Handling and Processing of Non Blood Specimen for Laboratory Testing Flashcards by pola ry

95% water and 5% solutes

Urine

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• Factors that influence urine volume includes:

fluid intake,
variations in the secretion of antidiuretic hormone,
and need to excrete increased amount of dissolved solids (glucose and salts)

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Normal daily urine output:

1200-1500 mL

*Range of 600-2000 mL is considered normal

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9 urine components

urea
creatinine
uric acid
chloride
sodium
potassium
phosphate
ammonium
calcium

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Specimen Collection

Recommended capacity of the container is

50mL

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Reasons for Rejecting Specimen

• specimens in unlabeled containers • nonmatching labels and requisition forms
• specimens contaminated with feces or toilet paper
• containers with contaminated exteriors
• specimens of insufficient quantity • specimens that have been improperly transported

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Non blood Specimen Handling
• Specimen Integrity

specimens should be delivered to the laboratory promptly and tested within ______

2 hours

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Non blood Specimen Handling

• Specimen Integrity

a specimen that cannot be delivered and tested within 2 hours should be

refrigerated or have an appropriate chemical preservative added.

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Non blood Specimen Handling

• Specimen Preservation

The most routinely used method of preservation is refrigeration at _________(temperature)

2°C to 8°C

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Specimen Handling

• Specimen Preservation

When a specimen must be transported over a long distance and refrigeration is impossible, ___________________ may be added

chemical preservatives

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Specimen Handling

• Specimen Preservatives

• Refrigeration
• Boric acid
• Formalin (Formaldehyde)
• Sodium fluoride

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7 Types of Non Blood Specimens

Random Specimen
First Morning Specimen
24 hour Specimen (Timed specimens)
Catheterized Specimen
Midstream Clean
Suprapubic Aspiration
Three Glass Collection

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Type of Specimen

most commonly received specimen - useful for routine screening tests to detect obvious abnormalities

Random Specimen

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Type of Specimen (Non Blood)

ideal screening specimen
also essential for preventing false-negative pregnancy tests and for evaluating orthostatic proteinuria - concentrated specimen

First Morning Specimen

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Type of Specimen (Non Blood)

carefully timed specimen must be used to produce accurate quantitative results

24 hour Specimen (Timed specimens)

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Type of Specimen

for bacterial culture
specimen is collected under sterile conditions by passing a hollow tube (catheter) through the urethra into the bladder

Catheterized Specimen

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Type of Specimen

-Catch Specimen
- provides a safer, less traumatic method for obtaining urine for bacterial culture and routine urinalysis
- urine is less contaminated from vaginal bacteria and other cells

Midstream Clean

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Type of Specimen

provides a sample for bacterial culture that is completely free of extraneous contamination.
the specimen can also be used for cytologic examination
urine may be collected by external introduction of a needle through the abdomen into the bladder

Suprapubic Aspiration

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Type of Specimen collection

detect the presence of prostatitis.

Three Glass Collection

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Physical Examination of Urine

Normal colors

pale yellow, yellow, dark yellow and amber

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Abnormal Urine Color

• Dark Yellow or amber - presence of the abnormal pigment bilirubin.
• Yellow-orange
• Red
• Brown or black
• Blue/green

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Physical Examination of Urine

CLARITY - refers to the transparency or turbidity of a urine specimen

5 Common terminology used to report clarity includes

clear, hazy, cloudy, turbid, and milky

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Physical Examination of Urine

CLARITY

no visible particulates, transparent

Clear

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Physical Examination of Urine

CLARITY

few particulates, print easily seen through urine

hazy

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Physical Examination of Urine CLARITY many particulates, print blurred through urine

cloudy

Physical Examination of Urine CLARITY print cannot be seen through urine

turbid

Physical Examination of Urine CLARITY may precipitate or be clotted

milky

Physical Examination of Urine ODOR Freshly voided urine

faint aromatic odor

Chemical Examination of Urine - consist of chemical-impregnated absorbent pads attached to a plastic strip. - color-producing chemical reaction takes place when the absorbent pad comes in contact with urine. - the reactions are interpreted by comparing the color produced on the pad with a chart supplied by the manufacturer.

Reagent Strips

- chemical analysis of urine includes

**KPPBBLUNGS** ketones pH protein blood bilirubin leukocytes urobilinogen nitrite glucose specific gravity

Chemical Examination of Urine 1. Store with desiccant in an opaque, tightly closed container. 2. Store below 30 degrees Celcius; do not freeze. 3. Do not expose to volatile fumes. 4. Do not use past the expiration date. 5. Do not use if chemical pads become discolored. 6. Remove strips immediately prior to use. *Reagent strips must be checked with both positive and negative controls a minimum of once every 24 hours.

Care of Reagent Strips

Sediment Preparation of Urine Specimen Volume - 10 and 15 mL is centrifuged in a

conical tube

Sediment Preparation of Urine Centrifugation __ minutes at a relative centrifugal force (RCF) of 400. all specimens must be centrifuged in capped tubes.

Sediment Preparation of Urine Sediment Preparation - sediment should remain in the tube after ___________ - sediment must be thoroughly resuspended by gentle agitation

decantation

normal fecal specimen contains:

bacteria, cellulose, undigested foodstuffs, GI secretions, bile pigments, cells from the intestinal walls, electrolytes, and water

Approximately _________ of feces is excreted in a 24-hour period

100 to 200 g

Feces Specimen Collection Special containers with _________ are available for ova and parasite collection

preservative

Feces Specimen Collection Preserved specimens can usually be kept at ________________.

room temperature

Feces Specimen Collection - **used for 24-, 48-, and 72-hour stool collections for fecal fat and urobilinogen** (these specimens must normally be refrigerated throughout the collection period)

Large gallon containers

Feces Macroscopic Screening • Color and Appearance Appearance: watery consistency present in diarrhea; small, hard stools seen with constipation; and __________________ stools, which suggest obstruction of the normal passage of material through the intestine.

slender, ribbon-like

Feces Chemical Testing of Feces Occult Blood - Annual testing for occult blood has a high positive predictive value for detecting

colorectal cancer in the early stages

- most frequently used screening test for fecal blood - based on detecting the pseudoperoxidase activity of hemoglobin

Guaiac-Based Fecal Occult Blood Tests

Feces requires the collection of at least a 3-day specimen. The patient must maintain a regulated intake of fat (100 g/d) before and during the collection period. The specimen is collected in a large, pre-weighed container. Before analysis, the specimen is weighed and homogenized. Refrigerating the specimen prevents any bacterial degradation. - confirmatory test for steatorrhea

Quantitative Fecal Fat Testing

Feces Absence of bile salts that assist pancreatic lipase in the breakdown and subsequent reabsorption of dietary fat (triglycerides) produces an increase in stool fat

Steatorrhea (fecal fat)

- major fluid in the body - provides a physiologic system to supply nutrients to the nervous tissue, remove metabolic wastes, and produce a mechanical barrier to cushion the brain and spinal cord against trauma

Cerebrospinal Fluid

• Specimen Collection routinely collected by lumbar puncture between the third, fourth, or fifth lumbar vertebra - Specimens are obtained by a physician; most often through lumbar puncture (spinal tap)

Cerebrospinal Fluid

Cerebrospinal Fluid Collection order of draw

• Tube No. 1: Chemistry and Immunology • Tube No. 2: Microbiology • Tube No. 3: Hematology (Cell counts) • *A Fourth tube may be drawn for the microbiology lab

Cerebrospinal Fluid Appearance Normal CSF

Clear, Crystal-clear and Colorless

Cerebrospinal Fluid Appearance • The major terminology used to describe CSF appearance includes

crystal-clear, cloudy or turbid, milky, xanthocromic, and hemolyzed/bloody

Cerebrospinal Fluid Appearance - used to describe CSF supernatant that is pink, orange, or yellow.

Xanthochromia

Cerebrospinal Fluid • Reason for collection:

- to diagnose meningitis, subdural hemorrhage, and other neurological disorders.

Routine tests performed on CSF:

- cell counts, chloride, glucose, and total protein.

Semen is composed of four fractions that are contributed by the

testes, epididymis, seminal vesicles, prostate gland, and bulbourethral glands

Semen Composition:

• Spermatozoa 5% • Seminal fluid 60% to 70% • Prostate fluid 20% to 30% • Bulbourethral glands 5%

Semen Specimen Collection - collected and tested to evaluate

fertility and postvasectomy.

When a part of the ____ portion of the ejaculate is missing, the sperm count will be decreased, the pH falsely increased, and the specimen will not liquefy

first

- When part of the ____ portion of ejaculate is missing, the semen volume is decreased, the sperm count is falsely increased, the pH is falsely decreased, and the specimen will not clot.

last

Semen Specimen Collection - Specimens are collected following a period of sexual abstinence of at least

2 days to not more than 7 days

Semen Specimen Collection - If the sample is collected at home, it must be kept warm and delivered to the laboratory within

1 hour

Semen Specimen Collection Specimens should be collected by masturbation; only _________________________________ should also be used to collect the specimen

nonlubricant-containing rubber or polyurethane condoms

Semen Specimen Collection Sample should be kept at ____(temperature)

37°C

- A fresh semen specimen is clotted and should liquefy within ________ minutes after collection

30 to 60

Semen ph

pH 7.2 to 8.0

Normal Semen Appearance

has a gray-white color, appears translucent, and has a characteristic musty odor

Semen analysis for fertility evaluation consists of both macroscopic and microscopic examination. Parameters reported include

appearance, volume, viscosity, pH, sperm concentration and count, motility and morphology

- joint fluid - is a viscous liquid found in the cavities of the movable joints (diarthroses) or synovial joints - hyaluronic acid: contribute the noticeable viscosity - clear, pale-yellow, viscous fluid that lubricates and decreases friction in movable joints - normally occurs in small amounts but increases when inflammation is present

Synovial Fluid

- to identify or differentiate arthritis, gout, and other inflammatory conditions.

Synovial Fluid Reason for collection

Synovial Fluid Specimen Collection - Synovial fluid is collected by needle aspiration called

arthrocentesis

Normal synovial fluid does not

clot

Synovial Fluid Specimen Collection Turbidity is frequently associated with the presence of

WBC

Normal viscous synovial fluid resembles

egg white

Synovial Fluid Specimen Collection Collected in tubes:

• **EDTA or heparin tube** for cell counts, identification of crystals, and Smear preparation; • **Sterile tube** for culture and sensitivity; • **Nonadditive tube** for macroscopic appearance, and immunology tests and to observe clot formation.

- it provides lubrication between the parietal and visceral membranes

Serous Fluid

3 types of Serous fluids

• Pleural fluid • Peritoneal fluid • Pericardial fluid

Serous Fluid aspirated from the pleural space, or cavity, surrounding the lungs

Pleural fluid

Serous Fluid aspirated from the abdominal cavity

Peritoneal fluid

Serous Fluid aspirated from the abdominal cavity

Peritoneal fluid

Serous Fluid aspirated from the pericardial cavity surrounding the heart

Pericardial fluid

-pale-yellow, watery, serum-like fluid found between the double-layered membranes enclosing the pleural, pericardial, and peritoneal cavities - lubricates the membranes and allows them to slide past one another with minimal friction. - normally present in small amounts, but volumes increase when inflammation or infection is present or when serum protein levels decrease.

Serous Fluid

Serous Fluid - aspiration procedures are referred to as

thoracentesis (pleural), pericardiocentesis (pericardial), and paracentesis (peritoneal)

Serous Fluid Collected in:

• **EDTA tube** is used for cell counts and the differential. • **Sterile heparinized or sodium polyanethol sulfonate (SPS)** evacuated tubes are used for microbiology and cytology. • Chemistry tests can be run on clotted specimens in **plain tubes or in heparin tubes**

present in the amnion, a membranous sac that surrounds the fetus - provides a protective cushion for the fetus, allow fetal movement, stabilize the temperature to protect the fetus from extreme temperature changes, and permit proper lung development. - amount increases in quantity throughout pregnancy, reaching a peak of approximately 800 to 1200 mL during the third trimester, and then gradually decreases prior to delivery.

Amniotic Fluid

- can be analyzed to detect genetic disorders such as Down’s syndrome, identify hemolytic disease resulting from blood incompatibility between the mother and fetus, and determine gestational age • *most common reasons: to detect problems in fetal development and assess fetal lung maturity.

Amniotic Fluid

Amniotic Fluid preferably collected after __ weeks of gestation (pregnancy) and is obtained by a physician

Amniotic Fluid Collection: - Amniotic fluid is obtained by needle aspiration into the amniotic sac, a procedure called

amniocentesis

Amniotic Fluid the first 2 or 3 mL collected can be contaminated by maternal blood, tissue fluid, and cells and are _________

discarded

Normal amniotic fluid is ________ and may exhibit slight to moderate turbidity from cellular debris, particularly in later stages of fetal development

colorless

Amniotic Fluid Specimen Handling • The specimen should be protected from light to prevent _________________ and delivered to the laboratory ASAP.

breakdown of bilirubin

Amniotic Fluid Specimen Handling • Specimens for chromosome analysis (cytology) must be kept at ____ temperature.

room

Amniotic Fluid Specimen Handling • Specimens for some chemistry tests (gases) must be kept on ___.

ice

• mucus or phlegm that is ejected from the trachea, bronchi, and lungs through deep coughing • For the diagnosis or monitoring of lower respiratory tract infections such as tuberculosis (TB), caused by Mycobacterium tuberculosis. • FYI: The microbe that causes TB is called an acid-fast bacillus (AFB), and the sputum test for TB is often called an AFB culture.

Sputum

• Preferred specimen: First morning • Atleast 1 hour after meal

Sputum

Methods of Tissue Examination

Fresh Tissue Examination Preserved/Fixed Tissue Examination

4 Methods of Fresh Tissue Examination

Teasing or Dissociation Squash Preparation (Crushing) Smear Preparation Frozen Section

Fresh Tissue Examination method A selected tissue specimen is immersed in a watch glass containing NSS, carefully dissected or separated and examined

Teasing/Dissociation

Fresh Tissue Examination method Small pieces of tissues are placed in a microscopic slide and forcibly compressed with another slide or coverslip

squash preparation

Fresh Tissue Examination method Methods of Smear Preparation:

1.streaking 2.spreading 3.pull apart 4.touch or impression smear

Fresh Tissue Examination method Smear Preparation used for preparing mucoid secretions vaginal secretions, sputum and gastric content) use a spatula, dissecting needle or applicator stick and streak in a zigzag fashion

STREAKING

Fresh Tissue Examination method Smear Preparation used for thick mucoid secretions (smears of fresh sputum and bronchial aspirates)

SPREADING

Fresh Tissue Examination method Smear Preparation for serous fluids, concentrated sputum, and enzymatic lavage form the GIT, smears of urinary sediment, vaginal pool and breast secretions

PULL - APART

Fresh Tissue Examination method Smear Preparation for preparation of direct impression from the cut surface of tissue like the lymph nodes and other surgical or autopsy secretions.

TOUCH OR IMPRESSION SMEAR

TISSUES is a pathological laboratory to perform rapid microscopic analysis of a specimen. The technical name for this procedure is Cryo section.

The frozen section procedure

designed to remove all extractable water from the tissue, replacing it with a support medium that provides sufficient rigidity to enable sectioning of the tissue without parenchymal damage or distortion.

Fixed tissue examination

Fixed Tissue Histopathologic Techniques/Steps

• Numbering • Fixation • Dehydration • Clearing • Impregnation • Embedding • Blocking • Trimming • Sectioning • Staining • Mounting • Labelling

Fixed Tissue Gross Examination of Specimen • Surgical cut –up • Specimen Dissection • Grossing Medtech will assist pathologist in doing the gross examination, he/she will write down __________________________________

descriptions of the specimen received.

Handling and Processing of Non Blood Specimen for Laboratory Testing Flashcards

(105 cards)