"Excellent course! I would recommend this course to anyone learning or refreshing their basic knowledge in hemostasis."

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Reading Gram Stained Direct Smears

Betty Smith, MT (ASCP), Jaimy Hill, MT (ASCP)

Has your laboratory ever had difficulty correctly reporting out cerebrospinal and joint fluid gram stains during off hours? This course helps provide training for technologists who must read gram stain but do not work primarily in the microbiology laboratory. Great for cross-training and for clinical laboratory science students as well.

Continuing Education (CE) Credits

P.A.C.E. Contact Hours: 1.5 hour(s)
Florida CE: General (Microbiology/Mycology/Parasitology): 1 hour(s)

Other Microbiology Courses

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Reading Gram Stained Direct Smears Objectives

Define a DIRECT SMEAR.
Describe several ways that GRAM STAINED DIRECT SMEARS are CLINICALly useful.
Discuss examination of DIRECT SMEARS with respect to: control smears, MACROSCOPIC appearance, and characteristics of appropriate microscopic fields.
Discuss the IDENTIFICATION of common NONBACTERIAL elements with respect to: purpose, size, shape, differentiating characteristics, and GRAM STAIN reaction.
Identify the following types of BACTERIA found in GRAM STAINED DIRECT SMEARS: gram postive COCCI, GRAM NEGATIVE COCCI, GRAM POSITIVE bacilli, GRAM NEGATIVE bacilli, GRAM NEGATIVE DIPLOCOCCI.
Discuss the procedure for reading GRAM STAINED DIRECT SMEARS with respect to: principle, procedure, and sources of error.

Reading Gram Stained Direct Smears Outline

Introduction to Reading DIRECT SMEARS

What is the value of a DIRECT SMEAR?
Information from GRAM STAINED DIRECT SMEARS can often help the PHYSICIAN make a quick DIAGNOSIS.
CULTURE results are not correlated with direct GRAM STAIN results.
DIRECT SMEARS can be used as quality control mechanisms.

Choosing Microscopic Fields

How to Choose a Microscopic Field
Quality Control Smears
MACROSCOPIC Smear Appearance
Thick Smears
Thin Smears
Thin Smears
Properly DECOLORIZED Smears
Precipitated Stain
UNDER-DECOLORIZED smear
Regarding the smear shown in this illustration, which of the following is true?
Regarding the smear shown in this illustration, which of the following is true? (Choose ALL of the correct answers)
Regarding the smear shown in this illustration, which of the following is true? (Choose ALL of the correct answers)
Regarding the smear shown in this illustration, which of the following is true? (Choose ALL of the correct answers)
The smears used for quality control are: (Choose ALL of the correct answers)
A marking pen can be used to mark the back of a:

NONBACTERIAL Cells in DIRECT SMEARS

CELLULAR elements
EPITHELIAL CELLS
WHITE BLOOD CELLS
RED BLOOD CELLS
Yeast cells
FUNGAL HYPHAE
Match the GRAM STAIN reaction for each of the following NONBACTERIAL elements.
Most background material is GRAM NEGATIVE.
WHITE BLOOD CELLS are GRAM NEGATIVE.
Which of the following cells are about the same size as red cells?
EPITHELIAL CELLS can be differentiated from WHITE BLOOD CELLS because EPITHELIAL CELLS have a SEGMENTED NUCLEUS.

BACTERIA in DIRECT SMEARS

IDENTIFICATION of BACTERIA
GRAM POSITIVE COCCI (GPC)
GRAM NEGATIVE COCCI (GNC)
GRAM POSITIVE RODS(GPR)
GRAM NEGATIVE RODS (GNR)
INTRACELLULAR BACTERIA.
GRAM NEGATIVE DIPLOCOCCI
EPITHELIAL CELL
In this slide, which structure or structures are present? (Choose ALL of the correct answers)
In this slide, what is the conspicuous structure?
In this slide, WHITE BLOOD CELLS, and GRAM NEGATIVE COCCI are present.
In this slide, which structure or structures are present? (Choose ALL of the correct answers)
The cell indicated by the arrow is a WHITE BLOOD CELL containing GRAM NEGATIVE DIPLOCOCCI.

Reading and Reporting DIRECT SMEARS

Principle
Overall Procedure
EVALUATION of Controls
Size and Appearance of CELLULAR Elements
RECORDING BACTERIAL Characteristics
Reporting DIRECT SMEAR Results
Significance of Specific Findings:
CONTAMINATED GRAM STAIN Solution
Special Considerations for GENITAL Smears
Reporting GENITAL Smears
The background material in a GRAM STAINED SMEAR that has been adequately DECOLORIZED is:
How many fields should be examined before you quantitate a DIRECT SMEAR?
If a smear is OVER-DECOLORIZED, it can be salvaged by repeating the GRAM STAINING procedure.
GRAM NEGATIVE COCCI which occur in pairs with their adjacent sides flattened, giving them a coffee bean shape are:
In a male with a purulent URETHRAL EXUDATE, a presumptive DIAGNOSIS of GONORRHEA is made by finding GRAM NEGATIVE INTRACELLULAR DIPLOCOCCI in a DIRECT SMEAR of the EXUDATE.

Reading Gram Stained Direct Smears Keywords

Click on a term below to see its use in this Reading Gram Stained Direct Smears course and other available MediaLab courses.

gram negative (19 occurances)
direct smear (16 occurances)
white blood cell (15 occurances)
epithelial cell (14 occurances)
gram positive (10 occurances)
hyphae (10 occurances)
gram stain (9 occurances)
bacteria (9 occurances)
cellular (9 occurances)
nonbacterial (8 occurances)
red blood cell (8 occurances)
intracellular (7 occurances)
gram negative cocci (6 occurances)
clinical (6 occurances)
evaluation (5 occurances)
gram negative diplococci (5 occurances)
gram positive cocci (5 occurances)
diplococci (5 occurances)
underdecolorized (4 occurances)
nucleus (4 occurances)
organism (4 occurances)
gram negative rod (4 occurances)
genital (4 occurances)
decolorized (4 occurances)
coli (4 occurances)
bacterial (4 occurances)
aureus (3 occurances)
budding (3 occurances)
diagnosis (3 occurances)
culture (3 occurances)
gonococci (3 occurances)
gonorrhea (3 occurances)
fungal (3 occurances)
gram stained (3 occurances)
gram stained smear (3 occurances)
identification (3 occurances)
neisseria (3 occurances)
macroscopic (3 occurances)
physician (3 occurances)
oil immersion field (3 occurances)
segmented (3 occurances)
staphylococcus (3 occurances)
sputum (2 occurances)
tubular (2 occurances)
under-decolorized (2 occurances)
niesseria (2 occurances)
nonsegmented (2 occurances)
gram positive rod (2 occurances)
gram staining (2 occurances)
escherichia (2 occurances)
contaminated (2 occurances)