specimen management Flashcards
what is the goal of the collector in specimen collection?
maintain the viability of organisms with minimal contamination
if possible, collect specimen in the _____ of the infection and _____ are administered.
acute phase (or within 2-3 days for viral infections), before antibiotics
specimens are collected in what kind of container?
sterile
what type of swab is used for upper respiratory tract specimen?
pre-moistened swab
type of swab that contain excessive fatty acids
cotton-tipped swabs
this counteracts and absorbs fatty acids when added to media.
charcoal
this type of swab is used for viral isolation
nylon flocked swab
what is the appropriate specimen collection for your wounds?
needle aspiration
what are the specimens that patient can collect by themselves?
-urine
-sputum
-stool
what is the ideal time for specimen transport
within 30 mins of collection, preferably within 2hrs
time duration of specimen collection for fungal culture, hair, and nail scrapings
72 hrs
time duration of specimen transport of unpreserved urine
30mins
if transport is delayed, under what conditions can the specimen be maintained by storage
-preservatives
-anticoagulants
-transport or holding medium or culture media
what type of preservation is used to maintain urine colony counts
Boric acid
type of preservation used for stool for ova and parasite examination
polyvinyl alcohol (PVA) and buffered formalin
type of bacterial infection procedure that should be collected WITHOUT a preservative but can be refrigerated
Clostridium difficile toxin assay
at what temperature should your stool be preserved when transport is delayed for >48hrs
frozen at -70 dec C
what cannot be added to fecal specimens for bacteriological testing
preservatives (fixatives)
type of holding media for stool specimen if delay is >2hrs
Cary-Blair transport media
contains substances that do not promote the multiplication of microorganism
transport or holding media
this prevent clotting of specimens, including blood, bone marrow, and SVF
anticoagulants
the most appropriate/common anticoagulant used for microbiology specimens
sodium polyanethol sulfonate at 0.025%
at what ratio is your SPS for blood
10:1 ratio
it is added to counteracts the action of SPS
additional of 1% gelatin
type of anticoagulant used for viral cultures and isolation of Mycobacterium spp.
Heparin
at what temperature should your blood be stored at
less than or equal to 2hrs at ROOM TEMP
what is the goal of shipping infectious substances
to safeguard employees in the transportation and the general public
the three layers of your triple package consists of:
primary receptable
secondary container
third receptable
this layer should be watertight, leak-proof, and labeled properly
primary receptable
this layer is sealed and placed into sturdy outer container constructed of fiberboard
secondary receptable
this layer protects the secondary container from physical damage during transport
third receptable
what level requires immediate processing
level 1 (critical/invasive)
what level is unprotected and may quickly degrade
level 2
what are the levels of specimen prioritization
level 1-critical
level 2-unpreserved
level 3-quantitation required
level 4- preserved
the most common clinical specimen used in laboratory for microbio culture
Blood
when can blood be drawn
during the time of febrile (fever) episode
type of disinfectant used for the venipuncture site
chlorhexidine-alcohol (70% alcohol, 2% chlorhexidine, 2% tincture of iodine)
type of disinfectant used for the cap of the blood culture bottles
70% isopropyl alcohol
what is the recommended skin antiseptic for blood culture
chlorhexidine gluconate
how many mL of blood can be collected per day
60ml
_______ will satisfy the requires volume of the sample to detect bacteremia
3 sets of blood culture
what is the limited set can be drawn in a 24-h period
not more than 4
recommended blood-to-broth ratio
1:5 to 1:10
specimen of choice for urine culture
Clean-voided midstream (CVS)
specimen of choice in urine for molecular studies
first morning specimen
how many ml should pass before collecting remainder of urine
catheterized specimen
collected directly in the bladder for anerobic culture
suprapubic aspirate
this aspirates 5-10ml with needle and syringe
indwelling catheter
specimen of choice for the detection of GI pathogens
Stool
how many specimens can be collected for bacterial infection
3 specimen (once a day for 3 days)
how many specimen can be collected for parasitic infection
3 specimens within 10 days
what stain used for observing fecal WBCs
methylene blue
if pxn received antiparasitic drug, when can specimen be collected
after 7 to 10 days
when can specimen be collected when undergoing barium studies
until the barium has cleared (4 to 5 days)
what appears white chalky substance in the stool when viewed under the microscope
barium
type of specimen used to diagnose bacterial pneumonia
sputum
preferred specimen for AFB microscopy
first early morning specimen
basis if the sputum is rejected if it represents the saliva and not the lower respi secretions
bartlett’s criteria
for sputum samples to be accepted for cultivation, there should be ______ and_______ per LPO
<10 squamous epithelial cells, >25 pus cells
how many tubes need or is required in collecting CSF
3 tubes
what type test is done in 1st tube
chemistry
type of test is done in 2nd tube
Microbiology
in collecting 2nd tube of CSF, how much is collected for bacteria, virus
≥ 1mL
in collecting 2nd tube of CSF, how much is collected for AFB, fungi
≥ 2mL
test done in the 3rd tube of CSF specimen
hematology
at what temp and duration should the CSF be stored
6 hours at 35-37 deg c
specimen of choice for the recovery of bordetella pertussis
nasopharynx sawb
in nasal swab its not needed to do___, but instead _____
gram stain, direct culture
recommended specimen for the routine culture of group A streptococci
Throat/pharynx swab
used to diagnose STDs or Venereal diseases
Genital specimen: cervix
the site of collection for cervix
endocervical canal
traditional specimen of choice of chlamydia trachomatis
urethra swab
types of abscess
superficial and deep
type of abscess, which swabs along the outer edge
superficial
type of abscess, which aspirate with needle and syringe and place on an anaerobic transport system
deep
this specimen instill local anesthetic before collection
corneal scrappings
in direct examination of corneal scrapings, the use of ________ assist with location of specimen
10mm frosted ring slides
involves the preparation of samples for microscopy and culture
specimen processing
allows the processor to determine the adequacy of the specimen and the need for special processing
gross examination
an indicator of an anaerobic infection
presence of a necrotic tissue samples (black discoloration)
in preparation of swabs how many swabs must be used
two swabs
the preferred instrument for smears from thin liquid
cytocentrifugation
a useful tool that provides rapid information
direct microscopic examination
direct examinations are usually not performed on:
throat
nasopharyngeal
vagina, cervix, and anal crypts
stool specimens
what specimens are inoculated directly onto selected media
sterile body fluids
pus
urine
sputum
methods for concentration of your specimen
centrifugation and filtration
what chemical reagent is used to dislodge material from the fibers of the swab
vortexed (mixed) in 0.5 to 1ml of saline or broth
if the volume of fluid is ___, the specimen ca be ________ at _____.
> 1mL,centrifuged for 20 mins at 3000g
minimum concentration to visualize bacterial cells by light microscopy
10^5 bacteria cell/1mL
this indicate a life-threatening situation that need to be acted on promptly
critical values
what is the primary plate
BAP
CHOC
MAC
IV catheters are inoculated for ______
semi-quantitative maki roll plate
aids in the diagnosis of catheter-related infection
semi-quatitative maki roll plate
how many colonies must be present after incubation to perform identification and susceptibility test
15 or more colonies
conjunctiva on plate should be transported_____
within 15mins at room temp
what are swabbed in the genital specimen: vagina
secretion from the mucous membrane of the vagina
this isolates helicobacter pylori
gastric biopsy
for rectal swab what chemical is utilized to observe fecal leukocytes
methylene blue
what are specimen that are under in the level 1
amniotic fluid, blood, brain, CSF, pericardium fluid, heart valves
specimens under the level 2
drainage from wounds, feces, sputum, tissue
what specimen are under level 3
catheter top, urine, and tissue for quantification
what specimen is under the level 4
feces and urine in preservative, swabs in holding medium
