LEARNING TASK

M100

Name: Johnda D. Petran BSM 1 BLOCK: A

TOPIC: SPECIMEN COLLECTION

Search and study for the following:

List and distinguish the following: (Rx10 each)

 Midstream Clean-Catch Urine Specimen: For general urinalysis, culture, and sensitivity tests.
 Clean the genital area with a wipe provided, and collect the midstream urine into a sterile container,
after discarding the first part of the stream. Prevents contamination from urethral or genital flora.
 24-Hour Urine Collection: This method requires collecting all urine voided over a 24-hour period.
 It's often used for certain tests, such as creatinine clearance, proteinuria, or collection of hormones.
A large, clean container with an opening for collection is typically used, and a preservative may be
added to the container.
 Random Urine Specimen: A simple collection of urine for routine tests. No specific instructions are
given regarding the timing of the sample. Used for a wide range of tests, including urinalysis for
diabetes or UTIs.
 First-Morning Void: The first urine sample of the day is collected. Used for specific tests like
pregnancy tests or hormone measurements.
 Catheterization: Used when the patient can't provide a sample voluntarily. The urine is collected
through a catheter inserted into the bladder.

Types of Urine Collection for Infants:

 Pediatric Urine Bag: A sterile bag adheres around the child's genital area to catch urine.
 Used for urinalysis or urine culture when it's difficult to collect a clean sample from the infant.
 Suprapubic Aspiration: A procedure in which a needle is inserted through the abdomen into
the bladder to collect urine. Done under sterile conditions, typically by a healthcare provider.
 Cotton Ball/Cotton Wool Method: For infants, a cotton ball is placed in the diaper to absorb
the urine. The cotton ball is then squeezed to extract the urine for testing.
  Clean-Catch Method: Similar to the adult clean-catch method, but it requires specialized
pediatric urine collection bags. The bag adheres around the infant's genital area and collects
urine.
3. Test of Glucose in the urine
Test for detection of Glucose in urine
BENEDICT TEST
 Principal: When urine is boiled in Benedict solution, blue alkaline copper sulphate is reduced to red
brown cuprous oxide if a reducing agent is present.
 Method: Take 5ml of Benedict's reagent in a test tube, add 8 drops of urine. Boil the mixture.
 Nil: no change from the Blue color
 Trace: Green without precipitate
 1+(approx 0.5grams/dl) Green with precipitate
 2+(approx 1.0 grams /dl) Brown precipitate
 3+(approx 1.5 grams /dl) Yellow orange precipitate
 4+(approx >2grams/dl) Red precipitate
 Detects all reducing substances like glucose, fructose, lactose
 Sensitivity is 200 mg of glucose /
Reagent strip method
 Specific for glucose
 Based on glucose oxidase peroxidase reaction
 More sensitivity(sensitivity 100 mg glucose/dl)
4. Test of albumin in the urine
Tests for Detection of Protein:
Reagent strip method
Principle:
 Indicator strip coated with bromo-phenol blue indicator
 Buffered to pH 3.0 with citrate
 Protein changes ionization of dye
 Semi quantitative method

Notes:
 Mainly reactive to albumin
 False negative- Bence Jones protein, myoglobin, haemoglobin
 False positive- Gross haematuria, highly alkaline urine, contaminated urine

Sulphosalicylic acid test

 Protein gets precipitated after adding organic acid like sulphosalicylic acid

Method:
 2ml of clear urine in a test tube
 If urine neutral or alkaline- add one drop of glacial acetic acid
 Add 2-3 drops of 3-5% sulphosalicylic acid
 Check turbidity against dark background

Notes:
 More sensitive and reliable than boiling test
 False positive- gross haematuria, highly concentrate urine, radiographic dye, excess uric acid,
tolbutamide, sulphonamide, salicylates, penicillins
 False negative- very dilute urine
 Can detect- albumin, myoglobin, haemoglobin, Benes Jones Protein
5. Stool Specimen
 Stool specimens are collected for the analysis of various conditions including gastrointestinal infections
(e.g., salmonella, E. coli), inflammatory bowel diseases, and gastrointestinal bleeding.
 These specimens can be collected in special containers or on special testing kits.
6. Types of Stool Test
Ova and Parasites (O&P) Examination:
 This test is used to detect the presence of parasites and their eggs (ova) in the stool. It is often
performed to diagnose parasitic infections like giardiasis, amoebiasis, and helminth infections.
 The stool sample is examined under a microscope for the presence of parasites or their eggs.
Stool Culture:
 This test is used to identify bacterial pathogens that cause gastrointestinal infections, such as
Salmonella, Shigella, or Campylobacter.
 The stool sample is cultured on special media to grow bacteria. The cultured bacteria are then identified
and tested for antibiotic sensitivity.
Fecal Occult Blood Test (FOBT):
 This test is used to detect small amounts of blood in the stool that are not visible to the naked eye
(occult blood).
 FOBT can be an early indicator of colorectal cancer, inflammatory bowel disease, or other
gastrointestinal conditions.
 Different methods can be used, including guaiac-based (chemical reaction) and immunochemical
(antibody-based) tests.
Fecal Immunochemical Test (FIT):
 Similar to FOBT, FIT is a more specific and sensitive test to detect the presence of blood in the stool.
 FIT uses antibodies specific to human hemoglobin, providing more accurate results with less false
positives than guaiac-based tests.
 It is commonly used as a screening tool for colorectal cancer.
 Stool Elastase Test:
 This test measures the levels of pancreatic elastase, an enzyme produced by the pancreas, in the
stool.
 Low levels of elastase may indicate pancreatic insufficiency, which can be seen in conditions like
chronic pancreatitis or cystic fibrosis.
 The test helps in diagnosing malabsorption disorders.
Stool Calprotectin Test:
 This test measures the levels of calprotectin, a protein associated with inflammation, in the stool.
 Elevated levels of calprotectin may indicate inflammatory bowel disease (IBD) such as Crohn's disease
or ulcerative colitis.
 It is used for diagnosing and monitoring the activity of IBD.
Fecal Fat Test (Fecal Lipid Test):
 This test measures the amount of fat in the stool, which can help diagnose malabsorption disorders
such as pancreatic insufficiency or celiac disease.
 The stool sample is collected over a 72-hour period to get an accurate measurement of fat excretion.
Fecal Lactoferrin Test:
 This test measures the levels of lactoferrin, a protein associated with inflammation, in the stool.
 Elevated levels of lactoferrin may indicate inflammatory bowel disease (IBD).
 It is used for diagnosing and monitoring the activity of IBD.
7. Types of Sputum Specimen
Expectorated Sputum:
 This is the most common type of sputum specimen and is collected when a person coughs up mucus.
 The sample is collected in a sterile container and sent to the laboratory for analysis.
 It is often used for testing for respiratory infections such as tuberculosis, pneumonia, or bronchitis.
Induced Sputum:
 Induced sputum is collected by administering an inhalation therapy (such as a nebulized saline
solution) to stimulate mucus production.
 The person is then asked to cough deeply to produce sputum, which is collected in a sterile container.
 This method is used when a person is unable to produce sputum on their own or when a deeper
sample is needed for analysis.
Bronchoscopy Specimen:
 A bronchoscopy is a procedure in which a flexible tube (bronchoscope) is inserted through the nose or
mouth and down the trachea to collect a sample from the bronchi or lung.
 The bronchoscope can be used to collect sputum samples, biopsy tissues, or wash fluids from the
lungs.
 This method allows for more direct access to the lower respiratory tract and is often used when other
methods are not sufficient.
Nasopharyngeal Swab:
 This is not technically a sputum specimen but can be used to collect samples from the upper
respiratory tract.
 A cotton swab is inserted into the nose and rubbed against the nasopharynx to collect mucus.
 Nasopharyngeal swabs are often used for testing for respiratory infections such as influenza or COVID-
19.
Tracheal Aspirate:
 A tracheal aspirate is a sample of mucus that is collected by suctioning it out of the trachea through a
tube or catheter.
 This method is used in patients who are intubated (breathing through a ventilator) or have a
tracheostomy (a surgical opening in the neck leading to the trachea) and cannot produce sputum on
their own.
Bronchoalveolar Lavage (BAL):
 This procedure involves instilling sterile saline into the bronchial tree and then suctioning it back out to
collect a sample of the bronchoalveolar lavage fluid.
 The lavage fluid contains a mixture of lung surfactant and inflammatory cells from the alveoli.
 It is used for testing for various lung diseases and infections.
Sputum Culture:
 This is not a type of sputum specimen but is a common test that can be performed on sputum samples
to identify the microorganisms causing a respiratory infection.
 The sputum sample is placed on a culture plate and incubated to allow any bacteria or fungi present to
grow.
 The resulting culture can be analyzed to identify the microorganisms and determine the most
appropriate treatment.
8. Blood Specimen:
a. No Fasting
 CBC (Complete Blood Count)
 Comprehensive Metabolic Panel
 Lipid Panel
 Thyroid Function Tests
b. Fasting
 Fasting blood glucose test
 Lipid panel (cholesterol test)
 Basic metabolic panel
 HbA1c (glycated hemoglobin) test
9. Body Secretions
 Include sweat, saliva, vaginal secretions, and synovial fluid (fluid that lubricates joints).
10. RIGHTs of Specimen Collection
 Right Patient
 Right Specimen
 Right Time
 Right Site
 Right Method
 Right Document
 Right Reason
 Right Interpretation
 Right Equipment
 Right Process