue
Pink
Yellow
Green
Magenta

Back 55

Blue: GBS
Yellow: Listeria monocytogenes
Pink: Pneumococcus
Green: Neisseria meningitidis
Magenta: H. influenzae

Front 56

Name organism

Thayer-Martin
Ferments maltose

Back 56

Neisseria meningitidis

Front 57

Lazy-Beta hemolysis

Back 57

Streptococcus agalactiae

Front 58

Name organism

Back 58

Streptococcus agalactiae

Front 59

Name organism

Back 59

Listeria spp.

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Name organism

Back 60

Listeria monocytogenes