AIIMS CRE, SNO-2024
Obstetrics & Gynaecology
Easy
A cervical smear should be collected in a:
Appeared in: AIIMS CRE, SNO-2024
Explanation
- Modern cervical screening predominantly uses Liquid-Based Cytology (LBC), which has a higher sensitivity than conventional Pap smears.
- For LBC, the cervical cells are collected using a brush or broom and then transferred into a special vial containing a liquid preservative.
- This vial is a sterile, screw-capped container, designed to preserve the cells, prevent contamination, and ensure the sample is suitable for laboratory analysis.
- The liquid medium allows for a more uniform distribution of cells on the slide and filters out obscuring materials like blood and mucus.
Why Other Options Were Wrong
- Option A: A plastic bag is not sterile and does not contain any preservative. It cannot maintain the viability or morphology of the cells, leading to sample degradation and risk of contamination.
- Option C: A heparinized tube contains the anticoagulant heparin. It is specifically designed for collecting blood samples to prevent clotting. It is not used for cytological specimens as cervical cells do not clot.
- Option D: Formalin is a fixative used for solid tissue specimens (histopathology), not individual cells (cytology). It causes cross-linking of proteins, which hardens the tissue but severely distorts the nuclear and cytoplasmic details needed to evaluate a Pap smear.
Related Visual
- Visual 1: Image: A liquid-based cytology (LBC) collection kit, clearly showing the sterile screw-capped vial with preservative fluid alongside a cervical collection brush/broom.
- Visual 2: Diagram: A comparison showing the process of a conventional Pap smear (smearing on a slide) versus Liquid-Based Cytology (rinsing the brush in a vial).
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Specimen collection and handling for cervical cytology (Pap smear) as background academic context rather than a clinical decision trigger.
- A nurse's primary role in Pap smear collection is to ensure the correct procedure and equipment are used, as improper sampling is a major cause of false-negative results.
- Proper patient education is crucial. The nurse should instruct the patient to avoid douching, using tampons, or having intercourse for at least 48 hours before the test, as these can interfere with the results.
- Ensuring the vial is correctly labeled with patient details and immediately sent for processing maintains sample integrity and prevents diagnostic errors.
How to Approach the Question
- First, identify the key procedure in the question: collecting a 'cervical smear'.
- Recall that a cervical smear (Pap test) is a form of exfoliative cytology, meaning it examines individual cells, not whole tissue.
- Consider the requirements for a cytology specimen: the cells must be well-preserved, not dried out, and free from contamination to allow for accurate microscopic examination.
- Evaluate each option based on these requirements. A 'plastic bag' offers no preservation. A 'heparinized tube' is for blood. A 'formalin jar' is for tissue, not cells.
- Conclude that a 'sterile screw-capped container', which can hold a liquid preservative, is the only logical choice for preserving individual cells for cytological analysis.
Concept Tested & Keywords
- Concept Tested: Specimen collection and handling for cervical cytology (Pap smear).
- Stem keywords: cervical smear, collected, container
- Lead-in keywords: BEST, MOST RELEVANT CLUE
- Negative lead-in flag: false
Question ID
QHR8WEww8p6VekL-BBwRZF
Practise the full AIIMS CRE, SNO-2024
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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