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Parasitology [LEC] > [Discussion] MODULE 1 UNIT 4 > Flashcards

[Discussion] MODULE 1 UNIT 4 Flashcards

1
Q
  • Based on symptoms, history
A

Clinical Diagnosis

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2
Q
  • Through physical examination
A

Clinical Diagnosis

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3
Q
  • Use of laboratory tools for specific identification
A

Laboratory Diagnosis

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4
Q
  • demonstration of the parasite (e.g., adults, eggs, larvae, cysts, or trophozoites), or parasite components (e.g., antigens and DNA) in the specimen
A

Direct method

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5
Q

This provides definitive diagnosis of parasitic infection.

A

Direct method

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6
Q
  • tests for the evidence of parasitic infection other than actually finding the organism itself
A

Indirect method

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7
Q

This provides only presumptive evidence of infection.

A

Indirect method

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8
Q
  • Parasitic infections are usually diagnosed by examination of a specimen/material under the microscope.
A

Microscopic Method

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9
Q

Microscopic Method is basically a two-step process:

A

i. detection of the parasite
ii. identification based on distinctive morphologic characteristics.

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10
Q
  • the most common procedure performed in the area of parasitology is the examination of a stool specimen for ova and parasites (O&P exam)
A

Direct microscopy

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11
Q
  • ova - refers to the egg stage of select parasites and parasites encompass the other morphologic forms that may be present.
A

Direct microscopy

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12
Q
  • Appropriate specimen is examined microscopically for parasite diagnostic stage by:
A

• direct wet mounts • wet mounts of concentrates • permanent stains

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13
Q

Direct microscopy spps

A

• Cysts & trophozoite of Entamoeba histolytica
• Cysts & trophozoites of Giardia lamblia
• Balantidium coli
• Oocysts of Cystoisospora belli, Cryptosporidium parvum
• Oocysts of Cyclospora cayetanensis, Sarcocystis spp
• Unembryonated egg of Ascaris lumbricoides, & embryonated egg Ascaris lumbricoides
• Eggs of Trichuris trichiura and Diphyllobothrium latum
• Eggs of Capillaria philippinensis and Taenia spp
• Eggs of Hymenolepis nana and Dipylidium caninum
• Eggs of Fasciola spp. and Fasciolopsis busk
• Eggs Schistosoma japonicum, Schistosoma manson
• Rhabditiform larvae of Strongyloides stercoralis

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14
Q
  • The gold standard in the diagnosis of common protozoan & helminth infections.
A

Direct microscopy

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15
Q
  • Simple, low cost
A

Direct microscopy

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16
Q

Direct microscopy- low sensitivity: when parasites are low in numbers such as in:

A

• light infections • during pre-patent • chronic periods of infection- may yield false negative results

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17
Q

Direct microscopy problem

A

Concentration technique

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18
Q

Perianal swab – Graham scotch tape method

A

Enterobius vermicularis (pinworms)

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19
Q

Direct microscopy
• Blood –

A

Plasmodium spp., Trypanosma spp

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20
Q

Direct microscopy
Sputum

A

Strongyloides stercoralis

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21
Q

Culture methods using xenic or axenic media have been described for some protozoan parasites

A

• Trichomonas vaginalis • Leishmania spp. • Trypanosoma cruzi • Entamoeba histolytica • Acanthamoeba spp • Naegleria fowleri.

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22
Q

Culture technique is not routinely done due to:

A

• infrequent requests • lack of familiarity with methods • the need for special equipment, supplies, & reagents, and • the waiting period for several days or weeks for the result

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23
Q
  • Inoculation of a suspected specimen into a laboratory-bred, parasite-free animal
A

Xenodiagnosis

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24
Q

Specimen may also be examined grossly for parasite stage that are large enough to be seen by the naked eye, such as some

A

adult worms, and proglottids of tapeworms

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25
Q
  • Permits batch processing
A

IMMUNODIAGNOSTIC METHODS

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26
Q
  • Do not require experienced microscopists
A

IMMUNODIAGNOSTIC METHODS

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27
Q
  • Detects the specific antigen unique to the parasite if present in the specimen
A

Antigen detection

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28
Q
  • Detects the specific antibody produced by the body after exposure to the parasite
A

Antibody detection

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29
Q
  • A positive test result is indicative of current infections
A

ANTIGEN DETECTION

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30
Q
  • Superior sensitivities and specificities, easy to use, quick turnaround times
A

ANTIGEN DETECTION

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31
Q

ANTIGEN DETECTION for Plasmodium

A

Example: Malarial kits
Specimen: Serum/Whole blood

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32
Q

AG detection indicate specific species of

A

Plasmodium

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33
Q

ANTIGEN DETECTION for E. histolytica/dispar

A

Specimen: Stool
Example: ELISA

34
Q

ANTIGEN DETECTION for T. vaginalis

A

Specimen: Vaginal discharge
Example: ELISA

35
Q

ANTIGEN DETECTION for W. bancroft

A

Example: Immunochromatographic test
Specimen: Whole blood, Plasma, Serum

36
Q
  • determine the presence of antibodies
A

ANTIBODY DETECTION

37
Q

immune response formed against parasitic antigens, to provide evidence of infection

A

antibodies

38
Q

ANTIBODY DETECTION ADVANTAGES:
- recommended in the diagnosis of:

A

Parasitic infections that reside in the host’s deep tissues

occult infections

39
Q
  • may provide early detection when significant levels of antibodies are produced before the patent stage.
A

ANTIBODY DETECTION

40
Q
  • in some people, parasitic infections may not stimulate antibody response or seroconversion may be delayed with onset of clinical symptoms
A

ANTIBODY DETECTION

41
Q
  • A false positive test may be produced when examining individuals from endemic areas
A

ANTIBODY DETECTION

42
Q
  • does not distinguish between active and previous infection because antibodies may decline slowly and persist even after cure
A

ANTIBODY DETECTION

43
Q
  • low sensitivity and specificity
A

ANTIBODY DETECTION

44
Q

high levels of sensitivity and specificity for parasite identification

A

Nucleic acid amplification tests (NAATs)

45
Q

• ability to differentiate morphologically similar organisms

A

MOLECULAR TECHNIQUE

46
Q

• lack of reliance on subjective microscopic features

A

MOLECULAR TECHNIQUE

47
Q

• may also be used to monitor the success of antiparasitic therapy

A

MOLECULAR TECHNIQUE

48
Q

are performed by injecting parasitic antigen intradermally and observing the reaction

A

Skin tests

49
Q

response is seen within 30 minutes of infection in immediate hypersensitivity reaction

A

wheal and flare

50
Q

response is seen within 48 hrs of infection in delayed hypersensitivity reaction

A

erythema and induration

51
Q

• Montenegro test:

A

Kala-azar (Leishmania donovani)

52
Q

• Bachman intradermal test:

A

Trichinellosis (Trichinella spiralis)

53
Q

• Casoni’s test:

A

Hydatid disease (Echinococcus granulosus)

54
Q

These tests are used to look for some parasitic diseases that may cause lesions in the organs.

A

Radiologic examination

55
Q

X-Ray spp

A

Diphyllobothrium latum

56
Q

Radiologic examination types

A

Ultrasound
MRI

57
Q

is a guarantee that the information in the laboratory result can be relied upon by the physician to confirm or rule out parasitic infections

A

QUALITY ASSURANCE

58
Q

PRE-ANALYTICAL PHASE includes

A

a. Test ordering and request forms
b. Proper specimen collection, storage, and transport
c. Specimen receipt and accessioning
d. Training of personnel

59
Q

Test ordering and request forms include

A

• source/type of the sample
• patient’s name and identification number
• The physician’s name
• and the date and time of sample collection

60
Q

• Correct type of specimen and/or (?) of specimen collection
• Appropriate (?)
• (?). Certain medications and substances may interfere with the detection of parasites, thus should be avoided starting days before and continuing through the test period.
• Acceptable amount or (?) of the specimen
• Manner of specimen collection, storage, transport
• Proper specimen (?) (source/type of specimen the patient’s name and identification number, the physician’s name, and the date and time of sample collection)
• Use of (?)
• (?) from sample collection to receipt and examination in the laboratory.

A

time
specimen container
Patient preparation
volume
labelling
preservatives
Time frame

61
Q

A record system is maintained to track the specimen received into the laboratory.

A

Specimen receipt and accessioning

62
Q

The person performing the parasitologic examination must be familiar with appropriate technical procedures to be used for each type of specimen and morphologic recognition and differentiation of parasites.

A

Training of personnel

63
Q

ANALYTICAL PHASE includes

A

Standard operating procedures (SOP)
Reference Materials
Equipment
Reagents and supplies
Personnel

64
Q

Standard operating procedures (SOP)

-Instructions for proper (?) of specimens
-Criteria for (?) of specimens
-Preparation of (?)
-Equipment (?)
-Detailed description of (?)
-Criteria for (?) of parasites
-(?) procedures
-(?) of results
-(?) practices
-Healthcare (?)

A

collection and handling
acceptance and rejection
maintenance
reagents and solutions
techniques
identification
Quality control
Reporting and interpretation
Health and safety
waste management

65
Q

Reference Materials
-Reference (?)
-(?) specimens of helminth eggs, larvae, and protozoan cysts
-(?) of helminth eggs, larvae, and protozoan cysts
-(?) of protozoan trophozoites, cysts, and oocysts
-(?) of blood with blood parasites (malaria, filaria

A

books, manuals, atlases
Formalin-preserved
Temporary mounts
Stained fecal smears
Permanent stained smears

66
Q

Equipment
-Always follow (?)
-Ensure that all equipment are (?) correctly
-Equipment are maintained on a routine basis by (?) and mechnical maintenance and repair is performed by (?). All data related maintenance and/or repair activities must be recorded

A

manufacturers manual and instructions
installed and used
laboratory staff; qualified service technician

67
Q

Reagents and supplies

A

Certificate of Product Registration (CPR)
Material Safety Data Sheets
Checking of Inventory
Reagent preparation

68
Q

Personnel
-Each laboratory personnel has the responsibility to perform all (?) in strict accordance with the policies contained in the SOP manual
-there should be adequate and effective (?) for the laboratory personnel
-They must be encouraged to participate in (?) esp. on the use of appropriate parasitological echniques and on morphologic recognition and differentiation of parasites

A

operational techniques
continuing education program
in-service training, seminar, workshops

69
Q

• reporting and recording of the stool analysis results are in accordance with the SOP manual

A

POST-ANALYTICAL PHASE

70
Q

should be written neatly on the form i.e. the writings readable and understood by the one receiving the results

A

reports

71
Q

• All reports are checked and signed by (?) who performed the test before they are issued out

A

POST-ANALYTICAL PHASE

laboratory staff

72
Q

are kept in the laboratory for future use or management of the patient in accordance with the clinical laboratory’s retention policy

A

• Patient data logs

73
Q

• Results must be released in a timely manner

A

POST-ANALYTICAL PHASE

74
Q

defined as “a set of procedures for continuously assessing laboratory work and the emergent results” (WHO, 1981)

A

Internal quality control (IQC)

75
Q

This primarily monitors day-to-day accuracy and reproducibility in any procedure

A

Internal quality control (IQC)

76
Q

Because this is done locally within the laboratory, corrective action can be done immediately.

A

Internal quality control (IQC)

77
Q

are sometimes used interchangeably

A

quality control (QC) and IQC

78
Q

A program of evaluation of the laboratory’s performance by an external agency

A

External quality assessment (EQA)

79
Q

T or F

Upon unacceptable IQA result identification, the problem must be investigated for possible causes and any necessary corrective action taken

A

F - EQA

80
Q

In the Philippines, the EQA program is referred to as (?) that is conducted by a (?)

A

National External Quality Assessment Scheme (NEQAS)
National Reference Laboratory (NRL)

81
Q

is the reference laboratory designated to conduct NEQAS in parasitology laboratories

A

Research Institute for Tropical Medicine (RITM)

82
Q

Proficiency testing events are given

A

annually

Parasitology [LEC] (23 decks)

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