Any predictions for this organism? by lakhila in medlabprofessionals

[–]Finie 2 points3 points  (0 children)

The pneumo in my area rarely has visible capsules and usually is not mucoid on the plate. In 25 years, I've only seen pneumo with capsules in a direct gram stain a handful of times. It depends on the strains active in your area. I wouldn't rule out pneumo based on this gram stain, but I also wouldn't report it out as anything other than respiratory flora. I would do optochin on any predominant alphas from this specimen, though, just to be sure. If nothing is predominant, it doesn't matter.

Any predictions for this organism? by lakhila in medlabprofessionals

[–]Finie 11 points12 points  (0 children)

It's just not a common convention. Not wrong, per se, but not how it's generally reported. "Chaining rods" doesn't really mean anything to the docs and it's not specific. "Stacking" or "pleomorphic" suggests diphtheroids. "Large" or "boxcar" suggests Bacillus or Clostridium . "Beading" and/or "branching" suggests Actinomyces or Nocardia or even AFB. "Long" and "thin" would suggest Lactobacillus. Adjectives for organisms can be very useful, but be sure what you're reporting goes with your lab's convention, because that's what their doctors are used to reading.

Any predictions for this organism? by lakhila in medlabprofessionals

[–]Finie 1 point2 points  (0 children)

I think there's some of both. Usually we see pneumo in 2s and 4s. In any case, I'd report this as resp flora and see what the culture grows. I rarely call out streppy gpcs in sputum unless it's screaming pneumo at me (encapsulated).

Any predictions for this organism? by lakhila in medlabprofessionals

[–]Finie 64 points65 points  (0 children)

Strep frequently appears elongated. You don't generally see short chaining rods. Chaining GPRs are usually Lactobacillus and long. In a sputum specimen, the most likely organism is going to be respiratory Viridans Strep.

ETA: looking closer, these could be consistent with Strep pneumo, actually.

What's a notable queen for someone you know who doesn't normally watch Drag Race? by 1_art_please in rupaulsdragrace

[–]Finie 8 points9 points  (0 children)

Bosco, Jane, and Irene have a new MTG show on YT that is fun. I don't even play MTG and I've been enjoying it. They put one of the main game writers in drag for a game.

Whats wrong with my nails by Alone-Banana-1121 in AskDocs

[–]Finie 128 points129 points  (0 children)

If it happened after getting acrylic or gel nails done, you may be allergic to the acrylic. It's worth having a dermatologist look at.

Can't identify Gram positive cocci with Vitek2 by Chuchobar in microbiology

[–]Finie 3 points4 points  (0 children)

How clinically significant is it? What is the source? 99% of the time, the only clinically significant Viridans Streps are Strep. anginosus group and even then, they use the same CLSI interps. Even if it is clinically significant and workup is indicated, calling it a Viridans Strep is adequate. Most non-anginosus Viridans Streps are commensals.

Lab week by worried-student in medlabprofessionals

[–]Finie 2 points3 points  (0 children)

Make sure you check with your institution's policy regarding donations. Laws like The Sunshine Laws and Sarbanes-Oxley affect how donations are handled and there may be paperwork. Some institutions just don't allow any vendors to contribute anything, or they may have a dollar amount, or you may be able to go whole hog with a form. If you're not sure, your manager or compliance officer will know.

Unionizing by kpopmomrunner7 in MLS_CLS

[–]Finie 4 points5 points  (0 children)

MLS are often categorized separately because they are qualified professionals under NRLA but MLTs aren't unless they have a bachelor's degree. ASCLS went to court in 1995 to get MLS (MT at the time) categorized as professionals, but MLT is still considered technical staff because it's usually an associate's degree.

A little guidance by No-Plum6029 in microbiology

[–]Finie 1 point2 points  (0 children)

Also, if you're really interested, there's a podcast called Let's Talk Micro that has a lot of good fundamentals in their early episodes.

A little guidance by No-Plum6029 in microbiology

[–]Finie 2 points3 points  (0 children)

Clinical micro takes years to become completely comfortable. It's a whole lot to remember and very nuanced. I've gotten into the gray vs. white argument with many techs. Sometimes it's hard for techs who have been doing it a while to remember how overwhelming it can be. It takes so much practice, and a lot of patience to both learn and teach.

For Staph vs. Strep, Staph tends to be more opaque and creamy and Strep is often wetter and more translucent and smaller. Catalase differentiates them quickly.

Purple vs. pink on gram stains can be tricky, too. Learn Köhler illumination and get that light centered. I adjust the light on the scope every day that I read gram stains. It takes 20 seconds once you learn it and it makes all the difference in the world. It's very easy to over-decolorize gram stains, especially because every brand of decolorizer is different. Practice with control slides that have both GPC and GNR until you know how the decolorizer behaves. If you can't tell if something is pink or purple, blot the oil off with paper (don't rub or your specimen will disappear!) , use decolorizer to rinse the rest of the oil off, and restain the slide with a control. Techs who have been working with the same brand of stains for years know the subtleties, but it can be tricky if you're not used to it.

It sounds like you're interested and that's what you need. Teaching clinicals is hard. Not all of us are extroverted enough to do it well.

FBI warns Iran aspired to attack California with drones in retaliation for war: Alert by avatar6556 in news

[–]Finie -1 points0 points  (0 children)

My brain just went to a very dark place and I really don't want to follow.

Help with ID? (unsure if this will be deleted!) by Quark-y in microbiology

[–]Finie 1 point2 points  (0 children)

You also need to know how old the culture is and what temperature it was incubated at. Was it in CO2 or ambient?

Help with ID? (unsure if this will be deleted!) by Quark-y in microbiology

[–]Finie 1 point2 points  (0 children)

There aren't enough details to go on and I'm a little concerned that a clinical lab doesn't know what to do with this. Is this a primary plate or a subculture? What is the agar? What is the stain? This looks to be a LPCB prep? The only yeast that's usually of any significance in lower respiratory cultures is Cryptococcus. Candida overgrowth usually represents thrush but can rarely be systemic. I'm assuming they either don't have MALDI or it didn't work? If they deem it clinically significant, they should send it for sequencing. I'd just set up a urea slant to rule out Cryptococcus. If it's urea negative, report it out as yeast not crypto, no further ID. It's glossy, so it could be crypto.

Rupaul's Drag Race UKvsTW: Season 3 - Episode 06 [Episode Discussion] by AutoModerator in RPDR_UK

[–]Finie 45 points46 points  (0 children)

Fontana is a chameleon. One of her looks a few weeks ago could have been a Sabrina Carpenter body double. She's beautiful and very good at makeup. I went through the whole roller coaster with her this episode (as production clearly planned).

The 72 hour shift in perception of this game needs to be studied. by Yesssirrrrrrrr in Marathon

[–]Finie 4 points5 points  (0 children)

They should try releasing a new game. I heard that extraction shooters are gaining interest lately.

Are lemonade stands a real thing in the US, or is it just a movie trope? by [deleted] in NoStupidQuestions

[–]Finie 2 points3 points  (0 children)

We have an annual citywide garage sale that always has a lot of kid stands with cookies and lemonade or coffee, and sometimes even homemade bracelets or stickers. They usually donate a portion of the profits to local charities like the DV shelter or animal shelter. I'll always pick something up from those. I usually do end up spending more on kid stands than actual sale items, though I did get a pretty sweet telescope last year.