Specimen Collection And Handling Flashcards by Lea San Juan

During SCH we need to use

Use clean, dry, wide-mouthed, leak-proof containers with a screw cap

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Containers must not contain

dirt, urine, or water contamination.

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Why do we need to bring or send the specimen to the lab as soon as it is voided

To prevent deterioration of protozoans and morphological alterations

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We must note patients

Name/identifier and date/time collection on the cotainer

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Request form includes

Patients name
Age
Sex
Date/time collection
Requesting physician
Requested procedure
Presumptive diagnosis
Prior infection
Travel history

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In collecting spx, we must collect

Freshly passed stool

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Liquid spx

5ml or 5-6 tbsp

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Solid spx

20-40g (thumb size)

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Recommend for collection

Directly on the continer
Toil bowl method
Infants diaper
On paper and scoop after

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We must reject spx

Contamintion urine & water
Collection from soil
With evidence of barium
Liquid fecal beyond 60 mins
Formed stool beyond 24hrs

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Contaminated with water can kill

Trophozoites

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Contamination with urine can kill

Ascaris lumbricoides

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______ in urine kills or deactivates the ova

Ammonia

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nonpathogenic free-living parasite are presents which looks the same

Collection from soil

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Used in radiologic test

Barium

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barium leaves behind a residue that makes fecalysis difficult

Barium enema

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administered to their large intestines via the
anus to highlight in the x-ray and inspect for
abnormalities

Barium

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Decreases the number of protozoan for several weeks

Intake of antibiotics

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Leave crystalline residues that can interfere with fecalysis

Intake of drugs/medicinal substances

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Remedy of intake of drugs and antibotics

Collect prior to intake

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Factors to consider

Intakes of drugs/medicinal suns
Intakes of antibiotics
Anti-diarrheals

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is a body mechanism to eliminate toxic pathogens inside

Anti-diarrheals

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Collection must be done a _____ after the last intake or administration of any of these drugs

Week

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Store at ____ and maintain it in cool temperature (inside a box with coolant) during transport

4-8°C

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Preservatives use for wet mount examination

10% formalin

Preservatives used for specimen that req staining

Polyvinyl alcohol or PVA

Ratio

3:1 3 parts preservative to 1 part stool

Color of stool

Black Brown Yellow Green

Consistency

Formed Soft Loose Watery

Recommended for cyst

Formed

Recommended for trophs

Watery

Always note the presence of _________ and _______ in the stools

Mucus and blood streaks

Prioritize examination of _____ stools especially those with mucus or blood as they may contain _________

Liquid stool Motile amoeba

__________ must be examined ideally within 30 minutes after passage

Watery spx

____________ must be examined ideally within 1 hour after passage

Soft spx

___________ must be examined within 12 hours after passage

Formed spx

Positive stools are mixed with moistened soil or granulated charcoal placed in a cheesecloth and submerged in a water in a funnel

Copro culture

COPRO CULTURE Principle:

Rhabditiform larvae transforms to Filariform larvae with the presence of water

__________ notorious to have water tropism (water attraction)

Filariform larvae

Harvest larvae using

Baermann technique

Increases the chances of recovering Strongyloides from samples

Harada mori or test tube culture method

Positive stool is applied to the filter paper and placed into a test tube with ___ of boiled or distilled water

7 ml

The tube is incubated at ____ C for up to___.

24-28°C 10 days.

______ migrate to the water and transform into filariform larvae.

Strongyloides rhabditiform larvae

If the patient cannot expectorate,______________________ may be used

10% sodium chloride or hydrogen peroxide

Examine consistency of sputum

Serous Mucoid Purulent Bloody

Test using wet mount ___________ or concentrate by adding an equal amount of 3% NaOH, mix, centrifuge, and perform wet mount on the sedi

saline or iodine for trophozoites

Sputum examination detects

→ migrating larvae of Ascaris lumbricoides → Strongyloides stercoralis → Hookworms → Paragonimus [westermani] ova - reside in the lungs (most of the time isolated in the sputum) → Pulmonary hydatid cysts of Echinococcus granulosus → Trophozoites from pulmonary amebic abscess by Entamoeba histolytica

[The act of _________ the phlegm creates the possibility of having sputum present in the stool sample]

Swallowing

Examination of urine may be use to detect

Trichomonas vaginalis Schistosoma haematobium

Prefer in urinary bladder and it is not common in ph

Schistisoma haematobium

pingpong motility which travels from one field to another [Females are symptomatic, Males are otherwise]

Trichomonas vaginalis

3 COMMON Schistosoma

● Schistosoma mansoni ● Schistosoma japonicum ● Schistosoma haematobium

_______ for the demonstration of __________in amebic liver abscess cases

Liver aspirates Entamoeba histolytica trophozoites

Aspirate on the ________ of the abscess, not on the center

margins or the walls

Duodenal aspirates for

Giardia lambia Strongyloides stercoralis

A capsulated yarn is swallowed by the patient and reach the duodenum

Intestinal intubation or entero test/string test

Retrieve after___ hours and examine the mucoidal material clinging to the yarn

Cutaneous ulcerations in________

Leishmaniasis

Aspirate below the___ bed using a sterile needle

Ulcer

Prepare a smear and stain with______

Giemsa stain

CSF may demonstrate the presence of the trypomastigotes of_________ and the trophozoites of______

Trypanosoma spp Naegleria

Immediate Examination of csf is needed within ______

20 minutes

CSF must be centrifuged at_________ discard the supernatant, and examine the sediment

7,000 g for 10 minutes,

Useful in the diagnosis of Trichinella spiralis infection (presence of encapsulated larvae)

Muscle biopsy

Can reveal the presence of deposited Schistosoma japonicum eggs

Rectal biopsy

_______ is a routine method of stool examination primarily useful in the detection of motile protozoan trophozoite.

DFS

About___ of stool (Amount forming a cone at the tip of an applicator stick)

2 mg

Inportance of dfs

● To detect motile trophozoites. ● To detect ova and cysts present in moderate number. ● To detect erythrocytes, leukocytes, cellular debris or excess fat.

Recommended specimens are___________ and samples that ______________

FRESH STOOL SPECIMENS HAS NOT BEEN refrigerated nor preserved.

Materials neee for dfs

Applicator stick Cover slide Microscope glass slode Permanent market Beaker Pipette Lugols iodine soln 0.85% Nss

Characteristics of imperfect smear

● Improper patient identification ● Mismatched sample and patient ● Insufficient and/or excessive stool sample ● Insufficient and/or excessive reagents ● Incomplete mixing of specimen and reagent ● Presence of fecal debris ● Bubble formation ● Uneven distribution of mixture ● Crooked/Offset/Slanted Cover Slips ● Leakage of mixture on the edge of the slip and slide

Aside from parasites, we may also see the following:

→ White blood cells/pus cells: PMNs or eosinophils → Red blood cells → Fat globules → Macrophages which may be mistaken for amoebic trophozoites → Charcot-Leyden crystals ▪ by products of the degradation of eosinophil granules → Epithelial cells from the intestinal tract → Eggs of arthropods, plant nematodes, and spurious parasites → Fungal spores →Plant elements: fibers, cells, pollen grains, starch granules, vegetable spirals

→ REMEMBER:_____________ is IMPORTANT before doing any examination! → Make sure to work on a _________

Proper patient identification flat and steady surface

Degradtion of eosinophil granules

Charcot leyden crystals

Specimen Collection And Handling Flashcards

(75 cards)