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Clinical Bacteriology > (M) Lesson 9: Direct Sputum Smear Microscopy > Flashcards

(M) Lesson 9: Direct Sputum Smear Microscopy Flashcards

1
Q

Test to see whether there are TB bacilli present in the phlegm

A

Direct Sputum Smear Microscopy (DSSM)

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2
Q
  • To test this, the MedTech will smear phlegm on a thin glass slide with a special stain and look for TB bacilli on the slide under the microscope
  • This usually takes 1 day to get the results
A

DSSM

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3
Q
  • Main tool for the diagnosis of Pulmonary TB
  • It provides a definitive diagnosis of active TB
  • Active TB means it spreads/multiplies inside the body
A

DSSM

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4
Q
  • Simple and economical procedure
  • Usually easy to set up (All you need is a skilled microscopist, compound microscope and materials for sputum smear)
A

DSSM

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5
Q
  • Is an infectious disease caused by Mycobacterium tuberculosis
  • It is an illness in which the bacteria are multiplying, attacking a part of the body (usually the lungs)
A

TB Disease

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6
Q
  • TB disease that occurs in lungs
  • If a patient is infected, it produces cough that lasts 3 weeks or longer
A

Pulmonary TB

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7
Q
  • A condition which TB bacteria are alive but inactive in the body
  • Patient with latent TB do not have symptoms and cannot spread TB to other people
  • Usually have a positive TB skin test
A

Latent TB Infection

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8
Q
  • TB disease in any part of the body other than the lungs
  • Example: Kidney, Spine, Brain, or Lymph Nodes
A

Extra-Pulmonary TB

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9
Q
  • Liquid that is injected under the skin during TB skin test to diagnose latent TB infection.
  • PPD stands for Purified Protein Derivative
A

Tuberculin or PPD

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10
Q
  • Directly observed therapy
  • You will meet the health worker everyday for several weeks in the health center
A

DOT

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11
Q
  • Good Ventilation
  • Table/bench to prepare smears
  • A sink or plastic basin to stain smears
  • Table/bench for Microscope and paper works
  • Non-slip flooring
  • Area for receiving of specimens
A

Basic requirements for TB Microscopy Laboratory

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12
Q

Zone Divisions in TB Laboratory

For microscopy, record keeping and storage areas

A

Clean Zone

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13
Q

Zone Divisions in TB Laboratory

Specimen receiving, and smear preparation and staining are performed

A

Dirty Zone

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14
Q
  • Moving in a single direction
  • You may open your windows or fan for proper ventilation, but the airflow should still be unidirectional
  • Clean to dirty areas
A

Unidirectional airflow

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15
Q

Potential Hazards

  • Coughing is a good mechanism for producing aerosols through droplet nuclei.
  • Provide a designated area for sputum collection.
A

Sneezing or Coughing by TB patients

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16
Q

T or F: Patients are allowed to collect sputum in the bathroom.

A

F (not allowed)

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17
Q

Potential Hazards

  • It still produces aerosol
A
  • Flaming a wire loop with adherent sputum
  • Heat fixing the smear while still wet
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18
Q

Potential Hazards

  • One of the most common potential hazard (in the whole laboratory)
  • Wear PPEs in handling specimen
A

Poor handling of specimen

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19
Q

Potential Hazards

  • Ensure proper storage of reagent and use small containers
A

Fire from flammable reagent

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20
Q

Familiarize yourself with the safety practices in TB laboratory.

A
  • Assume ALL specimens are potentially infectious
  • Never smoke, eat or drink in the laboratory
  • Wash hands with soap and water at least before and after performing any procedure
  • Keep the windows open to establish airflow in working areas
  • Quantities of flammable reagents should be safe, cool and in well-ventilated storage place
  • Formation of aerosols must be avoided as strictly as possible
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21
Q

T or F: We should reject broken or leaking containers.

A

Teh, edi T

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22
Q

____ is a potential hazard to the laboratory personnel

A

Leaking containers

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23
Q

Once collected, allow the sputum specimen to stand undisturbed for ____ before opening to settle any aerosol.

A

at least 20 minutes

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24
Q

Open sputum containers with care and away from the face to prevent ____.

A

Splashes

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25
Q

How do we remove residual sputum?

A

Swirl the wire loop in the sand or beads containing 70-90% alcohol before sterilizing in a flame to prevent aerosol.

26
Q

N95 vs. Surgical Masks

  • Do not filter out infectious droplet nuclei
  • Does not significantly reduce the risk of infection by aerosol inhalation
A

Surgical Masks

27
Q
  • Effective respiratory protection is expensive and must be fitted correctly to be functional
  • Offer better protection against respiratory aerosols
  • Designed to filter airborne particles compared to surgical masks that filters larger particles and block splashes
A

N95

28
Q

T or F: Do not reuse gloves and never wear gloves outside the laboratory.

A

T

29
Q

T or F: Remove gloves before operating equipment to avoid contamination

A

T

30
Q
  • Always wear gloves in performing laboratory procedures
  • Change ASAP if they are dirty or torn
A

T

31
Q

How should laboratory coats be worn?

A
  • Fully buttoned with sleeves down
  • Should cover the entire upper body because it will give you extra protection
32
Q

How do we handle accidental contamination on the bench or the floor?

A
  1. Place a paper towel or cloth over the spill area and apply disinfectant solution such as 5% hypochlorite/phenol
  2. Stand for 15-20 minutes
  3. Clean the contaminated material and put it inside the waste container
  4. **For final wash: ** clean with 70% alcohol
  5. Wash hands thoroughly
33
Q

The success rate of obtaining a positive smear will also depend on the?

A

Quality of specimen

34
Q
  • Should contain mucoid or mucopurulent material
  • Should be obtained from the lower respiratory tract rather than the sample consisting saliva
A

Good quality sputum

35
Q

Contains pus, composed of white blood cells, cellular debris, dead tissue, serous fluid, and viscous liquid (mucus)

A

Purulent sputum

36
Q
  • Typically yellow or green
  • Seen in cases of bronchitis or acute upper respiratory tract infection (common cold, laryngitis)
A

Purulent sputum

37
Q
  • Often described as off-white, yellow, green, opaque and sometimes red coloration
  • Idicates large amount of white blood cells
A

Mucopurulent sputum

38
Q

A good quality sputum should contain?

A
  • Mucoid
  • Mucopurulent
  • Bloodstained material (tinge of blood)
  • Thick consistency
39
Q

Indicators of saliva?

A

Mostly composed of bubbles that are thin and watery

40
Q

Ideal Specimen Container

Familiarize.

A
  • Volume capacity of 50 mL
  • Made of transparent material
  • Wide-mouthed (at least 35 mm in diameter)
  • Screw-capped
  • Leak-proof and unbreakable
  • Easily labeled walls
  • Single-use combustible material
41
Q

Labels to be put on the container?

A
  • Patient name
  • Date and Order of Collection
  • Laboratory Serial Number
42
Q

These are pulmonary specimens.

A
  • Sputum (Expectrorate and Induced)
  • Laryngeal Swab
  • Bronchial Secretions
  • Pleural Effusions
  • Gastric Lavage/Aspirate
43
Q

Specimen of choice for detection of Tb

A

Sputum

44
Q

Produced by inhalation of warm aerosol of strike 5-10% sodium chloride in water produced by nebulizer

A

Induced Sputum

45
Q
  • Indicated for children who produce almost no sputum
  • Rarely used for adults
A

Gastric Lavage/Aspirate

46
Q

Extra-pulmonary Specimen

A

Collected Aseptically
* Body Fluids

Not Collected Aseptically
* Urine
* Semen and Prostate secretions
* Stool samples

47
Q

How many sputum specimens are recommended for the laboratory diagnosis of TB?

A

Two

48
Q

Identify the type of sputum collection.

  • Specimen 1: Specimen is collected anytime of the day
  • Specimen 2: Early morning collection
A

Spot Early Morning Collection

49
Q

Identify the type of sputum collection.

  • Two consecutive sputum specimen, collected on the same day at least 1 hour apart
A

Spot-Spot Collection (Frontloading)

50
Q

Hi, please study how to prepare a smear as well as the staining methods <3

Nasa transes ni Anne mwa.

A

Good luck !!

51
Q

How to examine a smear?

A

Scan the smear by moving across the smear in horizontal direction (end to end).

52
Q

Read ____ before reporting a negative result. If no AFB is seen in one length, examine another horizontal length of the slide.

A

at least 300 visual fields

53
Q

Usually ____ may be read if the slide is positive for AFB.

A

100 fields

54
Q

National Reporting Scale for AFB

No AFB seen in 300 visual fields

A

0

55
Q

National Reporting Scale for AFB

1-9 AFB seen in 100 visual fields (write the actual number of AFB seen)
Example: +1, +2, +3, +4

A

+n

56
Q

National Reporting Scale for AFB

10-99 AFB seen in 100 visual fields

A

1+

57
Q

National Reporting Scale for AFB

1-10 AFB/OIF in at least 50 visual fields

A

2+

58
Q

National Reporting Scale for AFB

More than 10 AFB/OIF in at least 20 visual fields

A

3+

59
Q

Hello me ulit, please study and read the prevention of false-positive and false-negative sputum results hehe.

A

Go bff!!

60
Q

Consequences of False Positivity

A

Unnecessary treatment (wastage of drugs)

61
Q

Consequences of False Negativity?

A
  • Patient remains untreated, resulting in suffering, spread of TB and death
  • Intensive phase treatment may not be extended, leading to inadequate treatment

Clinical Bacteriology (33 decks)

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