Question

1. Instruct a patient in the collection of specimens for occult blood, including providing an explanation of dietary restrictions. 2. Explain the physiologic significance of the lecithin-sphingomyelin (L/S) ratio.

Answer 1

1. Following instructions should be dine for the collection of occult blood.

Remove the hemoccult slide from the envelope. Make sure that they are not wetting.

Open the large front flap of slide. Do not mind the discolouration in it.

Sit on the toilet and collect your stool.

Take a sample of stool in one end of applicator and make a smear over the slide square marked as A. Same way make smear on square B by taking sample from different part of stool.

Cover the slide and put back it into the envelope.

Dietary restrictions: before 3 days of test avoid red meat beef lamb or liver

Also avoid raw fruits and veggies. Food containing vitamin c also avoided.

If the patient is having antacids or anti diarrhoeals should be stopped until the test is over.

2. Significance of Lecithin-Sphingomyelin test:

It is the marker of fetal lung maturity. If the ratio is less than 1.5:1 then baby lung are immature. If it is between 1.5:1 and 1.9:1 then baby is under risk of immature lung and if it is more than 2:1 then baby have matured lungs.

It is very important to find out lung maturity inorder to predict the life of the baby outside the uterus. It will help to find whether the baby have any difficulty to breath or not.

3. Etiology: Transudate can be caused from congestive heart disease or hypoprotenemia. It is due to the change in osmotic pressure. Exudate can be caused from malignancy, inflammation, chemotherapy or radiation therapy. It is by the damage of capillary wall.

Appearance: transudate have clear appearance wherever exudates have turbid or bloody appearance.

Lab tests: transudate have low protein content less than 30 g/L where as exudate have high protein content greater than 30 g/ L.

transudate have low cellularity where as exudates have high.

Transudate implies systemic problems whereas exudates implies local problems.

4. The tests performed in pleural fluid include gram stain and cultures, cell counts and differential tests and glucose amylase, lactic acid dehydrogenase test.

These tests are used to detect cause of accumulation of fluid in the chest cavity. Any injury or inflammation in the pleura can be noted. The presence of the microorganisms can also be detected. So that the detection of diseases like pneumonia , cancer, kidney diseases or any inflammatory diseases can be diagnosed. Heart failure or cirrhosis is detected from the transudate pleural sample collection.