OTHER NON-BLOOD SPECIMENS Flashcards by arabella erivera

• To evaluate fertility and post vasectomy
procedures
• Abstain from sexual activity for 3 days and not
longer than 5 days before collecting the sample

semen

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(t or f)
semen

• Collected at the laboratory in a warm sterile
container
- Collected by the male patient [not the doctor,
not the medical technologist]
- Our responsibility as medtech is to provide
instruction

true

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• Test we do for semen
• Record the time of sample collection, and the
sample receipt, on the requisition form because certain parameters of the semen analysis are based
on specimen life span

SEMENALYSIS

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The time that the semen is placed on the
sample container must be recorded
We have to actually wait 1 hour at minimum
from collection before testing it [semen is a
very viscous fluid, semen will exhibit
liquefaction (nagiging malabnaw ang semen)
and makes it easier to handle]

SEMENALYSIS

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• Kept at 37 degree Celsius [incubators meant for
microbiology]

Fructose and prostaglandins content
Must view under microscope (to see sperm)
We really do not manually count to the millions;
we use glassware such as counting chambers
[use formulas to get millions]

SEMENALYSIS

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• Surrounds the brain and spinal cord to supply
nutrients to the nervous tissue
- Originate at the central nervous system
- Middleman of CNS and blood vessels [BV
doesn’t attach to the tissues in the CNS, there is
a blood-brain barrier]

CEREBROSPINAL FLUID (CSF)

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• Produce a barrier to cushion the brain and
spinal cord against trauma
• Routinely collected by lumbar puncture [inserting
of needle; serves as tract (gripo)] between the third,
fourth, or fifth lumbar
vertebrae

CEREBROSPINAL FLUID (CSF)

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the who will will collect
CSF

Physician

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Clear and colorless
- To diagnose meningitis, subdural hemorrhage, and
other neurological disorders

Normal CSF:

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performed on CSF:
- Cell counts,
- Chemistry tests (chloride, glucose, total
protein)

Routine tests

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(t or f)

• There should no red blood cell in CSF [subdural
hemorrhage, if there is rbc]
• WBC is normal, but should be in few amounts
only

true

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• “Joint fluid”
• Clear, pale- yellow, viscous fluid that lubricates and
decreases friction in movable joint
- Allow movement without causing damage to the
bones
• Normally occurs in small amounts but increases when inflammation is present

SYNOVIAL FLUID

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Collected by the doctor [puncture between the
joints;: arthrocentesis; usual site: knee]

SYNOVIAL FLUID

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Collected in three tubes:

for cell counts, identification of crystals, and smear
preparation

EDTA or heparin tube

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Collected in three tubes:

tube for culture and sensitivity

sterile tube

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Collected in three tubes:

for macroscopic appearance,
chemistry, and immunology tests and to
observe clot formation

Non-additive tube

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are microscopic tests for synovial fluid

Leukocyte count and neutrophils

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[gout: increase in uric acid] [should not
see _______ in synovial fluid (normally)]

Crystals

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• Pale-yellow, watery, serum-like fluid found between
the double-layered membranes enclosing the
pleural, pericardial, and peritoneal cavities
[digestive organs; expand withour damaging each
other is because of the presence of serous fluid]
• Lubricates the membranes and allows them to slide
past one another with minimal friction [causing
minimal tissue damage]

SEROUS FLUID

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• Normally present in small amounts, but volumes
increase when inflammation or infection is present
or when serum protein levels decrease
• Fluid that is collected by the physician

SEROUS FLUID

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• Increase in fluid volume: EFFUSION
• Collected in: - EDTA tubes if cell cunts or smears are ordered
[microscopy]
- Heparin or sodium fluoride tubes for chemistry
tests [glucose, protein immunologic tests]
- Non-anticoagulant tubes for biochemical tests
- Sterile heparinized tubes for cultures

SEROUS FLUID

body fluid
aspirated from the pleural space,
or cavity, surrounding the lungs

Pleural fluid

body fluid:

aspirated from the abdominal cavity

Peritoneal fluid

aspirated from the pericardial cavity surrounding the heart

Pericardial fluid

• Clear, almost colorless to pale- yellow fluid that fills the membrane (amnion or amniotic sac) that surrounds and cushions a fetus in the uterus

AMNIOTIC FLUID

• Preferably collected after 15 weeks of gestation (pregnancy) and is obtained by a physician using a procedure called

transabdominal amniocentesis

• Can be analyzed to detect genetic disorders such as Down’s syndrome, identify hemolytic disease resulting from blood incompatibility between the mother and fetus, and determine gestational age • Most common reasons: to detect problems in fetal development and assess fetal lung maturity

AMNIOTIC FLUID

• levels: used to estimate gestational age of the developing fetus • is normally sterile and must be collected in a sterile container - Aluminum foil or carbon paper [alternative]

AMNIOTIC FLUID

• The specimen should be protected from light to prevent breakdown of bilirubin and delivered to the laboratory ASAP • Specimens from chromosome analysis must be kept at room temperature • Specimens for some chemistry tests must be kept on ice (or refrigerator temperature)

AMNIOTIC FLUID

• An antigen normally present in the human fetus that is also found in amniotic fluid and maternal serum

ALPHA-FETOPROTEIN (AFP)

is initially performed on maternal serum, and abnormal results are confirmed by amniotic fluid ____testing - Can also be seen in adults also, but in very small amounts; marker for liver disorder

ALPHA-FETOPROTEIN (AFP)

problems in fetal development (such as neural tube [pre-cursor to the brain and spinal cord] defects or the potential for Down’s syndrome)

Abnormal AFP levels

• Can be assessed by measuring the amniotic fluid levels of substances called ___________which act as surfactants to keep the alveoli of the lungs inflated • Results are reported as a lecithin-to-sphingomyelin (L/S) ratio

FETAL LUNG MATURITY, phospholipids

• Lungs are most likely to be immature if the L/S ratio is less than 2 • Amniotic fluid testing to assess fetal lung maturity may be ordered on or near the patient’s due date and is often ordered stat when the fetus is in distress

FETAL LUNG MATURITY

examines stomach contents for abnormal substances and measures gastric acid concentration to evaluate stomach acid production

Gastric analysis

• Aspirating a sample of gastric fluid by means of a tube passed through the mouth and throat (oropharynx) or nose and throat (nasopharynx) into the stomach after a period of fasting tested to determine acidity prior to stimulation • Fasting sample (patient should not have eaten for a certain period of time) • First collected

BASAL GASTRIC ANALYSIS

• After the basal sample has been collected, a gastric stimulant, commonly histamine or pentagastrin, is administered intravenously and several more gastric samples are collected at timed intervals • All specimens are collected in sterile containers • The role of the phlebotomist in this procedure: - Help label specimens - Draw blood for serum gastrin (a hormone that stimulates gastric acid secretion) determinations

BASAL GASTRIC ANALYSIS

• Mucus or phlegm that is ejected from the trachea, bronchi, and lungs through deep coughing • For the diagnosis, or monitoring of lower respiratory tract infections such as Tuberculosis (TB)

SPUTUM

FYI: The microbe that causes TB

acid-fast bacillus (AFB),

and the sputum test for TB is often

AFB culture

(t or f) sputum test: A minimum of 3-5 mL is typically required for most tests

true

• A less invasive, painless alternative to blood collection for obtaining cells for DNA analysis • The phlebotomists collects the sample by gently massaging the mouth on the inside of the cheek with a special swab - Swabs are included in DNA testing [sterile]

BUCCAL SWABS

• DNA is later extracted from cells on a swab • Often, these samples are collected for legal purposes such as paternity testing: therefore, follow strict COC protocol

BUCCAL SWABS

• Fluid secreted by glands in mouth • Used to monitor hormone levels and detect alcohol and drug abuse (recent drug use) - Marker for recent drug use

SALIVA

specimens for hormone tests, however, are typically frozen to ensure stability and sent to a laboratory for testing • The containers for this specimen has markers up until where the specimen should be collected

SALIVA

• Collected for trace an heavy metal analysis and the detection of drugs of abuse • Use of ______samples for drug testing is advantageous because hair is easy to obtain and cannot be easily altered or tampered with (unlike urine and saliva)

HAIR (AND NAILS)

shows evidence of chronic drug use rather than recent use - Ample size is grams - Scalp hair

hair

• Collected and analyzed for hydrogen content in one type of lactose tolerance tests and to detect the presence of Helicobacter pylori (H. pylori) • Collected by the patient but assisted by a medical technologist

BREATH

• This test s based on the fact that H. pylori produces urease, an enzyme that breaks down urea but is not normally present in the stomach

C-UREA BREATH TEST (C-UBT)

• Helps identify problems with the digestion of carbohydrates such as lactose (milk sugar) and fructose (fruit sugar) and is thought to be the most accurate lactose tolerance test • Can also be used to detect bacteria overgrowth in the small intestine

HYDROGEN BREATH TEST

• Tissue specimens from biopsies may also be sent to the laboratory for processing • Most tissue specimens arrive at the laboratory in formalin or another suitable solution and need only be accessioned and sent to the proper department

TISSUE SAMPLES

• It is important for the phlebotomist to check the procedure manual to determine the proper handling for any unfamiliar specimen - For example, tissues for genetic analysis should not be put in formalin • Improper handling can ruin a specimen from a procedure that is, in all probability, expensive, uncomfortable for the patient, and not easily repeated

TISSUE SAMPLES