(P) Lec 2: Specimen Collection, Procedure and Fixatives Flashcards
Rupert-based
A laboratory section where we test urine and other bodily fluids are processed under the microscope
Clinical Microscopy section
HEADS UP
some cards are associating qs, so select all the possible correct answer
“Both” or “All of the Above” and “NOTA” is implied if wala sa options… basta confident ka sa sagot mo, ok?
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choose mo lang wrong answer kapag pinapahanap ko okay?
parasite ka kaya madali nalang ‘to sa’yo eme mahal ko kau sipag nyo para aralin si sir jerny
refers to the eggs stage of the parasites
Ova
This encompasses the other morphologic forms
Parasites
Microscopic examination
A. Collection
B. Transport
C. Fixatives
D. ALL
D
typical stool collection protocol consists:
A. 3 collected in 10 days
B. 5 collected in 14 days
A
Certain medications and substances may interfere with the detection of parasites, except:
A. antidiarrheal medicines
B. antacids
c. mineral oil
d. barium
nota
Stool is collected:
A. 3 and a half days after the completion of therapy
B. a week after antimalarial medications
C. a week after therapy
C
Specimen container:
A. has 4g of stool
B. made of waxed cardboard or plastic
both
Specimen container, except:
A. Travel history
B. Collector’s name
C. Address
D. Clinical findings
C
TOF. Urine contamination is not allowed as it may destroy some parasites.
T
recommended time frame for liquid stool within?
30 minutes
to preserve the stage of amoeba
stage of amoeba
invasive to the skin tissue and fast to die
trophozoites
TOF. Cysts live in watery environment to move and attack tissues.
F (tropho)
Incorrect holding time
A. Formed: 24 hrs
B. Semi-formed: 120 mins
C: liquid stool = 30 mins
B: should be within 1 hr
substances that preserve the morphology of protozoa and prevent further development/stages of certain helminth eggs and larvae
fixatives
ratio of fixative to stool specimens
3:1
hindi tatlong tae
Recovery
Formalin
PROTOZOA and HELMINTHS
protozoa—amoeba, flagelates, ciliated
helminths—nematodes, trematodes, and cestodes (worms)
incorrect concentrations of formalin are commonly used.
A. 5% ideally preserves protozoan cysts
B. 5% ideally preserves larvae
C. 10% concentration preserves helminths eggs
B
10% concentration preserves helminths eggs and larvae
preservative
not for permanent smears:
A. formalin
B. pva
C. schaudinn
A
Advantages of Formalin, except
A. Easy to prep
B. Long shelf life
C. For smear or staining
C
Disadvantages of Formalin
A. Trophozoites cannot be recovered
B. Morphologic details of cysts and eggs may fade
C. Can cause eye irritation or teary eye
All
PVA
A. act as an adhesive
B. useful for the fixation of intestinal protozoans, helminth eggs and larvae
A
PVA
A. preparation of a permanent stained smear
B. added to Schaudinn’s solution
both
A disadvantage of PVA because the solution contains mercuric chloride.
Schaudinn
PVA
A. Long shelf live when stored at cold temperature
B. Antigen test is positive
NOTA
A. warm temperature
B. negative
Methiolate AKA
timerosal
TOF. MIF is a 2 in 1 that acts as a staining and preservative, similar to formalin.
F (formalin is only a preservative)
MIF
A. easy to prepare
B. yields unsatisfactory results
C. easy identification of protozoans
B
useful for the fixation of intestinal protozoans, helminth eggs and larvae.
A. MIF
B. Formalin
C. PVA
A
Sodium Acetate Formalin
A. Toxic-free
B. Multiple vials
NOTA
Can be used for performing concentration techniques and permanent stained smears.
A. MIF
B. SAF
C. PVA
D. Formalin
B
SAF Advantages
A. protozoa is clear
B. addition of albumin to the microscope slide
C. long shelf-life
D. A & C
C
SAF Disadvantages
A. addition of albumin to the microscope slide
B. protozoa is not clear
Both
Alternative Single-Vial System
A. free of formalin
B. usef for concentration techniques
both
Alternative Single-Vial System
A. used for intestinal protozoans
B. free of mercury
C. used for permanent smears
D. B & C
E. A & C
D
Applicable Lab Procedures: Positive Concentration
Choose all that applies
A. 10% formalin
B. SAF
C. PVA
D. Modified PVA
E. Single-vial system
All
Applicable Lab Procedures: Positive or negative Concentration
Choose all that applies
A. 10% formalin
B. SAF
C. PVA
D. Modified PVA
E. Single-vial system
C & D
Applicable Lab Procedures:
Does not use permanent stain. Choose all that applies:
A. 10% formalin
B. SAF
C. PVA
D. Modified PVA
E. Single-vial system
A
Applicable Lab Procedures:
Uses trichrome as a permenent stain. Choose all that applies:
A. 10% formalin
B. SAF
C. PVA
D. Modified PVA
E. Single-vial system
C, D, E
Applicable Lab Procedures:
Only uses iron hematoxylin as a permanent stain. Choose all that applies:
A. 10% formalin
B. SAF
C. PVA
D. Modified PVA
E. Single-vial system
B
Applicable Lab Procedures: Antigen test is negative
Choose all that applies:
A. 10% formalin
B. SAF
C. PVA
D. Modified PVA
E. Single-vial system
C, D & E
Applicable Lab Procedures: Positive antigen tests.
Choose all that applies:
A. 10% formalin
B. SAF
C. PVA
D. Modified PVA
E. Single-vial system
All except PVA
Applicable Lab Procedures: Positive or negative antigen test
Choose all that applies:
A. 10% formalin
B. SAF
C. PVA
D. Modified PVA
E. Single-vial system
D & E
Elements which may found in stool specimens
A. macrophages for amebic cysts
B. epithelial cells for trophozoites
C. animal hairs may look like trophozoites
B
Correct
A. macrophages for amebic trophozoites
B. epithelial cells for trophozoites
C. animal hairs may look like helminth larvae
- Is used to measure objects observed microscopically accurately.
- Is a disk that is inserted into the eyepiece of the microscope.
- Calibration is necessary
Ocular Micrometer
Ocular Micrometer
diagnostic stages of parasites detected microscopically are measured in units known as
A. nm
B. µm
C. mm
B. microns
Ocular Micrometer
TOF. Obsolete
T
Direct Wet Preparations
A. the presence of cysts is being detected
B. 0.85% saline solution (NSS) is the reagent of choice
B
A. the presence of motile protozoan trophozoites is being detected
suggested size for the glass slide
3x2
size of the square cover slip
22mm
Direct Wet Preparations
Trophozoites can be stained to demonstrate the nuclear morphology using?
Nair’s buffered methylene blue solution (BMB)
Nair’s buffered methylene blue solution (BMB)
A. Entamoeba cytoplasm stains pale blue
B. nucleus stains darker blue
both
TOF. If the specimen is received in fixative, the direct wet preparation can be done from the O&P procedure.
F (eliminated from the procedure)
the concentrate and permanent stain techniques are performed.
Objective
fixed or smear slides
OIO
Objective
fresh slides
LPO or HPO
Objective
pus cells or rbcs
HPO
Objective
epithelial cells or muscle fibers
LPO
Direct Wet Iodine Preparation
A. enhance the detail of the protozoan TROPHOZOITES
B. destroy the cysts stage of protozoan
NOTA
May be made to enhance the detail of the protozoan cysts.
It destroy the TROPHOZOITES stage of protozoan.
Direct Wet Iodine Preparation
Stain
Lugol’s or D’Antoni’s formula
Lugol’s or D’Antoni’s formula
A. cytoplasm will stain orange
B. nucleus will be pale and refractile
C. glycogen will be deep red
B
the cytoplasm will stain golden yellow, the nucleus will be pale and refractile, and the glycogen will be deep brown.
Direct Fecal Smear
A. Adapted from (WHO 1994).
B. Basic microscopic technique
Both
Kato-Thick Smear
stool is placed over a glass slide and covered with cut?
cellophane paper
Kato-Thick Smear
Weight of stool
50 to 60 mg of stool (approximately the size of two mongo beans)
Kato-Thick Smear
The cellophane paper is soaked in
A. glycerine
B. carbon fusin
A
glycerine and malachite green solution
Kato-Thick Smear
a clearing solution
glycerine
Kato-Thick Smear
used to give color to the cellophane in order to give a pale green background to the eggs and to minimize the brightness of the microscopic field
Malachite green
Kato-Thick Smear
can also be used if malachite green is not available
Green cellophane
Kato-Thick Smear
A. Ascaris and Trichuris
B. Hookworm
C. protozoan cyst and trophozoites
A
detecting eggs with thick shells such as in Ascaris and Trichuris
Kato-Thick Smear
TOF. If the preparation is too long before examination, hookworm eggs become too transparent or distorted making identification very difficult.
T
10-20 minutes is the preparation to best examined the smear
These techniques use differences in specific gravity and centrifugation to separate the parasites from fecal debris and increase their recovery.
Concentration Methods
Concentration Methods
A. might be detected using wet preparations
B. used for low concentration of parasites
C. be performed on fresh or preserved stool specimens.
D. trophozoites do not survive
All of the Above
Two types of Concentration methods
Sedimentation and floatation
Parasites are concentrated in the sediment of the tube following centrifugation; the parasite settles at the bottom
Sedimentation
the parasites are less dense than the solutions used and, during centrifugation, they float to the surface
Floatation
FEAS Procedure
A. Methyl acetate is added to a saline-washed formalin-fixed sample
B. Based on specific gravity
B
Formalin- Ethyl Acetate Sedimentation Procedure
Ethyl acetate is added to a saline-washed formalin-fixed sample and the tube is then centrifuged.
Formalin- Ethyl Acetate Sedimentation Procedure
Disadvantage:
A. Difficult to perform
B. Does not provide good recovery of most parasites
C. contains more fecal debris than a flotation technique
C
Acid Ether Concentration Technique (AECT)
A. Reagents are 20% HCl and Ether
B. also for animal stool
C. does not recover Trichuris, Capillaria, and trematode eggs especially Schistosoma
D. most widely used sedimentation technique.
B
AECT
A. possible destruction of protozoan cysts
B. loss of parasite to the plug of debris
Both
Formalin Ether Concentration (FECT)
A. recovery of both helminth eggs and protozoan cysts
B. uses 10% formalin
Both
FECT
A. Only uses formalin
B. More parasites can be recovered from formalin-preserved samples
B
Can also be done with formalin-preserved and PVA- preserved stools.
FECT
TOF. Parasite morphology is also better preserved in formalin than in PVA.
T
Formalin Ether Concentration (FECT)
creates 4 layers which are?
- ether and dissolved fats,
- fecal debrie,
- formol water
- and sediment
FECT
At what layer are the parasites present?
Sediment
Flotation Technique
based on differences in specific gravity between the sample debris, which in this case is heavy and sinks to the bottom of the test tube, and potential parasites, which are lighter and float toward the top of the tube
Zinc Sulfate Flotation Technique
Formol-Ether Sedimentation Technique was adapted from?
Cheesbrough 2009 (modified), WHO 1994
Zinc Sulfate Flotation Technique
Zinc sulfate with a specific gravity of
A. 1.130 - 1.200
B. 1.180 - 1.200
C. 1.200 - 1.480
B
Zinc Sulfate Flotation Technique
Main reagent
33% ZnSO4 solution is the main reagent. in 1000ml of water
Sheather’s Sugar Flotation
A. BEST for the recovery of trophozoites
B. use of a phase microscope
C. Boiled sugar solution preserved with formalin
B
With this procedure, visualization of oocysts can be better appreciated through the use of a phase microscope.
Sheather’s Sugar Flotation
Is considered as the BEST for the recovery of coccidian oocysts, mainly (3)
Cryptosporidium, Cyclospora and Isospora
Sheather’s Sugar Flotation
Boiled sugar solution preserved with?
phenol
Brine Flotation
A. saturated table salt solution
B. specimen directly mixed with brine solution
C. not useful for operculated eggs
All
Brine Flotation
A. Centrifugation is needed
B. hookworm and Schistosoma become badly shrunken
C. Useful for Clonorchis, and heterophyids
B
- Centrifugation is not needed since helminth eggs rise to the surface of the solution.
- Not useful for operculated eggs like Clonorchis, and heterophyids because these do not float in brine solution
final procedure in the O&P examination
A. Direct Wet Preparation
B. Concentration methods
C. Permanent Stains
C
as a microscope slide that contains a fixed sample that has been allowed to dry and subsequently stained
A. Smear
B. Permanent Stain
C. Direct Wet Iodine Preparation
B
Permanent Stain
Designed to confirm the presence of:
A. protozoa cysts
B. trophozoites
Both
Permanent Stain
Allows laboratory technicians to observe detailed features of protozoa by staining?
intracellular organelles
Permanent Stain
reviewed under what objective?
OIO
Permanent Stain
A. a hundred fields are reviewed
B. Modified acid-fast stain
B
Permanent Stain
Two common stains are used for routine O and P testing and these includes?
modified acid-fast and modified trichrome stain
Wheatley Trichrome:
A. Time-consuming
B. stained clearer and sharper
C. excellent morphology of the intestinal protozoa
D.uses distinct color differences among the structures
D
Iron-Haematoxylin:
A. Easy to perform
B. Most widely used permanent stain
C. Helminth eggs are very dense and will not float
D. Less fecal debris is removed
C
Specialized Stain
A. do not detect oocysts of the coccidian parasites
B. do not detect spores of microsporidia
C. modified acid-fast stain
D. modified trichrome stain
All of the above
TOF. Modified acid-fast stain has become an important permanent stain procedure for the detection of the oocysts of Cryptosporidium, as well as those of Isospora and Cyclospora
T
galing!
Modified Acid-Fast Stain
Has been developed that incorporates what step (reagent)?
carbol fuchsin
Modified Acid-Fast Stain
A. other protozoa are normally recovered using wheatley trichome
B. detection of acid-fast parasites
B
Modified Acid-Fast Stain
Cryptosporidium sp. oocysts stained with trichrome creates a color red appearance due to the addition of?
Ziehl Neelsen
Stool Culture Methods: Coproculture
A. Positive stool is applied to the filter paper and placed into a test tube with about 7cc of boiled or distilled water.
B. Positive stools are mixed with moistened soil or granulated charcoal.
B
TOF. Harada Mori simulates environmental conditions in nature.
F (Coproculture)
Coproculture
Larvae are harvested using what procedure?
Baermann procedure
- Positive stool is applied to the filter paper and placed into a test tube with about 7cc of boiled or distilled water.
- Use of test tubes and filter paper strips
Harada-Mori or the Test Tube Culture Method
Harada-Mori or the Test Tube Culture Method
TOF. Filariform larvae will generally move upward against the downward capillary movement of water
F
downwards against the upward capillary movement
Harada-Mori or the Test Tube Culture Method
TOF. Strongyloides larvae may move upwards and accumulate at the upper end of the filter paper strip.
T
Harada-Mori or the Test Tube Culture Method
Temperature:
Environment:
Days:
Temperature: 25c
Environment: Dark
Days: 7
Harada-Mori or the Test Tube Culture Method
A. Discard the supernatant
B. Discard the sediment
A
Kato Katz Method
the main determinant for the sensitivity of this technique
consistency of the stool
kato = konsistency
Kato Katz Method
A. some drier stools yield higher egg counts than moist ones
B. only be done on liquired and preserved samples
A
Kato Katz Method
TOF. Can only be done on fresh formed stools.
T
Kato Katz Method
1% eosin solution can be layered over the cellophane paper for the identification of?
Schistosoma ova
Skistosoma
Kato Katz Method
This solution can help in the visualization of the miracidium (larval stage of parasitic flatworms like schistosoma).
1% eosin solution
It saponifies fat and frees eggs from fecal debris
Stoll Egg Count
Stoll Egg Count
A. 0.1N NaOH
B. stool displacement flask
C. Similar to Kato Katz
ALL
Stoll Egg Count
a stool displacement flask calibrated at?
56mL and 60 mL
Stoll Egg Count
stool diluent
NaOH
Stoll Egg Count
Amount of diluted stool used for egg counting is measured by?
stoll pipettes
Stoll Egg Count
stoll pipettes are calibrated at?
0.075 mL and 0.15mL
Perianal Swab
A. Used to recover eggs of Enterobius vermicularis
B. Used to recover Taenia spp.
Both
Perianal Swab
This migrates out throughout the anus at night time, and deposits eggs on the perianal skin
Enterobius gravid female
gravid; nanganak yung parasite ganern
Perianal Swab
TOF. Entamoeba spp. gravid segments can crawl out of the anus and in the process, ova are squeezed out of the segment and are deposited on the perianal skin
F (Taenia spp)
Stool Screening Methods AKA
rapid methods.
Stool Screening Methods
Can be obtained as kits that contain?
monoclonal antibodies
Stool Screening Methods
TOF. This commercial antibody is used to detect antigens in patient specimens.
T
Stool Screening Methods
Current assays include
A. enzyme immunoassay (EIA)
B. direct fluorescent antibody (DFA)
C. membrane flow cartridge
All
Stool Screening Methods
TOF. Highly sensitive and specific but they only detect one or two pathogens at a time.
T
Stool Screening Methods
TOF. It is technically demanding as the O&P examination
F
Duodenal Material
Specimen may be collected by:
A. Fecal test
B. Enterotest
C. Urine test
B
+ nasogastric intubation
TOF. Cysts must be examined promptly in duodenal fluid because they easily disintegrate.
F (Trophozoites)
Duodenal Material
simpler method for collecting duodenal material without requiring intubation
Enterotest
nasogastric intubation–your doctor or nurse will insert a thin plastic tube through your nostril, down your esophagus, and into your stomach. Once this tube is in place, they can use it to give you food and medicine
Duodenal Material
Enterotest is inteded for?
A.Giardia Duodenalis trophozoites
B. Helminth eggs
C. Taenia spp.
A
Enterotest is inteded for?
A. Strongyloides larva
B. Cryptosporidium coccocels
C. Giardia Duodenalis trophozoites
All
Enterotest
TOF. A gelatin capsule that contains a coiled length of nylon should be swallowed by the patient.
teh Yarn lang
Duodenal Material
The capsule dissolves in the stomach and the weighted string is carried to the?
duodenum
Duodenal Material
TOF. The free end of the string is wrapped to the patient’s tongue.
F (neck or cheek with tape)
Duodenal Material
hours of incubation?
4 hours
Doudenal Material
The bile stained mucous material brought up on the string is then examined microscopically via (2):
A. concentration methods
B. wet preparation
C. permanent stain
B & C
Sigmoidoscopy
Can be performed by doctors and RMTs.
F (doc lang)
Sometimes, there’s something inserted in the ass hole to clearly see the intestine
Sigmoidoscopy
Sigmoidoscopy
Often helpful for detecting?
E. histolytica.
Sigmoidoscopy
Material from ulcers obtained by aspiration or scraping should be examined by?
direct wet preparations and permanent stains
Sigmoidoscopy
may be recovered
A. E. histolytic
B. Coccidian parasites
C. microsporidia
ALL
Sigmoidoscopy
TOF. Samples suspected to contain microsporidia are best processed using surgical pathology methods.
F (amoeba)
Cellophane Tape Preparation
the specimen of choice for the detection of?
Enterobius vermicularis (pinworm)
Cellophane Tape Preparation AKA
Otherwise known as the Graham technique or scotch tape swab
Cellophane Tape Preparation
A. afternoon specimens are the ideal time to collect the sample
B. a a total 8 specimens should be collected daily before ruling out
C. method should be done after washing the anal area to see persistent parasites
NOTA
Blood parasites recovered in the blood, except:
A. Trypanosoma gambiense
B. T. rhodesiense
C. T. cruzi
NOTA
kasama lahat sa trypanosoma spp.
Blood parasites recovered in the blood, except:
A. Leishmania donovani
B. Plasmodium
C. Microfilaria
D. Taenia spp.
E. Babesia spp.
D
Some parasites (e.g., Trypanosoma spp., microfilariae; nematodes) that can be detected by observing motility under low- and high-power magnification.
Fresh Wet Preparation
Fresh Wet Preparation
TOF. Species identification is not possible for this method.
T
Stained Smears
prepared from 2-3 small drops of blood which are mixed and spread with continuous movement over an area which is about 2m in diameter
THICK
Thick Smear:
A. thick at one end and thin and feathery at the other end
B. dehemoglobinized prior to staining
C. most useful in species identification of malarial parasites
B
Thin smear:
A. rapid diagnosis of malarial infection
B. used in the demonstration of microfilariae
C. slides are fixed with methanol before staining
C (applicable to thick also)
Stains for blood parasites
preferred stain because it allows for the detection of parasite detail necessary for species identification
Giemsa Stain
Giemsa Stain
A. RBC = white
B. WBC = purple
C. Eosinophils = deep brown
D. Neutrophils = light pink purple
B
Giemsa Stain
A. Sheath = clear
B. Cytoplasm = light blue
C. Nuclei = purple
D. Schuffner’s dots = black
A
Stain of choice for peripheral blood smear preparation or hematology
Wright’s stain
Wright’s stain
TOF. Fixation is needed.
F (because it already contains alcoho)
Wright’s stain
Stained smears show:
A. WBC = Bright blue nuclei
B. eosinophilic = bright purple red
C. neutrophilic = pink
All
Delafield hematoxylin
A. Useful in demonstrating the detailed structures of entamoeba.
B. thick films are dehemoglobinized in 2% formalin with 1% acetic acid
C. The main stain is a mixture of hematoxylin and sodium hydroxide
B
Delafield hematoxylin
Stained smears could be permanently mounted with?
A. canada balsam stain
B. trichome stain
C. acid fast stain
Canada balsam or permount
Capillary Tube Method
After centrifugation, there will be three (3) layers:
Red cell layer
White cell layer
Plasma
Capillary Tube Method
Microfilariae and trypanosomes can be readily visualized under a microscope at what area of the tube?
buffy coat area
Capillary Tube Method
TOF. Trypanosomes and Microfilaria are concentrated at the buffy coat portion.
F (tryp and leishmania)
TOF. The capillary tube can be broken down at the area of the white cell layer after centrifugation of the capillary tube
T
Capillary tube method
White cell layer can be spread and stained with?
A. Giemsa
B. Wright’s stain.
Both
Quantitative Buffy Coat
Makes use of a capillary tube which is precoated with?
acridine orange and potassium oxalate
Quantitative Buffy Coat
This is inserted to enlarge the layers
Cylindrical float
Quantitative Buffy Coat
After centrifugation, the tube is read using an?
ultraviolet microscope
Quantitative Buffy Coat
DNA of the parasites takes up the what stain causing fluorescence among the non-fluorescing red blood cells.
A. acridine orange
B. potassium oxalate
A BADINGGGGG
Useful in the demonstration of malaria parasites, microfilariae, trypanosomes and Babesia
Quantitative Buffy Coat
Designed to concentrate blood specimens suspected of containing low numbers of microfilariae.
Knott’s Concentration
Knott’s Concentration
1 mL of venipuncture collected blood can be mixed with 10mL (9mL) of ?
2% formalin
Knott’s Concentration
Kind of smear?
Thick
Knott’s Concentration
After drying, it is subsequently stained using?
Giemsa-stained
Also useful when the density of microfilariae is low.
Membrane Filtration
Makes use of syringe attached to a Swinney filter holder
Membrane Filtration
Membrane Filtration
mL of fresh or anticoagulated blood
1
Membrane Filtration
lysed by adding?
10mL of distilled water
Membrane Filtration
lysed blood is then passed through the?
Swinney membrane filter
Membrane Filtration
What will be recovered from the Swinney membrane filter
microfilariae
membrane filtration
TOF. The membrane filter can be examined like a wet smear preparation or may be dried, fixed and then stained.
T
Specimens submitted for culture:
A. bone marrow
B. percutaneous
C. dirt under the nails
A
medium is an example f common culture medium designed for the recovery of Leishmania spp. and Trypanosoma cruzi.
Novy-MacNeal-Nicolle (NNN)
Culture
This is inoculated by the addition of a single drop of collected blood or ground tissue.
NNN Slant
Culture
added to the medium if the specimen originates from a source that may contain bacteria
Penicillin
For the diagnosis of amebic conditions and African sleeping sickness
Cerebrospinal Fluid and Other Body Fluids
Parasites found in the CSF
NATToMiTE
* Naegleria fowleri
* Acantamoeba spp.
* Trypanosoma spp. Trypomastigotes
* Toxoplasma gondii
* Microsporidia
* Taenia solium cysticercus larvae
* Echinococcus spp
CSF and Other
If Naegleria or Acantamoeba are suspected of being potential pathogens, the specimen can be cultured on?
non-nutrient agar seeded with Escherichia coli
CSF and Other
The CSF sediment is inoculated to the medium, sealed, and incubated at?
35c
Other Sterile Fluids:
A. Fluid present in cysts
B. Aspirates
C. Peritoneal fluid
D. Pleural fluid
E. Bronchial washings
ALL
Sputum
best time of collection
Specimen should be collected early in the morning
TOF. Saliva is not appropriate for examination
T
Sputum
May be examined directly via:
A. wet iodine preparation
B. n-acetylcysteine
Both
What specimen can this be seen?
Paragonimus westermani
Strongyloides stercoralis
E.histolytica, E. gingivalis, Ascaris lumbricoides and hookworms
Sputum
Tissue and Intestinal Biopsy
TOF. Not recommended for the recovery of a number of parasites, including intracellular.
F
Tissue and Intestinal Biopsy
Is the preferred method for handling these samples
impression smears
Tissue and Intestinal Biopsy
Organisms:
A. Trypanosoma spp.
B. Trichinella spiralis
C. Microsporidia
ALL
napagud na aq
the specimen of choice for patients suspected of liver abscesses caused by E. histolytica
HEPATIC ABSCESS
Urine and Genital Specimen
Specimen of choice for the detection of?
Schistosoma haematobium eggs, Trichomonas vaginalis trophozoites
Urine and Genital Specimen
TOF. Microfilariae can sometimes be found
T
with a heavy filarial infection
Genital Specimen
What are usually collected and examined for the presence of T. vaginalis trophozoites?
Vaginal, urethral specimens and prostatic secretions
Genital Specimen
A. collected in a swab of collection up with a lid
B. Iodine wet preparations
A
Genital Specimen
MEthod of choice
Saline wet preparations
Alternative techniques for the diagnosis of Trichomonas vaginalis includes, except:
Latex agglutination
Surgical removal
EIA
Nucleic acid probe
Culture methods
Surgical removal
Eye Specimens
This parasite best diagnosed by the collection and examination of corneal scrapings (aka touch prep or pressure smear)
A. keratitis
Eye Specimens
Ways on processing the samples:
A. Wet preparation
B. Scrapings and stained using the calcofluor white
B
Eye Specimens
color of Acantamoeba cysts
apple green
Eye ba organisms
oo
Acanthamoeba
T. gondii
Microsporidia
Loa loa
Mouth Scrapings or Nasal Discharge
Naegleria fowleri
Nasal
Mouth Scrapings or Nasal Discharge
E. gingivalis
Trichomonas tenax
Mouth
Skin scrapings
Useful in the detection of?
Onchocerca volvulus
Skin scrapings
this may be made using one of two collection techniques
Skin snips
Skin scrapings
TOF. Bleeding during scraping is usually normal.
F (make sure no bleeding)
Skin scrapings
TOF. Other techniques uses a razor blade with which a small cut into the skin is made.
T
Appropriate specimens from patients suspected of suffering from Leishmania and Trypanosoma and Toxoplasma
Animal Inoculation and Xenodiagnosis
a technique used for the diagnosis of Chagas’ disease
Xenodiagnosis
Utilize white mice to grow schistosomes into adults and the feces of the animal are collected for the eggs
Circumoval Precipitin Test (COPT)
Circumoval Precipitin Test (COPT)
Produces what that can cause precipitation reactions on the eggs of the parasites
antibodies
COPT
TOF. For Babesia spp.
F
COPT
TOF. Recovers S. mansoni and S. japonicum.
T
COPT
What result is BLEB formation on the eggs
Positive result
COPT
Incubation
34ºC for 24 hours
COPT
In a well slide, how much of the patient’s serum is placed?
3 drops or 0.075mL of the patient’s serum (blood)
COPT
After the addition of the serum, add 1 drop of?
egg suspension
COPT
cover glass, rimmed with a thin layer of what??? is placed on top of the well, to prevent drying of mixture
petroleum jelly
