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Index
I.3
Nontreponemal test 756
Evaluation of test procedures for
syphilis 768
Conrmatory test 768
Screening tests for syphilis 768
Specic test
(semi-conrmatory) 768
Fluorescent treponemal antibody absorption
test (FTA-ABS) 767
Rapid plasma reagin (RPR) test 756
Calibration 758
Interpretation of RPR results 762
Principle 757
Qualitative (screening) test 759
Quality control 759
Quantitative (reporting the titre) 761
Reagents and supplies 758
RPR slide test (qualitative) 760
Specimen 757
Treponemal test 763
Treponema pallidum
haemagglutination absorption test 765
Observation and reporting 766
Principle 765
Procedure 765
Reagents 765
Treponema pallidum IgM ELISA 763
Interpretation 764
Procedure 764
Specimen 763
Faecal specimen 574
Laboratory diagnosis of dysentery, diarrhoea
and enteric fever 574
Collection of specimen 575
Direct microscopic examination 575
Laboratory investigation 575
Laboratory diagnosis of infantile
diarrhoea 576
Other bacterial infections 579
Campylobacter spp. 579
Salmonella typhi 574
Shigella spp. 574
Vibrio infections and cholera 577
Halophilic 577
Laboratory investigation 577
Specimen collection 577
String test 578
Procedure 579
Reagent 578
V. cholerae 577
Vibrio parahaemolyticus 577
Forensic investigation for the presence of
semen 880
Chemical examination 881
Procedure 881
Reagent 881
Microscopic examination 880
Specimen collection 880
Formulae and preparation of culture media and
biochemical reagents 614
Preparation of culture media and biochemical
reagents 615
Amies transport medium 615
Bacitracin test 616
Bile esculin agar 616
Bile solubility test 617
Bismuth sulphite agar 617
Blood agar 617
Bordet-Gengou medium 618
Brain heart infusion broth and agar (BHIB,
BHIA) 619
Brilliant green agar 620
Cary–Blair transport medium 620
Catalase test 620
Cetrimide agar 621
Chocolate agar 621
Christensen urea agar 641
Citrate utilization test 621
Coagulase test 622
Deamination (phenylalanine) reaction 623
Decarboxylation 623
Deoxycholate citrate agar medium 624
Egg yolk agar 624
Eosin-methylene blue agar (EMB) 625
Eugon agar base 625
Fletcher’s medium for Leptospira 626
Gelatine liquefaction test 626
GN broth 627
Hydrogen–sulphide production test 627
Indole test 628
Kovac’s reagents 628
Lowenstein–Jensen medium 628
MacConkey agar 629
Mannitol salt agar 630
McBride medium 629
Methyl red test and Voges–Proskauer
Reaction (MR-VP) 630
Middlebrook 7H10 agar 631
Motility test 632
MR-VP broth 631
Mueller–Hinton agar 632
Nutrient broth and nutrient agar 632
Peptone water 633
Phenylalanine agar 633
Phenylethyl alcohol agar (PEA) 634
Salmonella–Shigella (S–S) agar 634
Selenite F broth 635
SIM medium 635
Simmon citrate agar 622
Staphylococcal latex agglutination test 636
Stuart transport medium 636
Sugar fermentation medium 636
Tellurite agar 637
Thayer–Martin medium 637, 638
Thioglycollate medium 638
Thiosulphate citrate bile salt sucrose (TCBS)
agar 640
Medical Laboratory Technology: Volume 2
I.4
Triple sugar iron agar (TSIA) slant 639
Trypticase soy broth (TSB) and Trypticase
soy agar (TSA) 641
Urease broth 642
Urease test 641
Xylose lysine desoxycholate agar 642
Preparation of indicator solutions 615
Gastric juice 869
Clinical signicance 869
Microscopic examination 869
Globulins 730
Human chorionic gonadotrophin 797
Slide agglutination test (Qualitative) 797
Observation and reporting 799
Precautions 799
Principle 798
Procedure 798
Reagents and supplies 798
Specimen 798
Semiquantitative estimation of hCG 799
Procedure 800
Specimen 800
Identication of pathogenic microbes 523
Direct examination 523
Presumptive diagnosis 523
Primary culture 524
Bacitracin 524
Examination of primary culture 524
Faecal materials 524
Inhibitory discs 524
Optochin 524
Primary culture media 524
Special biochemical media 526
Streaking 524
Subcultures 524
Use of inhibitory discs 526
Primary culture media 523
Secondary culture 523, 526
Broth culture method 527
Carbohydrate fermentation test 526
Paper-disc method 527
Identifying characteristics of common pathogenic
bacteria 591
Actinomyces 591
Bacillus anthracis 591
Bacteroides 592
Bordetella pertussis 592
Borrelia 592
Brucella 593
Citrobacter 593
Clostridium 594
Corynebacterium diphtheriae 594
Edwardsiella 595
Enterobacteriaceae 595
Enterococcus 605
Escherichia coli 595
Francisella tularensis 596
Haemophilus inuenzae 596
Klebsiella 596
Lactobacillus 597
Leptospira 597
Listeria monocytogenes 597
Moraxella catarrhalis 598
Mycobacterium 598
Mycobacterium leprae 598
Mycobacterium tuberculosis 598
Neisseria gonorrhoeae (gonococcus) 599
Neisseria meningitidis (meningococcus) 599
Nocardia 599
Prevotella and Porphyromonas 600
Proteus 600
Providencia 601
Pseudomonas 601
Salmonella and Shigella 601
Serratia 602
Shigella 602
Staphylococcus aureus 603
Streptococcus agalactiae 604
Streptococcus pneumoniae 605
Streptococcus pyogenes 604
Vibrio cholerae 605
Yersinia 605
Identifying characteristics of common pathogenic
fungi 663
Characteristic features 663
Dimorphic 663
Hyphae 663
Mould 663
Mycelium 663
Phenotypic 663
Septa 663
Yeast 663
Conventional approach and current
development 664
Dermatomycosis 664
Epidermophyton 666
Microsporum 666
Trichophyton 666
Identication challenge 664
Subcutaneous mycosis 666
Chromoblastomycosis 667
Mycetomas 667
Sporothrix schenckii 666
Systemic mycosis 668
Monomorphic pathogenic yeasts:
Cryptococcus 668
Opportunistic fungi: Aspergillus, Mucor,
Rhizopus 668
Phenotypic dimorphs: Candida,
Geotrichum 668
Thermally Dimorphic Organisms: Histo-
plasma, Coccidioides, Blastomyces 668
Immune process of the body 730
First line of defence 730
Inammation 730
Flowchart showing the three lines of defence in
the body 731
Second line of defence 731
Index
I.5
Chemotaxis 731
Third line of defence 731
Cell-mediated immunity 731
Humoral immunity 731
Memory 731
Primary immune response 731
Secondary immune response 732
Specicity 731
T cells and B cells 732
Immune response 729
Immunity 729
Immunoglobulins 730
Immunologic test for pregnancy 797
Immunology 729
Immunology and serology 735
Infectious mononucleosis and monospot test 785
Monospot test (heterophil test) 786
Procedure 786
Supplies 786
Introduction to fungi and mycotic agents 644
Saprophytic 645
Laboratory culture 500
Aerobic culture 519
Alkaline–pyrogallol method 520
Anaerobic culture 519
Biochemical media and tests 502
Quality control of commonly used media
and biochemical tests 502
Brewer anaerobic jar and Gas-Pak system for
anaerobic culture 521
Palladium granules 521
Candle jar technique 519
Capnophilic culture 519
Culture environments 517
Aerobes 517
Anaerobes 517
Capnophiles 517
Facultative anaerobes 517
Microaerophilic organisms 517
Culture media 500
Broth media 501
Primary media 501
Secondary media 501
Semisolid media 501
Solid media 501
Dierential media 501
Enrichment media 501
General-purpose media 501
Inoculation in test tubes 516
Inoculation of multiple tubes 517
Making of agar slants 506
Bu 506
Stab cultures 506
Making of culture plates 507
Other special media for anaerobes 520
pH adjustment of culture media 502
Preparation of culture media 502
Procedure of streaking on primary media 513
Alternative method of streaking 516
Continuous streaking method 514
Discontinuous streaking method 514
Media selection for primary culture of
various specimens 513
Procedure of streaking on primary solid
agar plates 514
Streaking technique 515
Procedures of aseptic transfers 509
Aseptic transfer in case of test tubes 512
Aseptic transfer technique with capped
culture tubes 512
Aseptic transfer to Petri dishes 512
Aseptic transfer using loop 511
Selective and selective-dierential media 501
Storing of culture media 505
Thioglycollate broth method 519
Transport media 502
Amies transport media 502
Cary-Blair 502
Stuart transport medium 502
Use of inoculating needle and loop 508
Flame sterilization of loop and needle 509
Making of inoculating loop 509
Preparing wire loops 508
Laboratory diagnosis of bacteraemia 556
Common oending organisms 556
Laboratory diagnosis of septic throat 557
Respiratory tract specimens 557
Streptococcus pyogenes 557
Throat swab 557
Laboratory diagnosis of helminth infections 716
Cestodes 717
Identication characters of helminths 717
Ancylostoma duodenale and necator americanus
(hookworms) 719
Ascaris lumbricoides (large intestinal
roundworm) 717
Corticated 717
Enterobius vermicularis (pinworm) 719
Fertilized eggs 718
Hymenolepis nana (dwarf tapeworm) 723
Liver uke (Fasciola hepatica) and intestinal
uke (Fasciolopsis buski) 723
Onchocerciasis 722
Laboratory ndings 722
Onchocerca volvulus 722
Schistosoma (blood ukes) 723
Laboratory investigation 723
Strongyloides stercoralis (threadworm) 719
Taenia spp. (beef and pork tapeworm) 724
Dracunculiasis (Guinea-worm
disease) 724
Dracunculus medinensis 724
Laboratory diagnosis 724
Trichuris trichiura (whipworm) 719
Unfertilized eggs 718
Wuchereria bancrofti (Microlaria) 720
Blood staining procedure for examining
microlaria 721
Chyluria 720
Medical Laboratory Technology: Volume 2
I.6
Concentration technique 722
Lymphatic lariasis 720
Nocturnal periodicity 720
Observation 720
Procedure 720
Serodiagnosis of Wuchereria Bancrofti
(Microlaria) infection 722
Identication of common helminth eggs 716
Nematodes 717
Soil transmied nematodes 717
Trematodes 717
Laboratory diagnosis of leprosy 587
Procedure for skin scrapings 588
Specimen collection 587
Laboratory diagnosis of mycotic infections 649
Evaluation of laboratory methods 649
Conventional methods 650
Laboratory culture 656
Common culture media used in
laboratory for various mycotic
infections 656
Preparation of culture media 657
Chlamydospore agar 657
Cornmeal agar 657
Liman Oxgall agar 657
Potato–dextrose agar 658
Rice–grain medium 658
Sabouraud dextrose agar (SAB) 658
Sabouraud dextrose agar with
antibiotics 660
Sabouraud dextrose broth 660
Requirements for laboratory culture 656
Laboratory procedures 651
Calcouor white with 10% KOH 654
Direct microscopic examination of
specimens 652
Histopathology of fungal infections 652
India ink preparation of CSF 654
Macroscopic examination 652
Wet mount in alkali solution 653
Wet mount in water 652
Wet mount procedures 652
Most likely mycotic agents in various
specimens 650
Cerebrospinal uid 651
Other specimens 651
Pus and exudates 651
Skin scrapings, nails and hairs 650
Sputum 651
Specimen collection and processing 650
Biochemical and other tests 661
Carbohydrate utilization (assimilation)
test 662
Germ tube test 661
Urease test 662
Microscopic examination of laboratory
cultures 660
Coverslip sandwich technique 661
Slide culture 661
Wet mount in lactophenol coon blue
(LPCB) 661
Laboratory diagnosis of parasitic infections 712
Cestodes 713
Classication of human parasites based on the
life cycle 713
Common intestinal parasites found in humans
713
Ectoparasites 712
ELISA update 715
Dot-ELISA 715
FAST-ELISA 715
Luciferase immunoprecipitation system
(LIPS) 715
Rapid antigen detection system
(RDTS) 715
Endoparasites 712
Helminths 713
Laboratory investigation 714
Nematohelminths 713
Platyhelminths 713
Trematodes 713
Laboratory diagnosis of pinworm infections 703
Cellophane tape method 703
Equipment and supplies 703
Procedure 703
Enterobius vermicularis 703
Specimen collection for pinworm infection 704
Laboratory diagnosis of protozoan infections 708
Chagas disease (Trypanosoma cruzi) 712
Chromatoid bodies 709
Laboratory diagnosis 712
Entamoeba histolytica 709
Characteristic features of E. histolytica 709
Charcot–Leyden crystals 709
Identifying characters of E. histolytica, E. coli
and I. büetschlii 709
Giardia lamblia 709
Leishmania 710
Laboratory diagnosis 710
Procedure 710
Morphological characters of common parasitic
protozoa 708
Sporozoa 711
Trichomonas vaginalis 710
Trypanosomes 711
Laboratory diagnosis of sleeping
sickness 711
Limitations 711
Microscopy 711
Serodiagnosis 711
Card agglutination test 711
Tsetse y 711
Laboratory diagnosis of renal
function 810
Collection of urine specimen 813
Instructions to female patient 813
Instructions to male patient 813
Instructions for 24-h urine specimens 814
Index
I.7
Midstream method 813
Common urine preservatives 813
Containers for urine collection 811
Identication of specimens 812
Preparation of the patient 811
Storage and preservation of urine
specimens 812
Urine specimens 810
Laboratory diagnosis of tuberculosis 570
Drug susceptibility testing 574
Gastric uid 571
Collection of specimen 571
Direct examination 572
Examination of slide and reporting 572
Intubation 571
Laboratory culture 573
Laboratory investigation 571
Preparation of smear 572
Report the results 573
Identication characters of Mycobacterium
tuberculosis 573
Inspissation process 574
Specimen collection and transportation 570
Protocol 570
Transportation of sputum specimen 571
Unacceptable specimens 571
Laboratory diagnosis of viral infections 531
Chikungunya 540
Laboratory diagnosis 541
Prevention 541
Criteria for diagnosing primary infection 533
Criteria for diagnosing secondary
infection 533
Dengue virus 541
IgG ELISA 541
Laboratory diagnosis 541
MAC-ELISA 541
Direct examination 532
Serological testing 532
Determination of the concentration of serum
antibodies (titre) following infection 532
ELISA (enzyme-linked immunosorbent
assay) 532
RIA (radioimmunoasay) 532
Zika virus infection 533
Calculation of results 539
Clinical signicance 533
Contents of the test kit 535
Pipeing protocol 539
Preparation and stability of the
reagents 536
Principle of the ELISA test 534
Procedure 538
Serological tests 534
Specimen preparation, processing and
handling 537
Summary of test reactions 535
Test characteristics 540
Three basic steps of incubation and
washing 538
Laboratory examination of body uids 805
Laboratory identication of infectious agents 553
Blood 553
Blood collection procedure 553
Biphasic 555
Monophasic 555
Sodium polyanethol sulphonate (SPS) 555
Laboratory investigation of other specimens for
parasitic infections 705
Sputum 705
Vaginal and urethral swab 706
Collection of specimen 707
Laboratory diagnosis of trichomoniasis 707
Procedure for microscopic examination 707
Urine 705
Urogenital swab 706
Laboratory procedures in parasitic infection 682
Collection and processing of faecal
specimens 684
Denitive diagnosis 682
Handling of specimens 683
Laboratory examination of stool 688
Gross examination 689
Identifying characters of large worms 689
Ancylostoma, Necator 689
Ascaris lumbricoides 689
E. vermicularis 689
Hymenolepis nana 689
Taenia 689
Trichuris trichiura 689
Preservation and transport of faecal
specimens 685
Direct examination of faecal material 688
Direct examination of liquid stool 688
Laboratory report of stool examination 701
Gross examination 701
Microscopic examination 702
Reporting 702
False-positive report 702
Measurement procedure 690
Microscopic examination of formed
stool 690
Preparation of PVA-xed smear 687
Preservatives 685
Procedure of xing stool specimen 687
Procedures for microscopic
examination 691
Direct wet mount 692
Flotation method for concentrating faecal
material 698
Flotation method of concentration 698
Formalin–ether centrifugal
sedimentation method 696
Iodine wet mount 692
Microscopic examination of stained dry
faecal smears 699
Iron haematoxylin stain 701
Trichrome stain 699
Medical Laboratory Technology: Volume 2
I.8
Procedure 697
Saline wet mount 692
Sedimentation method for concentration
faecal material 695
Simple sedimentation method 696
Processing of stool specimen for intestinal
parasite infection 688
Reagents 685
Stool specimen 683
Common protozoan infections in humans
and specimen required for laboratory
diagnosis 683
Cysts 683
Direct wet mount 683
Saline wet mount 683
Trophozoites 683
Tentative diagnosis 682
Limitations of serological diagnosis 542
Microbiology laboratory update 675
Antifungal susceptibility testing 676
Automation in microbiology laboratory 675
Immunologic and biochemical markers 676
Minimal inhibitory concentrations (MIC) 677
Morphological features of mycotic agents 646
Classication of mycotic agents 646
Dimorphic yeasts 648
Fungi imperfecti 646
Identifying characters of various mycotic
agents 647
Monomorphic moulds 646
Monomorphic yeasts 648
Thermally dimorphic mycotic agents 648
Mycotic agents classied by location 662
Deep 663
Candidiasis 663
Endemic mycoses 663
Systemic mycosis 663
Subcutaneous 662
Supercial 662
Candidiasis 662
Dermatomycosis 662
Pityriasis versicolor 662
Nasopharyngeal swab 559
Haemophilus infection 563
Chocolate agar 563
Direct examination 563
Satellite test 563
Laboratory diagnosis of bacterial
meningitis 562
Laboratory diagnosis of bacterial pneumonia
(S. pneumoniae) 561
Bile solubility test 561
Quellung test 561
Laboratory diagnosis of diphtheria
(Corynebacterium diphtheriae) 560
Laboratory diagnosis of thrush (Candida
albicans) 563
Sabouraud dextrose agar 563
Laboratory diagnosis of whooping cough
Bordetella pertussis 560
Meningococcal infection (Neisseria
meningitidis) 562
Carbohydrate oxidation test for the
identication of Neisseria species 562
Opportunistic fungi and lamentous bacteria 648
Current development 649
Parasites 679
Blood parasites 679
Classication 680
Clinical parasitology 679
Common parasitic diseases, their causal
agents 681
Denitive host 679
Geographic distribution 681
Host 679
Immunocompromised hosts 679
Infection 679
Infective stage and diagnostic stage 681
Infestation 679
Intermediate hosts 679
Life cycle 680
Opportunistic parasites 679
Prevention of parasitic infection 682
Mosquito control measures 682
Susceptibility and treatment 682
Transmission routes 681
Pathogenic organisms 730
Microscopic examination 485
Acid-fast stain 495
Albert’s stain 499
Procedure 500
Reagent 499
Direct examination (wet mount) 485
Dark-eld microscopy 486
India ink preparation 489
Method of examining hanging drop 488
Procedure for wet mount 486
Procedure of hanging drop
examination 488
Wet mounting technique 487
Examination of stained smear (dry
mount) 489
Dierential stains 489
Simple staining 489
Gram staining 490
Gram staining procedure 493
Gram-staining reaction of important
pathogenic bacteria 494
Principle 490
Procedure 492
Reagent 491
Kinyon method (’cold stain’) 499
Procedure 499
Reagent 499
Modied Ziehl–Neelsen stain (’cold
stain’) 498
Index
I.9
Procedure 499
Reagent 498
Simple staining 489
Procedure 490
Reagent 490
Ziehl–Neelson method (’hot stain’) 496
Procedure 496
Reagent 496
Preservation of stock cultures 521
Long-term preservation 521
Short-term preservation 523
Principles of serological procedures 737
Epitope 738
Monoclonal antibodies 738
Polyclonal antibodies 738
Recognition of antigen–antibody
reactions 737
Reporting of serological tests 738
Qualitative 738
Quantitative 738
Semiquantitative 738
Sensitivity and specicity of test
procedure 738
Titre determination 738
Problems in serological assays 746
Complement 749
Principle of counter
immunoelectrophoresis 748
Principle of immunoelectrophoresis 748
Prozone phenomenon 746
Processing of watery stool specimen during cholera
epidemic 893
Chemical tests 897
Serological reactions 897
Staining and biochemical reactions of
V. Cholerae 897
Clinical signicance and treatment 893
Dispatch of specimen for laboratory
culture 894
Epidemic cholera 893
Laboratory analysis 894
Immobilization test 894
Laboratory culture 896
Oxidase test of colonies 897
Oxidase test results 897
Microscopic examination 894
Equipment and reagents 895
Procedure 895
Specimen collection and processing 893
Transport media 894
Purulent exudates 564
Ear exudates 568
Otitis externa 568
Routinely cultured 568
Exudates from infected wounds: specimen
collection and processing 564
Beta-haemolysis 565
Biochemical reactions 566
Laboratory diagnosis 565
Oxidase test 566
Eye exudates 567
Commonly used media 567
Direct examination 567
Laboratory culture 567
Nagler reaction for identifying Clostridium
perfringens 567
Quality control in microbiology 521
Quality management in serology laboratory 751
Internal quality assessment (IQA) 752
Monitoring the operation of laboratory
equipment 752
Workbook records 751
Quellung reaction 549
Dierentiating aerobic gram-negative
cocci 550
Gram-negative bacilli 550
Enterobacteriaceae 550
Gram-negative cocci 549
Branhamella catarrhalis 549
Moraxella catarrhalis 549
N. gonorrhoeae 549
Neisseria meningitidis 549
Gram-positive bacilli 550
Bacillus anthracis 550
Bacillus cereus 550
Clostridium spp. 550
Corynebacterium diphtheriae 550
Listeria monocytogenes 550
Obligate intracellular organisms 552
Organism with no cell wall 553
Respiratory tract 551
Spirochetes and lamentous bacteria 552
Zoonotic 552
Quick reference of media and biochemical
tests 527
Spot test for oxidase 530
Virus 530
Role of microbiology laboratory 473
Routine examination of urine 814
Physical examination 814
Appearance (transparency or clarity) 816
Colour 815
Odour 816
Phenylketonuria 816
Procedure 815
Volume 815
Specimen preparation 814
Reagents, supplies and equipment 814
Specic gravity 816
Determination of specic gravity of
urine 817
Refractometer method 819
Principle 819
Procedure 819
Refractometer method of determining the
specic gravity of urine 820
Medical Laboratory Technology: Volume 2
I.10
Urinometer method 817
Correction of urinometer reading 81
Flotation method of determining specic
gravity of urine 817
Precautions 818
Principle 817
Procedure 817
Reading the urinometer scale 818
Rules of microbiology laboratory 474
Additional information for specimen
collection 477
Immediate culture 478
Criteria to reject specimens 478
Laboratory records 478
Accession number 479
Book-in ledger 479
Day-book 479
Report book 479
Technician’s record book 479
Procedures for reporting of results 479
Routine laboratory reports 479
Conrmatory reports 480
Grading 481
Provisional reports 480
Quantication of results 481
Stat (urgent) report 480
Stages of reporting—partial and
denitive 480
Safety regulations 481
Dealing with mishaps caused by contaminated
materials 482
Disposal of specimens after laboratory
use 482
Specimen collection and processing 474
Containers 475
Containers and collection devices used for
various specimens 477
Transportation of specimen 477
Charcoal-impregnated swabs 477
Transport media 477
Semen analysis 872
Abnormal results 874
Clinical signicance 874
Examination of seminal uid 873
Laboratory investigation 875
Physical examination 876
Appearance 876
Coagulation and liquefaction 876
pH 876
Volume 876
Chemical examination 879
Fructose 879
Microscopic examination 877
Commonly seen abnormalities 878
Normal forms of sperms 878
Sperm count 878
Sperm morphology 877
Sperm motility 877
Study of stained smear 878
Basic fuchsin stain 878
Giemsa stain 878
Normal results 874
Specimen collection 874
Serodiagnosis 736
Evaluation of serodiagnostic procedures 737
Serodiagnosis of streptococcal infection 780
Additional serodiagnosis kits 784
Serological identication of Staphylococcus
and Streptococcus 785
Staphylococcal and streptococcal
infections 784
Anti-streptolysin (ASO) tube test
(quantitative) 782
Observation and reporting 784
Principle 783
Procedure 783
Reagents and supplies 783
Anti-streptolysin O (ASO) slide agglutination
test (qualitative) 780
Principle 781
Procedure 781
Reagents, supplies and equipment 781
Specimen collection and storage 780
Principle 780
Streptozyme slide agglutination test
(qualitative) 782
Principle 782
Procedure 782
Reagents and supplies 782
Serodiagnostic tests for miscellaneous
infections 786
Acquired immuno-deciency syndrome
(AIDS) 786
Rapid tests for HIV antibody 787
Dipstick test 787
Observation and reporting 788
Procedure 788
Reagents and supplies 788
Enzyme-linked immunosorbent assay for
HIV 787
Quality control 787
Immunoassay for inuenza 796
Chromatographic immunoassay 796
Leishmaniasis 795
Immunological tests 796
Laboratory diagnosis 796
Malaria 790
Dipstick test for malaria 790
Observation and reporting 791
Procedure 790
Reagents and supplies 790
Rubella (German measles) 792
Toxoplasmosis 792
Toxoplasma IgA ELISA 792
Interpretation 794
Procedure 793
Results 793
Specimen collection 792
Index
I.11
Trypanosomiasis 794
Agglutination test for trypanosomiasis 794
Observation and reporting 795
Reagents and supplies 794
Specimen collection 795
Viral hepatitis 788
Dipstick test for hepatitis B surface
antigen 789
Procedure 790
Reagents and supplies 790
ELISA for hepatitis B surface antigen 788
Precautions 789
Procedure 789
Reagents and supplies 789
Serological tests for syphilis 754
Nontreponemal test 755
Treponemal test 755
VDRL (Venereal Disease Research Laboratory)
test 755
Serous uids 861
Clinical signicance 861
Introduction 861
Laboratory investigation 861
Chemical examination 863
Microbiological examination 863
Microscopic examination 862
Physical examination 861
Specimen collection 861
Specic bacteria 549
Gram-positive cocci 549
Staphylococci 549
Streptococci 549
Sputum specimen 568
Collection of sputum specimen 568
Laboratory diagnosis 569
Charcot–Leyden crystals 569
Direct examination 569
Routine procedure for sputum culture 570
Sputum induction by aerosol technique 569
Stool examination 882
Clinical signicance 883
Collection of faecal specimen 883
Disposing the specimen after examination 884
Laboratory investigation 884
Chemical examination of stool 889
Faecal occult blood test (FOBT) 889
Aminophenazone test for occult
blood 891, 892
Benzidine test for occult blood in
stool 891
Guaiac occult blood test 890
Microscopic examination 886
Artefacts seen in stool specimen 887
Dry mount 889
Examination of faecal material for direct
microscopic examination 886
Wet mount 886
Procedure 886
Physical examination 884
Colour and consistency 885
Odour 885
Presence of blood, mucous and pus 885
Synovial uid 864
Abnormal ndings with synovial uid 864
Clinical signicance 864
Introduction 864
Laboratory investigation 865
Physical examination 865
Clot formation 866
Tests for viscosity 865
Mucin clot test 865
String test 865
Microscopic examination 866
Microscopic examination of crystals 866
Chemical examination 867
Glucose 867
Microbiological examination 867
Wet mount 866
Specimen collection 865
Systematic grouping of pathogenic bacteria 547
Basis of grouping 547
Classication of commonly encountered
pathogenic bacteria 548
Traveller’s mycoses 663
Urine examination 814
Microscopic examination 820
Examination of urine sediment 821
Casts and crystals of urine
sediment 824
Cellular structures seen in urine
sediment 823
Clinical signicance 821
Identication of microscopic elements in
urine sediment 825
Cellular elements 825
Casts 826
Cellular casts 826
Epithelial cells 826
Granular casts 826
Hyaline casts 826
Microorganisms 827
Other substances in urine
sediment 828
Oval fat bodies 827
Red blood cells 825
Unorganized elements 827
Waxy casts 826
White blood cells 826
List of commonly requested tests 830
Bilirubin 831
Blood 832
Glucose 831
Ketones 832
Leukocyte esterase 834
Nitrite 834
pH 832
Medical Laboratory Technology: Volume 2
I.12
Protein 833
Specic gravity 834
Urobilinogen 833
Multitest reagent strips 829
Precautions of handling test strips 830
Preparation of urine specimen for microscopic
examination 822
Procedure 821, 829
Quality control 823
Quality control and reference values 830
Reagent strip readers 829
Specimen for reagent strip test 830
Rapid chemical tests 829
Single analyte and special reagent strips 834
Bilirubin 841
’Ictotest’ tablet test 841
Procedure 841
Blood 842
Benzidine test 842
Principle 842
Procedure 843
Reagents 843
Glucose 835
Benedict’s test 835
Alternative quick
method 836
Principle 835
Procedure 835
Reagent 835
Clinitest tablet method 837
Principle 837
Procedure 837
Ketone 840
’Acetest’ tablet 840
Principle 840
Procedure 840
Mucopolysaccharide (MPS) 843
Principle 843
Phenylpyruvic acid 843
Principle 843
Interpretation 843
Protein 837
Heat test for Bence–Jones protein 839
Clinical signicance 839
Principle 839
Reagents 839
Heat test for protein 838
Principle 838
Procedure 838
Reagents 838
Sulphosalicylic acid test 837
Principle 837
Procedure 837
Reagent 837
Urobilinogen 841
Ehrlich test 841
Principle 841
Wallace–Diamond quick screen
method 841
Conrmation of screening test 842
Reagents 841
Screening procedure 842
Urine specimen 579
Laboratory diagnosis of urinary tract
infections 580
Identication procedure 581
Procedure to determine colony count 580
Pyuria 579
Signs of infection 579
Specimen collection 580
Urethral, prostatic and cervical exudates 582
Laboratory diagnosis of gonorrhoea 582
Laboratory culture 583
Laboratory culture of Neisseria
gonorrhoea 584
Laboratory diagnosis of gonorrhoea in
female by direct examination 583
Laboratory diagnosis of listeriosis 585
Listeria monocytogenes 585
Psychrotroph 585
Specimen collection 582
From the female 582
From the male 582
Vaginal discharge 867
Clinical signicance 867
Laboratory investigation 868
Laboratory culture 869
Microscopic examination 868
Three-slide test for vaginitis 868
Rapid tests for vaginosis and vaginitis 869
Specimen 868
Visible immunologic reactions used in
serodiagnosis 739
Complement xation 742
Counterimmunoelectrophoresis 746
Enzyme immunoassay (EIA) 744
Fluorescent antibody (FA) technique 745
Haemagglutination,
haemagglutination-inhibition, and
neutralization reactions 741
Anti-streptolysin O test 742
Haemagglutination inhibition 742
Neutralization reaction 742
Immunoelectrophoresis 746
Labelled antibody techniques 744
Membrane immunoassays 744
Precipitation, occulation, and
agglutination 740
Radial immunodiusion (RID) 745
Single radial immunodiusion technique 746
Staphylococcal coagulation 741
Visual immunologic reactions used in
serodiagnosis 740, 743