Specimen Transport Guidelines Quiz
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Questions and Answers

According to the provided guidelines, which specimen type requires transport at room temperature and must arrive at the PHLC within 24 hours of collection?

  • Dermatological specimens
  • Enteric specimens
  • Cerebrospinal fluid
  • Blood for hepatitis B virus (HBV) DNA, hepatitis C virus (HCV) RNA, and human immunodeficiency virus (HIV-1) RNA quantitation (correct)

    • What is the recommended temperature for transporting specimens generally, if a delay in despatch is unavoidable?

  • Room temperature
  • 2-25°C
  • 2-8°C
  • 4°C (correct)

    • Which of the following specimens should be transported at room temperature?

  • Spore strips (correct)
  • Plasma/serum separated within 24 hours of collection
  • EDTA blood for HBV DNA, HCV RNA, and HIV-1 RNA quantitation
  • Genital specimens (correct)

    • According to the guidelines, what is the recommended time frame for transporting specimens to the laboratory after collection, if possible?

    <p>Within 24 hours (D)</p> Signup and view all the answers

    If a delay in despatch is unavoidable, what is the recommended temperature for storing plasma/serum that has been separated within 24 hours of collection?

    <p>2-8°C (D)</p> Signup and view all the answers

    What is the recommended temperature for transporting specimens for bacterial/fungal culture and parasitology examination, excluding blood, cerebrospinal fluid, dermatological, genital specimens, and spore strips?

    <p>Room temperature (D)</p> Signup and view all the answers

    What is the acronym used for the Public Health Laboratory Services Branch, as referenced in the text?

    <p>PHLC (D)</p> Signup and view all the answers

    Which of the following organizations is referenced in the text concerning specimen transport guidelines?

    <p>World Health Organization (D)</p> Signup and view all the answers

    Based on the provided information, what does the acronym 'EDTA' stand for in the context of specimen transport?

    <p>Ethylenediaminetetraacetic acid (D)</p> Signup and view all the answers

    What is the primary function of the hypervariable region of an antibody?

    <p>To bind to specific antigens, enabling the antibody to recognize and target a particular pathogen. (B)</p> Signup and view all the answers

    Which antibody class is most abundant and plays a crucial role in neutralizing antibodies?

    <p>IgG (D)</p> Signup and view all the answers

    Considering the information provided about antibody titer, what can be concluded about a person with high IgM levels and low IgG levels?

    <p>The person is likely currently infected with a pathogen and has not yet had time to develop long-term immunity. (B)</p> Signup and view all the answers

    Which of the following statements about antibody production is NOT accurate?

    <p>Antibodies are always present in the blood, even before exposure to an antigen. (D)</p> Signup and view all the answers

    Why are neutralizing antibodies important for preventing viral infections?

    <p>They bind to the virus and physically block it from entering human cells. (A)</p> Signup and view all the answers

    Which of the following BEST describes the 'Cradle-to-Grave' principle in clinical specimen collection?

    <p>Ensuring that the specimen is collected, transported, processed, and disposed of in a way that minimizes the risk of contamination. (C)</p> Signup and view all the answers

    Which of the following is NOT directly related to the concept of 'Aseptic Non-Touch Technique (ANTT)' principles in clinical specimen collection?

    <p>Ensuring that the specimen is taken from the correct anatomical site. (B)</p> Signup and view all the answers

    The 'Aseptic Non-Touch Technique (ANTT)' emphasizes the importance of avoiding contamination of which specific areas during specimen collection?

    <p>The patient's skin surrounding the collection site. (B)</p> Signup and view all the answers

    Which of the following is NOT a key component of the 'Aseptic Non-Touch Technique (ANTT)'?

    <p>Using only non-sterile instruments for collection purposes. (B)</p> Signup and view all the answers

    Which of the following is a primary goal of adhering to the 'Aseptic Non-Touch Technique (ANTT)'?

    <p>Preventing the spread of infectious agents from the patient to the healthcare provider. (C)</p> Signup and view all the answers

    The principles of 'Aseptic Non-Touch Technique (ANTT)' are based on the understanding that:

    <p>Microorganisms are commonly present on the skin and surrounding tissues. (D)</p> Signup and view all the answers

    Which of the following is NOT a relevant authority or organization that provides guidelines for good quality clinical specimen collection?

    <p>American Society for Microbiology (ASM) (D)</p> Signup and view all the answers

    What is the purpose of a biological safety cabinet (BSC)?

    <p>To protect the operator, product, and environment from contamination. (D)</p> Signup and view all the answers

    Which of the following microbes is associated with Biosafety Level 4 (BSL-4) due to its high risk of causing serious and often fatal disease?

    <p>Variola virus (smallpox) (C)</p> Signup and view all the answers

    According to the provided content, what is the primary objective of adhering to Aseptic Non Touch Technique (ANTT) requirements?

    <p>Reducing the risk of contamination by ensuring proper use of sterile equipment. (B)</p> Signup and view all the answers

    What is the significance of the International Air Transport Association (IATA) in relation to clinical specimen collection?

    <p>They establish regulations for the safe transportation of clinical specimens. (D)</p> Signup and view all the answers

    Identify the Biosafety Level (BSL) that is appropriate for working with Mycobacterium tuberculosis.

    <p>BSL-3 (D)</p> Signup and view all the answers

    Which of the following options is a significant difference between a standard laboratory setting and a Biosafety Level 3 (BSL-3) laboratory?

    <p>BSL-3 labs have a specific design and infrastructure to minimize the risk of contamination. (A)</p> Signup and view all the answers

    Which of the following practices is not considered a component of Good Quality Clinical Specimen Collection/Sampling Principles?

    <p>Performing routine medical examinations on patients before specimen collection. (C)</p> Signup and view all the answers

    Why is it important to keep the lid of a culture plate closed during the inoculation process?

    <p>To prevent accidental contamination of the culture plate. (C)</p> Signup and view all the answers

    Which of the following steps is NOT essential when using a Biological Safety Cabinet (BSC)?

    <p>Disposing of all waste materials in a sealed container immediately after use. (A)</p> Signup and view all the answers

    What is the primary reason for adhering to local requirements regarding clinical specimen transportation?

    <p>To maintain the safety of the environment and public health. (C)</p> Signup and view all the answers

    Which of the following is TRUE regarding RNA viruses?

    <p>Their high genetic diversity makes it challenging to develop effective vaccines. (B), They primarily use ribose sugar in their nucleotide structure. (D)</p> Signup and view all the answers

    Based on the provided information, what is a primary advantage of PCR over traditional methods for DNA/RNA analysis?

    <p>Its ability to produce numerous identical copies of DNA or RNA molecules within hours. (C)</p> Signup and view all the answers

    What is the significance of the Ct (cycle threshold) value obtained in Real-Time PCR?

    <p>It indicates the quantity of DNA/RNA present in the sample, with lower values indicating greater initial concentration. (D)</p> Signup and view all the answers

    Which characteristic makes Real-Time PCR a more advantageous technique compared to traditional PCR?

    <p>Its requirement for fluorescent labeling allows for real-time monitoring of the amplification process. (D)</p> Signup and view all the answers

    What type of analysis is typically performed using Real-Time PCR, given its name?

    <p>Quantitative analysis, determining the amount of a specific DNA/RNA sequence present. (C)</p> Signup and view all the answers

    How does the Ct value relate to the initial amount of DNA/RNA in a sample?

    <p>A lower Ct value indicates a greater initial amount of DNA/RNA. (D)</p> Signup and view all the answers

    Which of the following is a reason why studying RNA viruses is challenging?

    <p>Their high mutation rate makes it difficult to develop effective vaccines. (A)</p> Signup and view all the answers

    Why might Real-Time PCR be preferred for diagnosing infectious diseases compared to traditional PCR?

    <p>It is more sensitive and provides a quantitative measure of pathogen load. (A)</p> Signup and view all the answers

    What is the key difference between ribose and deoxyribose, the sugars found in RNA and DNA, respectively?

    <p>Ribose contains one more oxygen atom than deoxyribose. (B)</p> Signup and view all the answers

    Flashcards

    Cradle-to-Grave Principles

    The comprehensive approach to managing clinical specimens from ordering to reporting.

    Clinical Specimen Collection

    The process of obtaining samples for testing and diagnosis.

    Aseptic Technique

    Methods to prevent microorganism transfer during clinical procedures.

    Non-Touch Technique (NTT)

    A method to avoid contamination of key parts during procedures.

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    Aseptic Non-Touch Technique (ANTT)

    A specific technique combining aseptic and non-touch methods for safety.

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    Standard Operating Procedures (SOPs)

    Established protocols for consistent performance in clinical practices.

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    Statutory Requirements

    Regulations that must be followed in clinical practices.

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    Cooler / Room Temp

    Transport temperature requirement for specimens: either in cool conditions or at room temperature.

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    Vertical Positioning

    Specimens must be transported in a vertical position as required.

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    Biohazard Label

    Containers must have a label indicating biohazard risk to ensure safety.

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    Transport Timing

    Specimens should be sent to the lab as soon as possible, ideally the same day of collection.

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    Refrigeration Temperature

    Keep specimens under refrigeration at 4°C if delay is unavoidable, for preservation.

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    Room Temperature Specimens

    Certain specimens, like blood and CSF, need to be kept at room temperature during transport.

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    EDTA Blood Storage

    EDTA blood for certain viruses must be kept at 2-25°C and arrive within 24 hours.

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    Plasma/Sera Processing

    Plasma/serum should be separated within 24 hours and stored at 2-8°C for up to 6 days.

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    Public Health Laboratory Services

    PHLC's guidelines for specimen transport and temperature control to ensure accuracy in testing.

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    Safety Transportation - Local Requirements

    Local regulations and guidelines for transporting clinical specimens safely.

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    Safety Transportation - International Requirements

    Global standards for the safe transport of clinical specimens by air.

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    Biosafety Levels (BSL)

    Categories used to determine the safety measures required in labs to handle pathogens.

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    BSL-1

    Basic biosafety level for work with well-characterized agents not known to cause disease in healthy humans.

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    BSL-2

    Biosafety level for work with moderate-risk agents that can cause disease but are treatable.

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    BSL-3

    High-level containment for work with agents that can cause serious or potentially lethal disease through inhalation.

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    BSL-4

    Maximum biosafety level for handling dangerous and exotic agents that pose a high risk of fatal disease.

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    Biological Safety Cabinet (BSC)

    A controlled environment that protects users and the product from contamination during lab work.

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    Airflow in Biological Safety Cabinet (BSC)

    Controlled airflows in BSCs prevent contamination and protect samples and workers.

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    Antigen

    A foreign substance that triggers an immune response.

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    Antibody Structure

    Consists of two light chains and two heavy chains with a hypervariable region.

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    Neutralizing Antibodies

    Antibodies that block viruses and reduce infectivity.

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    IgM and IgG

    IgM is the first antibody produced; IgG provides long-lasting immunity.

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    Antibody Titer

    A blood test that measures the presence and amount of antibodies.

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    RNA vs DNA

    RNA viruses mutate faster and are genetically diverse compared to DNA viruses.

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    Ribonucleic Acid

    RNA is made of ribonucleotides containing ribose sugar and uracil base.

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    Polymerase Chain Reaction (PCR)

    PCR amplifies DNA/RNA copies quickly using specific primers.

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    Real-Time PCR

    Also known as qPCR, it measures fluorescent signals during amplification.

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    Ct value

    The cycle threshold (Ct value) indicates how many cycles are needed to detect DNA/RNA.

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    Fluorescent Labeling

    Fluorescent labels used in Real-Time PCR track DNA/RNA during amplification.

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    Quantitative PCR

    Quantitative PCR (qPCR) measures the exact amount of nucleic acid in real time.

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    Nucleotides in RNA

    RNA contains adenine (A), guanine (G), cytosine (C), and uracil (U).

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    Mutation Rate

    RNA viruses exhibit a higher mutation rate compared to DNA viruses.

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    PCR Amplification

    PCR amplifies even small amounts of nucleic acids in a sample.

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    Study Notes

    Microbiology Lecture (L03)

    • Principles and Methods of Diagnosis Clinical Sampling
      • Cradle-to-Grave Principles: covers the entire process of clinical sampling from ordering to reporting
      • Ordering: Initiates the process
      • Collection/Sampling: Collection of sample from the patient.
      • Transportation/Storage: Safe and appropriate transportation and storage of the collected sample.
      • Specimen Processing: Analyze the collected specimen in the lab.
      • Diagnosis: Determine the cause of disease using lab results.
      • Treatment: Treatment based on the diagnosis
      • Result Interpretation: Interpreting lab results
      • Reporting: Provide results to the relevant people/offices.
      • Disposal of Specimen: Proper disposal of the specimen.

    Good Quality Clinical Specimen Collection/Sampling Principles (1)

    • Compliance with Statutory Requirements, Standard Operating Procedures (SOPs), & Professional Standards
    • American Society for Microbiology recommendations and guidelines
    • Clinical & Laboratory Standards Institute recommendations and guidelines
    • WHO (World Health Organization) guidelines
    • Quality Assurance-critical to ensure the reliability of the collected samples.
      • Includes methods, requirements and procedures for sample collection, including line draws, blood cultures, and venipuncture in children.
    • Guide to Requests for Laboratory Testing: Provides information for collecting correct samples based on testing required for the samples.

    Good Quality Clinical Specimen Collection/Sampling Principles (5)

    • Awareness of the Usage of RIGHT Clinical Specimen Containers
    • Stool Collection Cup with Small Spoon: Use of collection cup for stool samples
    • Midstream Urine (MS) container with boric acid: Using appropriate container for urine samples needing preservation
    • Blood Sampling Holder + Winged Needle: For blood samples
    • Vacuum Blood Collection Tubes: For various blood types
    • Specimen containers should be used appropriately for their intended purposes
    • Detailed procedures for collection of correct samples

    Good Quality Clinical Specimen Collection/Sampling Principles (7) – Safe Transportation of Collected Specimen Principles

    • Compliance to Requirements – Local Laboratory, international standards
    • Emergency Spill Kit: Requirements for emergency spills
    • Transport container with Biohazard Label: Ensuring secure transport
    • Vertical placement of containers when carrying samples
    • Temperature regulations for transport of clinical specimens

    Specimen Transportation - Temperature Requirement

    • Specimens should be transported to the laboratory as soon as possible • Ideally, within the same day after collection.
    • If delay is unavoidable, specimens should be refrigerated at 4°C, except for certain types requiring room temperature
    • Specific temperature requirements for different specimens (e.g., blood, CSF)

    Microbiological Tests Used In The Diagnosis Of Tuberculosis (TB)

    • Sputum for acid-fast bacilli (AFB) direct smear and culture examination
    • Mycobacterial culture (6-8 weeks)
    • Other possible clinical samples include gastric washings, bronchial aspirate, pleural fluid, biopsy specimens of the lung, or non-respiratory specimens, such as early morning urine (EMU), lymph node aspirate, pericardial fluid, cerebrospinal fluid, and joint fluid.

    Specimen Collection - Catheter

    • Catheter Specimen Urine (CSU): from Catheter Sampling Port.
    • After Catheter Insertion
    • Collect Urine from Urine Bag
    • Use alcohol swabs to disinfect the sampling port and the urine bag outlet for sterilization.

    Specimen Collection - Midstream Urine

    • Midstream Urine (MSU): Urine For Culture & Sensitivity Tests
      • A test to identify the presence of bacterial and fungal (yeast) infections, which may lead to urinary tract infections(UTI) in adults
      • Before procedure, perform hand hygiene
      • Clean urethral opening and genital area.
      • Pass the first portion of the urine into the toilet and collect midstream urine into the MSU specimen container to one-half full.
      • Seal, label, and deliver to clinical lab immediately, store at 4-8°C if not delivered immediately.

    First Catch/ Void Urine / Clean Catch Urine

    • Clean urethral opening and genital area with a wet tissue.
    • Collect first catch urine into the specimen container without preservatives.
    • Seal, label, and send to the Clinical Laboratory immediately if possible, otherwise store in a cool place

    Skin Disinfection For Sterile Sites

    • Various Skin disinfectants are available to apply, with the duration of application varying depending on the chosen disinfectant

    Identifying Microbes By Staining

    • Gram Stain
    • Ziehl-Neelsen Stain

    Identifying Microbes By Microscopy

    • Microscopes are used to examine microscopic appearance of microbes to assist in identifying specific samples

    Microbiological Culture

    • Used to identify microbes by growing/culturing microbes for visual inspection

    Blood Culture Medium

    • Blood culture: blood sample submitted for culture of microorganisms
    • enables the recovery of potential pathogens from patients suspected of having bacteremia or fungemia
    • Various types of tubes, including aerobic and anaerobic tubes

    Blood Culture Videos

    • Video links are provided

    Genotypic Methods

    • Examination of genetic material (DNA/RNA)
    • Frequently used to identify microorganisms when culturing bacteria is unnecessary or impractical

    DNA & RNA

    • Deoxyribonucleic Acid (DNA)
    • Ribonucleic acid (RNA)
    • Nucleic acids- Two main types, Ribonucleic acid (RNA) and Deoxyribonucleic Acid (DNA)

    DNA/RNA Components

    • Nucleosides: A nitrogenous base and a five-carbon sugar (ribose or deoxyribose)
    • Nucleotides: A nitrogenous base, a five-carbon sugar, and one or more phosphate groups

    What is Deoxyribonucleic Acid (DNA)?

    • Deoxyribonucleic Acid (DNA) is a molecule that stores genetic information needed for an organism's development and function
    • DNA consists of two linked strands that are arranged in a double helix
    • Each strand has a backbone comprised of repeating sugar (deoxyribose) and phosphate groups

    What is Ribonucleic acid (RNA)?

    • Ribonucleic acid (RNA) is a nucleic acid that is present in all living cells and has similar structure to DNA
    • RNA is predominately single-stranded.

    DNA vs RNA

    • Key differences between DNA & RNA molecules
    • RNA differs from DNA both chemically (use of ribose instead of deoxyribose, and use of uracil instead of thymine) and structurally

    Commonly Used Genotypic Tests

    • Polymerase Chain Reaction (PCR)
    • Real-Time PCR

    Polymerase Chain Reaction (PCR)

    • PCR is a method used to rapidly produce numerous and identical copies of DNA or RNA molecules
    • The method can potentially amplify even minute quantities of nucleic acids within a sample to identify specific DNA sequences

    What Real-Time PCR?

    • Video link provided
    • Uses fluorescent labeling

    Real-Time PCR and Ct value (cycle threshold)

    • Ct measures the number of cycles needed to replicate DNA/RNA until it can be detected
    • Lower value of Ct suggests a higher concentration of DNA/RNA initially

    Significance of Ct value

    • Ct < 35: Confident positive results
    • Ct > 35: Might be false positive results

    Immunological Test: Antigen - Antibody Reaction

    • Antibodies bind to antigens
    • A method used to determine the amount of a particular antibody or antigen in a sample
    • Antibodies are types of proteins in the immune system
    • Antibodies also called immunoglobulins (Ig)

    Immunological Tests

    • Serological tests based on antibody specificity, fitting like a hand in a glove
    • Used to determine the immunological status of patients, to confirm a suspected diagnosis, or screen individuals for disease.

    Antigen & Antibiotic Tests

    • Serologic tests are used to determine if a person has been exposed to a particular microbe
    • Serologic tests use antibody binding to a specific site (epitope) on an antigen

    Antigen-Antibody Reaction

    • Antigen: Any foreign material to the body, like viruses or a bacteria.
    • Antibody: A protein component of the immune system that recognize foreign materials, neutralize them and offer protection from them in the future.

    Got Vaccinated = Got Antibody = Got Protection?

    • Video link provided
    • Discussion of if vaccination=antibody=protection

    Neutralizing Antibodies, Antibody Titer

    • Neutralizing antibodies are antibodies that can block viruses from infecting cells
    • Antibody titer is a blood test to determine the presence and amount of antibodies to determine if a person has been infected by a pathogen before

    What Do IgG, IgM?

    • Antibodies(Ig) are important elements of the human immune system.
    • Types of antibodies include Immunoglobulin M and Immunoglobulin G (IgM and IgG)
    • IgM is short-lasting, first line defense against bacteria or viruses
    • IgG offers long-lasting protection ("previously infected" status)

    Understanding Hepatitis B Serological Tests Results

    • Discusses various Hepatitis B tests, including HBsAg, anti-HBs, and anti-HBc tests and their roles in diagnosing and monitoring Hepatitis B infection.
    • Explaining the significance, what it means and how it helps establish a diagnosis.

    Enzyme-linked Immunosorbent Assay (ELISA)

    • Enzyme-linked immunosorbent assay (ELISA) is a common method used to detect the presence of antibodies, antigens, proteins, and glycoproteins in biological samples.
    • Explanation of the step-by-step ELISA procedure.

    Sandwich ELISA Protocol

    • Video link provided for the Sandwich ELISA procedure

    False Positive Result

    • False positive result discussion regarding an instance of testing for pregnancy where the test was wrongly interpreted as positive
    • Details of the false positive in that case are presented, including relevant events.
    • Possible contributing factors to false positives were mentioned.

    Serological Tests - Sensitivity vs Specificity

    • Explaining aspects of serological techniques

    HIV Laboratory Diagnostic Algorithm

    • Details provided about HIV diagnostic tests.
    • HIV screening and confirmatory tests explained

    Lab. Results - Right Interpretation

    • Importance of correctly interpreting test results

    Specific Site Algorithm for Pneumonia...

    • A detailed, specific site-specific algorithm for pneumonia diagnosis is described
    • Key signs, symptoms and laboratory tests, including imaging evidence are explained

    Catheter associated Urinary Tract Infection (CAUTI)

    • Criteria/features needed to make the diagnosis of a urinary tract infection (UTI) when a patient has a catheter

    Determining Clinical Significance Of Cultures

    • Importance of culture results and their interpretation in identifying infections correctly.
    • Discussion of the implications of false positive and negative results due to factors like sample contamination or antibiotic administration.

    Take Home Message

    • Summary of the key points covered concerning principles and methods of clinical sampling

    Principles & Methods of Diagnosis Clinical Sampling

    • Summary of the key strategies to be applied for correct sample collection, transport, processing, reporting, and treatment.

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    NUR1016 Microbiology & Pharmacology Lecture 3 (2024/2025) PDF

    Description

    Test your knowledge on the transport guidelines for various specimen types in the Public Health Laboratory Services. This quiz covers the recommended temperatures, time frames for delivery, and specific requirements for different laboratories. Perfect for professionals in the healthcare and laboratory fields.

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