finals - miscellaneous Flashcards
(168 cards)
1
Q
sputum is Derived from ___, ___, and ____ of the pulmonary tract.
A
alveoli, trachea, bronchi
2
Q
sputum is a Secretion of the ____ (lining the respiratory tract)
A
goblet cells
3
Q
a sputum in normal condition is A mucus secretion of goblet cells and other organs associated with ___
A
respiratory
epithelium
4
Q
Hallmark of sputum
A
dust cells
5
Q
Macrophages with carbon deposits
A
DUST CELLS
6
Q
2 ways of preserving sputum
A
refrigerator and the use of 10% formaldehyde
7
Q
why is formalin in cannot be used for bacteriologic purpose as a preservative
A
because of its bacteriostatic effect
8
Q
in collection, the Mouth should be free from ___
A
foreign objects
9
Q
in collecting sputum,
are we allowed to wear dentures, eat food and smoke?
A
nope
10
Q
in collecting sputum, what should we do prior to collection
A
gargle
11
Q
which sputum specimen is the best
A
early morning
12
Q
how to induce sputum
A
- Nebulized hypertonic saline or distilled water
- Chest percussion
- Postural drainage
- Aerosolized 15% NaCl and 10% glycerin
13
Q
criteria for the sputum container
A
clean, sterile, wide mouth
bottle or disposable plastic
containers.
NEVER USE PAPER
CUPS!
14
Q
how to process fixation of sputum
A
- Patient expectorates into a jar of 70%
ethanol - Spread fresh sputum on slide and spray pap’s fixative
15
Q
Sputum gram stain assesses the sample for ___.
A
adequacy
16
Q
Anaerobic culture transported in an what type of container (should be immediately for immediate plating)
A
air tight container
17
Q
Tuberculosis culture (maybe stored at ___ for up to ___hours)
A
room temperature; 48
18
Q
Physical Characteristics of sputum
A
v Quantity/Volume
v Consistency
v Reaction
v Turbidity
v Odor
v Color
19
Q
Small amount of volume of the sputum is associated to diseases such as
A
a. early PTB
b. acute bronchitis
c. pneumonia
20
Q
a Over 100cc/24hrs of sputum is associated to diseases such as
A
pulmonary edema
b. Broncheictasis- characterized by bronchial dilatations/swelling of bronchi
c. Lung abscess-lesion on the lungs because of infection.
21
Q
characterized by bronchial dilatations/swelling of bronchi
A
Broncheictasis-
22
Q
abscess-lesion on the lungs because of infection.
A
lung abscess
23
Q
Over 500cc/ 24hrs of sputum is associated into what diseases
A
Amoebic abscess- infection caused by parasite
24
Q
Over 1,000cc/ 24hrs of sputum is associated to what diseases?
A
a. severe broncheictasis
b. cavity TB- hole on lungs/ white spots on the lungs
c. chronic bronchitis
d. acute edema of the lungs
25
Watery consistency of sputum
_____ is responsible for sputum’s viscosity
sialic acid
26
Blood-gelatinous sputum (_____)
Currant-Jelly
27
Blood-gelatinous sputum (Currant-Jelly) is caused by
Klebsiella pneumoniae infection
Pneumococcal pneumonia
28
Stringy Mucoid Sputum (may also appear frothy) is caused by
Follows asthma exacerbation
29
Cloudy, mucoid sputum is caused by
Chronic bronchitis
30
Three layered appearance (stagnant, purulent sputum)
Bronchiectasis
Lung abscess
31
normal pH of sputum
Slightly acidic
pH 6.5 - 7.0
32
list down all the physical consistency of sputum
watery
blood-gelatinous sputum
stringy mucoid sputum
cloudy, mucoid sputum
three layered appearance
33
list down all the physical characteristics of a sputum in terms of turbidity
Frothy sputum or serous (air bubble, hemoglobin)
mucoid
foamy, clear material
34
Frothy sputum or serous (air bubble, hemoglobin) is caused by
pulmonary edema
35
Mucoid in turbidity of a sputum is caused by
*Bronchiectasis
*TB with cavities
36
Foamy, clear materials is caused by
saliva
nasal secretions
37
normal odor of sputum
odorless
38
Sweetish odor of sputum is caused by
In pulmonary tuberculosis with cavities, bronchiectasis, bronchomoniliasis
39
Putrid or foul odor of sputum is caused by
Usually due to Fusobacteria & Spirochetes found in mouth, or anaerobic infections within the lung,
lung abscess and necrotizing bronchogenic carcinoma
40
Cheesy odor of sputum is caused by
In necrosis or malignant tumors and perforating emphysema
41
Fecal Odor of sputum is caused by
Rupture sunphrenic or liver abscess and in enteric gram negative products.
42
Normally, the color is greatly influenced by ___, as well as nature of
the disease and the sputum itself
pus
43
normal color of sputum
colorless or translucent or opaque
44
white or yellow sputum causes
When pus is present, seen in advance pulmonary tuberculosis,
chronic bronchitis, jaundice and lobar pneumonia
45
gray color of sputum is caused by
When pus and epithelial cells are present
46
bright green or greenish color of sputum is caused by
When bile is present as in jaundice, rupture of the liver abscess into
the lungs and infection caused by Pseudomonas aeruginosa
47
red or bright red sputum is caused by
When there is fresh blood or new hemorrhage. If blood streaks are
present, it is indicative of pulmonary tuberculosis or bronchiectasis
48
anchovy sauce or rusty brown sputum is caused by
When old blood is present, seen in pneumonia, pulmonary gangrene,
rupture of amoebic abscess of the liver into the lung or pigmented
cells in chronic passive congestion, due to cardiac pigment after
hemorrhage from the lung pulmonary infarction.
49
prune-juice color of sputum is caused by
Pneumonia and chronic cancer of the lungs
50
rusty red sputum is caused by
lobar pneumonia
51
olive green or grass green sputum is caused by
cancer
52
black sputum indicates __
Indicates inhalation of dust or dirt, carbon, charcoal, in cases like anthracosis and heavy smokers.
53
yellow green sputum is caused by
Due to destruction of neutrophils and release of verdo peroxidase
54
Macroscopic Structures of sputum
Fragments of necrotic tissue, pulmonary tissue or bits cartilaginous rings, from pin-point to pin size
Cheesy masses
55
Cheesy masses are present in
so-called nummular sputum from a tuberculosis cavity, pulmonary gangrene, abscess of the lungs and actinomycosis
56
Macroscopic Structures of sputum
Curschmann’s spiral is seen in ___
bronchial asthma
57
Yellowish-white, spirally twisted mucoid strands
Curschmann’s spiral
58
These are branching tree-like casts of the
bronchi, seen in lobar pneumonia, fibrinous
bronchitis and diphtheria
bronchial cast
59
Yellow of gray caseous masses, seen in
asthma, putrid bronchitis
Dittrich’s bodies/plugs
60
Emits a foul odor when crushed
Dittrich’s bodies/plugs
61
Lung stones are called as
Bronchioliths or pneumoliths
62
Small calcified nodules or stagnant contents of cavities or
dilated bronchi or calcified tuberculosis tissue. Sometimes
the core is a small foreign body or a fungal growth
Lung stone
63
Include concretions formed in the bronchi made of calcium carbonate and phosphate and aspirated substances
such as: pollen, seeds, dust
Foreign bodies
64
Parasites seen in sputum
Echinococcus granulosus,
Toxaplasma canis,
paragonimus westermanii
65
in microscopic examination
the sputum Must be treated first with ____ to dissolve the mucus.
Sodium Hydroxide (NaOH) and Potassium Hydroxide (KOH)
66
microsco[ic examination
Normally present in the walls of
the alveoli, bronchioles and the
blood vessels
elastic fibers
67
microscopic examination
v Yellow, wavy threads
v Usually coiled into balls, seen in
bright colorless with central
lines
Curschmann’s spiral
68
Indicates stasis and decomposition of the sputum in the body or in an
old specimen that is often unsatisfactory
Crystals
69
a crystal that is Seen in bronchial asthma, arises from the disintegration of
eosinophil
Charcot Leyden crystals
70
a crystal that Stains black in hematoxylin and red with eosin
Charcot Leyden crystals
71
charcot leyden crystal shape
Often octahedral and/or hexagonal in shape
72
a crystal that is Rhombic and brownish red
hematoidin
73
a crystal in sputum that is Arranged in rosettes
hematoidin
74
a crystal of sputum that is Resulted down from breaking down of old blood and are found inpulmonary infections, lung abscess, pulmonary infarction
hematoidin
75
Colorless, thin, rhombic plates with
notched corner. This indicates stasis with
fatty degeneration of exudates and are
often in lung abscess and emphysema
Cholesterol crystals
76
Long, colorless needles, arranged in seeves.
Also indicates stasis with fatty degeneration of
exudates and are often in lung abscess
Fatty acid crystal
77
Blood pigmented cells, chiefly hemosiderin
§ Appears as round grayish or colorless
§ Diffuse staining
§ Found in congestive heart failure
Heart failure cell
78
§ Contain carbon and are less important
§ Appears as angular black granules both intracellular and extracellular
§ Seen in anthracosis, heavy tobacco smokers and in people living in
smoky atmosphere
Carbon–Laden Crystals
79
Colorless, round, oval or ear-shaped globules of various sizes
myelin globules
80
Reported in order to minimize confusions with more important
structures like Blastomyces.
myelin globules
81
myelin globules resembles __
fat droplets and yeast-like fungi
82
Large structures show peculiar concentric or irregular spiral markings
myelin globules
83
v Abundant in the scanty morning sputum of health persons and may be
found in closely packed sputum
v Absent or scarce in specimens with inflammatory exudates
myelin globules
84
Small and yellowish structures with sulphur granules
which can be seen with unaided eye
Actinomyces hominis
85
consist of a network of threads having more or less
radial arrangement
Actinomyces hominis
86
Actinomyces hominis Similar structure with __ under LPO
Actinomyces bovis
87
Seen in Actinomycotic pulmonary infection
Actinomyces hominis
88
v Hyphae are rods usually jointed or branched and often arranged in meshwork (mycelium)
Moulds and Yeast
89
Spores are highly refractive spheres and ovoid
Moulds and Yeast
90
Seen in pneumomycosis specifically infection by Aspergillus fumigatus
Moulds and Yeast
91
Grows in sputum upon long standing of tuberculosis specimen
Moulds and Yeast
92
Cluster of ciliated columnar cells found in the sputum of asthmatic patients
Creola Bodies
93
Major blood present in sputum
Leukocyte
94
Markedly increased when pus is present
Leukocyte
95
___are commonly seen in allergic patients (asthma) and can
be demonstrated by Wright’s stain
Eosinophil
96
Present in lung hemorrhage, pulmonary tuberculosis, and Paragonimus westermanii infection
Erythrocytes
97
Detected by Guaiac or benzidine tests or presence of blood
derivatives such as hemosiderin
Erythrocytes
98
3 Layers of Sputum after Standing
(After 24 hours of standing)
1. Carbohydrate mucus upper
layer
2. Opaque watery material - middle
3. Sediments- 3rd layer or
bottom
99
The common eccrine glands function in the regulation of the body
temperature
sweat
100
They are innervated by cholinergic nerve and are a type of exocrine gland
sweat
101
__has been analyzed for its multiple inorganic and organic contents, but
with one notable exception, has not proven a clinically useful model.
Sweat
102
The exception is the analysis of sweat for chloride and sodium levels in the
diagnosis of __
CYSTIC FIBROSIS
103
Also known as
mucoviscidosis
Cystic Fibrosis
104
An autosomal, recessive
inherited disease that
affects the exocrine glands
and causes electrolyte and
mucous abnormalities
Cystic Fibrosis
105
in Pilocarpine Nitrate Iontophoresis
_____is introduced into skin by iontophoresis to stimulate locally
increased sweat gland secretion. The resulting sweat is absorbed by filter paper
or gauze, diluted with water and analyze for sodium and chloride determination
Pilocarpine
106
Site of Iontophoresis
Sweat should only be collected from the arms or legs
v The area for stimulation must be free from skin lesion
v The skin should be cleaned with distilled water, washed
followed by drying with paper tissue
107
brown color in macroduct collection
Ochronosis
108
red color in macroduct collection
Rifampin overdose
109
blue color in macroduct collection
Occupation exposure to copper
110
blue black color in macroduct collection
Idiopathic Chronhidrosis
111
It should approximate the chloride concentration, so it is measured to
provide better quality control
sodium
112
Discrepancies for sodium and chloride is influenced by __
air bubbles (decrease
concentration) and temperature fluctuations
113
Use the ___method for measuring sweat electrolytes provides a
means for evaluation of young infants without subjecting them to the
Rigos traditional sweat collection method
osmometer
114
normal sodium concentration
<70 mEq/L
115
normal chloride concentration
< 50 mEq/L
116
abnormal range of sodium
> 90 mEq/L
117
abnormal range of chloride
> 60 mEq/L
118
equivocal range of sodium
70-90 mEq/L
119
equivocal range for chloride
50-60 mEq/L
120
vDigestive enzymes
v Pepsin (protein)
v Lipase (fats)
v Rennin (to curdle milk)
121
vDigestive enzymes are produced bby
chief cells (Zymogen or peptic cells)
122
Gastric Juice composition
99% H2O, 1% solid
123
Hormone stimulating secretion of HCl
gastrin
124
High secretion of gastrin due to gastrin-secreting tumor oxygenating
from the pancreas
Zollinger-Ellison
125
Gastric Juice composition
v Electrolytes
mucin
intrinsic factor
126
Electrolytes in gastric juice
* H+ (1 million times greater than blood)
* Na, Cl, Mg, Ca, Fe
127
From the goblet or mucous cells to prevent autodigestion of the stomach
mucin
128
For the absorption of Vitamin B12 to prevent Pernicious Anemia
intrinsic factor
129
collection of gastric tube for fasting patient
Intubation
130
collection of gastric tube for non fasting patient - best evacuated tube
Ewald’s or Boa’s Method (
131
Commonly Used Stimulants for gastric juice collection
vStimulant of choice
vPentagastrin
132
a stimulant that is a vSynthetic compound resembling gastrin
pentagastrin
133
a stimulant that vProduce more rapid response
pentagastrin
134
vNo discomfort
vSpecimens are collected at 15 minutes interval for 1 hour
following the administration
pentagastrin
135
a stimulant for gastric juice
When used, collection must continue for 2 hours because
maximum output is delayed
histalog
136
a tubeless method for gastric juice
TUBELESS METHOD
ü __
Diagnex blue test
ü Patient is given an Azure A dye
137
a chemical stimulant for gastric that Assess vagotomy procedure
INSULIN
138
normal color of gastric juice
Grayish or bile-stained;
colorless
139
greenish color of gastric juice
old bile
140
red color of gastric juice
presence of blood
141
fecal odor of gastric juice
intestinal obstruction, gastrocolicfistula
142
Foul or Putrid odor of gastric juice
carcinomatous ulcer
143
Alcoholic odor of gastric juice
alcoholic coma, after alc test
meal
144
Amoniacal odor of gastric juice
uremia
145
Rancid odor of gastric juuice
stenosis and fermentation
146
pH of gastric juice
Acidic (pH 1.6-1.8)
147
sg of gastric juice
1.001- 1.010 9 (ave 1.07)
148
refers to normal secretion of gastric juice withpH between 1.6 - 1.8
euchlorhydia
149
increase free hcl above normal around 60 ml
in cases of peptic ulcer
hyperchlorhydia
150
decrease hcl in gastric juice
hypochlorhydia
151
hypochlorhydia is caused by
carcinoma of the stomach
chronic gastritis
gastric syphilis
152
absence of free hcl
achlorhydia
153
achlorhydia is caused by
pernicious anemia
pellagra
advanced gastric cancer
154
is lactic aid normally presnt in gastric juice?
nope, normally absent
155
presence of lactic acid in gastric juice signifies__
Indicates advanced gastric cancer
156
Maybe found in the stomach from the
fermentation of CHO or from the production of
lactic acid-forming bacteria like Boas-oppler
bacilli
lactic acid
157
occult blood in gastric acid are seen in __
Seen in peptic ulcers and gastric carcinoma
158
tests for lactic acid
Modified
Uffelmann’s
Strauss
Kelling’s
159
Modified
Uffelmann’s reagent and end color
FeCl3 +
phenol
yellow
160
strauss reagent and end color
FeCl3 + ether
yellow
161
Kelling’s reagent and end color
FeCl3
yellow
162
the absence of __ indicates organic disease
renin and pepsin
163
test for renin
1. Reitman
2. Riegel
164
test for pepsin
1. Bauer
2. Hammerschlag
165
Causes of Hyperacidity
Duodenal ulcer
Gastric cell hyperplasia
Carcinoid tumor
ZE syndrome P
Multiple endocrine neoplasia
Excessive histamine production as in Systemic Mastocytosis
166
Causes of Hypoacidity
Gastritis
Gastric carcinoma
Partial gastrectomy
Pernicious anemia
167
Absence of HCl and renin in gastric juice
Achylia gastrica
168
Inability to produce a pH less than 6.0 following gastric stimulation
Anacidity
