Test Preparation

Test Preparation

Oral Glucose Tolerance Test
  • For non pregnant patient:
    • Collect fasting blood specimen in fluoride tube and urine specimen
    • Administer 75 gm glucose orally
    • Collect two additional blood specimen in fluoride tube and urine samples as follows:
      • 60 min. after glucose
      • 120 min. after glucose
  • For pregnant patient:
    • Collect fasting blood specimen in fluoride tube and urine specimen
    • Administer 75 gm glucose orally
    • Collect blood sample in fluoride tube and urine samples as follows:
      • 2 hour after glucose
Cortisol
  • Morning sample:
    • Collect plain sample at 8 am
    • Specify time and the date on the tube
    • Overnight fasting is preferred
  • Evening sample:
    • Collect plain sample at 4 pm
    • Specify time and the date on the tube
    • Four hours of fasting is recommended for evening specimen
Prolactin

Prolactin shows diurnal variations so preferred to be collected fasting before 10 am.

Routine examination of Urine:
  • For routine examination of urine, first morning sample is the best sample
  • First morning urine is the specimen voided immediately after an overnight bed rest before breakfast and other activities. This is also called early morning urine. It is recommended that the early morning urine should be voided after an 8 hours period of recumbency.
  • The phlebotomist/Collection Center provides a clean and dry wide mouth plastic bottle with screw cap top.
  • Patient should wash his/ her hands before sampling.
  • Remove the screw cap from the specimen container, being careful not to touch the inner surface of the container of the cap.
  • Collect a midstream-sample in the specimen container by first voiding in the toilet. While still voiding, move the collection container into the "midstream" of the urine to interrupt flow and obtain the sample.
  • It is necessary to fill the specimen cup only half full.
  • Be sure the cup has been properly labeled and tightly closed so that there is no leakage.
  • Care must be taken to avoid faecal contamination in children.
  • Sample Container store in given plastic bag.

    Male

    • Wash your hands
    • Retract foreskin
    • Start urinating into toilet
    • Collect urine sample (Do not touch the inside of the container)
    • Finish urinating into toilet
    • Place cap on container

    Female

    • Wash your hands
    • Spread labia apart
    • Start urinating into toilet
    • Collect urine sample (Do not touch the inside of the container)
    • Finish urinating into toilet
    • Place cap on container
  • For female – Do not collect urine during menstrual period.
Sputum Sample
  • Sputum samples are usually collected to check for chest infections, but may occasionally be used to check for cells lining the airways. In some cases 3 specimens will be collected on 3 consecutive days to increase the yield of the test.
  • Request for sputum examination are generally one random collection unless your doctor specifies that consecutive collections are required. Collections for cell examination (cytology) and TB are usually collected in sets of 3 consecutive days. Always try to produce an early morning collection for these tests.
Urine Culture (Aerobic)
  • Sterile, dry, wide mouth, leak proof bottles are needed.
  • First morning midstream sample is the best sample
  • Instruction to patients for collection of midstream urine sample

    Male

    • Wash your hands
    • Retract foreskin
    • Start urinating into toilet
    • Collect urine sample (Do not touch the inside of the container)
    • Finish urinating into toilet
    • Place cap on container

    Female

    • Wash your hands
    • Spread labia apart
    • Start urinating into toilet
    • Collect urine sample (Do not touch the inside of the container)
    • Finish urinating into toilet
  • Place cap on container
  • For female – Do not collect urine during menstrual period.
  • Do not collect sample from the collection bag.
Pregnancy Tests

Should preferably be the first morning sample.

24 hrs Urine Collection
  • Unless instructed by the physician, a patient should maintain the usual amount of liquid in take but not to consume alcoholic beverages
  • Instructs the patient that the preservative in the container should not be discarded
  • Do not pass urine directly into the 24 hours container. Collect each void in a smaller container and pour it into the 24 hours container
  • On the day of collection, patient should empty his bladder (first morning urine) into the toilet (not to be included in the 24 hours collection). Note this time and date on the container label.
  • Collect the next voiding and added to the 24 hrs container
  • Add all subsequent voiding in the 24 hrs container.
  • Keep the urine container in cool area
  • The last sample to be added in the 24 hrs container should be the first specimen voided the next morning at the same time as previous mornings first voiding.
Stool collection occult blood
  • 1 to 3 stool samples collected on different days may be submitted as single test.
  • Instructions to be followed:
    • Eat well balanced diet including fibers, curd, fruit & vegetables
    • Avoid for 3 days before and during collections. Red meat & vitamin C from supplements, citrus fruits, juices, high peroxidase containing fruits & vegetables like turnips, radish, cauliflower & melons
    • Drugs to be avoided – NSAID for 7 days, Iron supplement that contain more than 250 mg of vitamin C for 3 days prior to collection
    • Specimen collected 3 days prior to or during menstrual period, bleeding haemorrhoids or haematuria are unacceptable.
    • Transport stool sample at room temperature
Stool Collection for Parasite and Ova
  • Many parasites are intermittently passed. It is recommended that examination of stool for ova & parasites before therapy should include upto 3 specimen collected for 1-3 days to increase probability of detecting parasites
  • Freshly passed stool should be submitted for examination
  • Collect the stool specimen in a clean plastic screw cap container. Lightly close the cap of container.
  • Barium, antibiotics, anti malarial, and laxative interfere with the detection of intestinal protozoa. Specimen should be given at least seven days post treatment.
Semen Analysis:
  • Abstinence for a period minimum of three days is required.
  • Urinate prior to collection.
  • Wash genital area with warm water only.
  • Do not use soap.
  • Remove the cap of the container immediately prior to the collection.
  • Obtain the sample by masturbation only. The only lubricant is acceptable is glycerin.
  • Ejaculate directly into the container. Collect the entire ejaculate.
  • Replace lid.
  • Note time of collection
Post Coital Test - PCT
  • Is a test in evaluation of infertility, which examines interaction between sperms & mucus of cervix.
  • PCT is scheduled close to ovulation when mucus is abundant.
  • Couple is asked to have “Sexual intercourse “ preferably in early morning hours. Report to lab between 4-6 Hours.
  • Mucus is aspirated from cervical canal, kept on glass slide & examined under microscope for motile sperms & infection.
  • Poor PCT may indicate mucus or sperm problem, Presence of antisperm antibody, ovulatory problem & poor coital technique.
  • Precautions :
    • Do not use any lubricant.
    • 3 Days abstinence.
    • Not rinse vagina.
    • After intercourse, rest on back for about 30Min – 1Hr with and raising your back with a pillow & report in lab between 4-6 Hrs for PCT test.
RADIOMETRIC CULTURE (AFB)
  • Sputum
    • The preferred sample is an early morning expectoration.
FUNGAL CULTURE
  • Sputum
  • The preferred sample is an early morning expectoration.
  • Instruction to patient-
    • Patient should rinse his mouth with water before sputum is collected.
    • Avoid adding saliva or nasopharyngeal discharges.
    • Obtain the sample after deep cough or with induction after steam inhalation.
    • Do not pool multiple samples collected during a 24 hrs period.
  • Urine
    • First morning sample approx. 20-40 ml should be collected in a sterile screw capped container provided by the lab.
Mantoux Test
  • Instruction to patient –
    • Do not scratch
    • Do not apply soap
    • Do not apply any ointment
    • Report to lab after 48 hours
HIV Test
  • All HIV tests in lab need to be pre-counseled by HIV Counselor.
  • No Test to be taken unless HIV Counselor permit & counseling done.
  • Patient consent is taken before sample collection
  • Reports for HIV will be dispatched by HIV Counselor only.