Introduction Specimen collection, transport, handling, preservation, and processing Flashcards

1
Q

Termed as parasite gains entry into an unsuspecting host

A

Mode of Transmission

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2
Q

A parasite that cannot survive outside of a host

A

Obligatory Parasite

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3
Q

A parasite that is capable of existing independently of a host. Give 1 example

A

Facultative Parasite
Strongyloides stercoralis (lives inside and outside)

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4
Q

A parasite that is established inside of a host

A

Endoparasite

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5
Q

It is termed as “Infestation”

A

Ectoparasite

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6
Q

It is termed as “Infection”

A

Endoparasite

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7
Q

A parasite that is established in or on the exterior surface of a host

A

Ectoparasite

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8
Q

A parasite that occurs in an unusual host

A

Incidental Host

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9
Q

It is termed as where one that harbors the sexual phase of parasite development

A

Definitive Host

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10
Q

It is termed as where one that harbors the asexual phase of parasite development

A

Intermediate Host

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11
Q

Host harboring parasites that are parasitic for humans

A

Reservoir Host

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12
Q

It is termed as where the parasite-harboring host

A

Carrier

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13
Q

Parasite- Host Relationship:
“Living together”

A

Symbiosis

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14
Q

Association of two different species of organisms that is beneficial to one and neutral to the other

A

Commensalism

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15
Q

An example of Commensalism Parasite

A

Entamoeba coli

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16
Q

Association of two different species of organisms that is beneficial to both

A

Mutualism

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17
Q

Association of two different species of organisms that is beneficial to one at the other’s expense

A

Parasitism

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18
Q

Termed as where it is responsible for transmitting the parasite from one host to another

A

Vector

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19
Q

This vector is essential in the life cycle of the parasite

A

Biological Vector

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20
Q

This vector is not essential to the parasite but transport the parasite

A

Mechanical/ Phoretic Vector

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21
Q

Termed as reinfected with the same species

A

Superinfection

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22
Q

Give 2 parasite that can cause Superinfection

A

Strongyloides
Capillaria philippensis

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23
Q

Termed as parasite living inside the red blood cells. Give 1 parasite

A

Hematozoic
Plasmodium spp

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24
Q

When an infected person is his own source of re-exposure

A

Autoinfection

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25
Q

Termed as where a parasite living inside the cells of the tissues. Give 1 example

A

Cytozoic
Isospora

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26
Q

A parasite living inside the lumen of the intestines

A

Enterozoic

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27
Q

A parasite living inside the body cavities. Give 1 example

A

Coelozoic
Mansonella ozzardi

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28
Q

Termed as where a parasite which invades or becomes fixed in an organ or habitat

A

Erratic Parasite

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29
Q

A term where it lays the eggs which hatch after leaving the body of the host

A

Oviparous

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30
Q

A term in which the parasite lays eggs which hatch before leaving the host

A

Oviviparous

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31
Q

A term in which it bears living young instead of laying eggs. Give 1 example

A

Viviparous
Trichinella

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32
Q

Cestodes are
a. Tapeworm
b. Roundworms

A

Tapeworms

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33
Q

Nematodes are
a. Tapeworms
b. Roundworms

A

Round worms

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34
Q

An enlargement of areas such as
the breast, leg, and scrotum caused by a parasite’s presence

A

Elephantiasis

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35
Q

A single-celled
eukaryotic animal

A

Protozoa

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36
Q

Which of the following specimen type is most often submitted for parasite study?
A. Blood
B. Sputum
C. Urine
D. Stool

A

Stool

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37
Q

Which of the following correctly represents the three
major groups of clinically significant parasites?
A. Protozoa—worms; Metazoa—single-celled parasites; Arthropods—insects and their allies
B. Protozoa—insects and their allies; Metazoa—
worms; Arthropods—single-celled parasites
C. Protozoa—single-celled parasites; Metazoa—
worms; Arthropods—insects and their allies
D. Protozoa—single-celled parasites; Metazoa—
insects and their allies; Arthropods—worms

A

C. Protozoa—single-celled parasites; Metazoa—
worms; Arthropods—insects and their allies

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38
Q

The form of a
parasite that
enters a host

A

Infective Stage

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39
Q

A destructive
process that has
characteristic
symptoms

A

Disease

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40
Q

A host
responsible for
transferring a
parasite from one
location to
another

A

Transport Host

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41
Q

A Protozoan class that has an extruding cytoplasm

A

Sarcodina

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42
Q

This parasite causes the “Beaver Fever”

A

Giardia lamblia

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43
Q

Which are true
I. Giardia lamblia causes steatorrhea
II. Steatorrhea are fecal fats where it destroys the microvilli of the intestine
III. Giardia lamblia causes showering effect of trophozoite; jerky motility

a. I
b. II
c. I and II
d. I and III

A

c. I and II
- Giardia lamblia: falling leaf motility
- Trichomonas: jerky motility

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44
Q

What antibiotic can rule out Entamobea histolytica?

A

Metronidazole

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45
Q

What is the effects of metronidazole when given to patient?

A

Patient may die because of dehydration

46
Q

Viral dysentery may be caused by what virus?

A

Rotavirus

47
Q

What is the preferred amount for stool collection?

A

2-5 grams (walnut/peanut/thumb- sized)

48
Q

How many is required for collecting watery stool samples?

A

5-6 tablespoons

49
Q

This may be mistaken as adult nematode

A

Tissue fibers

50
Q

Stool Collection Protocol:
__ specimens collected in __ days

A

3 and 10

51
Q

Stool Collection Protocol:
__ specimens collected in __ days for Entamoeba histolytica

A

6 and 14

52
Q

What immunological test may be done to differentiate E. histolytica from E. dispar?

A

Polymerase Chain reaction (PCR)

53
Q

Processing time for stool samples:
a. Liquid stool:
b. Semi-Formed Stool:
c. Formed Stool:

A

a. 30 mins
b. 1 hour
c. up to 24 hours

54
Q

Stool samples from patients whose therapy includes barium, bismuth, or mineral oil should be collected prior to therapy or not until __ to __ days
after the completion of therapy

A

5 to 7 days

55
Q

Collection of specimens from patients who have taken antibiotics
or antimalarial medications should be delayed for how many weeks after following therapy

A

2 weeks

56
Q

Urine should not be allowed to contaminate the stool specimen because it may destroy?

A

Trophozoite

57
Q

True or False:
Stool should not be retrieved from toilet bowl water because
free-living trophozoite and nematodes may be confused with human parasites

A

FALSE
- it should be free living protozoan

58
Q

The specimen container should be labeled with

A

Patients Name
Age/Sex
Date and Time of Collection

59
Q

In the microscopic element of stool samples:
What can be seen in Semi-Formed stools?

A

Cyst & Trophozoite

60
Q

In the microscopic element of stool samples:
What can be seen in Formed stools?

A

Helminth eggs and larvae

61
Q

In the microscopic element of stool samples:
What can be seen in Liquid/Diarrheic stools?

A

Trophozoites

62
Q

What is the ratio of fixative to stool?

A

3:1

63
Q

What is the ratio of stool to preservative?

A

1:3

64
Q

True or False
Intake of antibiotics usually increase the number of protozoans for several weeks

A

FALSE
- decrease the number of protozoans

65
Q

What is the temperature for the temporary storage of fecal samples in a refrigerator?

A

3-5 degrees Celcius

66
Q

A preservation method describes as the simplest way to preserve a stool sample

A

Refrigeration

67
Q

Specimen for Diagnosis:
a. Urine is used for the recovery of
b. Sputum is used for
c. Blood is used for

A

a. T. vaginalis & S. haematobium
b. Paragonimus westermani and Larvae of nematodes
c. Malarial parasites, filarial worms, Leishmania and Trypanosoma

68
Q

A culture method used for Trypanosoma spp. and Leishmania spp.

a. In this culture method what is the inhibitor

A

NNN (Novy-MacNeal-Nicolle Medium)

a. Penicillin

69
Q

Specimen for Diagnosis:
Sputum should be digested with

A

4-5% Sodium hydroxide

70
Q

It is described as the screening method for Malarial Parasite

A

Thin Smears

71
Q

Thick smear lyses the ___ to see the malarial parasite

A

RBC

72
Q

What malarial parasite is known to cause Relapse & has an enlarge RBCS?

A

P. vivax
P. ovale

73
Q

This causes Strawberry Cervix

A

T. vaginalis

74
Q

These 3 parasite is described to have a “Larvae of Nematodes”

A

ASH
Ascaris, Strongyloides stercoralis, Hookworms

75
Q

Specimen for Diagnosis:
a. CSF is used for ______ species and collection is obtained from the

A

a. Acanthamoeba species; lumbar tap

76
Q

What are the diseases caused by Acanthamoeba species?

A

Granulomatous
Amebic Keratitis

77
Q

Specimen for Diagnosis:
I. Tissue aspirates:
a. Liver aspirates: _______ cysts and ______ abscess
b. Duodenal Aspirate is for _________ and _______ infection
c. Broncho-alveolar lavages is used for
d. Muscle is for ______
e. Rectal is for _______ secondary to ________

A

a. hydatid cyst and liver amoebic abscess
b. Giardia & Strongyloides
c. P. westermani (A. lumbricoides, HW, S. stercoralis)
d. T. spiralis
e. Granulomas secondary to Schistosomiasis

78
Q

Collection of Duodenal aspirate is done by ____________. This will test for the presence of hint SABS _______, _______, _______, _________ (Large intestines)

A

Sigmoidoscopy; Shigellosis, Schistosomiasis, Amoebiasis, Balantidiasis

79
Q

Duodenal Drainage/ String Test/ Enterotest is used to collect duodenal contents collected for _______ and ______

A

Giardia & Strongyloides

80
Q

TRUE OR FALSE:
String test makes use of a Nylon cord sticked in the outer cheek and capsule is being inserted to the mouth

A

TRUE

81
Q
  1. Most common parasite found in the urine
  2. Most common contaminant found in the urine
A
  1. T. vaginalis
  2. E. vermicularis
82
Q

What are the clearing agent used in Graham Scotch Tape Method?

A

Toulene & Xylene

83
Q

Processing of Blood Samples:
1. Fresh water smears is for the diagnosis of ________ and ______
2. (Thin/Thick) for the study of morphology of parasite and blood cells
3. (Thin/Thick) for malarial survey
4. What method is the most common way used for capillary method? (Finger prick or Venous Blood Sample)

A
  1. Trypanosomes & Microfilaria
  2. Thin Dry Smears
  3. Thick Dry Smears
  4. Finger Prick
84
Q

Thin or Thick Dry Smear: This has the process to dehemoglobinized the RBCS

A

THICK DRY SMEAR

85
Q

Thick Dry Smears:
a. How many drops of blood? and in diameter
b. Dehemoglobinized using
c. What can be seen in this smear

A

a. 2-3 drops of blood; 2 cm in diameter
b. Water
c. Cyst & Trophozoites

86
Q

Most preffered stain for Blood Parasites?

A

Giemsa

87
Q

CONSISTENCY OF STOOL
1. Rice water stool -
2. Pea soup -
3. Flattened/ Ribbon like -
4. Bulky/ Frothy -
5. Butter-like
6. Hard and Scybalous

A
  1. Cholera
  2. Typhoid (green and water)
  3. Spastic colitis, cancer, ulcer, tumors, syphilis
  4. Bile duct obstruction, pancreatic disorders
    such as in cases of steatorrhea
  5. Cystic fibrosis
  6. Constipation (goat droppings)
88
Q

COLOR OF STOOLS:
1. Yellow
a. Presence of ____ and _____
2. Red
a. used to treat TB

  1. Black/ Tarry
  2. Dark red/ Chocolate Brown
  3. Green
  4. Gray or Putty
  5. Blood-streaked mucus
A
  1. Bilirubin
    a. Santonin & Senna
  2. Lower GIT
    a. Rifampin
  3. Upper GIT bleeding
    - iron, bismuth, charcoal
  4. Upper GIT bleeding
  5. Biliverdin due to liver and hemolytic disorders, increased vegetable diet, calomel (anti-fungal)
  6. Bile duct obstruction
  7. Amoebiasis, Dysentery (amoebic or Bacilli), colitis, malignancies, constipation
89
Q

STOOL ODOR:
1. Sour/Rancid
a. Infant stool (______ from milk)
b. Adult stool: _______ due to the passage of excessive ______

  1. Putrid/Extremely Foul
A
  1. a. Fatty acids
    b. Steatorrhea; Carbohydate
  2. Ulcerate and malignant tumor of the lower bowel, alkaline stools, putrefaction of
    undigested protein by the bacteria present in
    GIT
90
Q

BRISTOL STOOL CHART
Type 1: Severe Constipation
- Separate, ___ lumps

Type 2: Mild Constipation
- Lumpy and _____ like

Type 3: Normal
- _____ Shaped with _____ in the surface

Type 4: Normal
- ______, _____ sausage or _____

Type 5: Lacking Fibers
- Soft ____ with _____ edges

Type 6: Mild Diarrhea
- _____ consistency with _____ edges

Type 7: Severe Diarrhea
- ______ consistency with no solid pieces

A

Type 1: Severe
- hard

Type 2: lumpy and sausage liked

Type 3: Normal
- Sausage shaped with cracks in the surface

Type 4: Normal
- smooth, soft sausage/ snake

Type 5: Lacking Fiber
- soft blobs with clear cut egdes

Type 6: Mild Diarrhea
- Mushy with ragged edges

Type 7: Severe Diarrhea
- liquid consistency

91
Q

DIAGNOSTIC PARASITOLOGY:
1. Giemsa Stain - prepared from ______ or commercially prepared stock solution

  1. Wright Stain: contains _______ where _______ is needed. Hallmark makes uses of
  2. Delafied Hematoxylin: detailed structure of _______
    - Hemoglobinized in 2% _____ with 1% ______
    - Stain: mixture of ______ and ____________
  3. Enumerate the 2 capillary tube method
    a. Hallmark of using Quantitative buffy coat
    b. Buffy coat has the junction of _____ and ______.
    c. Finger prick is collected using _________ capillary tube. What color?
    d. What color is the non-heparinized tube?
    e. 3 layers after centrifugation from bottom to top
    f. These 2 parasites are concentrated at the buffy coat portion
    g. White blood cell layer can be stained with _____ or _____ Stain
A
  1. powder
  2. alcohol, fixation
  3. microfilariae
    - 2% formalin with 1% acetic acid
    - hematoxylin and ammonuim alum
  4. Buffy Coat and Quanti Buffy Coat
    a. DNA satins
    b. Plasma and RBCS
    c. Heparinized; green
    d. Blue
    e. PRBC - White cell (buffy coat) - Plasma
    f. Leishmania& Trypanosomes
    g. Giemsa or Wright Stain
92
Q

Quantitative Buffy Coat:
a. Capillary tube is precoated with ________ and _______ which may be known as DNA stains
b. Useful in demonstration of malarial parasites such as (give 3)

A

a. Acridine orange
Potassium oxalate

b. Microfilaria, trypanosomes, Babesia

93
Q

Venous Blood Sample:
1. Knotts Concentration: ___ intensity with microfilariae
a. __ ml of blood mixed with __ ml of __% formalin

  1. Membrane Filtration: makes use of a syringe attached to a _____ filter holder
    a. How many ml of water should be added
A
  1. low intensity
    a. 10 ml of blood + 2% formalin
  2. Swinney Filter holder
    a. 10 m
94
Q

STOOL PRESERVATIVES : FORMALIN
a. How many % is used for protozoan cyst and trophozoite
b. How many % is used for helminth egg and larvae

c. Used for ____ examinations and _____ procedures but not for permanent stains. While _____ cannot be recovered

A

a. 5%
b. 10%

c. direct; concentration; trophozoite

95
Q

STOOL PRESERVATIVES:
1. Known to be an all purpose fixative

  1. Used for fresh stool samples and contains Mercuric chloride
  2. It is known to be the plastic resin w/c serves to adhere the stool
  3. Modified PVA and contains copper sulfate or zinc sulfate
  4. Acts as a moutant and adhesive
  5. Useful for intestinal protozoans, helminth eggs and larvae
  6. MIF
    a. Stain:
    b. Fixative
  7. A liquid fixative used to stain for Acid fast and detection of coccidian oocyst but has a poor adhesive property
A
  1. Formalin
  2. Schaudinn’s
  3. PVA
  4. PVA
  5. PVA
    6.Merthiolate Iodine Formalin
  6. a. Stain: Iodine
    b. Fixative: Formalin
  7. Sodium Acetate Formalin (SAF)
96
Q

MICROSCOPIC EXAMINATION:
1. Mistaken as Protozoans

  1. Mistaken as Yeast
    a. Hallmark of yeast
  2. Mistaken as Trophozoites of E. histolytica
  3. Disintegration of eosinophils
  4. Mistaken as S. stercoralis
  5. Mistaken as Taenia ova/ eggs
  6. Mistaken as larvae of nematodes
A
  1. PMNS
  2. RBCS
    - Budding
  3. Macrophages
  4. Charcot leyden crystals
  5. Plant cells/ fibers
  6. Pollen grains
  7. Plant / animal hairs
97
Q

CHEMICAL EXAMINATION:
1. FOBT - indicates hemorrhage in the ____
a. Principle:
b. Patient should be free from __ meat for ___ days

  1. Methods of FOBT
    a. most sensitive prone to false reaction
    b. most commonly employed
    c. fluorometric test for Hb and Porphyrin
A
  1. GIT
    a. Pseudoperoxidase activity of hemoglobin
    b. red meat for 3 days

2.
a. Benzidine
b. Guaiac
c. Hemoquant

98
Q

TECHNIQUES:
1. DFS
a. __ mg stool
b. useful for motile protozoan ______
c. ___% NSS for _____ BMB (_____ buffered Methylene blue)
d. Weak Iodine solution is used for _________ cyst
- __ % Lugols Iodine

  1. Kato Thick Smear
    a. Screening for ______ eggs/ ova
    b. KTS is Quali or Quanti?
    c. __ to __ mg of stool
    d. Examine within?
    e. Useful for ______ and _______
    -Not for ______ cyst and _______
A
  1. a. 2 mg
    b. trophozoite
    c. 0.85% NSS for motility
    - Nair buffered Methylene blue
    d. Protozoan cyst
    - 2% lugols iodine
  2. a. helminth eggs/ova
    b. Qualitative
    c. 50-60 mg of stool
    d. 10-20 mins
    e. Whipworm and Ascaris
    - Not for protozoan cyst and trophozoites
99
Q

Do we still need to report Commensal Parasite?

A

Yes, since there might be a pathogenic or non-pathogenic stain

100
Q

TECHNIQUES: CONCENTRATION
1.
a. T/F: recommended for heavy infection
b. Sedimentation: low or high SG
c. Flotation: low or high SG
d. Enumerate the layer from bottom to top

  1. Sedimentation
    a. Acid Ether Sedimentation Technique
    - Dissolves Albumin: ___%
    - Dissolves fats: ________
    - Recommended for ________, _________, & ________ hint TCT

b. Formalin Ether Sedimentation Technique
- T/F: Most commonly used
- Fixative: ___% Formalin
- Dissolves Fat:
- Substitute for ether:
- T/F: Can be done with formalin and PVA
- Useful for__________ eggs & ________ cyst

  1. Flotation
    a. Zinc Sulfate uses ___%
    - Specific Gravity of __ to __

b. Brines
- __________ table salt solution
- T/F: High Cost
- These two parasites are badly shunken: _______ & ________
- _______ eggs wont float

c. Sheather’s sugar
- _______ sugar preserved with _____
- Uses what type of microscope
- Useful for _________ cyst

A

1.
a. FALSE: light infection
b. Higher SG
c. Lower SG
d. Sediment - Formalin - Plug of debris - Ether

  1. a. Acid Ether
    - 40%
    - Ether
    - Trichuris, Capillaria, Trematodes

b.
- TRUE
-10% formalin
-Ether
- Ethyl acetate
- TRUE
- helminth eggs and protozoan cyst

  1. a. 33%
    - SG: 1.18 (fresh) to 1.20 (fixed)

b.
- saturated table salt
- FALSE: low cost
- Schistosoma and HW
- Operculated eggs wont float

c.
- boiled sugar preserved with phenol
- Phase contrast
- Coccidian cyst

101
Q

Which of the following parasitic stages is not usually detected after using a concentration technique?

A. Protozoan cysts
B. Protozoan trophozoites
C. Helminth eggs
D. Helminth larvae

A

B. Protozoan trophozoites

102
Q

STAINS
1. Modified AFS
a. identification of oocysts of the ________ species
b. T/F: Difficult to detect with routine stains such as trichome
c. Does not require _______

  1. Chromotrope Stain
    a. Uses various components of _________ stain
    b. Used to differentiate __________ spores from background ________ elements
    c. Prepare a _____ smear, __ uL of __% formalin fixed suspension
  2. Quick Hot Gram Chromotrope Stain
    a. T/F: Alternative stain to the chromotrope that is fast, reliable, and simple method to differentiate microsporidian
    b. Bring the slides to water before performing _____ stain
  3. Modified Safranin Technique
    a. Produces a more _____ staining of these ______
    b. Stains need to be ______ using either hot plate or microwave
  4. Trichome Stain
    a. Modification of _________
    b. Well stained smear of _________ protozoa, _____ cells, _____ and _____ materical
    c. Specimen: fresh stool or stool fixed in ___
    d. Color of E. histolytica cytoplasm
    e. Color of E. coli cytoplasm
  5. Calcofluor White
    a. Diagnosis for ___________ species
    b. A ________________ technique for the detection of ____________, _______________ species, _________________, _______________ species
    c. T/F: Considered as a quick screening tool but not for species identification
A
  1. Modified AFS
    a. Oocysts of coccidian spp
    b. True
    c. does not require Heating
  2. Chromotrope Stain
    a. Trichome stain
    b. microsporidia spore from bckgd fecal elements
    c. thin smear, 10 ul of 10% formalin
  3. Quick Hot Gram Chromotrope Stain
    a. TRUE
    b. Giemsa stain
  4. Modified Safranin Technique
    a. uniform staining of the oocysts
    b. heated
  5. Trichome Stain
    a. Gomori
    b. Intestinal protozoa, yeast, human cells, artifact material
    c. PVA
    d. E. histo: light pink
    e. E. coli: purple tint
  6. Calcofluor White
    a. Acanthamoeba spp
    b. chemfluorescent technique
    - microsporidia, Acanthamoeba, Pneumocystis jiroveci, Dirofilaria spp.
    c. TRUE
103
Q

The permanent stained smear is critical for detection of helminth eggs and larvae
A. True
B. False

A

B. False

104
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

105
Q

Give 2 parasites that can be seen in mouth scrapings

A

E. gingivalis and Trichomonas tenax

106
Q

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

A

B. False

107
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

C. Tissue

108
Q

In the collection and transport of stool
specimens for parasites, which parasitic
stage is most affected by the length of time
from collection to examination?
A. Cysts
B. Trophozoites
C. Oocysts
D. Helminth larvae

A

B. Trophozoites

109
Q

When using preservatives, what is the
appropriate ratio of fixative to stool?

A. One part fixative to one part stool
B. Two parts fixative to one part stool
C. Three parts fixative to one part stool
D. Four parts fixative to one part stool

A

C. Three parts fixative to one part stool

110
Q

One of the biggest disadvantages of formalin as a fixative for O&P is that:
A. It cannot be used for concentration
procedures.
B. It cannot be used for permanent stained
slides.
C. It cannot be used for direct microscopic examinations.
D. It cannot be used for detecting protozoan cysts

A

B. It cannot be used for permanent stained
slides.

111
Q

Give 3 parasites that can be recovered
using specialized culture methods

A

Entamoeba histolytica, Trichomonas vaginalis, Leishmania spp., Trypanosoma cruzi, Toxoplasma gond