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(% you ha&e taken any medicines such as Pepto !ismol in the last * days "thistype o% medicine can inter%ere $ith the x-ray#

+ou $ear a hospital go$n during the x-ray procedure. +ou must remo&e all e$elry. +oumust sign an in%ormed consent %orm.

'. (ari&m S &die"

Defini ion! De"#rip ion$

A barium s$allo$ test may be suggested i% you are ha&ing di%%iculty s$allo$ing,or i% you ha&e chest pain or re%lux "back%lo$ o% stomach uices into the lo$er part o% theesophagus#.

A barium meal test may also be suggested i% you are ha&ing these problems, or i% youare ha&ing unexplained &omiting, pain in your abdomen, se&ere indigestion or blood inyour stool "$hich may be coming %rom your stomach or duodenum or else$here in yourdigesti&e system#.

!arium s$allo$ and barium meal tests help doctors to diagnose in%lammation, ulcers ortumors in the esophagus, stomach or duodenum.

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(n many barium tests, you may be gi&en an in ection to relax your muscles. Thismay be gi&en directly into a &ein "( # or into your muscles "( #. This $ill help $ith thecramping %eeling and pro&ide a better test result. The radiologist may ask you i% youha&e glaucoma, in $hich case this drug is not recommended and an alternati&e may be

used.

+ou $ill be asked by the radiographer to stand or lie in a number o% di%%erent positions$hile x-rays are taken. The x-ray machine is linked to a tele&ision monitor andphotographs or &ideo %ootage can be taken i% necessary. /enerally, the procedure takesaround 01 minutes.

2ometimes you may need to ha&e %ollo$-up x-rays. (n some cases, se&eral x-rays maybe re3uired, o&er three to six hours, in order to examine the small intestine and colon"large bo$el#.

). *ap"&le Endo"#opy

Defini ion! De"#rip ion$

4apsule endoscopy is a procedure that uses a tiny $ireless camera to takepictures o% your digesti&e tract. The camera sits inside a &itamin-si5ed capsule that yous$allo$.

As the capsule tra&els through your digesti&e tract, the camera takes thousandso% pictures that are transmitted to a recorder you $ear on a belt around your $aist oro&er your shoulder.

4apsule endoscopy helps doctors see inside your small intestine 6 an area that isn7teasily reached $ith con&entional endoscopy.

4apsule endoscopy can be used by adults and by children $ho can s$allo$ thecapsule. The procedure is usually started in a doctor7s o%%ice.

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+. *hole#y" o"omography

2onography is used to detect gallstones and e&aluate the gallbladder, biliarysystem, and ad acent organs. 2onography has nearly replaced cholecystography.

,. *hole"#y" ography

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Defini ion! De"#rip ion$

A cholecystogram is an x-ray procedure used to help e&aluate the gallbladder.8or the procedure, a special diet is consumed prior to the test and contrast tablets arealso s$allo$ed to help &isuali5e the gallbladder on x-ray. The test is used to help indiagnosing disorders o% the li&er and gallbladder, including gallstones and tumors.

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On the day be%ore the procedure is per%ormed, the indi&idual ingests a high-%atmeal at noon and a %at-%ree meal in the e&ening. T$o to 9 hours a%ter the e&ening meal,

a radiopa3ue contrast medium "iopanoic acid# is ingested in tablet %orm. All other %oodand %luids except $ater are restricted until completion o% the test. On the day o% the test,an enema may be administered. The indi&idual lies %ace do$n "prone position# on ahard, %lat "radiographic# table and x-ray %ilms are taken o% the gallbladder. The indi&idualthen lies on the le%t side "le%t lateral decubitus position#, and then stands erect $hilemore x-ray images are taken. The indi&idual may then be gi&en a high-%at meal orsynthetic %at-containing agent to stimulate gallbladder emptying. :-rays are taken ;ormal %ood intake can beresumed a%ter the test is completed.

-. *olono"#opy

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Defini ion! De"#rip ion$

4olonoscopy is a procedure that enables an examiner "usually agastroenterologist# to e&aluate the inside o% the colon "large intestine or large bo$el#.The colonoscope is a %our %oot long, %lexible tube about the thickness o% a %inger $ith acamera and a source o% light at its tip. The tip o% the colonoscope is inserted into the

anus and then is ad&anced slo$ly, under &isual control, into the rectum and through thecolon usually as %ar as the cecum, $hich is the %irst part o% the colon.

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The procedure usually takes 91 to *< minutes to complete.

+our nurse $ill ask you to put on a hospital go$n that opens at the back or a go$n andtrousers that ha&e a hole cut in the back.

+ou $ill be asked to $ear an oxygen mask or ha&e small tubes placed ust under yournostrils through $hich oxygen is passed. +ou $ill ha&e a drip inserted into a &ein in the

back o% your hand to gi&e you any medicines you may need. +ou $ill probably be gi&ena sedati&e and a painkiller to make sure you7re relaxed and com%ortable during theprocedure.

+our doctor $ill ask you to lie on your le%t-hand side and he or she $ill gently insert thecolonoscope into your rectum. ?ubricating elly $ill be used to make this as easy aspossible.

Air $ill be pumped into your bo$el to make it expand slightly, $hich makes thecolonoscope pass through more easily. This might %eel uncom%ortable and you maypass some $ind. +our doctor $ill gently mo&e the colonoscope up through your bo$el.The colonoscope is %lexible and the doctor can rotate the tip o% the instrument so that it%ollo$s the cur&es in your bo$el.

The images %rom the camera at the end o% the colonoscope appear on a monitor @ theseenable your doctor to look at the inside o% your bo$el. During the procedure you may beasked to change your position @ %or example turning %rom your side on to your back.This helps your doctor to look at di%%erent areas o% your bo$el. )e or she may press onyour abdomen to help mo&e the colonoscope in the right direction.

During the procedure your doctor may take a biopsy or remo&e small polyps. This is

3uick and painless and is done by passing instruments inside the colonoscope. Thesamples $ill be sent to a laboratory %or testing to see i% the cells are benign or malignant"cancerous#.

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. D/0ylo"e Te"

Defini ion! De"#rip ion$

The D-xylose absorption test measures the le&el o% D-xylose, a type o% sugar, in ablood or urine sample. This test is done to help diagnose problems that pre&ent thesmall intestine %rom absorbing nutrients in %ood.

D-xylose is normally easily absorbed by the intestines . When problems $ithabsorption occur, D-xylose is not absorbed by the intestines , and its le&el in blood andurine is lo$.

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8or 0* hours be%ore a D-xylose test, do not eat %oods high in pentose, a sugar similar toD-xylose. These %oods include %ruits, ams, ellies, and pastries.

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edicines such as aspirin and indomethacin can inter%ere $ith the results o% a D-xylosetest. 8or this reason, your doctor may instruct you to temporarily stop these medicinesbe%ore the test.

Do not eat or drink anything except $ater %or to ;0 hours be%ore ha&ing this test.4hildren younger than B years old should not eat or drink anything except $ater %or *

hours be%ore the test.

A D-xylose test can take a long time. (t might be a good idea to bring something you cando 3uietly $hile you $ait, such as a book to read.

. Endo"#opi# Re rograde *holangiopan#rea ography

Defini ion! De"#rip ion$

Cndoscopic retrograde cholangiopancreatography "C 4P# is a techni3ue thatcombines the use o% endoscopy and %luoroscopy to diagnose and treat certain problemso% the biliary or pancreatic ductal systems. Through the endoscope, the physician cansee the inside o% the stomach and duodenum , and in ect radiographic contrast into theducts in the biliary tree and pancreas so they can be seen on :-rays.

C 4P is used primarily to diagnose and treat conditions o% the bile ducts and mainpancreatic duct, including gallstones , in%lammatory strictures "scars#, leaks "%rom traumaand surgery#, and cancer.

C 4P can be per%ormed %or diagnostic and therapeutic reasons, although thede&elopment o% sa%er and relati&ely non-in&asi&e in&estigations such as magneticresonance cholangiopancreatography " 4P# and endoscopic ultrasound has meantthat C 4P is no$ rarely per%ormed $ithout therapeutic intent.

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C 4P is conducted at a hospital or outpatient center by a doctor and assistants$ho ha&e speciali5ed training in this procedure. Patients recei&e a local anesthetic thatis gargled or sprayed on the back o% the throat. The anesthetic numbs the throat andcalms the gag re%lex.

An intra&enous needle is inserted into a &ein in the arm i% sedati&es $ill be gi&en.Doctors and other medical sta%% monitor &ital signs $hile patients are sedated.

During C 4P, patients lie on their back or side on an x-ray table. The doctor inserts an

endoscope do$n the esophagus, through the stomach, and into the duodenum. ideois transmitted %rom a small camera attached to the endoscope to a computer screen$ithin the doctorEs &ie$. Air is pumped through the endoscope to in%late the stomachand duodenum, making them easier %or the doctor to examine.

When the doctor locates the duodenal papilla, a blunt tube called a catheter is slidthrough the endoscope and guided through the papillary opening. Once the catheter isinside the papilla, the doctor in ects a dye into the ducts. The dye, also called contrastmedium, allo$s the ducts to be seen on x rays. : rays are then taken to see the ductsand to look %or narro$ed areas or blockages.

Procedures to treat narro$ed areas or blockages can be per%ormed during C 4P. Tosee the ducts during treatment procedures, the doctor uses x-ray &ideo, also called%luoroscopy. 2pecial tools guided through the endoscope and into the ducts allo$ thedoctor to open blocked ducts, break up or remo&e gallstones, remo&e tumors in theducts, or insert stents. 2tents are plastic or expandable metal tubes that are le%t innarro$ed ducts to restore the %lo$ o% bile or pancreatic uice. A kind o% biopsy calledbrush cytology allo$s the doctor to remo&e cells %rom inside the ducts using a brush that%its through the endoscope. The collected cells are later examined $ith a microscope%or signs o% in%ection or cancer.

Occasionally, C 4P is done a%ter gallbladder surgery, i% a surgical bile leak issuspected, to %ind and stop the leak $ith a temporary stent.

2. Endo"#opy

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Defini ion! De"#rip ion$

Cndoscopy is a procedure that lets your doctor look inside your body. (t uses aninstrument called an endoscope, or scope %or short. 2copes ha&e a tiny camera

attached to a long, thin tube. The doctor mo&es it through a body passage$ay oropening to see inside an organ. 2ometimes scopes are used %or surgery, such as %orremo&ing polyps %rom the colon.

There are many di%%erent kinds o% endoscopy. )ere are the names o% some o% them and$here they look.

Arthroscopy' oints !ronchoscopy' lungs 4olonoscopy and sigmoidoscopy' large intestine 4ystoscopy and ureteroscopy' urinary system ?aparoscopy' abdomen or pel&is pper gastrointestinal endoscopy' esophagus and stomach

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8or an in&estigation o% the stomach and duodenum, you $ill be asked to lie on yourside. +ou may be sedated or ha&e local anaesthetic sprayed on the back o% your throat.

A %lexible endoscope is then passed into your digesti&e tract through your mouth.

13. E"ophagoga" rod&odeno"#opy

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Defini ion! De"#rip ion$

Csophagogastroduodenoscopy "C/D# is a diagnostic procedure that allo$s thephysician to diagnose and treat problems in the upper gastrointestinal " /(# tract.The doctor uses a long, %lexible, lighted tube called an endoscope. The endoscope isguided through the patient7s mouth and throat, then through the esophagus, stomach,and duodenum "%irst part o% the small intestine#. The doctor can examine the inside o%

these organs and detect abnormalities.

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A%ter enough %asting, a local anesthetic "?idocaine# is sprayed to the back o% thethroat to pre&ent coughing or gagging $hen the endoscope is inserted. +ou $ill then be

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re3uested to bite on to a mouth guard to protect your teeth and lie on your le%tside. sually, an analgesic and a sedati&e are in ected intra&enously as pre-medications. The endoscope is then inserted do$n the throat until it reaches theduodenum. 4are%ul examinations o% the esophagus, stomach, and the duodenum aremade. O%tentimes, a painless biopsy sample is taken through the endoscope using asmall %orceps to test %or bacteria or to be sent %or microscopic examination. The entireprocedure lasts %or about < to ;1 minutes.

In raga" ri# p4

The p) o% gastric secretions is sometimes measured to monitor the e%%ecti&enesso% antacid or )0-receptor antagonist drug therapy

11. Manome ry

Defini ion! De"#rip ion$

anometry is measurement o% pressure $ithin &arious parts o% the /( tract. (t isdone by passing a catheter containing solid-state or li3uid-%illed pressure transducersthrough the mouth or anus into the lumen o% the organ to be studied. anometrytypically is done to e&aluate motility disorders in patients in $hom structural lesionsha&e been ruled out by other studies.

anometry is used in the esophagus, stomach and duodenum, sphincter o%

Oddi, and rectum. Aside %rom minor discom%ort, complications are &ery rare. Patientsmust ha&e nothing by mouth "npo# a%ter midnight.

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While you are sitting up, a member o% your health care team sprays your throat$ith a numbing medication or puts numbing gel in your nose or both.

A catheter is guided through your nose into your esophagus. The catheter maybe sheathed in a $ater-%illed slee&e. (t doesn7t inter%ere $ith your breathing.

)o$e&er, your eyes may $ater, and you may gag. +ou may ha&e a slight nosebleed%rom irritation.

A%ter the catheter is in place, you may be asked to lie on your back on an examtable, or you may be asked to remain seated.

+ou then s$allo$ small sips o% $ater. As you do, a computer connected to thecatheter records the pressure, strength and pattern o% your esophageal musclecontractions.

During the test, you7ll be asked to breathe slo$ly and smoothly, remain as still aspossible, and s$allo$ only $hen you7re asked to do so.

A member o% your health care team may mo&e the catheter do$n into yourstomach $hile the catheter continues its measurements.

The catheter then is slo$ly $ithdra$n.

The test usually lasts 01 to 91 minutes.

1'.%er#& aneo&" Tran"hepa i# *holangiogram

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Defini ion! De"#rip ion$

Percutaneous transhepatic cholangiogram "PT4A# is a radiologic procedure usedto pinpoint bile duct blockages in your li&er.

A local anesthetic and medications are gi&en to make you sleepy and relaxed be%ore theprocedure. The doctor then inserts a long, %lexible needle into your li&er, using :-rays toguide the path. Once the needle has reached your li&er, the doctor in ects a dye thatmakes it possible to see the bile ducts on :-ray.

The test is considered normal i% the ducts appear to be o% normal si5e and the dye %lo$ssmoothly. +ou are diagnosed as ha&ing a problem $ith your bile duct system i% the ductsare much narro$er or $ider than they should beF or, i% there is a duct $here the dye istrapped and cannot %lo$.

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+ou lie on a table $earing a hospital go$n. An ( "intra&enous# line is insertedinto a &ein in case you need medicines or %luid during the procedure. An area o&er yourright ribcage is cleaned $ith an antibacterial soap. Then the radiologist may take apicture o% your abdomen $ith an o&erhead camera. edicine is in ected through a smallneedle to numb the skin and the tissue underneath the skin in the area $here the dye is

to be in ected. +ou may %eel some brie% stinging %rom the numbing medicine.

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A separate needle is then inserted bet$een t$o o% your ribs on your right side. A smallamount o% xray dye is in ected, and some pictures are taken that are &isible on a &ideoscreen. +our doctor ad usts the placement o% the needle until it is clear that the dye is%lo$ing easily through the ducts "drainage tubes# inside your li&er.

!ecause taking the x-ray pictures sometimes re3uires a signi%icant amount o% time, the

doctor replaces the needle $ith a so%ter plastic tube. 8irst, the syringe holding the dye isdetached %rom the top o% the needle, lea&ing the needle in place. The doctor then gentlypushes a thin $ire through the needle and into the duct $here the needle has beensitting. >ext the needle is pulled out, sliding o&er the outside end o% the $ire. The $ire isle%t $ith one end inside the li&er to hold the position $here the needle had been. A thinplastic tube similar to an ( line is slid along the $ire, like a long bead on a string, until itis in the same place $here the needle $as. The $ire is then pulled out, and the dyesyringe is attached to the tube.

ore dye is in ected through the plastic tube, and pictures are taken $ith the &ideo

camera as the dye spreads inside the li&er. (% there is no blockage, the dye drains out o%the li&er through the bile ducts and begins to sho$ up on the x-ray in the area o% yoursmall intestine. Once all o% the needed pictures ha&e been taken, the plastic tube ispulled out, and a small bandage is placed o&er your side. The $hole test usually takesless than an hour.

p4 S im&la ion Te" "

Test in&ol&ing p) stimulation are used to determine the response o% gastric acid

secretion to a chemical stimulusF they are sometimes used to diagnose hyposecretoryand hypersecretory gastric acid disorders. /astric secretions are collected %rom thestomach by aspiration through a nasogastric tube. 2ecretions are collected at baselineand a%ter stimulation $ith beta5ole or pentagastrin.

S#hilling Te"

The 2chilling test is used to determine $hether the body absorbs &itamin !;0 normally.

This test may be done in %our di%%erent stages to %ind the cause o% a lo$ &itamin !;0le&el.

2tage (' +ou get t$o doses o% &itamin !;0 "cobalamin#. +ou take a small, %irstdose "a radioacti&e %orm o% !;0# by mouth. +ou get a second, larger dose by ashot ; hour later. +ou then collect your urine o&er the next 0* hours and deli&er itto a lab or your doctor7s o%%ice. The urine is checked to see i% you are absorbing&itamin !;0 normally. (% 2tage ( is abnormal, 2tage (( may be done 9 to G dayslater.

2tage ((' +ou are gi&en radioacti&e !;0 along $ith intrinsic %actor. (ntrinsic %actor is a protein produced by cells in the stomach lining. The body needs it so theintestines can absorb &itamin !;0.2tage (( o% the test can tell $hether a lo$ &itamin !;0 le&el is caused byproblems in the stomach, pre&enting it %rom producing intrinsic %actor.(% 2tage (( is abnormal, a 2tage ((( test is done.2tage (((' This test is done a%ter you ha&e taken antibiotics %or 0 $eeks. (t can tell$hether abnormal bacterial gro$th has caused the lo$ &itamin !;0 le&els.2tage ( ' This test determines $hether lo$ &itamin !;0 le&els are caused byproblems $ith the pancreas. With this test, you take pancreatic en5ymes %or 9

days. +ou then take a radioacti&e dose o% &itamin !;0.1).Sigmoido"#opy

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Defini ion! De"#rip ion$

A sigmoidoscopy is a screening or diagnostic test that allo$s a doctor to seeinside the lo$er 01 inches o% the sigmoid colon and rectum "also called the largeintestine#, $hich plays an important role in the bodyEs ability to process $aste.

During a sigmoidoscopy, the doctor inserts a sigmoidoscope "a pencil thin, %lexible tube$ith a light and a camera# into the anus "the opening at the end o% the large intestine,$here bo$el mo&ements lea&e the body#. The tube is slo$ly mo&ed through the rectum"the %inal portion o% the large intestine, $hich stores $aste# and into the lo$er part o% thecolon. The doctor &ie$s the inside o% the colon through the scope or on a &ideo monitor.

A sigmoidoscopy is o%ten used to %ind intestinal polyps, $hich are small abnormalgro$ths that may become cancerous, as $ell as to screen %or colorectal cancer. (t canalso be used as a diagnostic test %or patients $ho ha&e rectal bleeding, a change inbo$el habits, or other symptoms.

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During the test'

+ou lie on your le%t side $ith your knees dra$n up to your chest.

The doctor gently places a glo&ed and lubricated %inger into your rectum to check %orblockage and gently enlarge "dilate# the anus. This is called a digital rectal exam.

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>ext, the sigmoidoscope is placed through the anus. The scope is a %lexible tube $ith acamera at its end. The scope is gently mo&ed into your colon. Air is inserted into thecolon to enlarge the area and help the doctor &ie$ the area better. The air may causethe urge to ha&e a bo$el mo&ement or pass gas. 2uction may be used to remo&e %luidor stool.

The doctor may take tissue samples $ith a tiny biopsy tool inserted through thescope. )eat "electrocautery# may be used to remo&e polyps . Photos o% the inside o%your colon may be taken.

2igmoidoscopy using a rigid scope may be done to treat problems o% the anus orrectum.

E. 4EMATOLOGI* SYSTEM

General Labora ory Te" "

1. A(O (lood Typing

Defini ion! De"#rip ion$

!lood typing is a method to tell $hat speci%ic type o% blood you ha&e. What type youha&e depends on $hether or not there are certain proteins, called antigens, on your redblood cells.

!lood is o%ten grouped according to the A!O blood typing system. This method breaksblood types do$n into %our types'

Type A Type ! Type A! Type O

+our blood type "or blood group# depends on the types that are been passed do$n toyou %rom your parents.

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A blood sample is needed and $ill bedra$n %rom a &ein.

The test to determine your blood group is called A!O typing. +our blood sample ismixed $ith antibodies against type A and ! blood, and the sample is checked to see$hether or not the blood cells stick together "agglutinate#. (% blood cells stick together, itmeans the blood reacted $ith one o% the antibodies.

The second step is called back typing. The li3uid part o% your blood $ithout cells"serum# is mixed $ith blood that is kno$n to be type A and type !. Persons $ith type Ablood ha&e anti-! antibodies, and those $ith type ! blood ha&e anti-A antibodies. TypeO blood contains both types o% antibodies. These t$o steps can accurately determineyour blood type.

!lood typing is also done to tell $hether or not you ha&e a substance called h %actoron the sur%ace o% your red blood cells. (% you ha&e this substance, you are consideredhH "positi&e#. Those $ithout it are considered h- "negati&e#. h typing uses a methodsimilar to A!O typing.

'. (lood Smear

Defini ion! De"#rip ion$

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A blood smear is a diagnostic test used to look %or abnormalities $ithin the blood. Thecell types are examined under a microscope %or unusual shapes or si5es. There arethree main cells $ithin the blood that the test %ocuses on'

red cells "$hich carry oxygen throughout the body# $hite cells "$hich %unction as part o% the bodyEs immune system# platelets "$hich are important %or blood clotting#

Abnormalities in the shape, si5e, and number o% the red blood cells can a%%ect ho$oxygen tra&els throughout the blood. These abnormalities are o%ten caused by a mineralor &itamin de%iciency, but can be caused by abnormal proteins such as in sickle cellanemia.

White blood cells are an integral part o% the bodyEs immune system, a net$ork o% tissuesand cells that %unction to keep the body sa%e %rom in&ading microorganisms andeliminate existing in%ection. Disorders a%%ecting these cells can o%ten result in the bodyEsinability to eliminate or control in%ections.

Platelet disorders a%%ect blood clotting and are o%ten the result o% the body producing the$rong amount o% platelets needed "either too many or too %e$#.

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Procedure %or making !lood smears "thin %ilms# '

To do a blood smear you need t$o slides. On one slide the blood sample isplaced - this is the IsampleI slide. The second slide is used to smear the drop o%blood - this the IspreaderI slide.4lean the sample slide by $iping it $ith alcohol. )andle slides by edges only."any grease on the slide $ill cause the dried blood to %lake o%% during staining#.Place a &ery small drop o% blood near the end o% the sample slide.Place the end o% the spreader slide on the sample slide so that the short sidededge o% the spreader is ust belo$ the drop o% blood.The next t$o steps should be done 3uickly to a&oid smears that are too thick.)olding the spreader at an angle o% 91o "relati&e to the sample slide#, push thespreader so that the edge ust barely touches the drop o% blood. !y capillaryaction, a thin line o% blood $ill spread along the edge o% the spreader .Juickly drag the spreader along the entire length o% the sample slide in one %luidmotion. >ote that the blood is being dragged by the spreader.

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(leeding Time Te#hni5&e

The test is per%ormed using a disposabletemplate that produces a uni%orm incision. Theincision, either hori5ontal or &ertical, is placed on thelateral aspect o% the %orearm, about < cm belo$ the

antecubital %ossa, a%ter a blood pressure cu%% hasbeen in%lated to approximately *1 mm )g. !loodmay be absorbed o%% the skin, but care must betaken to a&oid pressure. The time is measured %romthe moment o% incision to the moment bleedingstops. The time may &ary based on the commercialtemplate used, the direction o% the incision, and the location on the arm. Cach institutionmust establish its o$n upper limits o% normal.

A# i6a ed %ar ial Thrombopla" in Time Te#hni5&e

4itrated plasma, an acti&ating agent, andphospholipid are added together and incubated at9G 4. 4alcium is added, and the time necessary %or the clumping o% kaolin is measured. The normaltime is usually reported as less than 91 to 9ote' The

thickness o% the preparation may preclude an examination under oil immersion2ee 8igure ;, $hich illustrates this modi%ied /ram staining method.

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,. India In< %repara ion

Defini ion! De"#rip ion$

A diagnostic test used to detect the cryptococcal organism C. neoformans . A dye,called (ndia ink, is added to a sample o% 428 %luid, and i% the %ungi is present, they $ill

become &isible as the dye binds to the capsule surrounding the %ungus .

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2pecimen 4ollection' 2pecimens should be collected in sterile containers or $ith sterile

s$abs and transported immediately to the laboratory. This product is used incon unction $ith other biochemical and serological tests to identi%y cultures o% isolatedorganisms.

Me hod of :"e$ ix the specimen $ith a small drop o% (ndia on a clean glass slide.Place a co&er slip o&er the smear and press gently. The preparation should bebro$nish, not black. sing reduced examine the smear microscopically ";11:# %or thepresence o% encapsulated cells as indicated by clear 5ones surrounding the cells.

No e$ The (ndia is ready to use. 8urther dilution $ith $ater is not recommended.

No e$ Production o% capsular material may be increased by culti&ation in a ; peptonesolution "Peptone !roth, 4at. no. K;

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The minimum bactericidal concentration " !4# is the lo$est concentration o% anantibacterial agent re3uired to kill a particular bacterium. (t can be determined %rombroth dilution minimum inhibitory concentration " (4# tests by subculturing to agarplates that do not contain the test agent.

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;. 8rom each (4 broth tube $ithout &isible gro$th, ali3uot a ;11 ml &olume o% thebroth onto ueller-)inton agar and spread across the entire sur%ace o% the plate.

0. ecord the dilution o% the subcultured (4 tube on each plate and incubate at9o gro$th indicates that theantibiotic $as bactericidal at that dilution. /ro$th indicates that the antibiotic $asbacteriostatic but not bactericidal at that dilution.

. %o a""i&m 4ydro=ide prepara ion

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The KO) " potassium hydroxide# preparation is used to %ind out $hether a %ungalin%ection is present on the skin .

A sample o% skin is taken by lightly scraping the in%ected area.

The skin sample is placed on a slide $ith KO) solution. This solution slo$ly dissol&esthe skin cells but not the %ungus cells. The %ungus cells can then be seen $ith amicroscope. 4olor stains may be used so that the %ungus is easier to see.

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The KO) test %or %ungus is conducted on an outpatient basis and patients do notneed to prepare in ad&ance. esults are usually a&ailable $hile the patient $aits or thenext day i% sent to a clinical laboratory . The KO) test procedure may be per%ormed by aphysician , physician assistant, medical assistant, nurse, or medical laboratorytechnician. (% %ungal cultures are re3uired, the test is per%ormed by a technologist $hospeciali5es in microbiology.

;. 4ollection' 2kin, nail, or hair samples are collected %rom the in%ected area on thepatient. 8or skin samples, a scalpel or edge o% a glass slide is used to gently

scrape skin scales %rom the in%ected area. 8or hair samples, a %orceps is used toremo&e hair sha%ts and %ollicles %rom the in%ected site. (% the test is being sent to alaboratory, the scrapings are placed in a sterile co&ered container.

0. The scrapings are placed directly onto a microscope slide and are co&ered $ith;1 or 01 potassium hydroxide.

9. The slide is le%t to stand until clear, normally bet$een %i&e and %i%teen minutes, inorder to dissol&e skin cells, hair, and debris.

*. To enhance clearing dimethyl sul%oxide can be added to the slide. To make the

%ungi easier to see lactophenol cotton blue stain can be added.

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A rapid plasma regain " P # test is a blood test used to screen patients %orsyphilis. (t $orks by detecting the antibodies that the body produces to %ight thein%ection.

2yphilis is a sexually transmitted in%ection that can be %atal i% le%t untreated. The Ptest allo$s a doctor to con%irm diagnosis and begin treatment, reducing the chances o%complications and the spread o% the disease by an in%ected but una$are person.

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!ring P Antigen 2uspension, Positi&e 4ontrol, >egati&e control and samples to roomtemperature "01@91 o4# be%ore use.

All reagents are ready %or use as supplied. /ently mix the reagents be%ore useF a&oid%oaming.

>&ali a i6e R%R Te" %ro#ed&re$

;. ?abel a P card $ith patient and control in%ormation being care%ul not tointer%ere $ith the test areas o% the card.

0. sing disposable serum dispensers or droppers, dispense one %ree-%alling drop"1.1< ml# o% serum or plasma sample onto a circle on the test card. When usingdroppers dispensers, keep it in a &ertical position to ensure accurate deli&ery.

9. epeat by adding one %ree-%alling drop o% positi&e control and >egati&e controlusing a ne$ dispenser %or each sample.

*. 2pread the sample smoothly across the circle area using the paddle side o% theDispenser as sho$n by instructor. Take care not to scratch the test area.

ote' hold the antigencontainer upside do$n directly o&er the test area such that the drop %alls directlyonto the center o% the circle. DO >OT 2T( O 2P CAD T)C A>T(/C>.

=. Place the card on an automatic rotator and co&er to maintain humidity. otate at;11 Q < rpm %or minutes "G minutes

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2erologic tests can in&ol&e a number o% laboratory techni3ues. Di%%erent types o%serologic tests can be used to diagnose &arious health issues. Tests ha&e one thing incommon' they all %ocus on proteins made by the bodyEs immune system. This &ital bodysystem helps keep us healthy by destroying %oreign in&aders that can make us ill. (tdoesnEt matter $hat type o% techni3ue is used in the laboratory during serologic testing6the process %or the patient is the same.

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2. ?enereal Di"ea"e Re"ear#h Labora ory Te"

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The &enereal disease research laboratory " D ?# test is designed to assess$hether or not you ha&e syphilis, a sexually transmitted in%ection. (nstead o% testing %orthe bacteria that causes syphilis, the D ? test checks %or antibodies to this bacteria.+our immune system produces a speci%ic kind o% an ibody "a type o% protein# $hen it

de%ends your body %rom syphilis. Testing %or this antibody can let your doctors kno$$hether you ha&e syphilis.

+ou do not need to ha&e signs or symptoms o% syphilis %or this test to be accurate.!ecause it checks %or syphilis antibodies, it can be used regardless o% $hether youcurrently ha&e any symptoms.

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;. 4ollect a G-m? blood serum sample in a red-topped tube. Obser&e standard

precautions. 8asting is usually not re3uired.0. Place specimen in a bioha5ard bag %or transport to the laboratory.

13.8e Mo&n "