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Analysis of Urine and Other Body Fluids > Chapter 10 - Sputum & Bronchoalveolar Lavage > Flashcards

Chapter 10 - Sputum & Bronchoalveolar Lavage Flashcards

1
Q

True or false: you can also find sputum spx in upper respi tract

A

True

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2
Q

Mixture of plasma, electrolytes, mucin & water

A

Tracheobronchial secretions

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3
Q

Acceptable sputum spx

A 
WBC = >25/LPF
SEC = <10/LPF
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4
Q

Most preferred sputum sample (routine)

A

First morning

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5
Q

Sputum spx for volume measurement

A

24-hour sputum

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6
Q

Sputum spx for pediatric px

A

Throat swab

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7
Q

Sputum spx collection for noncooperative px

A

Sputum induction

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8
Q

Sputum spx collection for debilitated/unconscious px

A

Tracheal aspirations

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9
Q

Determinde whether sputum volume is inc or dec in the ff:

  1. Bronchial asthma
  2. Acute bronchitis
  3. Bronchiectasis
  4. Lung abscess
  5. Stage of healing
  6. Pulmonary hemorrhage
  7. Gangrene
  8. Edema
  9. Early pneumonia
  10. TB
A
  1. Dec
  2. Dec
  3. Inc
  4. Inc
  5. Dec
  6. Inc
  7. Inc
  8. Inc
  9. Dec
  10. Inc
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10
Q

Identify the color of sputum for the ff conditions:

  1. Dust or dirt, carbon, charcoal
  2. Lobar pneumonia by Strep pneumo
  3. Kleb pneumo infxn
  4. Cancer
  5. Inc pus (TB, bronchitis, jaundice, pneumo)
  6. Fresh blood or hemorrhage, TB
  7. Inc pus & epithelial cells
  8. Old blood, pneumonia
  9. Bronchiectasis
  10. Inc bile
  11. Made up of mucus only
  12. P. aeruginosa infxn
  13. Pneumonia, gangrene
  14. Pneumonia, chronic lung cancer
  15. Anthracosis
  16. Lung abscess
  17. Congestive heart failure
  18. Smoking
A
  1. Black
  2. Rusty (w/ pus)
  3. Currant, jelly-like
  4. Olive green / grass green
  5. White / yellow
  6. Red / bright red
  7. Gray
  8. Anchovy sauce / rusty brown
  9. Red / Bright red
  10. Bright green / greenish
  11. Colorless or translucent
  12. Bright green / greenish
  13. Anchovy sauce / rusty brown
  14. Prune juice
  15. Black
  16. Bright green/ greenish
  17. Rusty (w/o pus)
  18. Black
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11
Q

Identify the odor of the ff sputum conditions:

  1. Normal
  2. Lung gangrene
  3. Necrosis
  4. Enteric gram-neg bacterial infxn
  5. Empyema
  6. Advanced necrotizing tumors
  7. Tumors
  8. Bronchiectasis
  9. TB
  10. Liver abscess
A
  1. Odorless
  2. Foul / putrid
  3. Cheesy
  4. Fecal
  5. Cheesy
  6. Foul / putrid
  7. Cheesy
  8. Sweetish
  9. Sweetish
  10. Fecal
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12
Q

Identify the sputum consistency for the ff conditions:

  1. Bronchitis
  2. Asthma
  3. Lung edema
  4. Brochiectasis
  5. TB w/ cavities
A
  1. Mucoid
  2. Mucoid
  3. Serous / frothy
  4. Mucopurulent
  5. Mucopurulent
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13
Q

size of a pinhead, produces foul odor when crushed

A

Dittrich’s plugs

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14
Q

Color of Dittrich’s plus

A

Yellow / gray

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15
Q

Hard concretion in a bronchus

A

Lung stones (pneumoliths / broncholiths)

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16
Q

Branching tree-like casts pf the bronchi

A

Bronchial casts

17
Q

Yellow or white calcified TB structures or foreign material

A

Lung stones (pneumoliths / broncholiths)

18
Q

3 layers of standing sputum spx

A

Top: frothy mucus
Mid: opaque, water material
Bot: pus, bacteria, tissues

19
Q

Macroscopic structure in sputum spx whose significance is assoc w/ pneumoconiosis

A

Foreign bodies

20
Q

Structures in the sputum assoc w/ bronchial asthma

A

Dittrich’s plug, Charcot-Leyden crystals, Curschmann’s spiral, creola bodies

21
Q

Most common significance of this macro structure is histoplasmosis

A

Lung stones / pneumoliths / broncholiths

22
Q

Match the ff macro strictures of sputum w/ its corresponding clinical significance:

  1. Dittrich’s plug
  2. Lung stones (pneumoliths/broncholiths)
  3. Bronchial casts
  4. Layer formation
  5. Foreign bodies

A. Pneumoconiosis
B. Histoplasmosis, chronic TB
C. Lobar pneumonia, bronchitis, diphtheria
D. Bronchitis, bronchiectasis, bronchial asthma
E. Bronchiectasis, lung abscess, gangrene

A
  1. D
  2. B
  3. C
  4. E
  5. A
23
Q

Slender fibrils w/ double contour & curled ends

A

Elastic fibers

24
Q

Colorless, hexagonal, double pyramid, often needle-like, arise from disintegration of eos

A

Charcot-Leyden crystals

25
Q

Heart failure cells in sputum

A

Hemosiderin-laden macrophage

26
Q

Pigmented cells: angular black granules

A

Carbon-laden cells

27
Q

Coiled mucus strands

A

Curschmann’s spiral

28
Q

Colorless globules occurring in a variety of sizes & bizarre forms

A

Myelin globules

29
Q

Match the ff microscopic structures w/ their assoc clin sig:

  1. Bronchial asthma
  2. TB
  3. Mistaken as Blastomyces
  4. Heavy smokers
  5. Congestive heart failure
A. Pigmented cells
B. Curschmann’s spiral
C. Myelin globules
D. Elastic fibers
E. Charcot-Layden crystals
F. Creola bodies
A
  1. B, E, F
  2. D
  3. C
  4. A
  5. A
30
Q

Clusters of columnar epithelial cells seen in sputum spx

A

Creola bodies

31
Q

A procedure for collecting the cellular milieu of the alveoli by use of a bronchoscope through which saline is instilled into distal bronchi and then withdrawn

A

Bronchoalveolar lavage (BAL)

32
Q

BAL is an important doagnostic test for ____ in immunocompromised px

A

Pneumocystis carinii & Pneumocystis jiroveci

33
Q

Sputum is composed of approx. _____% of water and _____% solids

A

95% water ; 5% solids

34
Q

______ is the most important single component of sputum viscosity

A

Sialic acid

35
Q

_____ delineates the cysts of P. jiroveci

A

Grocott’s methanamine silver stain

36
Q

Determine which cells are most likely to be seen in a BAL w/ the ff conditions:

  1. Cigarette smokers
  2. Hypersensitivity rxn
  3. Toxin exposure
  4. Nonbacterial infxn
  5. Interstitial dse
  6. Bronchopneumonia
  7. Pulmonary lymphoma
A
  1. Neutro
  2. Eos
  3. Neutro
  4. Lympho
  5. Lympho
  6. Neutro
  7. Lympho
37
Q

Most predominant cell in BAL

A

Monocytes

38
Q

The physical properties of sputum reveal the secretions to be _____, that is, some of the properties of a liquid and some of a solid.

A

Viscoelastic

Analysis of Urine and Other Body Fluids (18 decks)

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