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Laboratory Identification of Tuberculosis
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Laboratory Identification of Tuberculosis

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@LustrousOnyx4501

Questions and Answers

What is the primary pathogenic organism responsible for tuberculosis?

  • Mycobacterium leprae
  • Streptococcus pneumoniae
  • Mycobacterium tuberculosis (correct)
  • Escherichia coli

    • What is the expected volume of blood in massive hemoptysis in a 24-hour period?

  • 100-200 ml
  • Above 800 ml
  • 600-800 ml
  • 200-600 ml (correct)

    • Which of the following describes Mycobacterium tuberculosis?

  • Gram-negative and sporing
  • Strongly gram-positive and encapsulated
  • Weakly acid-fast and aerobic (correct)
  • Sporing and motile

    • What type of microscopy is crucial for the laboratory identification of TB?

    <p>Direct sputum smear microscopy</p> Signup and view all the answers

    What should be done if the second sputum specimen is not submitted within three days of the first specimen?

    <p>Collect a new set of two sputum specimens.</p> Signup and view all the answers

    Which of the following media is NOT commonly used for culturing Mycobacterium tuberculosis?

    <p>Nutrient agar</p> Signup and view all the answers

    What is the minimum volume required for a sputum sample to be valid for Xpert MTB/RIF testing?

    <p>1 ml</p> Signup and view all the answers

    What is the main characteristic of Mycobacterium that contributes to its acid-fastness?

    <p>Mycolic acid in the cell wall</p> Signup and view all the answers

    Which tools are required for smear preparation?

    <p>Glass slides, applicator sticks, and a discard bucket.</p> Signup and view all the answers

    In terms of TB epidemiology, what is considered the primary source of infection?

    <p>Open case of pulmonary tuberculosis</p> Signup and view all the answers

    Which test result is NOT typically associated with Mycobacterium tuberculosis?

    <p>Nitrate reduction test positive</p> Signup and view all the answers

    Why is it important to avoid food particles or solid particulates before collecting a sputum specimen?

    <p>They may inhibit the Xpert MTB/RIF test.</p> Signup and view all the answers

    Which of the following is NOT recommended prior to sputum collection?

    <p>Brushing teeth</p> Signup and view all the answers

    What is the sequence of actions a patient should perform to collect a good quality sputum sample?

    <p>Breathe deeply, hold the breath, then exhale.</p> Signup and view all the answers

    What type of procedure does DSSM primarily involve?

    <p>Conventional Ziehl-Neelsen microscopy or smear.</p> Signup and view all the answers

    What should the healthcare provider do before collecting a sputum sample?

    <p>Record the patient information in the NTP Laboratory Register.</p> Signup and view all the answers

    What type of glass slides should be used for smear preparation?

    <p>Frosted, clean, and unscratched glass slides.</p> Signup and view all the answers

    Which of the following statements about the growth characteristics of Mycobacterium is accurate?

    <p>Growth is generally slow and occurs only in aerobic conditions</p> Signup and view all the answers

    What is the primary purpose of using the ZIEHL NEELSEN AFB stain?

    <p>To stain bacteria with high lipid content in cell walls.</p> Signup and view all the answers

    When preparing a smear, what technique should be used to ensure sterilization during the process?

    <p>Carry out the smear near a flame as it sterilizes the zone.</p> Signup and view all the answers

    What is the required size of the smear to be prepared on the slide?

    <p>3 cm x 2 cm.</p> Signup and view all the answers

    What is the recommended action after interpreting results and documenting them on laboratory forms?

    <p>Send the request form and results back within three working days.</p> Signup and view all the answers

    What advantage does fluorescence microscopy using LEDs provide compared to traditional microscopy methods?

    <p>It has increased sensitivity and faster processing.</p> Signup and view all the answers

    What should be done with the concrete preparation while steaming with carbol fuchsin to avoid drying?

    <p>Add more carbol fuchsin as needed</p> Signup and view all the answers

    What color do acid-fast bacilli appear after primary staining with carbol fuchsin?

    <p>Red</p> Signup and view all the answers

    Which of the following bacteria is NOT classified as acid-fast?

    <p>Legionella micdadei</p> Signup and view all the answers

    What is the purpose of counterstaining with methylene blue in the AFB staining method?

    <p>To differentiate between acid-fast and non-acid-fast bacteria</p> Signup and view all the answers

    During the heat-fixing process, what must be exercised due to safety concerns?

    <p>Care when handling the slide</p> Signup and view all the answers

    What is the effect of insufficient heat during the heat-fixing step?

    <p>Smear washing off during staining</p> Signup and view all the answers

    What should be done with the sputum specimen before transferring it to the slide?

    <p>Select and pick purulent portions using the uneven end of a stick.</p> Signup and view all the answers

    Which of the following is a key feature of the RITM Proficiency Testing for AFB?

    <p>Evaluation of laboratory competency</p> Signup and view all the answers

    What is the correct procedure right after washing off excess carbol fuchsin?

    <p>Decolorize with acid alcohol</p> Signup and view all the answers

    What is a significant advantage of Auramine-O staining over traditional Ziehl-Neelsen staining?

    <p>Higher sensitivity in detecting TB</p> Signup and view all the answers

    How does LED fluorescence microscopy improve diagnostic processes for TB?

    <p>By increasing TB detection rates in resource-limited settings</p> Signup and view all the answers

    What is a primary benefit of adopting digital microscopy systems in laboratories?

    <p>Reduction of human error through automation</p> Signup and view all the answers

    How long should a smear be air dried before fixing it by heat?

    <p>15-30 minutes</p> Signup and view all the answers

    Which benefit does digital microscopy provide that aids in enhancing quality control?

    <p>Allows for image archiving and remote diagnosis</p> Signup and view all the answers

    What role does RITM serve in the context of tuberculosis diagnosis in the Philippines?

    <p>Conducting external quality assessments for laboratories</p> Signup and view all the answers

    What is one of the aims of improving accuracy in TB diagnosis?

    <p>To help improve TB control measures</p> Signup and view all the answers

    What aspect of LED fluorescence microscopy contributes to its cost-effectiveness?

    <p>Longer lifespan and lower maintenance costs</p> Signup and view all the answers

    Study Notes

    Laboratory Identification of Tuberculosis

    • Tuberculosis (TB) is a contagious bacterial infection, primarily affecting the lungs but can also involve other body parts.
    • Early and correct diagnosis is essential for effective TB treatment and preventing transmission.
    • Laboratory identification is crucial, utilizing techniques such as direct sputum smear microscopy (DSSM), culture-based methods, and molecular assays.

    Mycobacterium Characteristics

    • Mycobacteria are aerobic, non-motile, non-capsulated, and non-sporing bacteria.
    • Mycobacterium tuberculosis (Mtb) is weakly gram-positive, strongly acid-fast, and known as acid-fast bacilli (AFB).
    • Liquid media for culture include Dubos’, Middlebrook’s, Proskauer and Beck’s, Sula’s, Sauton’s, and L–J media.

    Epidemiology and Infection

    • TB is the 13th leading cause of death globally and is the second leading infectious killer after COVID-19.
    • Infection sources are typically open cases of pulmonary TB; initial infections are termed primary infections.
    • Severe hemoptysis is defined as the expectoration of large blood volumes (200-600 ml in 24 hours) from the respiratory tract.

    Sputum Sample Collection

    • Ideal sputum collection methods involve spot-spot, early morning-spot, and early morning-early morning specimens.
    • Proper mouth cleaning and techniques for producing good-quality sputum are critical, including deep breaths and strong coughing.
    • Sputum samples should be minimally 5-10 ml for DSSM and 1 ml for Xpert MTB/RIF testing.

    Direct Sputum Smear Microscopy (DSSM) Procedure

    • DSSM can be performed via conventional Ziehl-Neelsen microscopy or fluorescence microscopy (FM), with FM providing increased sensitivity.
    • Key steps include recording patient information, preparing and staining the smear, decoding results, and timely communication of findings to the requesting unit.

    AFB Staining Method

    • Ziehl-Neelsen is a method used to stain acid-fast bacilli, which retain the primary stain (carbol fuchsin) and appear red post-staining.
    • Non-acid-fast bacteria will take on counterstains and appear blue or green.
    • Heat-fixing slides properly is crucial; overheating or insufficient fixation can damage bacteria or smears.

    Recent Updates in TB Diagnosis

    • Fluorochrome Staining (Auramine-O): Has shown greater sensitivity and faster reading times than traditional stains.
    • LED Fluorescence Microscopy:
      • More energy-efficient, improving accessibility in resource-limited environments.
      • Studies indicate better TB detection rates in low-resource settings compared to conventional microscopy.
    • Digital Microscopy:
      • Offers automation, reducing errors and increasing throughput.
      • Facilitates image archiving and remote diagnostics for quality control.

    RITM Proficiency Testing for AFB

    • The Research Institute for Tropical Medicine (RITM) implements proficiency testing as part of the National Tuberculosis Control Program (NTCP).
    • Key features include:
      • Evaluation of laboratory competency in AFB testing.
      • Assurance of quality through extensive quality assurance processes.
      • Accreditation and certification of laboratories for standardized diagnostic practices.
      • External Quality Assessment (EQA) to maintain diagnostic accuracy.
      • Enhancing overall TB control efforts through improved diagnostic reliability.

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    Description

    This quiz focuses on the laboratory identification methods for tuberculosis, particularly emphasizing updates on direct sputum smear microscopy. Understanding these diagnostic techniques is essential for effective treatment and prevention of TB transmission. Test your knowledge on the role of laboratory identification in managing this contagious disease.

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