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Laboratory Procedure Courses National Network of Prevention Training Centers

Laboratory Procedure Courses National Network of Prevention Training Centers. Linda Creegan, MS, FNP California STD/HIV Prevention Training Center Oakland, CA National STD Prevention Conference Chicago, March 2008. CLINICIANS…. Are you new to the STD clinic?

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Laboratory Procedure Courses National Network of Prevention Training Centers

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  1. Laboratory Procedure CoursesNational Network of Prevention Training Centers Linda Creegan, MS, FNP California STD/HIV Prevention Training Center Oakland, CA National STD Prevention Conference Chicago, March 2008

  2. CLINICIANS….. Are you new to the STD clinic? Is your clinic starting to use a new test? Trichomoniasis? Herpes? Bacterial Vaginosis? Syphilis? Rapid HIV test? Darkfield microscopy?

  3. Enroll in an NNPTC laboratory procedure course!! • Tests for STD specialty clinics • Syphilis tests • Gram stains • Saline and KOH wet mounts • Point-of-Care (POC) tests for STD

  4. Tests for STD Specialty Clinics

  5. Syphilis Tests • Serologic tests for syphilis • Learn to perform and interpret the qualitative RPR test • Darkfield microscopy • Learn to • Obtain the specimen • Use the microscope • Identify T. pallidum by morphology and motility

  6. Utility of Rapid RPR Test • Evaluation of patients withsymptoms of primary and secondary syphilis • Facilitates immediate diagnosis, treatment, and initiation of partner management activities

  7. Darkfield Microscopy Photo credit: Dr. Joseph Engelman, San Francisco City Clinic

  8. Morphology Rigid, uniform, tightly-wound spirals Tight coil is maintained despite active motility Length: 6-20 micrometers Width: VERY thin 0.10-0.18 micrometers, below the resolution of the light microscope Motility Exhibits three types of movement Translation: slow, forward or backwards movement Rotation: turning around the longitudinal axis Flexion: stiff bending, usually in the middle, and returning to original position Identifying T. pallidum by DF

  9. Gram Stains • Male urethral discharge, cervical and rectal specimens • Learn to • Obtain the specimen • Identify WBCs and GNID • Diagnose gonococcal vs non-gonococcal urethritis STD Atlas, 1997

  10. Saline and KOH Wet Mounts Vaginal specimens • Learn to • Obtain the specimen • Use the microscope • Identify findings (Clue cells, yeast forms, trichomonads) • Diagnose BV, yeast, trich Photo credit: Seattle STD/HIV Prevention Training Center

  11. Point-of-Care Tests for STD

  12. What are Point-of-Care tests? • Rapid diagnostic tests • Run in clinic or field setting • Very easy to perform • Usually require only microscope or simple lab equipment • Often CLIA waived • Provide results at same clinic visit • Diagnostic and screening applications

  13. Point-of-Care STD Tests:A Paradox • Generally not as sensitive as delayed lab tests • In populations where patients are less likely to return for results or F/U is difficult, higher treatment levels can be achieved with POC than with delayed tests • Homeless clinics • Emergency rooms • Correctional facilities

  14. Point-of-Care Test Courses • Learn about • Lab regulatory issues (CLIA) • POC tests for genital herpes, vaginitis, syphilis, CT and GC, and HIV • Obtaining specimens • Using test kits • Interpreting results • Maintaining quality assurance

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