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The India ink test is not diagnostic for cryptococcal meningitis because positive staining results are demonstrated in less than 50% of confirmed cases antibiotics quiz discount azitrox 100mg visa. The India ink stain is used as a presumptive test for the presence of which organism Candida albicans in blood or body fluids Microbiology/Correlate clinical and laboratory data/ Mycology/2 usually indicates an infection with a: A antibiotics for acne when pregnant generic 250mg azitrox with mastercard. Candida species Microbiology/Correlate clinical and laboratory data/ Mycology/2 4 antibiotic resistance documentary order cheapest azitrox and azitrox. B Superficial dermatophytes rarely invade the deeper tissues and are the cause of most cutaneous fungal infections antibiotics depression cheap azitrox 250 mg otc. Cutaneous disease involving skin, hair, and nails 445 446 Chapter 7 Microbiology 5. What is the first step to be performed in the identification of an unknown yeast isolate Which of the following yeast enzymes is detected using birdseed (niger seed) agar Nitrate reductase Microbiology/Apply knowledge of fundamental biological characteristics/Mycology/2 6. An isolate produced a constriction that was interpreted as a positive germ tube, but Candida albicans was ruled out when confirmatory tests were performed. Rhodotorula rubra Microbiology/Apply knowledge of fundamental biological characteristics/Mycology/2 which characteristic of an unknown yeast isolate All of these options Microbiology/Apply knowledge of basic laboratory procedures/Mycology/1 structures D the true germ tube (filamentous extension from a yeast cell) is approximately one-half the width and three to four times the length of the cell with no true hyphae constriction at the point of origin. Germ tubes represent true hyphae without constriction, and therefore the test should have been repeated along with carbohydrate tests before making a presumptive identification. D Cornmeal agar with Tween 80 (polysorbate) reduces the surface tension and allows for enhanced formation of hyphae, blastospores, and chlamydospores. C Pseudohyphae are the result of a pinching-off process, blastoconidiation, with the growth of filaments with constrictions. Arthrospores are the result of a breaking-off process of true septate hyphae resulting in square conidia. Which of the following yeasts is characteristically positive for germ tube production A careful evaluation of the tube origin for constriction is required to avoid a false-positive interpretation. Saccharomyces cerevisiae and Candida glabrata Microbiology/Apply knowledge of fundamental biological characteristics/Mycology/2 tube test are all used for the presumptive identification of: A. Candida albicans Microbiology/Apply knowledge of fundamental biological characteristics/Mycology/2 blastoconidia on cornmeal Tween 80 agar Microbiology/Apply knowledge of fundamental biological characteristics/Mycology/2 Cryptococcus spp. A Sexual spore production is a characteristic of the Ascomycotina, which produce an ascus (saclike structure) after the union of two nuclei. All of these options Microbiology/Apply knowledge of fundamental biological characteristics/Mycology/2 16. It is usually considered a contaminant but is an opportunistic pathogen, and must be identified when found in specimens from immunosuppressed patients. A the yeast isolate is inoculated directly into the molten agar base free of carbohydrates or is poured as a suspension onto a yeast nitrogen agar base plate. Growth around the disk indicates the ability of the yeast to utilize the carbohydrate(s) as a sole source of carbon.

Also antibiotics classes purchase 500mg azitrox amex, it is used to demonstrate hypervascular lesions (renal cell carcinoma) in the kidney bacteria helpful to humans buy 100mg azitrox visa. Decreased gamma activity is noted in a kidney with arterial stenosis or renovascular hypertension topical antibiotics for acne side effects buy cheap azitrox 100 mg. Decreased activity relative to the aorta is noted in a transplanted kidney that is experiencing rejection antibiotics insomnia purchase on line azitrox. Localized increased gamma activity is noted in a kidney that contains a hypervascular tumor (cancer). Renal structural scan this type of renal scan is performed to outline the structure of the kidney to identify pathology that may alter normal anatomic structure. A filling defect in the renal parenchyma may indicate a tumor, cyst, abscess, or infarction. Also, information concerning postrenal transplants can be obtained with this scan. Anatomic alterations in the parenchymal distribution of tracer may indicate transplant rejection. Renal function scan (renogram) Renal function can be determined by documenting the capability of the kidney to take up and excrete a particular radioisotope. A well-functioning kidney can be expected to rapidly assimilate the isotope and then excrete it. A poorly functioning kidney will not be able to take up the isotope rapidly or excrete it in a timely manner. Renal function can be monitored by serially repeating this test and comparing results. Renal hypertension scan this scan is used to identify the presence and location of renovascular hypertension. The captopril scan (captopril renography/scintigraphy) determines the functional significance of a renal artery or arteriole stenosis. These scans may predict the response of the blood pressure to medical treatment, angioplasty, or surgery. Renal obstruction scan this scan is performed to identify obstruction of the outflow tract of the kidney caused by obstruction of the renal pelvis, ureter, or bladder outlet. Often several of these scans are combined to obtain the maximum possible information about the renal system. A triple renal study may use all of these techniques to evaluate renal blood perfusion, structure, and excretion. Assure the patient that he or she will not be exposed to large amounts of radioactivity because only tracer doses of isotopes are used. Tell the patient that no sedation or fasting is required but that good hydration is essential. While the patient assumes a supine or sitting position, a gamma ray scintigraphy camera is passed over the kidney area and records the radioactive uptake on film. For the captopril renal scan, the patient is scanned after the administration of captopril. For the renal blood flow and the renal function scans, scanning is started immediately after the injection. For structural renal scans, the patient is asked to lie still for the entire time of the scan (30 minutes). Perfusion scans are done in approximately 20 minutes and functional renal scanning 799 scans in less than 1 hour. After Because only tracer doses of radioisotopes are used, inform the patient that no precautions need to be taken against radioactive exposure. Tell the patient that the radioactive substance is usually excreted from the body within 6 to 24 hours. Angiotensin and aldosterone increase blood volume, blood pressure, and sodium retention by the kidney (Figure 38).

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Chemistry/Apply principles of special procedures/ Biochemical theory and principles/2 26 bacteria 2014 discount azitrox 100 mg with amex. Assay use is restricted to serum Chemistry/Apply principles of special procedures/ Biochemical theory and principles/2 27 antibiotic 500mg dosage purchase azitrox 250mg on line. In such cases virus maker buy azitrox 500 mg fast delivery, the enzyme activity of the low calibrator (drug concentration equal to U infection xpert buy generic azitrox 250mg online. Substance Abuse and Mental Health Services Administration minimum for a positive test) is used as the cutoff. The antibody is covalently linked to the enzyme donor Chemistry/Apply principles of special procedures/ Biochemical theory and principles/2 27. Drug conjugated to a fragment of -galactosidase that is catalytically inactive competes with drug in the sample for a limited number of antibodies to the drug. The concentration of drug in the sample is directly proportional to the amount of chlorophenol red formed. Which statement is true regarding particle-enhanced turbidimetric inhibition immunoassay methods for therapeutic drugs C Particle-enhanced turbidimetric inhibition immunoassays are homogenous immunoassays frequently used to measure proteins and therapeutic drugs in serum or plasma. Polystyrene-modified latex particles conjugated to the drug (particle-bound drug) compete with drug in the sample for a limited number of antibodies. If drug concentration is low, more of the antibody binds to the particle-bound drug, increasing the turbidity of the reaction. These are drawn into the mass analyzer, usually a vacuum chamber containing two pairs of charged rods (a positive pair and a negative pair) called a quadrupole analyzer. By changing the potential and radio frequency applied to the rods, the travel of ions will vary depending upon their mass to charge (m/z) ratio. As ions emerge from the mass filter, they are detected by an electron multiplier tube. A total ion chromatograph displays the retention time of all ions detected and their abundance. Creatinine 5 mg/dL Chemistry/Evaluate laboratory data to detect sources of error/Toxicology/3 30. All of the values listed are within the limits of an acceptable sample with the exception of creatinine. Dry reagent strips are available that test for pH, specific gravity, creatinine, nitrite, peroxide, pyridinium, and glutaraldehyde. D Some drugs have a long half-life, and can be 301 Chemistry/Apply knowledge of fundamental biological characteristics/Drugs of abuse/1 32. Treatment with alkaline dithionite is used to convert carboxyhemoglobin to oxyhemoglobin B. Bichromatic analysis is required in order to eliminate interference by oxyhemoglobin D. Carboxyhemoglobin can be measured by potentiometry Chemistry/Apply principles of special procedures/ Carboxyhemoglobin/2 alcohol measurement is correct The reference method is based upon enzymatic oxidation of ethanol by alcohol dehydrogenase D. Gas chromatography methods require extraction of ethanol from serum Chemistry/Apply principles of special procedures/ Ethanol/2 detected for longer periods after use, but the detection window also depends on other variables such as dosage, frequency of use, and method sensitivity. In persons who use marijuana several times per week, cannabinoids can be detected several weeks after last use. C the absorbance spectras of oxy- and carboxyhemoglobin pigments overlap, and bichromatic or multichromatic analysis is required in order to accurately measure carboxyhemoglobin. In bichromatic analysis, oxyhemoglobin and methemoglobin are converted to deoxyhemoglobin by the addition of alkaline sodium dithionite.

For example antimicrobial coatings buy azitrox with visa, 99243 antibiotics you can give dogs generic azitrox 500mg on line, office consultation antibiotics green poop cheap 250 mg azitrox, requires a detailed history and examination as well as a low level of medical decision making complexity antibiotics for acne skin proven 100mg azitrox. Code 99243 could not be reported because only two of the three key components were at the correct level. Insurance companies or other third-party payers may request a consultation regarding a diagnosis, prognosis, or treatment plan for a patient. These types of consultations are also reported based on the location of the service-office or inpatient. If the consultation is mandated, such as those required by an insurance company, add modifier -32 (Mandated Service) to the code. For office consultations, a written or verbal request stating results is sent to the requesting physician. Can time be utilized to determine a consultation level of service rather than the key components The patient had had a right breast carcinoma 6 years earlier but over the past 4 months had developed progressively more painful back pain. The pain has caused her to have neck and leg pains as well, as she has adjusted her walking stance in order to alleviate the pain. Her past medical and surgical history was noted, including the fact that her mother and one sister had also had breast cancer. She had worked as a legal secretary up until 2 weeks earlier but is now on sick leave. The comprehensive physical examination performed by the physician was a complete multi-system review of 12 organ systems. The physician ordered a series of radiographic and laboratory tests and reviewed her recent spine x-ray series, which revealed multiple pathologic vertebral compression fractures. In his problem focused history, the physician noted that the man was a farmer and used his right hand and arm repeatedly, lifting heavy objects. The patient had no other complaints and reported to be in otherwise excellent health. The patient described the pain as severe and unrelenting, and it prevented him from using his arm. The physician diagnosed the problem as elbow tendinitis and bursitis, recommended warm compresses, and gave the patient a prescription for an anti-inflammatory medication. The patient had a history of essential hypertension and mild coronary artery disease. The internist noted, during the expanded problem focused history, that the patient had no complaints relative to his hypertension or heart disease. The physician performed an expanded problem focused physical examination of his head, neck, chest, and abdomen but found no major problems related to his cardiovascular or respiratory system. The internist confirmed the diagnoses previously established and made no changes in the management of either condition. The cardiologist performed a comprehensive cardiology physical examination, including cardiac monitoring, pacemaker evaluation, and review of his associated respiratory status. Noted in the comprehensive history were a variety of complaints the patient had in addition to the past pacemaker insertion and current mitral valve regurgitation diagnosed by cardiac catheterization. His review of systems elicited positive findings in the cardiovascular, respiratory, gastrointestinal, genitourinary, musculoskeletal, and neurologic systems. The physician had multiple management options concerning the pacemaker function but also had to consider new valvular problems that might have been present as well as related gastrointestinal symptoms. Extensive tests that had been performed recently were reviewed, and additional testing was ordered. Since the surgery, his previously controlled atrial fibrillation had become a problem again. The consultant suggested that the atrial fibrillation could be controlled better with a different medication.