PMLS 2 LECTURE

TOPIC: NONBLOOD SPECIMENS AND TESTS

TERM: FINALS SY. 2023- 2024

NONBLOOD SPECIMENS AND TESTS o Chemical examination

• Liquid or semiliquid substances produced by the body

and found in the intracellular and interstitial spaces and
within organs
• Involved in obtaining specimens
• Test administration
• Instruction
• Processing
o Labeling
• Transporting

LABELING AND HANDLING ▪ commonly used in the lab is the 4

parameters
• Same ID information as blood specimens - glucose, pH, protein, specific gravity
o Microscopic examination\
• Include type and/or source of specimen
• Apply to container, not the lid
• Familiarity with handling requirements is needed to
protect integrity of specimen & ensure accurate test
results
• All body substances are potentially infectious
(biohazard)
• Standard precautions must be observed in handling
them

URINE

• Most frequently analyzed nonblood body fluid

o readily available, easy to collect, and
generally inexpensive to test
• Its analysis can aid in: o examines a sample of urine sediment under a
o Providing information on many of body’s microscope
major metabolic functions o a measured portion of urine is
o Monitoring wellness centrifuged in a special plastic tube
o Diagnosis & treatment of urinary tract o Top portion of the specimen, is discarded
infections Detection & monitoring of metabolic after centrifugation
disease Determining effectiveness or
complications of therapy • Urine culture and sensitivity
o Requested on patients with symptoms of UTI
URINE TESTS / URINE ANALYSIS (UA) o Requires midstream clean-catch collection in
sterile container
• Routine Urinalysis o Urine is centrifuge first before culture
o Most common - incubating it for 18 to 24 hours
o Screens for urinary and systemic disorders
o Midstream collection • Urine cytology studies
o Examined within 2 hours from collection o Standard noninvasive method for diagnosis in
o Physical examination the detection for bladder CA (cancer)
▪ Volume o Microscopic examination of urine or bladder
▪ Color washings for exfoliated cancer cells
▪ Odor (eg. mousy, fruity) o Used to assess morphological changes in
▪ pH cells
▪ Specific gravity o First introduced by Papanicolaou in 1945
❖ The refractometer or a o Requires fresh and first stream urine
reagent strip is used to
measure specific gravity

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 2nd SEMESTER

• Urine Drug Screening • Suprapubic aspiration: (culture, cytology)

o performed to detect illicit use of recreational o Collected by inserting needle directly into
drugs, use of anabolic steroids to enhance bladder & aspirating (withdrawing by suction)
performance in sports, and unwarranted use • Pediatric: collected in plastic bag, for children not potty
of prescription drugs trained
o used to monitor therapeutic drug use in order
to minimize withdrawal symptoms AMNIOTIC FLUID
o used to confirm a diagnosis of drug overdose
• Clear, almost colorless to pale-yellow fluid that fills
• Urine Glucose and Ketone Testing membrane surrounding & cushioning fetus
o To screen for diabetes & monitor glucose & • Collected after 15 weeks gestation
ketone levels in diabetics • Analyzed to detect genetic disorders & problems in
o ketones are created when the body breaks fetal development
down fat for energy because the diet is o also used to estimate gestational age-
deficient in carbohydrates or when the body measures phospholipids
does not metabolize glucose properly - act as surfactants to keep the alveoli
o urine ketone levels can be used to diagnose of the lungs inflated
diabetic ketoacidosis and help differentiate • Fetal development problems can be detected by
between diabetic and nondiabetic coma measuring alpha-fetoprotein (AFP)
• antigen normally present in the human fetus that is also
• Urine pregnancy testing found in amniotic fluid and maternal serum
o Tests for hCG, a hormone appearing in urine • Must be collected in sterile container, protected from
after conception light, & delivered to lab ASAP
o First morning specimen is preferred due to • Amniocentesis - a procedure used to take out a small
high concentration sample of the amniotic fluid for testing
(transabdominal)
• Other urine tests o performed w/ ultrasound guidance and
o Electrophoresis aspirating 10 mL (approximately) of amniotic
o Heavy metals (copper & lead) fluid
o Myoglobin clearance • Collected by the physician
o Creatinine clearance
o Porphyrins CEREBROSPINAL FLUID
TYPES OF URINE SPECIMENS • Clear, colorless liquid that surrounds brain & spinal
cord
• Random: collected at any time • Used to diagnose:
o for routine urinalysis and screening tests o Meningitis
• First morning / 8-hour: first voided urine o Brain abscess
o preferred for many urine tests o CNS cancer
o higher specific gravity = more concentrated o Multiple sclerosis
• Fasting: second specimen voided after fasting • Routine tests: cell counts, chloride, glucose, & total
o typically used for glucose monitoring protein
• Timed: collected at specific times • Obtained between the L3 & L4
o Tolerance tests (GTT)
o 2-hour postprandial - monitor insulin therapy GASTRIC FLUID
of diabetes mellitus
o 24-hour - quantitative analysis of urine • gastric analysis examines stomach contents for
analytes abnormal substances and measures gastric acid
o Double-voided (empty bladder, wait specified concentration to evaluate stomach acid production
time (30 mins) to collect specimen)
• Diagnose gastric disease and assists in the selection
▪ commonly used for glucose and
of therapy
ketones
NASOPHARYNGEAL SECRETIONS
URINE COLLECTION METHODS
• From nasal cavity & pharynx
• Regular voided
• Cultured to detect presence of microorganisms
• Midstream
causing:
o free of genital secretions, pubic hair, and
o Diphtheria
bacteria surrounding the urinary opening
o Meningitis
• Midstream clean-catch: (for culture & sensitivity) o Pertussis (whooping cough)
o Requires special cleaning of genital area o Pneumonia
before collection
o Separate instructions for male and female
• Catheterized: (culture)
o Collected from sterile catheter inserted
through urethra into bladder

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 2nd SEMESTER

SALIVA SYNOVIAL FLUID

• Fluid secreted by glands in mouth • Clear, pale-yellow, viscous fluid that lubricates
• Can be collected quickly & easily in a noninvasive movable joints
manner • Normally occurs in small amounts
• Used to monitor hormone levels and detect alcohol & • Can be tested to identify or differentiate arthritis, gout,
drug abuse & other inflammatory conditions
• Typically collected in 3 tubes:
SEMEN o EDTA / heparin: for cell counts, ID of crystals,
smear prep
• Most commonly used for post-vasectomy patients o Sterile: culture & sensitivity
• Sperm-containing fluid discharged during male o Nonadditive: macroscopic appearance,
ejaculation chemistry, immunology tests & to observe clot
• Analyzed to assess fertility or effectiveness of formation
sterilization
• Examined for forensic reasons in criminal sexual OTHER NONBLOOD SPECIMENS
investigations
• Collected in sterile containers, kept warm, & protected • Buccal swabs
from light o for DNA analysis
• Ideally collected at the area of testing • Bone Marrow
o Aspirated & examined to detect & identify
SEROUS FLUID blood disease
o Physician inserts large-gauge needle into
• Found between double-layered membranes enclosing bone marrow in hip bone or sternum
pleural, pericardial, & peritoneal cavities o 1.0 to 1.5 mL of specimens is aspirated using
• Allows membranes to slide past one another with • Hair
minimal friction o for trace & heavy metal analysis % detection
• Can be aspirated for testing purposes by physician of drugs
• Type of serous fluid should be indicated on label: • Breath samples
o Pleural fluid o C-urea breath test
o Pericardial fluid - Used to detect H. pylori (bacteria
o Peritoneal fluid that damages stomach lining)
o Hydrogen breath test
SPUTUM - Helps identify problems with
digestion of lactose & fructose
• Mucous or phlegm ejected from trachea, bronchi, & - Thought to be most accurate lactose
lungs tolerance test
• Collected for diagnosis or monitoring of lower - Also used to detect bacterial
respiratory tract infections (tuberculosis) overgrowth in small intestine
• The microbe that causes TB is called an acid-fast • Feces
bacillus (AFB), and the sputum test for TB is often o helpful in the evaluation of gastrointestinal
called an AFB culture. disorders
o First morning specimens are preferred (larger • Throat swabs
volume) o Collected to aid in diagnosis of strep
o Collect at least 1 hour after a meal to avoid infections
gagging or vomiting • Tissue specimens
o Patient removes dentures & gargles with o From biopsies
water o Proper solution (in formalin)
o Patient take 3 or 4 deep breaths & then o Accessioned
coughs forcefully expelling sputum into
container

SWEAT

• Analyzed for chloride content in diagnosis of cystic

fibrosis
• Sweat chloride test
o Pilocarpine (sweat-stimulating drug) is
transported into skin by electrical stimulation
(iontophoresis)
o Sweat is collected, weighed, & analyzed for
chloride content
• Also used to detect illicit drug use; collected via
patches