The area of the federal government that ensures that the laboratory is stocked with gloves for their employees
when performing tests on patient blood sample is
The clue to the identification of the colony seen in the upper frame is the gram stain in the lower frame, in
which are seen short, rounded, gram positive bacilli, many of which possess distinct spores. As the colonies
grew aerobically, the presence of spores indicates Bacillus species. The colonies are spreading, smooth,
yellow-white and non-hemolytic. The lack of hemolysis and the small size of the bacterial cells suggests a
species other than Bacillus cereus, the species causing most human infections. The isolate was identified as
Bacillus circulans, which is consistent with the gram stain morphology. Clostridium septicum also produces
spores; however, this species is an anaerobe and would grow poorly if at all and not produce spores
aerobically. Listeria monocytogenes and Lactobacillus species are gram positive bacilli; however, neither of
these produce spores.
The colonies seen in the upper frame, grown after 48 hours incubation aerobically at 35°C, and the
accompanying gram stain in the lower frame are uncommonly associated with human disease, but have been
associated with septicemia, bronchopneumonia, osteomyelitis and other infections, particularly in intravenous
drug users. The most likely identification is:
Post-hepatic obstruction is characterized by a marked increase in alkaline phosphatase, GGT, conjugated
bilirubin, as well as other hepatic enzymes. The slight rise of ALT suggests that the issue is not hepatitis.
Renal and cardiovascular failure do not match the symptom of jaundice or the abnormal laboratory values.
Chem
Which of the following conditions would be suggested by a jaundiced patient experiencing a marked rise in
alkaline phosphatase, conjugated bilirubin, and a slight rise in ALT: