DIAGNOSTIC PROCEDURES (STOOL AND BLOOD) Flashcards
(160 cards)
1
Q
clearance period of antacids, antidiarrheals, barium, bismuth, laxatives (leaves crystalline residues)
A
7-10 days
2
Q
clearance period of antimicrobial agents (decrease the number of protozoans)
A
2-3 weeks
3
Q
clearance period of gallbladder dyes
A
3 weeks
4
Q
sufficient quantity of stool for routine O & P (Oval and Parasite)
A
2-5 um (thumbsize/3-5 tablespoon)
5
Q
possible contaminants of stool
A
soil, water, urine
6
Q
true or false:
place the specimen in a dry, clean, leak proof, tupperware
A
dry, clean, leak proof, waxed container with a screw cap (1/2 pint)
7
Q
what should the label of the container include?
A
patient’s name, age, sex, date, and time of collection
8
Q
number of specimens examined
A
3 specimens collected in different days within 10 days
9
Q
purpose of 3 specimens collected in different days within 10 days
A
to recover parasites that shed diagnostic form intermittently
10
Q
maximum time between collection and examination of liquid specimens
A
30 mins after collection
11
Q
maximum time between collection and examination of soft/semi-formed specimens
A
1 hour
12
Q
maximum time between collection and examination of formed specimens
A
up to 24 hours
13
Q
what should not be done with the stool specimen
A
- leave at room temp
- incubate
- freeze
14
Q
beyond one hour, stool must be ______ for up to 24 hrs
A
refrigerated
15
Q
what should be done for longer periods of preservation
A
2 vial system (10% formalin and PVA/Polyvinyl Alcohoi)
16
Q
ratio of stool to preservative
A
1:3
17
Q
all purpose fixative
A
10% formalin
18
Q
used to fix and stain
A
merthiolate-iodine formalin
19
Q
can be used for permanent stains
A
sodium acetate acetic acid formalin
20
Q
contain mercuric chloride
A
Schaudinn’s fluid & Polyvinyl alcohol
21
Q
toxic to man
A
mercuric chloride
22
Q
Schaudinn’s fluid with PVA
A
Polyvinyl Alchohol
23
Q
contain zinc sulfate/copper sulfate
A
modified PVA
24
Q
can be used for molecular testing
A
Modified PVA
25
formalin based preservative
- 10% formalin
- Merthiolate-iodine-formalin (MIF)
- Sodium acetate-acetic acid formalin (SAF)
26
PVA preservative
- Schaudinn's fluid
- Polyvinyl alcohol
- Modified alcohol
27
purpose of 2 vials of stool spx is needed
for formalin based and PVA preservative
28
tests that use 10% formalin
- Wet mount
- Concentration Technique
- Immunoassay
29
tests that use Merthiolate iodine formalin
- Wet Mount
- Concentration technique
30
tests that use sodium acetate acetic acid
- Wet Mount
- Concentration technique
- Permanent stain
- Immunoassay
31
tests that use Schaudinn's fluid
permanent stain
32
tests that use Polyvinyl Alcohol (PVA)
permanent stain
33
tests that use modified PVA
permanent stain
34
true or false
Permanent stain usually uses PVA
TRUE
35
lateral flow assay/immunochromatographic assay is used for coproantigens of:
- G. lamblia
- E. histolytica
- C. parvum
36
cysts are present the highest in ____
formed stool
37
trophozoites are present the highest in ________
watery stools
38
mixture of cyst and trophozoites are present in _____
soft and loose stool
39
true or false
the drier the stool, the higher the amount of trophozoite
false; the drier the stool, the higher the amount of cysts
40
normal color of stool
brown
41
brown color of stool is due to
urobilin/stercobilin
42
black/tarry discoloration of stool is due to
upper GI tract bleeding
43
mucoid and bloody stool is due to
dysentery
44
normal consistency of the stool
soft to well-formed
45
consistency gives clues on _______ present in abundance
parasite (protozoans) stage
46
consistency determines sensitivity of ________
egg counting techniques
47
macroscopic structures
adult worms, scolices, proglottids
48
necessary for identification of solium and saginata
gravid proglottids
49
microscopic examination for O&P examination
- Wet Mount
- Concentration technique
- Permanent stain
50
has poor sensitivity and prone to false negative
wet mount
51
wet mount aka
direct fecal smear
52
wet mount preparation
~ 2 mg of stool an a drop of 0.85% saline (NSS)
53
useful in detection of motile protozoans trophozoites, helminth eggs, and larvae
wet mount/direct fecal smear
54
wet mount may be stained by ________ to enhance the visibility of nuclear structures in protozoal cysts and aid in detecting glycogen inclusions
iodine (lugol's & D' Antoni's)
55
use _____________ for trophozoites
Mair's Buffered Methylene Blue
56
sedimentation procedures
- formalin ether (or ethyl acetate) concentration technique
- acid-ether concentration technique (AECT)
57
fixative for formalin ether concentration technique
formaline
58
used to remove fats in formalin ether concentration technique
ether/ethyl acetate
59
can be used for specimens preserved in formalin, MIF, SAF
formalin ether (ethyl acetate) concentration technique
60
formalin ether (ethyl acetate) concentration technique is efficient in recovering most ________ and __________ including ______
protozoan cysts; helminths eggs and larvae; operculated eggs
61
formalin ether (ethyl acetate) concentration technique is moderately effective to
schistosome eggs
62
true or false
formalin ether (ethyl acetate) concentration technique has more distortion of protozoal cysts compared to zinc sulfate floatation
false
- it has less distortion
63
this removes/precipitates albuminous/mucoidal substances in AECT
40% HCl
64
example of albuminous/mucoidal substance that is removed or precipitated by 40% HCl
proteins
65
AECT is recommended for
- animal parasites
- Trichuris
- Capillaria
- Schistosoma eggs
66
loss of parasite to the plug of debris and possible destruction of protozoan cysts is due to ________
acidity of medium
67
top to bottom of the tube in sedimentation techniques
1. Ether/Ethyl Acetate (TOP)
2. plug of debris
3. sedimentation medium (formalin/hydrochloric acid)
4. sediment (parasites) (BOTTOM)
68
where is the parasite located in sedimentation technique?
sediments
69
sedimentation medium
formalin/hydrochloric acid
70
which is decanted in sedimentation technique
ether/ethyl acetate, plug of debris, sedimentation medium
71
what should be done to loosen the plug of debris
wring the stick
72
Flotation procedures
- zinc sulfate flotation
- brine's flotation
- sheather's flotation
73
Zinc Sulfate Flotation is not used in ff
- operculated eggs
- heavy eggs/larvae
- thin shelled eggs (hookworm eggs)
74
SG for 33% ZnSO4 for processing fresh feces in Zinc Sulfate flotation
1.18
75
SG is adjusted to ___ if specimen is formalinized
1.2
76
Zinc Sulfate flotation is unreliable for the recovery of the ff:
- nematode larvae
- infertile eggs of Ascaris
- eggs of Taenia
- eggs of Schistosomes
- Cestode and Trematode eggs
77
if thin shelled eggs are put into hypertonic solution it will _____, causing ____ SG
shrink; increased
78
Brine's flotation uses __________ with a SG of 1.2
saturated salt solution
79
is centrifugation required for Brine's flotation
no
80
brine's flotation is not applicable for the following
operculated and thin shelled eggs
81
Sheather's flotaion uses ___________
boiled sugar solution preserved with phenol
82
Sheather's flotation is preferred to use for concentrating _____
coccidian oocysts
83
SG for Sheather's flotation
1.25 - 1.27
84
SG of medium (<,>,=) SG of parasite
> (parasite will float)
85
stains used in permanent staining
- iron hematoxylin
- wheatley's trichrome
- modified trichrome
- modified acid-fast stain
86
more commonly used in permanent staining
iron hematoxylin and Wheatley's trichrome
87
shades of gray-blue to black w/ pertinent nuclear structures in darker shades
iron hematoxylin
88
cytoplasm color in Wheatley's trichrome
blue green
89
color of nucleus, cytoplasmic inclusions, Charcot Leyden crystals in Wheatley's trichrome
red/red purple
90
10x the Wheatley's Trichrome dye content
modified trichrome
91
color of microsporidians in Modified Trichrome
pink to red
92
weaker acid decolorizer
modified acid-fast stain
93
used in modifies acid fast stain
1-3% HsSO4 (Sulfuric Acid)
94
is used to demonstrate Cryptosporidium, Cytoisospora, Cyclospora oocysts
modified acid-fast stain
95
acid fast variables
Cytoisospora and Cyclospora
96
artifact that resembles mature Entamoeba histolytica cysts
Neutrophil
97
macrophage, squamous, and columnar epithelial cells resembles:
amebic trophozoites
98
yeast, fungal conidia, mushroom spores, diatoms
Protozoan cysts or helminth eggs
99
mite eggs resemble
hookworm
100
what differentiate mite eggs from hookworms eggs
4-8 packets
101
pollen grains
Taenia and Ascaris eggs
102
what differentiates pollen grains from Taenia eggs
Taenia eggs have 6 hooklets inside
103
amount of stool used in Kato thick smear
~50-60 mg
104
contents of the mixture where cellophane is soaked
glycerin and malachite green
105
clearing agent used in kato thick smear
glycerin
106
provides green background
malachite green
107
process of kato thick smearn
~50-60 mg of stool is placed over a glass slide and covered with cellophane that has been soaked in a mixture of glycerin and malachite green
108
useful in mass stool examination and surveilance studies
kato thick smear
109
useful for assessing worm burden and monitoring the efficacy of antihelminthics especially in cases of soil transmitted helminths and schistosomiasis
egg counting techniques
110
STH
Soil Transmitted Helminths
111
technique that does not dry out easily
kato thick smear
112
modification of the kato thick smear which uses a measured amount of stool which has been sieved through a wire mesh
kato katz
113
formula for kato katz
eggs per gram feces (epg) = number of eggs counted x factor (depends on template used)
114
standard template from CDC
1.5 mm thick with a 6 mm hole
115
amount of feces delivered and factor in 1.5 mm thick with a 6 mm hole template
41.7 mg; factor 24
116
amount of feces delivered and factor in 1mm thick with a 9mm hole
50 mg; 20
117
amount of feces delivered and factor in 0.5 mm thick with a 6.5 mm hole
20 mg; 20
118
makes use of calibrated flask and stoll pipettes
stoll dilution
119
diluent used in stoll dilution
0.1 normal sodium hydroxide
120
saponifying agent
0.1 normal sodium hydroxide
121
used to determine severity of Schistosoma infection
Faust Maloney egg hatching technique
122
Faust Maloney egg hatching technique involves counting of _______
Schistosoma miracidia
123
uses moistened soil or granulated charcoal
copro culture
124
larvae is harvested using _____ in copro culture
Baerman technique
125
involves applying positive stool to a filter paper strip and placing it into a test tube with distilled water
harada-mori or test tube culture method
126
days and temp harada mori is done (ewan HAHA)
10 days at 25-30 degree Celsius
127
used to detect eggs of E. vermicularis
perianal swab
128
best time to collect specimen for E. vermicularis
Early morning before bath
129
what is added to improve visualization of eggs
xylene/toluene
130
for the diagnosis of amoebiasis (E. histolytica infection)
Sigmoidoscopy
131
also known as scotch tape/cellulose tape method
perianal swab
132
entero test is useful for the recovery of the ff
- G. lamblia
- C. parvum
- S. stercoralis
- rhabditiform larva in stool
133
true or false
eggs of S. stercoralis is seen in feces
false; it is never seen in feces
134
other terms for entero test
duodenal capsule test , string test
135
contact time of entero test
4 hrs
136
collected material must be analyzed within
1 hr
137
preferred specimen especially for malaria to avoid distortion of parasite morphology
fresh, non anticoagulated
138
non anticoagulated blood
directly from skin/capillary puncture
139
anticoagulated blood must be delivered to the laboratory within ___ and must be processed within ____
30 mins; 1hr
140
preferred time of collection for patient with malaria
before the next anticipated fever spike (theoretically; in reality, at the height of fever)
141
preferred time of collection for filariasis
depends on the periodicity
142
preferred time of collection for elephantiasis (W. bancrofti)
nocurnal periodicity (10pm to 2am)
143
gold standard for malaria
examination of stained smears
144
uses 2-3 drops of blood which are mixed to form a circular smear
thick blood smear
145
used to dehemoglobinize the blood before making thick blood smear
distilled water
146
used for rapid diagnosis or screening of malaria and for demonstrating trypomastigote and microfilariae
thick blood smear
147
prepared in a way that the smear is thick at one end, thin and feathery at the other end
thin blood smear
148
used for species identification
thin blood smear
149
thick smear
2-3 drops (6uL); 1.5 cm diameter
150
thin smear
1 drop (2-3 uL)
151
stain recommended for detection and identification of blood parasites; buffer pH: 7-7.2
giemsa stain
152
best stain to use for blood parasites
giemsa stain
153
allows visualization of stipplings
giemsa stain
154
not optimal for blood parasites; buffer pH: <6.8
wright's stain
155
used to demonstrate the detailed structures of microfilariae
delafield hematoxylin
156
delafield hematoxylin requires dehemoglobinization of thick films with ________
2% formalin in 1% acetic acid
157
romanowsky stains
giemsa stain and wright's stain
158
blood smears are stained with acridine orange
kawamoto technique
159
color of nuclear DNA and cytoplasmic RNA in kawamoto technique
nuclear DNA: green
cytoplasmic RNA: red
160
STAT specimen for Parasitology
CSF and blood specimen for Malaria
