Specimen Collection And Handling Flashcards
During SCH we need to use
Use clean, dry, wide-mouthed, leak-proof containers with a screw cap
Containers must not contain
dirt, urine, or water contamination.
Why do we need to bring or send the specimen to the lab as soon as it is voided
To prevent deterioration of protozoans and morphological alterations
We must note patients
Name/identifier and date/time collection on the cotainer
Request form includes
Patients name
Age
Sex
Date/time collection
Requesting physician
Requested procedure
Presumptive diagnosis
Prior infection
Travel history
In collecting spx, we must collect
Freshly passed stool
Liquid spx
5ml or 5-6 tbsp
Solid spx
20-40g (thumb size)
Recommend for collection
Directly on the continer
Toil bowl method
Infants diaper
On paper and scoop after
We must reject spx
Contamintion urine & water
Collection from soil
With evidence of barium
Liquid fecal beyond 60 mins
Formed stool beyond 24hrs
Contaminated with water can kill
Trophozoites
Contamination with urine can kill
Ascaris lumbricoides
______ in urine kills or deactivates the ova
Ammonia
nonpathogenic free-living parasite are presents which looks the same
Collection from soil
Used in radiologic test
Barium
barium leaves behind a residue that makes fecalysis difficult
Barium enema
administered to their large intestines via the
anus to highlight in the x-ray and inspect for
abnormalities
Barium
Decreases the number of protozoan for several weeks
Intake of antibiotics
Leave crystalline residues that can interfere with fecalysis
Intake of drugs/medicinal substances
Remedy of intake of drugs and antibotics
Collect prior to intake
Factors to consider
Intakes of drugs/medicinal suns
Intakes of antibiotics
Anti-diarrheals
is a body mechanism to eliminate toxic pathogens inside
Anti-diarrheals
Collection must be done a _____ after the last intake or administration of any of these drugs
Week
Store at ____ and maintain it in cool temperature (inside a box with coolant) during transport
4-8°C
Preservatives use for wet mount examination
10% formalin
Preservatives used for specimen that req staining
Polyvinyl alcohol or PVA
Ratio
3:1
3 parts preservative to 1 part stool
Color of stool
Black
Brown
Yellow
Green
Consistency
Formed
Soft
Loose
Watery
Recommended for cyst
Formed
Recommended for trophs
Watery
Always note the presence of _________ and _______ in the stools
Mucus and blood streaks
Prioritize examination of _____ stools especially those with
mucus or blood as they may contain _________
Liquid stool
Motile amoeba
__________ must be examined ideally within 30 minutes after passage
Watery spx
____________ must be examined ideally within 1 hour after passage
Soft spx
___________ must be examined within 12 hours after passage
Formed spx
Positive stools are mixed with moistened soil or granulated charcoal placed in a cheesecloth and submerged in a water in a funnel
Copro culture
COPRO CULTURE Principle:
Rhabditiform larvae transforms to Filariform larvae with the presence of water
__________ notorious to have water tropism (water attraction)
Filariform larvae
Harvest larvae using
Baermann technique
Increases the chances of recovering Strongyloides from samples
Harada mori or test tube culture method
Positive stool is applied to the filter paper and placed into a test tube with ___ of boiled or distilled water
7 ml
The tube is incubated at ____ C for up to___.
24-28°C
10 days.
______ migrate to the water and transform into filariform larvae.
Strongyloides rhabditiform larvae
If the patient cannot expectorate,______________________ may be used
10% sodium chloride or hydrogen peroxide
Examine consistency of sputum
Serous
Mucoid
Purulent
Bloody
Test using wet mount ___________ or
concentrate by adding an equal amount of 3% NaOH, mix,
centrifuge, and perform wet mount on the sedi
saline or iodine for trophozoites
Sputum examination detects
→ migrating larvae of Ascaris lumbricoides
→ Strongyloides stercoralis
→ Hookworms
→ Paragonimus [westermani] ova - reside in the lungs (most of the time isolated in the sputum)
→ Pulmonary hydatid cysts of Echinococcus granulosus
→ Trophozoites from pulmonary amebic abscess by
Entamoeba histolytica
[The act of _________ the phlegm creates the possibility of having sputum present in the stool sample]
Swallowing
Examination of urine may be use to detect
Trichomonas vaginalis
Schistosoma haematobium
Prefer in urinary bladder and it is not common in ph
Schistisoma haematobium
pingpong motility which travels from one field to another [Females are symptomatic, Males are otherwise]
Trichomonas vaginalis
3 COMMON Schistosoma
● Schistosoma mansoni
● Schistosoma japonicum
● Schistosoma haematobium
_______ for the demonstration of __________in amebic liver abscess cases
Liver aspirates
Entamoeba histolytica trophozoites
Aspirate on the ________ of the abscess, not
on the center
margins or the walls
Duodenal aspirates for
Giardia lambia
Strongyloides stercoralis
A capsulated yarn is swallowed by the patient and reach the duodenum
Intestinal intubation or entero test/string test
Retrieve after___ hours and examine the mucoidal material clinging to the yarn
4
Cutaneous ulcerations in________
Leishmaniasis
Aspirate below the___ bed using a sterile needle
Ulcer
Prepare a smear and stain with______
Giemsa stain
CSF may demonstrate the presence of the trypomastigotes of_________ and the trophozoites of______
Trypanosoma spp
Naegleria
Immediate Examination of csf is needed within ______
20 minutes
CSF must be centrifuged at_________
discard the supernatant, and examine the sediment
7,000 g for 10 minutes,
Useful in the diagnosis of Trichinella spiralis infection (presence of encapsulated larvae)
Muscle biopsy
Can reveal the presence of deposited Schistosoma japonicum eggs
Rectal biopsy
_______ is a routine method of stool examination primarily useful in the detection of motile protozoan trophozoite.
DFS
About___ of stool (Amount forming a cone at the tip of an applicator stick)
2 mg
Inportance of dfs
● To detect motile trophozoites.
● To detect ova and cysts present in moderate number.
● To detect erythrocytes, leukocytes, cellular debris or
excess fat.
Recommended specimens are___________ and samples that ______________
FRESH STOOL SPECIMENS
HAS NOT BEEN refrigerated nor preserved.
Materials neee for dfs
Applicator stick
Cover slide
Microscope glass slode
Permanent market
Beaker
Pipette
Lugols iodine soln
0.85% Nss
Characteristics of imperfect smear
● Improper patient identification
● Mismatched sample and patient
● Insufficient and/or excessive stool sample
● Insufficient and/or excessive reagents
● Incomplete mixing of specimen and reagent
● Presence of fecal debris
● Bubble formation
● Uneven distribution of mixture
● Crooked/Offset/Slanted Cover Slips
● Leakage of mixture on the edge of the slip and slide
Aside from parasites, we may also see the following:
→ White blood cells/pus cells: PMNs or eosinophils
→ Red blood cells
→ Fat globules
→ Macrophages which may be mistaken for amoebic trophozoites
→ Charcot-Leyden crystals
▪ by products of the degradation of eosinophil
granules
→ Epithelial cells from the intestinal tract
→ Eggs of arthropods, plant nematodes, and spurious
parasites
→ Fungal spores
→Plant elements: fibers, cells, pollen grains, starch
granules, vegetable spirals
→ REMEMBER:_____________ is
IMPORTANT before doing any examination!
→ Make sure to work on a _________
Proper patient identification
flat and steady surface
Degradtion of eosinophil granules
Charcot leyden crystals
