Posted in Medical School Stuff, Speeches, Study Tips & Techniques

Med Board Exam (PLE) Tips

Written on MARCH 17, 2018 on Facebook Notes

Oath Taking Ceremony

Hi. Hindi pa po ito yung speech ko (oo, magsspeech ako, kahit di ako top, bwaaaahaha), pero ito po ang sagot sa mga MOST FREQUENTLY ASKED questions niyo about MED BOARDS.

Pero hanggang ngayon, wala pa akong nagawang speech, haha. Kasi busy ako sa pagtulong sa kapwa, chaaaar. xD

My Message to my supporters (yes namaaaaan) when I did not top the exam 🙂

Pero TAKE NOTE:
Hindi ako larawan ng karamihan ng med students… medyo iba set-up ko kasi nagtuturo pa din ako kahit nagmemed o nagcclerk o nagpPGI so hindi applicable sa lahat siguro yung iba.

1) Saang review center ka?
– Sa sarili ko. Haha. Sobrang vain, pati pag-rereview, sarili eh noh. Self-review? K. Haha.
– Hindi ko din kasi maattendan ung review center dahil nga nagtuturo pa din ako kung saan-saang lupalop ng Pilipinas, haha. Naghahasik ng kalandian cause I need to #KeepTheLande

2) So, kung self-review ka, anong ginamit mong notes?
– Yung minana ko sa friends ko, hahahah, na 2 batches old na, so hindi updated, pero kinaya naman, hahahaha.
– Sa Micro/Para, sa totoo lang, hindi na ako nagreview, kasi naman….Chaaaar! xD #Humble

3) Anong subject ang dapat unahin?
– Hmmm, di ko din alam. Magtoss coin na lang. Bwaaaahahah.
– Basic muna siguro like Ana, Phy, Biochem or pwede ka ding mag by system, like CARDIO – aralin mo muna Anatomy, tas Physio, tas Pharma..etc.

4) Nagcoconsider ka bang magtutor for med boards?
– Ahmmm, bwaaaahaha. Hindi pa siguro. Pero I’ll share what I can, so abangan niyo po ung mga future projects ko. Lelz. #FeelingCelebrity

5) Any recommended review material?
– Ahmmm, haha, wala. Kasi no idea ako, dahil hindi nga ako nagreview center, pero advantageous pa din magreview center so go kayo.
– Pero for me, ito talaga the best websites/apps na nakatulong sa pagself-review.

PATHO: Pathoma videos and Dr. Minarcik
(http://www.medicalschoolpathology.com/2017-2018MP4Archives/) — IDOLS ko tong mga to, kaya gagayahin ko sila at maguupload din ako ng videos for teaching! OMG, so excited!

ANATOMY: TeachMeAnatomy (either the app or the website) and this doctor in YouTube (https://www.youtube.com/watch?v=iDXUwErttJA)

MY VIDEO TUTORIALS: Chaaaar. Sabay segway. Hahaha. Malay mo, makatulong. Sige na nga, wag na. Hahaha.

6) Overall tip?

  • BELIEVE. That’s the first step in everything. Nonsense naman kung mag-aaral ka tas iniisip mo din palang babagsak ka.
  • SLEEP. My average sleep is 7 to 8 hours.
  • CHILL. I usually play games (like ML, PUBG, etc) before, in between and after studying. That’s what makes me relax. Find out yours. Mahalaga, importante. Bwaaahaha.
  • PRAY. BEST. WEAPON. EVER.

Seriously though, STUDY as early as you can (this applies even to medtech students about to graduate and take the boards in a few months time). Sabi nga nila, do something today that your future self will thank you for…I THINK THAT’S TO STUDY EARLIER SO YOU WON’T NEED TO CRAM WHEN THE TIME COMES. But I know, we like cramming. Pero we can still change. 🙂

GOD WILL NEVER GIVE YOU A DREAM WITHOUT GIVING YOU THE ABILITY AND QUALIFICATION TO ACCOMPLISH THAT DREAM.

God bless DOCTORS OF THE PHILIPPINES!!!

Posted in Checkpoint Tutorials

#CheckPoint Tutorials for Medical Technologists

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MUST KNOWS (or not? XD)

FIRST, if you are too lazy to read everything here, then my tutorial is not for you. I’m sorry.

SECOND, if you are a fresh graduate/first timer, I suggest that you try in a review center first. But if you insist to join us, you are more than welcome.

THIRD, I do not accept everyone. I only want to do this for those who are fully willing to help themselves too. If you are looking for spoon feeding type of learning then I’m not the one who can help you.

FOURTH, please be aware that this is NOT the usual tutorial set-up nor the usual review center set-up you know…As in everything is NOT the usual.

FIFTH, please bear in mind that I am not forcing you to join. If you find it in your heart that you really want to do your review with us, then we are waiting for you. But if you don’t like any of the above rules, then thank you for your time.

There are a lot to explain (and some are really not explainable by words) but here’s a runthrough of #CheckPoint tutorials.

  • CheckPoint Tutorials for March 2019 will start on November 2019. Actual dates will be announced when PRC releases the final board exam dates.
  • We are currently having the tutorials in 2 areas. 
    • CheckPoint Manila version 10.0
    • CheckPoint Davao version 3.0
  • We don’t meet everyday.

Our schedule is not fixed since we (the tutors) are also working and so we will be developing a schedule that fits everybody.

  • Venues
    • CheckPoint Manila: OUR HOME at SAN MIGUEL (or PALATIW), PASIG CITY
      • We have a room for tutorials just in front of our home. I am very sorry if I cannot grant your request to do the tutorial anywhere other than this venue.
    • CheckPoint Davao: No permanent venue as of yet, we usually do tutorials in different coffee shops around Davao. 🙂
  • I do the teaching but I also get help from my colleagues.
    • CheckPoint Manila: I do most of the teaching but there’ll be subjects to be handled by Sir Ross Axel Rufino (Unciano Colleges).
    • CheckPoint Davao: Most subjects will be handled by Sir Jayson Sanchez (Davao Doctors College) while I teach certain subject/s whenever I have a schedule in Davao.

We have a tradition not to move to another topic until everyone in the group understands. And yes, you can tell us everything you want to understand and we will try our best to explain but we don’t guarantee being all-knowing. If we don’t know the answer to your question, then we are willing to study again for you. 

  • If you want an easy life and would just want to rely on recall questions, then you’re in the wrong place. 

You will pass because you understood the topics, not because you remember the recalls. But if you believe otherwise, then I can’t help you. That’s not how I roll.

  • We will also have a lot of practice exams with explanations why this and not that is the answer moments.
  • There will be unpleasant moments (typhoon, super traffic, dysmenorrhea days) to teach personally so that we’ll just have an online review.
  • I will require at least 50% downpayment for our expenses.
    • FEE: Manila – P11,000 & Davao – P12,000 (already inclusive of P1,860 worth of personalized #CheckPoint Notes – all available subjects)

I am not rich, I cannot support our growing #CheckPoint family with just my usual budget so, please pay. Haha. Usually, I use the money for our refreshments (food and coffeeeeee) and enjoyment (like ice skating, karaoke, arcades, haha, no kidding).

  • I DO NOT ACCEPT QUITTERS.

If you are joining us, make sure that you are not a quitter or if you really are, be prepared to change. To tell you the truth, I’m not willing to do this for someone who will QUIT on me, so, let’s have a contract as early as now.

  • I do this because I live to teach.

This has been my passion ever since and has been a part of my promise to my God (long story, you’ll know on the way). I choose to teach MedTech students who are willing to sacrifice, change for the better, believe in themselves and fight for their dreams. Even if it is hard, we will not quit.

SO, are you ready to be like us? ^^,

If yes, then SEND ME A MESSAGE, like right now. 🙂

P.S.
For those who’d like to know the in-between-experiences of the previous #CheckPointees, you are free to contact them.

CheckPoint v1.0

Ross Axel Rufino, RMT

Erwin Pagkatipunan, RMT

Kayla Lara, RMT

Josel Losada, RMT

Fatima Yao, RMT

CheckPoint v2.0

Hillary May Cuizon, RMT

Ahrjay Atienza, RMT

RF dela Cruz, RMT

Davicca Hwang, RMT

Chrismari Sison, RMT

CheckPoint v3.0

Wilfred Lawas, RMT

Mark Salvador Mabesa, RMT

Princess Alyssa Suerte, RMT

CheckPoint v4.0

Mia Cortez, RMT

Shirley Mae Magadang, RMT

Maria Corazon de Villa-Obnamia, RMT

John Gabriel Pagsanghan, RMT

CheckPoint v5.0

Patricia Inocencio, RMT

Sharmane May Almazan, RMT

Dette Nuñez, RMT

CheckPoint v6.0

Dexter de Vera, RMT

Dafy Macalalad, RMT

Aianna Valenton, RMT

CheckPoint v7.0

Michelle Reyes, RMT

Julia Aira Marie Sanchez, RMT

CheckPoint Manila v8.0

Alicia Abril, RMT

Lara Mae Ganaden, RMT

Jam Shane Supan, RMT

Georgina Belo, RMT

CheckPoint Manila v9.0

Gene Tulawie, RMT

Theodor Carandang, RMT

Almira Felias, RMT

CheckPoint Davao v1.0

Francis Jade Labatos, RMT

Geric Sam Lopez, RMT

Rey Marcelo Caupayan, RMT

Elspeth Katherine Luig, RMT

Denden Espero, RMT

CheckPoint Davao v2.0

Jamaica Cadorna, RMT

Shedney Mae Kawaling, RMT

Fauziyah Pagayao, RMT

Joanna Marie Guiraldo, RMT

Caryl Anne Abeto, RMT

GJ Gaetos, RMT

TO GOD BE ALL THE GLORY!

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Tara, aral? 🙂 Or manga na lang. Hehe!

Posted in Free Online Review

Free Online Review (FOR) You Sessions

Make sure you are a member of the Facebook group for these sessions.
We use ZOOM app and provide meeting ID via the Facebook group.
Join here: https://www.facebook.com/groups/1200764429948890/

UPCOMING…

We are offering ONLINE CLASSES FOR AUGUST 2020 MTLE and ASCPi!

See https://krizzaalmond.com/2020/05/02/med-tech-board-exam/ or https://krizzaalmond.com/2020/05/02/ascpi-online-class/
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FINISHED SESSIONS

For this session, companion notes can be downloaded by clicking this.

Posted in Study Tips & Techniques

Study Tips and Techniques

In this post, I’ll share how I usually study. This will be updated from time-to-time, so please check back regularly. In no particular order except for the very first entry which I personally think is the most important factor, here are some of my tips for you.

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#1 FAITH. TRUST. HOPE. in GOD.

Whether you are a first-timer, or a re-taker, it is essential that you develop a very strong faith in our Lord God… that He will not bring you here if He will not be with you all the way. He did not say it will be easy, but it is going to be worth it. So, whatever happened, happens and will happen, stay focused on your goal. Know and take confidence that God is in full control and do all you can to achieve your dreams.

#2 KNOW YOUR GOAL AND STAY POSITIVE.

Set your goals and everyday that you wake up, imagine yourself achieving them. That way, you’ll help yourself develop a positive attitude even in difficult times.

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#3 Know the important dates and details of the exam

See this for the PRC Schedule of Licensure Exam for 2021.

#4 Prepare COMPLETELY

This is not only an academic battle, which means that if you graduated with honors, you’ll be 100% assured of victory, the same way that those who did not graduate with any award are assured of failure. Many other important factors play a role in this and they should be addressed accordingly. So, prepare yourself ACADEMICALLY, MENTALLY and SPIRITUALLY.

#5 Know your LEARNING STYLE

Each of us has a different learning style and you’ll really be more productive if you know and apply yours. If you do not have any idea how you learn more, take a test here: To know your learning style, you may take a test here.

#6 Know when YOUR BRAIN IS MOST ACTIVE

Is it in the morning? Evening? With music or silent environment?
For some students, a quiet environment is better for studying. For some, it easily invites boredom and makes them sleepy.

So, for those who want music to accompany their studying trip, here are some playlists from Spotify. Although, you can make your own playlist, if you like.
Mozart Playlist
Sungha Jung
Anime Study Music

#7 Use REVIEW MATERIALS YOU REALLY UNDERSTAND

A lot of materials are out there in the market but not all may be helpful to you, so you have to find out which are really beneficial, especially if you’re on a tight budget. There are times that you want to have ALL that is available, which is okay if you really want to have them all, but there is a high chance that you’ll be overwhelmed one day and not know which to read/study.


May I please suggest you check out our #CheckPointNotes? See details here: HOW TO ORDER CHECKPOINT NOTES

DOWNLOAD FREE MEDTECH NOTES HERE

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#8 Make your OWN NOTES

If time permits and the exam dates are still away from today, please consider creating your own notes so it’ll be easier to master or memorize.

#9 Use a CHECKLIST

If you’re self-reviewing and do not know much about the frequently asked topics in the exam, it’s helpful to have a checklist so you’ll have a guide somehow. Click this (Local Board Exam Topic Checklist) to download the file I made for you and use it to help you track your progress. 

#10 Make and follow your schedule

I’ll upload a sample schedule I made for a friend, just so you’ll have an idea but you have to make your own schedule because you know YOU more than I do. 🙂

Use this planner if you want to. 🙂

#11 Use MNEMONICS

Check out this Facebook album of my #MgaWalangKwentangMnemonics and maybe you’ll find some of them useful.

#12 Others

[NEW] #13 Know the definition or etymology of the word

I, most of the time, do this to remember or understand better the topics I’m studying. 📔 I usually search for the meaning of the word/s or their etymology to understand them better. 🔎


For example, Luteinizing Hormone (LH), from Latin word ‘Luteum’ or ‘Luteus’ meaning yellow. So, it helps me to remember that one of the functions of this hormone is to stimulate development of the Corpus Luteum (yellow). 🍳


Whatever it is that helps you stay on track, do it. These tips may not be applicable to everyone but there’s no harm in trying them out and see if any of these will be helpful for you.

So, yeah, I wish you good luck and God bless! ❤

Happy aral!


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Posted in Checkpoint Tutorials, Online Classes

#TheCheckPointOnline ~ Med Tech Online Review

  1. Memory Cell Edition (MCE) — The Comprehensive Online Review Course
  2. End Cell Edition (ECE) — The Final Coaching Course

SEE REVIEW TESTIMONIALS HERE


Our online review courses are powered by #ThePhoenixxApp© (TPA)

Create an account here and try TPA for free!


MEMORY CELL EDITION (MCE)

Description:

Highlights and Inclusions:

  • REVIEW STYLE OPTIONS:
    • Scheduled review
      • If you like interacting with the lecturer, review assistants, and your online study buddies, join our scheduled review.
      • Live Sessions: 9am to 4pm
      • See our schedule below
    • Self-paced review
      • If you are working, or still an undergraduate, or simply prefer to study by your own, you can do self-paced review.
    • Hybrid review (combined scheduled and self-paced)
      • If you wish to do both, you can. Just maintain your communication with us so we can help you in any way we can.
  • VALIDITY OF ENROLLMENT:
    • Your enrolled subject/s will be VALID UNTIL COVID-19 PANDEMIC ENDS* OR UNTIL YOU TAKE THE BOARD EXAM, WHICHEVER IS SOONER
    • *Once pandemic ends, 1-year validity will follow
    • Example scenario: If you enroll today (March 2022) but you plan to take the board exam on March 2023, you can join all the batches of the review with no additional cost. (This offer is valid only during the COVID-19 pandemic.)
  • ENROLLMENT OPTIONS:
    • Per subject
      • Choose this option if you just want to enroll in selected subject/s only or if you do not have the budget yet for a full course review.
    • Full course
      • Choose this option if you wish to access all subjects right away.
      • Get a FREE END CELL EDITION (ECE) COURSE – THE ONLINE FINAL COACHING when you enroll in all subjects (whether in full course or per subject basis)
  • INCLUSIONS:
    • Use of ThePhoenixxApp
      • Unlimited replays of video lectures
      • Download option for offline viewing of videos
      • Practice exams/quizzes with feedback, item analysis and progress tracker
      • More in-app features to help you be more productive
    • Printable and annotatable soft copy of personalized MCE Notes and other review materials
    • Every subject (except MolBio*) will have the following academic activities (to be explained in detail during orientation)
      • MCE Lectures
      • Pre and Post-lecture Exams with rationalization
      • Evaluation Exams with rationalization
      • Mastery Sessions
      • Drills
      • Special lectures for selected subjects
      • *MolBio will only include lecture and pre/post-lecture exams
    • GENERAL ACTIVITIES
      • Co-MEMORY-ate
      • Mock Board Examination
      • Brainstorming sessions or virtual group study sessions (Study-With-Me via Discord)
      • Small group tutorial (by request)
    • EXTRA-CURRICULAR ACTIVITIES
      • Worship service/Bible studies
      • Mental health hygiene
      • Support group
      • Chillout sessions
      • ZOOMba sessions
      • Gaming sessions

Schedule and Review Fees for AUGUST 2022 MCE:

  • Lecture sessions: 9 am to 4pm
  • Pre/Post exams: Exam-taking is from 12:01 am to 5:59 pm, Ratio is at 6pm to 9pm
  • Evals: Exam-taking is from 9am to 11am, Ratio is at 2pm to 5pm
  • Dates include INDEPENDENT STUDY TIME (ISTs) which means FREE DAY
  • NO SUNDAY CLASSES
  • You may actually enroll now and use the currently available review materials and then join again when the new batch intended for August 2022 starts in May without paying another fee.
  • UNDERGRADUATES ARE WELCOME TO ENROLL.
ACTIVITYTARGET DATESREVIEW FEE
REFRESHMENT WEEKTO BE ANNOUNCED FREE FOR ALL MEMORY CELLS AND END CELLS
ORIENTATIONTO BE ANNOUNCED FREE FOR ALL MEMORY CELLS AND END CELLS
MOLECULAR BIOLOGY*TO BE ANNOUNCEDP1500
CCTO BE ANNOUNCEDP3000
BMVP (Bacte, MycoViroPara)TO BE ANNOUNCEDP3000
CMTO BE ANNOUNCEDP1500
HEMATO BE ANNOUNCEDP3000
ISBBTO BE ANNOUNCEDP3000
HTMLETO BE ANNOUNCEDP1500
DrillsTO BE ANNOUNCEDFREE FOR EVERY SUBJECT ENROLLED
MOCK BOARDSTO BE ANNOUNCEDFREE FOR ALL MEMORY CELLS AND END CELLS
Co-MEMORY-AteTO BE ANNOUNCED FREE FOR ALL MEMORY CELLS AND END CELLS
TOTAL FEEAll schedules inclusive of lecture days, ISTs, exams, ratio, and mastery sessions except MolBio

*Only includes lectures, notes and pre & post-lecture exams
P16,500
TARGET SCHEDULE OF ACTIVITIES FOR MARCH 2023 MTLE REVIEW

Watch this for a more detailed explanation of the MCE review course.

STEPS FOR ENROLLMENT

  • REQUIREMENTS:
    • Proof of payment (screenshot of transaction or photo of deposit slip/receipt)
    • Decent photo to be used for digital ID (preferably graduation pictures)
  • Slots for enrollment are unlimited. We can always accommodate you and your friends.
  • To get the materials ahead of schedule, please enroll at least 3 days before the subject starts (see schedule here)
    • If you were not able to enroll on time, you may still register any time and use ThePhoenixxApp to replay the video lectures

1) When you join, YOU AGREE TO THE FOLLOWING TERMS & CONDITIONS.
a. No recording in any form (audio, video, screenshot) will be allowed. Programs are in place to monitor your in-app activity and once you’ve violated our agreement, we will be compelled to file charges against you.
b. Your personal information will be kept strictly confidential and will not be sold, reused, rented, loaned or otherwise disclosed.
c. Only fully paid students will be allowed to join. Please BE HONEST and DO NOT invite students to join without paying individually.

2) To proceed with enrollment, please pay first using the following modes of payment. Fees are NON-REFUNDABLE and NON-TRANSFERABLE.

You can pay on a full or per subject basis. (SEE THIS FOR FAQs ABOUT PAYMENT)
To be able to get the materials on time, please enroll at least 3 days before the start of the subject/s.

If the subject/s you are enrolling in is/are already finished, you can still enroll any time as you wish and you will just be replaying the lectures in the app.

BANK DEPOSIT
BANCO DE ORO (BDO)
ACCOUNT NAME: Krizza-Almond S. Aguilar
ACCOUNT NUMBER: 00 732 001 4669

BANK OF THE PHILIPPINE ISLANDS (BPI)
ACCOUNT NAME: Mark Anthony N. Salido (account of my husband)
ACCOUNT NUMBER: 2349 2711 52

SECURITY BANK (SB)
ACCOUNT NAME: Krizza-Almond S. Aguilar
ACCOUNT NUMBER: 00000 17563681

GCASH (See QR code below)
If GCASH to GCASH or GCASH to bank, no extra fee
If kiosk (i.e., 7-11, palawan) to gcash, please add the required service fee to the amount to be transferred
GCash via PALAWAN: add 2% service fee
GCash via 7-11: add 3% service fee


PAYMAYA (See QR code below)

PLEASE DO NOT SEND PAYMENT VIA PALAWAN PERA PADALA.
HUWAG MAGPADALA SA PALAWAN EXPRESS PERA PADALA.
MODES OF PAYMENT

CLICK THIS FOR THE MCE ENROLLMENT FORM

3) Register using this MCE form. Please make sure you have the proof of payment ready as well as a decent photo which we will be using for your digital ID.

4) Wait for confirmation via text or email along with the instructions. Sir Axel will assist you. Kindly wait for his message.

Enroll in all subjects and automatically get a free online final coaching.

WHO CONDUCTS THE LECTURES?

Dra. Krizza-Almond S. Aguilar-Salido will handle most of the subjects but there will be invited special lecturers for a few subjects.

For a list of special lecturers, please click this.


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Posted in Lecture Notes

My Med Tech Notes in PDF for FREE!

Disclaimer: The notes I’m sharing may not be currently updated (as I’ve used some of them in my past lectures/reviews), so please always refer to textbooks if you encounter conflicting information.

Password protected.
If you’re new here, please ask for it thru private message. Click this.

ALL NOTES MAY BE USED FOR
UNDERGRADUATE, LOCAL BOARD EXAM OR INTERNATIONAL EXAMS (i.e., ASCPi)

— This list will be updated from time-to-time, so check back regularly. Click DOWNLOAD BUTTON to access each file below. —

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SEE STUDY TIPS & TECHNIQUES

ERRATUM FOR THIS: For the action of insulin, please change GLYCOGENOLYSIS to GLYCOGENESIS. Insulin lowers glucose and so it should increase conversion of glucose to glycogen (GLYCOGENESIS).

NOTE: Watch FREE ONLINE REVIEW (FOR) You discussion of the notes above here.

NOTE: If you want to watch the video lecture for the CM notes above, please see instructions here.

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QUIZZES/EXAMS


REVIEW STUFF SHARED BY STUDENTS

MISCELLANEOUS

MGA WALANG KWENTANG MNEMONICS

Posted in Lecture Notes

Med Tech Mycology Notes

FUNGI
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CHARACTERISTICS:

  • Eukaryotic
  • Thallophytes
    • have true nuclei
    • heterotrophic members of the plant family that lack stems and roots
  • Lack chlorophyll
  • Larger and with more complex morphology than the bacteria
  • Chitin in the cell wall
  • Ergosterol in the cell membrane
  • Saprophytic nature (derive nutrition from organic materials)
  • Lack of susceptibility to antibacterial antibiotics

TWO PHASES:

  • Multicellular MOLD – fluffy, cottony, woolly, or powdery mycelial mass, grows at 25°C
  • Unicellular YEAST – moist, creamy, opaque or pasty, resembling bacterial colony, grows from 35°C to 37°C
DIMORPHIC FUNGI – capable of two phases
Mold at 25°C to 30°C – INFECTIVE TO MAN
Yeast at 37°C – TISSUE/IN VIVO/INVASIVE

PARTS:

  • MYCELIUM – intertwining structure composed of tubular filaments known as HYPHAE
    • Vegetative portion or thallus – grows in or on a substrate and absorbs water and nutrients
    • Reproductive or aerial part – contains fruiting bodies that produce reproductive structures (conidia or spores); extends above the agar surface
  • HYPHAE – microscopic unit of fungi
    • Septate – contain cross-walls
      • All fungi except Zygomycetes
    • Aseptate/Coenocytic – continuous, without cross-walls
      • ZYGOMYCETES (Rhizopus, Mucor)
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FUNGAL REPRODUCTION:

  • SEXUAL – meiosis (reduction division of two fertile cells) followed by merging of the cells and nuclear fusion occurs
    • PERFECT FUNGI – fungi that exhibit sexual phase
    • ASCOSPORES – contained in a saclike ASCUS
      • CLEISTOTHECIUM – large, round, multicellular structure that surrounds the asci until it ruptures, releasing ascospores
    • BASIDIOSPORES – contained in a club-shaped BASIDIUM
    • OOSPORES – fusion of cells from two separate, nonidentical hyphae
    • ZYGOSPORES – fusion of two identical cells arising from the same hypha
  • ASEXUAL – involves only mitosis with nuclear and cytoplasmic division
    • IMPERFECT FUNGI – do not exhibit sexual phase
    • SPORANGIOSPORES – asexual spores contained in sporangia (sacs) and produced terminally on sporangiophores or aseptate hyphae
      • UNIQUE TO THE ZYGOMYCETES
    • CONIDIA – asexual spores produced either singly or multiply in long chains or clusters by specialized vegetative hyphae (conidiophores)
      • MACROCONIDIA – large, usually septate
        • Club, oval, or spindle shaped
        • Thick or thin walled
        • Spiny (echinulate) or smooth surface
      • MICROCONIDIA – small, unicellular
        • Round, elliptical, or pyriform (pear) shape
    • BLASTOCONIDIA or BLASTOSPORES
      • Develop as daughter cell buds off the mother cell and is pinched off
      • Blastoconidia of yeasts (including Candida) may elongate to form pseudohyphae
    • CHLAMYDOCONIDIA or CHLAMYDOSPORES
      • Thick-walled, resistant, resting spores produced by “rounding up” and enlargement of the terminal hyphal cells
      • Germinate into a new organism when favorable environmental conditions exist
        • Terminal – form at the hyphal tip
        • Sessile – form on the hyphal sides
        • Intercalary – form within the hyphal strand
    • ARTHROCONIDIA or ARTHROSPORES
      • Simple fragmentation of the mycelium at the septum into rectangular-, cylinder-, or cask-shaped spores
      • Thick walled spores which may be adjacent or alternate (empty spaces or disjunctor cells in between each arthrospores) in arrangement
      • Useful identification characteristic of Coccidioides immitis and Geotrichum candidum
CLASSIFICATION

Botanical Taxonomy

  • Zygomycota –Mucor, Absidia, Rhizopus
  • Ascomycota
  • Basidomycota
  • Deuteromycota – most medically important fungi
    • With septate hyphae
    • Asexual reproduction

Type of Mycoses

  • Superficial and cutaneous mycoses
  • Subcutaneous mycoses
  • Systemic mycoses
  • Opportunistic mycoses
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IDENTIFICATION METHODS

MICROSCOPIC

  • SALINE MOUNT – quick and simple method to observe fungal elements (budding yeast, hyphae, pseudohyphae)
    • Major disadvantage: Lack of contrast
  • 10% KOH PREPARATION – rapid and simple method to examine hyphae, budding yeast and spherules
    • KOH dissolves keratin in skin, hair, or nail
    • Chitin is resistant to effects of KOH
    • Hair can be examined to determine type of infection
      • ENDOTHRIX – fungal invasion within the hair shaft
      • ECTOTHRIX – infection outside the hair shaft
    • Disadvantage: Lack of contrast
  • CELLUFLUOR – chemofluorescent brightening agent
    • Can be added to the KOH solution
    • Binds to the chitin in fungal cell wall
    • Provides excellent contrast when examined with a fluorescent microscope
    • Fungi fluoresce intense apple green
  • INDIA INK/NIGROSIN – used to identify hyaline capsule of the yeast Cryptococcus neoformans
    • Capsules do not stain with India ink and appear as clear halos against a dark background
    • May be difficult to interpret; WBCs and artifacts can be mistaken for yeast or capsules
    • Cryptococcus may be capsule negative in immunodeficiency
    • Replaced by direct antigen testing for the cryptococcal capsular protein
  • LACTOPHENOL COTTON BLUE (LPCB) (AMAN) – imparts blue color to the fungal cell wall
    • Slides can be permanently sealed for later study with either Permount or clear nail polish
    • Can also be used in the tease preparation (wet mount) and slide cultures
  • HUCKER MODIFICATION OF GRAM STAIN – recommended for mycology
    • Fungi generally stain gram positive
    • Oval or budding yeast, hyphae, arthrospores generally stain well
    • C. neoformans may appear pale lavender with blue inclusions (capsule prevents adequate staining)
    • Fungi are 2 to 3x the size of gram-positive cocci
    • Hyphae are 2 to 3x wider than gram-positive bacilli
  • GIEMSA or WRIGHT’S STAIN – used for the detection of intracellular Histoplasma capsulatum in blood smears, lymph nodes, lung, liver, or bone marrow
    • H. capsulatum appears as small, oval yeast cell staining light to dark blue
    • C. neoformans also stain well
  • METHENAMINE SLIVER NITRATE STAIN – useful for screening of clinical specimens
    • Provides good contrast and staining for fungal elements
    • Fungi appear outlined in black, with an inner dark rose to black color against a pale green background
    • Viable and nonviable fungi are stained using this method
    • GOMORI METHENAMINE SILVER (GMS) NITRATE MODIFICATION – used in histology to detect fungi in specimens
  • PERIODIC ACID SCHIFF (PAS) – stains hyphae of molds and yeast
    • Periodic acid oxidizes the hydroxyl in the carbohydrates of the cell walls to form aldehydes which react with basic fuchsin dye to form a pink-purple complex
    • Counterstain of fast green can be used to provide contrast
    • Useful in staining tissue in histology

CULTURE

  • Must include a source of nitrogen (nitrite, nitrate, amino acids, or urea) and a carbon source (usually glucose)
  • Incubated at 30°C or RT (25-30°C)
  • Chloramphenicol – inhibits bacteria
  • Cycloheximide – inhibits saprophytic, contaminating fungi

PRIMARY ISOLATION MEDIA

SABOURAUD DEXTROSE AGAR (SDA)
Main general isolation medium Primary recovery of saprobic and pathogenic fungi Primary agar for initial culture Contains peptone and glucose Inhibitor for bacteria: ACIDIC pH (5.6)
SDA WITH CYCLOHEXIMIDE AND CHLORAMPHENICOL (SDA-CC) Recovery of pathogenic fungi Bacteria and saprophytic fungi inhibited Available commercially as Mycosel or Mycobiotic medium
MYCOSEL OR MYCOBIOTIC AGAR
Isolation of dermatophytes from hair, skin, and nail specimens Contains the inhibitory agents, cycloheximide and chloramphenicol Similar to DTM
DERMATOPHYTE TEST MEDIUM (DTM)
Can be substituted for SDA-CC for the recovery of dermatophytes from specimens contaminated with fungi or bacteria Isolation of dermatophytes from hair, skin, and nail specimens Dermatophytes produce alkaline metabolites, which raise the pH and change the color of the indicator from yellow to red Indicator: PHENOL RED Antibiotics inhibit saprophytic fungi and bacteria
BRAIN-HEART INFUSION (BHI) AGAR
Isolation of saprophytic and pathogenic fungi from sterile sites Bacteria also grown in BHI Can be supplemented with blood
BHI AGAR WITH ANTIBIOTICS, CYCLOHEXIMIDE AND CHLORAMPHENICOL
Isolation of pathogenic fungi exclusive of dermatophytes; useful for specimens that may be contaminated with bacteria or saprophytic fungi
BHI BIPHASIC BLOOD CULTURE BOTTLES
Recovery of fungi from blood or bone marrow
 

DIFFERENTIAL MEDIA

BIRDSEED (NIGER SEED) AGAR/ STAIB’S MEDIUM
Isolation of Cryptococcus neoformans: brown to black colonies in 4 to 7 days C. neoformans produces phenol oxidase which breaks down the medium resulting in the production of melanin Similar to caffeic acid agar
CORNMEAL AGAR WITH TWEEN 80
Stimulation of conidiation and chlamydospore production in Candida species; useful for species differentiation of Candida Cornmeal agar + 1% glucose: differentiates T. rubrum from T. mentagrophytes based on PIGMENTATION
COTTONSEED AGAR
Conversion of mold phase of Blastomyces dermatitidis to its yeast phase
NITRATE REDUCTION MEDIUM
Confirmation of nitrate reduction in C. neoformans
POTATO DEXTROSE AGAR
Stimulation of conidia production in fungi Useful in slide culture Also demonstrates pigment production of Trichophyton rubrum
RICE MEDIUM Identification of Microsporum audouinii
TRICHOPHYTON AGARS
Nutritional requirement tests for the differentiation of
Trichophyton #1: casein agar base (vitamin free)
#2: casein agar base and inositol
#3: casein agar base, inositol, and thiamine
#4: casein agar base and thiamine
#5: casein agar base and nicotinic acid
#6: ammonium nitrate agar base
#7: ammonium nitrate agar base and histidine
UREA AGAR
Detection of urease production by C. neoformans and differentiation of Trichophyton mentagrophytes from T. rubrum
YEAST ASSIMILATION MEDIA (CARBON OR NITROGEN)
Detection of carbohydrate assimilation through utilization of carbon (or nitrogen) by yeast in the presence of oxygen
YEAST FERMENTATION BROTH
Identification of yeasts by fermentation reactions with various carbohydrates

ORGANISMS AND THEIR DESCRIPTION TO FOLLOW 🙂

Posted in Online Classes

#TheCheckPointOnline Team

Dra. Krizza-Almond Sarmiento Aguilar-Salido, RMT, MT (ASCPi)

Hi! I’m the owner of this website and #TheCheckPointOnline Review. You can see my information in the “About Me” section of this site.

I have my own version of MCE Lectures for the following subjects:

  • Clinical Chemistry
  • Bacteriology
  • Hematology
  • Immunology & Serology
  • Blood Banking
  • Clinical Microscopy

I also handle the following special sessions:

  • Mastery Sessions
  • Co-MEMORY-ate
  • Final Coaching (End Cell Edition)

TheCheckPointOnline ADMIN

Sir Ross Axel Rufino, RMT

He assists all newly enrolled cells with the initial steps after registration. He also handles student concerns of all kinds.

Sir Red Lawas, RMT

He is one of the Junior Review Assistants who will be more than willing to help you in any way he can.

Ma’am Marian Felise Amican, RMT

She is one of the Junior Review Assistants who will be more than willing to help you in any way she can.

Ma’am Ma. Dhilyn Clariza

She is one of the Junior Review Assistants who will be more than willing to help you in any way she can.

SPECIAL LECTURERS

We also invited the following special lecturers to help our memory cell edition course more high-yield.

Ma’am Clarence Witty H. Mendoza, RMT, MSMT
Dr. Joseph Reuel B. Cruz, BSci., RMT
Sir Kristan J. Dela Cruz, RMT
Sir Benjie M. Clemente, RMT, MLS(ASCPi)cm, MPH
Sir Rojohn Sonny C. Cruz, RMT, PBT (ASCPi), MLS (ASCPi), MSMLS
Sir Lexus P. Delfin, RMT

Neocyte-senseis

Ma’am Leila Mae F. Marquez, RMT
Sir John Lee Del Corro, RMT
Doc Joan Mae Perez-Rifareal
Makarius Smart Learning
Posted in Checkpoint Notes, Lecture Notes

Clinical Microscopy – REAGENT STRIPS

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TEST PRINCIPLE TIMEREAGENTSFALSE (+)FALSE (-)
Glucose (correlated with ketones)  
Double sequential enzyme reaction  

ENZYMES: Glucose oxidase Peroxidase  

30 s
M – glucose oxidase, peroxidase, potassium iodide  
C – glucose oxidase, peroxidase, tetramethylbenzidine  

CHROMOGENS:
O-toluidine (pink to purple) Potassium iodide (blue to brown) Aminopropryl-carbazol (yellow to orange-brown) Tetramethylbenzidine (yellow to green)
Contamination by oxidizing agents and detergentsHigh levels of ascorbic acid, ketones, specific gravity
Low temperature   Improperly preserved specimens
Ketones (correlated with glucose)  

Sodium nitroprusside reaction  

40 s
M – sodium nitroprusside (acetoacetic acid)  

C – sodium nitroprusside + glycine (acetoacetic acid & acetone)
Phthalein dyes, highly pigmented red urine, levodopa   Medications containing free sulfhydryl groups (MESNA)Improperly preserved specimens
Specific Gravity  

pKa change of polyelectrolyte

pKa = dissociation constant

45 s
M – poly (methy lvinyl ether/maleic anhydride) bromthymol blue

C – ethyleneglycol-Bis (aminoethylether) bromthymol blue
High concentrations of proteins because of protein anionsHighly alkaline urines (>6.5) Add 0.005 to S.G. readings
pH
(correlated with Nitrite, LE, microscopic)  

Double-indicator system

60 s
Methyl red
Bromthymol blue
NoneRunover from the adjacent CHON pad may lower pH
Protein (correlated with blood, nitrite, LE, microscopic)

Protein error of indicators  

60 s
M – tetrabromphenol blue

C – tetrachloropenol tetrabromosulfonphthalein

ACID BUFFER: Citrate
Highly buffered alkaline urine High specific gravity   pigmented specimens, phenazopyridine quaternary ammonium compounds (detergents)   antiseptics, chlorhexidine   loss of buffer from prolonged exposure of reagent strip to the specimenProteins other than albumin
Blood (correlated with protein and microscopic)  

Pseudo-peroxidase activity of hemoglobin  

60 s
M – diisopropylbenzenedehydroperoxide tetramethylbenzidine

C – dimethyldihyroperoxide- tetramethylbenzidine    

spotted blue for intact RBCs uniform blue for Hb and myoglobin
Strong oxidizing agents, bacterial peroxidases   menstrual contaminationHigh specific gravity/ crenated cells   high concentration of nitrite   formalin, captopril, ascorbic acid > 25mg/dl   unmixed specimens
Bilirubin (correlated with urobilinogen)  

Diazo reaction

60 s
M – 2,4-dichloro-analine diazonium salt

C -2,6-dichorobenzene-diazonium-tetrafluoroborate  
Highly pigmented urines, phenazopyridine, indican metabolites of LodineSpecimen exposure to light, ascorbic acid >25 mg/dL, high concentration of nitrite
Urobilinogen (correlated with bilirubin)  

Ehrlich’s reaction

60 s
M – para-dimethylaminobenzaldehyde
C – 4-methoxybenzenediazonium-tetrafluroborate  
M – Porphobilinogen, indican, p-aminosalicyclic acid, sulfonamides, methyldopa, procaine, chlorpromazine, highly pigmented urine

C – highly pigmented urine
M – old specimens, preservation in formalin

C – old specimens, preservation in formalin, high concentration of nitrite
Nitrite (correlated with protein, LE and microscopic)  

Greiss reaction

60 s
M – p-arsanilic acid Tetrahydrobenzo(h)-quinolin-3-ol

C – Sulfanilamide, hydroxytetrahydro benzoquinoline      
Improperly preserved specimens  


Highly pigmented urine
Nonreductase-containing bacteria insufficient contact between bacteria and urinary nitrate (should be 4 hours) lack of urinary nitrate, large quantities of bacteria converting nitrite to nitrogen, presence of antibiotics, high concentration of ascorbic acid high specific gravity
Leukocytes (correlated with protein, nitrite and microscopic)  

Leukocyte esterase  

120 s
M – derivatized pyerole amino acid ester, diazonium salt  

C – indoxylcarbonic acid ester diazonium salt  
Strong oxidizing agents, Formalin, highly pigmented urine, nitrofurantoinHigh concentration of protein, glucose, oxalic acid, ascorbic acid, gentamicin, cephalosporins, tetracyclines
Posted in Lecture Notes

Clinical Microscopy – Automation

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WHAT’S IN HERE?

  • Principles Used in Automated Urinalysis and Microscopy
  • Automated Urinalysis Systems
  • Automated Body Fluid Analysis Systems
Principles Used in Automated Urinalysis and Microscopy
  • REFLECTANCE PHOTOMETRY
    • Used by automated reagent strip readers
    • Measure the light reflected from the reagent strip color pads and compare the amount of reflected light with a known standard
    • PRINCIPLE: light reflected from the colored reagent pads DECREASES in DIRECT PROPORTION to the INTENSITY OF THE COLOR produced by the reaction with the specific substance in the urine sample
      • the darker the color, the less light reflected
      • the lighter the color, the more light reflected
    • The concentration of a specific substance and concentration units are displayed on the reader’s display
  • LASER-BASED FLOW CYTOMETRY, IMPEDANCE & LIGHT SCATTER
    • Identify sediment elements in a urine sample
    • measures sediment conductivity and light scatter
      • Conductivity is based upon the impedance (the amount of resistance that occurs when a sediment passes through an electrical field) of sediments and counts the numbers of pulses (sediments).
        • The size of the pulse indicates the size of the sediment.
      • Light scattering characteristics of the sediments are determined by their movement through the laser light beam.
        • Identification depends on how the light is scattered by the sediment.
  • HARMONIC OSCILLATION
    • Assesses SPECIFIC GRAVITY
    • Method based upon densitometry in which a sound wave of a specific frequency changes in proportion to the density of the urine sample
    • Change in wave frequency is measured by a microprocessor and translates the reading to specific gravity
  • HYDRODYNAMIC FOCUSING
    • Identifies specific sediments
    • involves the movement of single urine sediments past the optics of a microscope to allow sediments to flow in several planes plane past the microscope objective
    • A flow cell also measures sediment conductivity, size, and light scattering traits
    • Questionable findings are viewed on a monitor for operator identification and confirmation
Automated Urinalysis Systems
  • INDIVIDUAL STRIP  READERS
  • SEMIAUTOMATED  ANALYZERS
    • dependent on an operator for specimen mixing, test strip, dipping,  and  inputting  of  physical  and  microscopic  results
  • FULLY  AUTOMATED CHEMISTRY ANALYZERS
    • add urine to the reagent strip
  • AUTOMATED URINE CELL ANALYZERS
    • mix, aspirate, dilute, and stain urine to classify urine sediment particles
  • COMPLETELY  AUTOMATED  SYSTEMS
    • perform a complete urinalysis that includes the physical, chemical, and microscopic parts of a routine urinalysis
WAIVED URINE CHEMISTRY INSTRUMENTS
Roche Diagnostics Criterion II Siemens Medical Solutions Diagnostics Clinitek®50 Siemens Medical Solutions Diagnostics Clinitek®101 Siemens Medical Solutions Diagnostics Clinitek®Status
SEMIAUTOMATED URINE CHEMISTRY INSTRUMENTS
Dirui Urine Analyzer H-50, 100, 200 Iris Diagnostics Division iChem®100 Roche Diagnostics URISYS®1800 Roche Diagnostics Chemstrip Criterion II Siemens Medical Solutions Diagnostics Clinitek®200, 200+, 500
FULLY AUTOMATED URINE CHEMISTRY INSTRUMENTS
Iris Diagnostics Division AUTION MAX® Iris Diagnostics Division iChem® VelocityTM Roche Diagnostics URISYS 2400® Siemens Medical Solutions Diagnostics Clinitek® Atlas
AUTOMATED SEDIMENT ANALYSIS
Iris Diagnostics Division iQ®200ELITETM Iris Diagnostics Division iQ®200SELECTTM Iris Diagnostics Division iQ®200SPRINTTM Sysmex UF-100® Urine Cell Analyzer
TOTALLY AUTOMATED URINALYSIS SYSTEMS
Iris Diagnostics Division iQ®200 Automated Urinalysis System iRICELL2000 (iChem® VelocityTM plus iQ®200ELITETM) iRICELL3000 (iChem® VelocityTM plus iQ®200SPRINTTM) Siemens Medical Solutions Diagnostics ADVIA Urinalysis WorkCell System (Clinitek® Atlas plus the Sysmex UF-100)
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DESCRIPTION OF SOME SELECTED INSTRUMENTS

  • CLINITEK 50 & CLINITEK STATUS
    • well  suited  for  small  volume  laboratories  and  physician’s offices
    • Memory storage for test results -100 for Clinitek 50 and 200 for Clinitek Status
    • automated  reading  of  microalbumin-to-creatinine  and  protein-to-creatinine  ratios and human  chorionic  gonadotropin  (hCG)
  • CLINITEK 200
    • For medium-volume to large-volume urinalysis laboratories and features a high specimen output of one strip every 10 seconds.
    • Multistix reagent test  strips  are  used,  and  the  instrument  has  the  ability  to report semiquantitative (mg/dL) results or plus (+) and SI units.
    • The reflectometer  is  calibrated  daily  and maintenance is required each day for all areas in contact with urine test strips
  • SYSMEX UF-SERIES
    • Fully automated sample analysis with automatic classification of all 10 formed element groups with SCATTERGRAMS and HISTOGRAMS for reference
    • Laser-based FLOW CYTOMETRY along with impedance detection, forward light scatter, and fluorescence
    • Sample is stained with 2 dyes
      • PHENATHRIDINE – orange dye, stains DNA
      • CARBOCYANINE – green dye, stains nuclear membranes, mitochondria, and negatively charged cell membranes
  • SYSMEX UF-SERIES
    • Stained sample is passed through the flow cell, where it is HYDRODYNAMICALLY FOCUSED and presented to a laser light beam that produces fluorescence and light scatter
    • Particles are identified by measuring the change in impedance of the sediment elements, as well as the height and width of the fluorescent and light scatter signals, which are presented in scattergrams and histograms
  • iQ 200 Automated Urine Microscopy Analyzer (IRIS)
    • Automatically analyses and classifies urine particles into 12 categories
    • Uses AUTO PARTICLE RECOGNITION (APR) software that classifies urine particles in the photographs based on size, shape, texture, and contrast
Automated Body Fluid Analysis Systems
  • cells are first mixed with reagent fixative and then counted
  • differentials counting enumerates numbers of neutrophils, lymphocytes, monocytes, and eosinophils
  • automated cell counters use larger numbers of cells, enhancing precision and accuracy
BODY FLUID ANALYZERSFDA APPROVED FOR USE WITH THESE FLUIDS:
Iris iQ Body Fluid ModuleCSF, Pleural & Peritoneal Peritoneal lavage, peritoneal dialysate, pericardial, general serous fluids, synovial
Siemens Medical Solutions Diagnostics ADVIA120 and 2120CSF
Sysmex XE-5000 Automated Hematology SystemCSF Serous body fluids Synovial fluid
Medical Electronic SystemsSemen

ADVIA120 Hematology System

  • First automated instrument with an FDA-approved automated CSF assay
    • Uses flow cytometry, light scatter, and absorbance to count the RBCs, WBCs, and performs a WBC differential that includes percentages and absolute numbers of mononuclear cells and PMNs on samples with >20WBCs/µL

AUTOMATION OF SEMEN ANALYSIS

  • SQA-V automates sperm counts and motility
    • has a two-channel measurement system that interacts with a specially designed testing capillary that contains the semen sample
    • one channel  “measures”  light  absorption  and  refraction  in sperm cells and translates this into concentration
    • one channel “counts”  light  interruptions  (signals)  caused  by sperm  cells  moving  across  the  field  of  light
    • In approximately 1 minute, thousands of signals are “read” resulting in exceptional accuracy and precision.
    • Automating the motility analysis eliminates reader subjectivity and variance among technologists.

AUTOMATION OF URINE PREGNANCY

  • Quantitative human chorionic gonadotropin (HCG) is one such test that is interpreted by the VEDALAB Easy Reader.
    • Immunochromatographic rapid test cards are read by the meter using a high-resolution CCD camera.
    • Integrated software analyzes the images and records the results.