SPUTUM/BAL/SWEAT

sputum

• a thick mucus-like material expectorated from the lower respiratory tract (brochi, lungs)

tracheobroncial secretions

• mixture of plasma ultrafiltrate, electrolytes, mucin and water

first morning specimen

• preferred specimen

• most concentrated

24 hour specimen

• for volume measurement

throat swab

• for pediatric patients

deep cough sputum

• avoid saliva contamination

tracheal aspiration/bronchoscopy

• for debilitated/unconscious

sialic acid

• important single component of sputum viscosity

red/bright red

• fresh blood or hemorrhage

anchovy sauce/rusty brown

• old blood, pneumonia

olive green/gas green

• cancer

rusty with pus

• lobar pneumonia

rusty without pus

• congestive heart failure

currant, jelly-like

• klebsiella pneumoniae

dittrich’s plugs

• yellow or gray material

• bronchial asthma

• macroscopic structure

broncholiths

• calcified material in bronchi (lung stones)

• histoplasmosis

• macroscopic structure

abestos bodies

• pneumoconiosis

• macroscopic structure

chracot-leyden crystals

• colorless, hexagonal, double pyramid, often needle-like

• bronchia, asthma

• microscopic structure

curschmann’s spirals

• coiled mucus strands

• bronchial asthma

• microscopic structure

myelin globules

• lipid bodies, mimics fungi

• microscopic structures

creola bodies

• clusters of bronchial epithelial cells

• bronchial asthma

• microscopic structure

bronchoalveolar lavage

• procedure for collecting the cellular milieu of the alveoli by use of a bronchoscope through which saline is instilled

• distilled test for pneumocystis carinii in immunocompromised patients

• cytologuc evaluation for interstitial lung diseases and malignancy

sweat

• is a liquid made from 99% water and 1% salt and fat

• primary diagnostic test for cystic fibrosis

cystic fibrosis

• autosomal recessive metabolic disorder affecting the mucous secreting glands of the body

• gene involved: mutation in the cystic fibrosis transmembrane conductance regulator on chromosome 7

gibson and cookies pilocarpine iontophoresis

• sweat chloride test

• principle: pilocarpine (a cholinergic agonist) stimulated sweat production when introduced into the skin using a mild electric current (iontophoresis) of 0.15 mAcurrent for 45 minutes