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Parasitology > CHAPTER 2.1 (OTHER SPECIMENS AND TECHNIQUES) > Flashcards

CHAPTER 2.1 (OTHER SPECIMENS AND TECHNIQUES) Flashcards

other parasite detection techniques aside from the usual O&P methods

1
Q

These are often used when the
physician suspects a particular parasite and the traditional O&P examination is negative.

These procedures include examination of?

A

duodenal material, sigmoidoscopy material,
and using cellophane tape to detect pinworms

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2
Q

Parasites that reside in the small intestine may be more difficult to recover in a stool specimen. In these situations, examining material from the ______ may yield success

A

duodenal area

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3
Q

How is duodenal material collected

A

Nasogastric Intubation or the Enteric Capsule Test (Enterotest)

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4
Q

Parasites that may be observed in duodenal material includes

A

Giardia intestinalis trophozoites, Cryptosporidiumspp.,
Isospora belli,
Strongyloides stercoralis,
eggs of Fasciola hepatica or Clonorchis sinensis

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5
Q

Duodenal fluid can be examined at a later time because even if there are trophozoites present, they will not deteriorate rapidly compared to normal fecal samples

true or false

A

False

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6
Q

Duodenal material can be examined
microscopically as a wet preparation. If the
volume of fluid is sufficient (>3 mL)

True or False

A

False >2 ml

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7
Q

In examining duodenal material, what type of concentration technique; fixative; and stain is used?

A

Sedimentation
PVA fixative
Trichrome/ Iron hematoxylin/ Acid-fast stain

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8
Q

Duodenal material can be used to perform antigen tests for

A

Cryptosporidium and/or Giardia

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9
Q

Explain the step by step process of Enterotest in collecting duodenal material

A
  1. Px SWALLOWS a gelatin capsule that contains a coiled length of yarn
  2. The capsule DISSOLVES
    in the stomach and the weighted string is
    carried to the duodenum.
  3. The FREE END of the string is attached to the patient’s neck or cheek with tape
  4. After a 4-hour incubation period, the
    yarn is PULLED BACK out of the patient
  5. The bile stained mucous material brought up on the string is then EXAMINED microscopically via wet preps and, if necessary, permanent stains.
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10
Q

is often helpful for detecting E. histolytica.

A

Examination of sigmoidoscopy (colon) material

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11
Q

Material from ulcers obtained by aspiration or scraping should be examined by

A

direct wet preparations and permanent stains

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12
Q

Other species that may also be recovered from examining material from the sigmoid colon.

A

Coccidian parasites and microsporidia

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13
Q

If E. histolytica is present, it indicates what stage will also be often present?

A

trophozoite stage

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14
Q

What other material can be collected from the colon?

A

Colon biopsy material

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15
Q

Colon material are best processed using surgical pathology methods when these organisms are suspected to be present

A

amebae

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16
Q

is the specimen of choice for the detection of Enterobius vermicularis (pinworm) eggs; Adult female pinworms may also be seen

A

cellophane tape prep

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17
Q

Why is it important that the specimen be
collected in the morning before the patient washes or defecates for cellophane tape prep?

A

At night, when the body is at rest, pregnant adult female worms exit the host, typically a child, through the rectum and lay numerous eggs in the perianal region

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18
Q

In addition to pinworm, there is evidence to support the use of Cellophane tape prep technique for the recovery of

A

Taenia spp. eggs

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19
Q

the standard protocol for specimens collected daily for the number of negative tests that should be performed to rule out a pinworm infection is

A

Five

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20
Q

From which area can the Enterotest be used to collect specimens?
A. Duodenum
B. Sigmoid colon
C. Stomach
D. Perianal area

A

A. Duodenum

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21
Q

Systemic or blood-borne parasitic infections are diagnosed by demonstrating the

A

diagnostic stage(s) of the responsible parasite(s) in a blood specimen

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22
Q

Parasites that may be recovered in
blood include

A

Leishmania donovani spp
Trypanosoma spp
Plasmodium spp
Babesia spp.
microfilariae

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23
Q

can be detected by observing motility in a
wet preparation of a fresh blood sample under low- and high-power magnification

A

Trypanosoma spp.
microfilariae

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24
Q

Blood specimens for
parasite study must be collected by

A

aseptic technique

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25
Q

Although these specimens provide the best morphology of the parasites, improper collection or smear preparation can lead to unsatisfactory results

A

Blood from the fingertip or earlobe

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26
Q

Capillary blood collected for detecting parasites should be

A
  1. free-flowing and not contaminated with the alcohol
  2. Not milked if from the finger
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27
Q

Why shouldn’t we milk the fingers when collecting blood samples from the finger for detecting parasites

A

Diluted by tissue fluids making it difficult to detect parasites

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28
Q

Anticoagulants causes what to samples for parasite detection in blood?

A

distortion to the staining
process and subsequent parasite morphology

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29
Q

Blood specimens that is collected through venipuncture should be collected in tubes containing

A

ethylenediaminetetraacetic
acid (EDTA)

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30
Q

If malaria is suspected,
it is best to prepare smears within

A

1 hour

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31
Q

Stage in detecting parasites in blood which consists of preparing thick and thin
blood smears, staining them using a permanent stain, and examining them microscopically

A

blood sample processing

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32
Q

Blood samples may also be processed by performing the ________

which is characterized by examining buffy
coat slides, or setting up and reading cultures

A

Knott technique

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33
Q

are frequently satisfactory for screening purposes, particularly when malaria is suspected.

A

Thick smears

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34
Q

provide the best view of the malarial
parasites in red blood cells and are recommended for species identification.

A

Thin smears

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35
Q

What type of thick smears allows them to typically have a much higher concentration of parasites than thin smears

A

dehemoglobinized thick smears

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36
Q

Thick smears are primarily used when

A

parasites are few in number or when
thin smears are negative

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37
Q

The advantage of the thick smear is

A

increased ability to detect the
malarial parasites

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38
Q

The disadvantage of the thick smear is

A

red blood cells have been lysed and it is not
possible to assess the morphology of parasites that are detected

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39
Q

There are two permanent
stains commonly used for the detection of blood parasites namely?

A

Wright’s stain and Giemsa stain

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40
Q

Stain that contains the fixative
and stain in one solution,

A

Wright’s stain

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41
Q

Stain where the fixative
and stain are not in one solution,

A

Giemsa stain

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42
Q

Wright’s stain typically yields only

A

satisfactory results

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43
Q

is considered the preferred stain because it allows for the detection of parasite detail necessary for species identification

A

Giemsa stain

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44
Q

Appearance of Select
Parasitic Structures and
Background Material on
GIEMSA STAIN

RED

A

Leishmania, trypanosome,
malaria, and Babesia nuclear
structures

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45
Q

Appearance of Select
Parasitic Structures and
Background Material on
GIEMSA STAIN

BLUE

A

Cytoplasm

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46
Q

Appearance of Select
Parasitic Structures and
Background Material on
GIEMSA STAIN

also… RED

A

Schüffner’s dots

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47
Q

Appearance of Select
Parasitic Structures and
Background Material on
GIEMSA STAIN

BLUE TO PURPLE

A

Nuclei

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48
Q

Appearance of Select
Parasitic Structures and
Background Material on
GIEMSA STAIN

CLEAR; MAY NOT STAIN

A

Sheath

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49
Q

Appearance of Select
Parasitic Structures and
Background Material on
GIEMSA STAIN

PALE RED

A

Red blood cells

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50
Q

Appearance of Select
Parasitic Structures and
Background Material on
GIEMSA STAIN

PURPLE

A

White blood cells

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51
Q

Appearance of Select
Parasitic Structures and
Background Material on
GIEMSA STAIN

PINK-PURPLE

A

Neutrophilic granules

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52
Q

Appearance of Select
Parasitic Structures and
Background Material on
GIEMSA STAIN

PURPLE-RED

A

Eosinophilic granules

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53
Q

is designed to concentrate blood specimens suspected of containing low numbers of microfilariae.

A

Knott Technique

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54
Q

How to do a simple modified version of KNOTT TECHNIQUE

A

combining 1 mL of venipuncture collected
blood with 10 mL of 2% formalin in
a centrifuge tube thoroughly mixed and spun for 1 minute at 500 × g.

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55
Q

What can we collect from the resulting
sediment of KNOTT TECHNIQUE

A

Thick slides may be made, dried, and
subsequently Giemsa-stained

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56
Q

Buffy coat cells may be extracted
from blood specimens, stained with Giemsa
stain, and microscopically examined for

A

Leishmania and Trypanosoma

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57
Q

How to collect and make buffy coat slides

A

collecting oxalated or citrated blood,
placing it in a Wintrobe tube, and spinning it for 30 minutes at 100 × g.

buffy coat may then be extracted using a capillary pipette

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58
Q

One such culture technique
that yields favorable results for the recovery
of Leishmania spp. and Trypanosoma cruzi
uses

A

Novy-MacNeal-Nicolle (NNN) medium.

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59
Q

Novy-MacNeal-Nicolle (NNN) medium is used in culture techniques to detect what parasites

A

Leishmania spp. and Trypanosoma cruzi

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60
Q

give the step by step procedure of the NNN medium

A
  1. NNN slant is inoculated by the ADDITION of a single drop of collected blood or ground tissue
  2. Penicillin is added to the medium if the specimen originates from a source that may contain bacteria
  3. PERIODIC EXAMINATION, every other day, should be conducted by observing the slant under 400× magnification.
  4. Negative cultures should be held
    for 1 month.
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61
Q

Cerebrospinal fluid (CSF) specimens may be collected for the diagnosis of

A

amebic conditions associated with select ameba

and African sleeping sickness

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62
Q

A wet preparation of CSF samples
can be prepared to search for the presence of the characteristic morphologic forms of

A

Naegleria fowleri and Acanthamoeba spp and the trypomastigote stages of Trypanosoma spp.

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63
Q

Special stains can also be performed on CSF including

A

Giemsa, trichrome, and modified trichrome
stains

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64
Q

If Naegleria or Acanthamoeba are suspected
of being potential pathogens, the CSF specimen can be cultured on

A

non-nutrient agar seeded with Escherichia coli

65
Q

The CSF sediment is inoculated
to the medium, sealed, and incubated at what temperature

A

35° C

66
Q

Other pathogens that might be recovered from the central nervous system include

A

Toxoplasma gondii and microsporidia and Taenia solium cysticercus larvae and Echinococcus spp.

67
Q

Sterile fluids other than CSF include several
specimen types, such as

A

fluid present in cysts,
aspirates,
peritoneal fluid,
pleural fluid, and
bronchial washings

68
Q

Tissue and biopsy specimens are recommended for the recovery of a number of parasites, including intracellular organisms such as

A

Leishmania spp. and T. gondii

69
Q

is the preferred method for handling tissue and biopsy samples

A

Surgical removal of the specimen followed by the preparation of histologic tissue sections and impression smears

70
Q

Other parasites that may be detected
in Tissue and Biopsy samples include

A

free-living ameba, Trypanosoma
spp., Trichinella spiralis, and microsporidia

71
Q

is the specimen of choice for patients suspected of liver abscesses caused by E. histolytica

A

Hepatic abscess material

72
Q

liver abscesses is caused by

A

Entamoeba histolytica

73
Q

Sputum is typically collected and tested from
patients suspected of being infected by the

A

lung fluke: Paragonimus westermani

74
Q

Patients with ________ will demonstrate motile larvae in their sputum

A

Strongyloides stercoralis hyperinfection

75
Q

Other parasitic infections that
may be found in sputum samples include

A

microsporidia, E. histolytica, Entamoeba gingivalis, Ascaris lumbricoides, and hookworm

76
Q

What type of specimen is recommended for sputum collection

A

early-morning specimen

77
Q

The sputum sample may then be examined directly via

A

wet preps and/or concentrated using
N-acetylcysteine or other appropriate agent

78
Q

Urine is the specimen of choice for the detection of

A

Schistosoma haematobium eggs

and Trichomonas vaginalis trophozoites

79
Q

can sometimes be found in the urine of patients with a heavy filarial infection.

A

Microfilariae

80
Q

The procedure for examining urine specimens for parasite detection

A
  1. Collected in a clean watertight container
  2. centrifuged on arrival
  3. Microscope analysis of sediment
81
Q

are typically collected and examined for the presence of T. vaginalis trophozoites.

A

Vaginal and urethral specimens, as well as
prostatic secretions

82
Q

are the method of choice for demonstrating the motile trophozoites in urine samples

A

Saline wet preparations

83
Q

Alternative techniques for the diagnosis of
T. vaginalis include

A

antigen detection methods using latex agglutination and EIA procedures

commercially available nucleic acid probe

commercial product that uses a
culture pouch

84
Q

is best diagnosed by the collection and examination of corneal scrapings

A

Acanthamoeba keratitis

85
Q

Other specimens that may be tested for eye infections include a

A

contact lens or contact lens solution

86
Q

The eye samples may be processed in several ways

the first way is?

A
  1. cultured on an agar plate seeded
    with gram-negative bacteria.
87
Q

Examining the culture plate from eye specimens should be done under

A

low dry magnification every day for 1 week

88
Q

Examining the culture plate from eye specimens should reveal

A

the trophozoites >4 days

and the cysts in 4 to 5 days

89
Q

The eye samples may be processed in several ways

the second way is?

A

the scrapings may be transferred
to glass slides and stained

90
Q

Eye scrapings observed under the glass slides are stained using?

A

calcofluor white stain

91
Q

Eye scrapings observed under the glass slides are microscopically observed using what type of microscope?

A

fluorescent microscopy

92
Q

In eye specimen samples, what parasite stains apple green when calcoflour white stain is used?

A

Acanthamoeba cysts

93
Q

Eye specimen samples when gone through staining procedures for parasite detection cannot stain what stage of the parasite?

A

trophozoites

94
Q

In addition to Acanthamoeba, T. gondii, what are other potential eye pathogens

A

microsporidia, and Loa loa

95
Q

microsporidia, and Loa loa can be detected using what?

A

histologic stains and specialized culture
methods

96
Q

Mouth scrapings are the sample of choice for the detection of

A

E. gingivalis and Trichomonas tenax

97
Q

nasal discharge specimens are helpful for the recovery of parasites such as

A

N. fowleri

98
Q

Material obtained via mouth scrapings
and nasal discharge should be placed in a

A

Airtight collection container (swab or cup)

99
Q

What techniques do we apply to mouth scrapings and nasal discharge?

A

Wet preps are more common
Permanent stains when applicable

100
Q

Skin Snips are useful in the detection of

A

Onchocerca volvulus

101
Q

Skin snips may be made using one
of two collection techniques. The objective of
both procedures is to obtain skin fluid without bleeding.

the first one is?

A

making a firm (scleral) punch into skin with a specially designed tool (sinearch ko: Gass Corneoscleral Punch maybe)

102
Q

Skin snips may be made using one
of two collection techniques. The objective of
both procedures is to obtain skin fluid without bleeding.

the second one is?

A

uses a razor blade with which a small cut into the skin is made

103
Q

Explain the step by step way we examine skin snips

A
  1. Tissues collected are placed in 0.2mL saline
  2. 30 minute incubation
  3. Microscopically examined
  4. Jerky movement of the microfilariae should be visible as they migrate from skin snip to the liquid saline
104
Q

are not a common means of detecting parasites. There are a few techniques available but they are not usually performed in the routine laboratory. Specialized laboratories and research facilities may offer these services.

A

Culture methods

105
Q

Parasites that can be isolated with culture include

A

E. histolytica
T. vaginalis
Leishmania spp.
T.cruzi
T. gondii

106
Q

Animal Inoculation and Xenodiagnosis are the appropriate techniques to use on appropriate specimens from patients suspected of suffering from

A

Leishmania and Trypanosoma as well as Toxoplasma

107
Q

Certain parasites have host specificity and require particular animals such as

A

Mice, guinea pigs, and hamsters

108
Q

Leishmania and Trypanosoma as well as Toxoplasma if suspected, these techniques are used

A

Animal Inoculation and
Xenodiagnosis

109
Q

is a technique that uses the arthropod host as an indicator of infection.

A

Xenodiagnosis

110
Q

Suitable specimens for animal inoculation vary depending on the parasite suspected; these include

A

blood, lymph node aspirates, CSF, and
bone marrow

111
Q

The specimens for animal inoculation and xenodiagnosis should be collected
using

A

aseptic technique

112
Q

Xenodiagnosis is a technique used for the
diagnosis of what disease

A

Chagas’ disease

113
Q

Explain how xenodiagnosis techniques is used for the diagnosis of Chaga’s disease

A
  1. An uninfected reduviid bug is allowed to take a blood meal from the patient
  2. bug’s feces is then examined to observe for the presence of T. cruzi
114
Q

Xenodiagnosis to diagnose Chaga’s disease is primarily used in?

A

South America and Mexico.

115
Q

Thick blood smears for malaria are recommended for
species identification
A. True
B. False

A
116
Q

Giemsa is the preferred stain for the detection of blood parasites.
A. True
B. False

A
117
Q

Which of the following is the specimen of choice to demonstrate intracellular parasites such as Toxoplasma gondii and Leishmania spp.?
A. Sputum
B. Urine
C. Tissue
D. Genital secretions

A
118
Q

Is usually considered as an adjunct or supplement to standard laboratory protocols. Include methods for antigen
and antibody detection.

A

Immunologic tests

119
Q

Occasionally, however, standard laboratory
tests are not sufficient for the diagnosis of
a parasite. For example, in some parasitic infections, the diagnostic stage is located deep in the tissues of the host

give an example of an infection like this

A

Toxoplasmosis

120
Q

Why is standard laboratory test not sufficient for the diagnosis of toxoplasmosis

A

it may not be possible to detect
its presence

121
Q

What disease can standard laboratory test not diagnose and may be dangerously invasive to attempt it

A

echinococcosis

122
Q

As standard laboratory test are not sufficient for diagnosing toxoplasmosis and echinococcosis what is the alternative?

A

immunologic assays can be used

(IMMUNLOGIC TESTS)

123
Q

The presence of an antibody
against a given parasite may not always indicate a current infection, WHY?

A

antibodies remain with a host for many years, a positive test result can occur from a past infection

124
Q

What can we safely consider as a positive result from immunologic tests?

A

detection of an antibody to a given parasite in a patient with no previous exposure prior to travel to an endemic area

125
Q

What org performs immunologic assays on
request

A

Centers for Disease Control and Prevention
(CDC)

(probably Research Institute for Tropical Medicine- National reference laboratory for parasites pag sa Philippines)

126
Q

The only commercial molecular test available is for the diagnosis of

A

T. vaginalis

127
Q

The detection of an antibody to a given parasite in a patient with no previous exposure prior to travel to an endemic area can be considered a positive result.

A. True
B. False

A

A. True

128
Q

BF

A

Bentonite flocculation

129
Q

CA

A

card agglutination

130
Q

CF

A

complement fixation

131
Q

DFA

A

direct fluorescent antibody

132
Q

EIA

A

enzyme immunoassay

133
Q

IB

A

immunoblot

134
Q

IHA

A

indirect hemagglutination

135
Q

IFA

A

indirect fluorescent antibody

136
Q

LA

A

latex agglutination

137
Q

PCR

A

polymerase chain reaction

138
Q

Rapid

A

immunochromatographic cartridge

139
Q

Cite the Parasitic Diseases that can be tested through Immunoassays and Molecular Techniques

A

African trypanosomiasis
Amebiasis
Babesiosis
Chagas’ disease
Cryptosporidiosis
Cysticercosis
Echinococcosis
Fascioliasis
Filariasis
Giardiasis
Leishmaniasis
Malaria
Microsporidiosis
Paragonimiasis
Schistosomiasis
Strongyloidiasis
Toxocariasis
Toxoplasmosis
Trichinellosis
Trichomoniasis

140
Q

Cite the Immunoassays and Molecular Techniques for these Parasitic Diseases

African trypanosomiasis

A

Antigen Test: –
Antibody Test: CA, IFA
Molecular Test: PCR

141
Q

Cite the Immunoassays and Molecular Techniques for these Parasitic Diseases

Amebiasis

A

Antigen Test: EIA, IFA
Antibody Test: EIA, IHA
Molecular Test: PCR

142
Q

Cite the Immunoassays and Molecular Techniques for these Parasitic Diseases

Babesiosis

A

Antigen Test: –
Antibody Test: IFA
Molecular Test: PCR

143
Q

Cite the Immunoassays and Molecular Techniques for these Parasitic Diseases

Chagas’ disease

A

Antigen Test: –
Antibody Test: CF, EIA, IFA
Molecular Test: PCR

144
Q

Cite the Immunoassays and Molecular Techniques for these Parasitic Diseases

Cryptosporidiosis

A

Antigen Test: DFA, EIA, IFA, Rapid
Antibody Test: –
Molecular Test: PCR

145
Q

Cite the Immunoassays and Molecular Techniques for these Parasitic Diseases

Cysticercosis

A

Antigen Test: –
Antibody Test: EIA, IB
Molecular Test: –

146
Q

Cite the Immunoassays and Molecular Techniques for these Parasitic Diseases

Echinococcosis

A

Antigen Test: –
Antibody Test: EIA,IB
Molecular Test: –

147
Q

Cite the Immunoassays and Molecular Techniques for these Parasitic Diseases

Fascioliasis

A

Antigen Test: –
Antibody Test: EIA,IB
Molecular Test: –

148
Q

Cite the Immunoassays and Molecular Techniques for these Parasitic Diseases

Filariasis

A

Antigen Test: Rapid
Antibody Test: EIA
Molecular Test: –

149
Q

Cite the Immunoassays and Molecular Techniques for these Parasitic Diseases

Giardiasis

A

Antigen Test: DFA, EIA, Rapid
Antibody Test: –
Molecular Test: PCR

150
Q

Cite the Immunoassays and Molecular Techniques for these Parasitic Diseases

Leishmaniasis

A

Antigen Test: Rapid
Antibody Test: EIA, IFA
Molecular Test: PCR

151
Q

Cite the Immunoassays and Molecular Techniques for these Parasitic Diseases

Malaria

A

Antigen Test: Rapid
Antibody Test: IFA
Molecular Test: PCR

152
Q

Cite the Immunoassays and Molecular Techniques for these Parasitic Diseases

Microsporidiosis

A

Antigen Test: IFA
Antibody Test: –
Molecular Test: –

153
Q

Cite the Immunoassays and Molecular Techniques for these Parasitic Diseases

Paragonimiasis

A

Antigen Test: –
Antibody Test: EIA, IB
Molecular Test: –

154
Q

Cite the Immunoassays and Molecular Techniques for these Parasitic Diseases

Schistosomiasis

A

Antigen Test: EIA
Antibody Test: EIA, IB
Molecular Test: –

155
Q

Cite the Immunoassays and Molecular Techniques for these Parasitic Diseases

Strongyloidiasis

A

Antigen Test: –
Antibody Test: EIA
Molecular Test: –

156
Q

Cite the Immunoassays and Molecular Techniques for these Parasitic Diseases

Toxocariasis

A

Antigen Test: –
Antibody Test: EIA
Molecular Test: –

157
Q

Cite the Immunoassays and Molecular Techniques for these Parasitic Diseases

Toxoplasmosis

A

Antigen Test: –
Antibody Test: EIA, IFA, LA
Molecular Test: PCR

158
Q

Cite the Immunoassays and Molecular Techniques for these Parasitic Diseases

Trichinellosis

A

Antigen Test: –
Antibody Test: BF, EIA
Molecular Test: –

159
Q

Cite the Immunoassays and Molecular Techniques for these Parasitic Diseases

Trichomoniasis

A

Antigen Test: DFA, LA, Rapid
Antibody Test: –
Molecular Test: DNA probe

Parasitology (6 decks)

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