SPUTUM, BAL, SWEAT Flashcards

1
Q

Tracheobronchial secretions are a mixture of

A

Plasma, electrolytes, mucin, water

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2
Q

Most important single component of sputum viscosity

A

Sialic acid

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3
Q

Acceptable sputum specimen criteria

A

<10 SEC/LPF and >/= 25 WBC/LPF

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4
Q

Preferred sputum specimen collection time

A

First morning

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5
Q

24-hour sputum collection use

A

Volume measurement

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6
Q

Pediatric sputum collection method

A

Throat swab

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7
Q

Non-cooperative patient sputum collection

A

Sputum induction

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8
Q

Debilitated/unconscious patient sputum collection

A

Tracheal aspiration

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9
Q

Sputum specimen preservation methods

A

Refrigeration or 10% formalin

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10
Q

Decreased sputum volume causes

A

Bronchial asthma, acute bronchitis, early pneumonia, stage of healing

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11
Q

Increased sputum volume causes

A

Bronchiectasis, lung abscess, edema, gangrene, tuberculosis, pulmonary hemorrhage

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12
Q

Colorless or translucent sputum indicates

A

Mucus only

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13
Q

White or yellow sputum indicates

A

Increased pus (TB, bronchitis, jaundice, pneumonia)

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14
Q

Gray sputum indicates

A

Pus and epithelial cells

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15
Q

Bright green or greenish sputum indicates

A

Bile, P. aeruginosa infection, lung abscess

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16
Q

Red or bright red sputum indicates

A

Fresh blood, hemorrhage, TB, bronchiectasis

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17
Q

Anchovy sauce or rusty brown sputum indicates

A

Old blood, pneumonia, gangrene

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18
Q

Prune juice sputum indicates

A

Pneumonia, chronic lung cancer

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19
Q

Olive green or grass green sputum indicates

A

Cancer

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20
Q

Black sputum indicates

A

Dust, carbon, charcoal, anthracosis, smoking

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21
Q

Rusty sputum with pus indicates

A

Lobar pneumonia

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22
Q

Rusty sputum without pus indicates

A

CHF

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23
Q

Currant jelly-like sputum indicates

A

Klebsiella pneumonia infection

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24
Q

Foul or putrid sputum indicates

A

Lung gangrene, advanced necrotizing tumors

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25
Q

Sweetish sputum indicates

A

Bronchiectasis, tuberculosis

26
Q

Cheesy sputum indicates

A

Necrosis, tumors, empyema

27
Q

Fecal odor sputum indicates

A

Liver abscess, enteric gram-negative bacterial infection

28
Q

Mucoid sputum indicates

A

Asthma, bronchitis

29
Q

Serous or frothy sputum indicates

A

Lung edema

30
Q

Mucopurulent sputum indicates

A

Bronchiectasis, tuberculosis with cavities

31
Q

Yellow or gray material, pinhead-sized, with foul odor when crushed

A

Dittrich plug

32
Q

Significance of Dittrich plug

A

Bronchitis, bronchiectasis, bronchial asthma

33
Q

Hard bronchial concentrations (lung stones), yellow/white calcified TB structure

A

Pneumoliths or broncholiths

34
Q

Broncholiths are commonly seen in

A

Histoplasmosis, chronic tuberculosis

35
Q

Branching tree-like bronchial casts are seen in

A

Lobar pneumonia, bronchitis, diphtheria

36
Q

Layers of sputum formation

A

1st (top) - frothy mucus

37
Q

Foreign bodies in sputum indicate

A

Bronchial calculi, asbestos bodies, silica particles

38
Q

Pneumoconiosis macroscopic structures

A

Foreign bodies

39
Q

Elastic fibers in sputum indicate

A

Tuberculosis

40
Q

Pigmented cells in sputum clinical significance

A

CHF, heavy smokers

41
Q

Heart failure cells in sputum

A

Hemosiderin-laden macrophages

42
Q

Carbon-laden cells in sputum microscopically

A

Angular black granules

43
Q

Coiled mucus strands in bronchial asthma

A

Curschmann’s spirals

44
Q

Colorless globules resembling blastomyces

A

Myelin globules

45
Q

Cluster of columnar epithelial cells in bronchial asthma

A

Creola bodies

46
Q

Parasites seen in lungs

A

A. lumbricoides, Strongyloides, hookworms, E. histolytica, E. gingivalis, T. tenax, P. westermani, E. granulosus, T. canis

47
Q

Important diagnostic test for P. jirovecii (P. carinii)

A

Bronchoalveolar lavage (BAL)

48
Q

Best stain for delineating P. jirovecii cysts

A

Grocott’s methenamine silver stain

49
Q

Most predominant cell in BAL

A

Alveolar macrophages (56-80%)

50
Q

Cells in BAL for interstitial disease, pulmonary lymphoma, nonbacterial infections

A

Lymphocytes (1-15%)

51
Q

Cells increased in cigarette smokers, bronchopneumonia, toxin exposure

A

Neutrophils (<3%)

52
Q

Cells in BAL for hypersensitivity reactions

A

<1-2%

53
Q

Percentage of ciliated columnar bronchial epithelial cells in BAL

A

4-17%

54
Q

Test used to diagnose cystic fibrosis

A

Sweat test

55
Q

Autosomal recessive disorder affecting mucous-secreting glands, associated with pancreatic insufficiency, respiratory distress, and intestinal obstruction

A

Cystic fibrosis

56
Q

Electrolyte increased in sweat in cystic fibrosis

A

NaCl

57
Q

Test to induce sweat production

A

Pilocarpine iontophoresis (Gibson and Cooke)

58
Q

Method to measure sweat sodium

A

Flame photometry, ion exchange electrode

59
Q

Current and duration for pilocarpine iontophoresis

A

0.16 mA current, 5 minutes

60
Q

Sweat sodium and chloride value diagnostic for cystic fibrosis

A

> 70 mEq/L

61
Q

Sweat sodium and chloride value for borderline cystic fibrosis

A

40 mEq/L