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MLT > BF Exam 1 Study Guide > Flashcards

BF Exam 1 Study Guide Flashcards

1
Q

In general, body fluids serve the following purposes:

A

maintain metabolic processes, allow movement and support , and keep organs functioning .

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2
Q

Body fluids are composed of ~ ___% intracellular and ___% extracellular fluids.

A

55% intracellular , 45% extracellular

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3
Q

Extracellular fluids are further classified in three groups

A

INTERSTITIAL FLUID, TRANSCELLULAR FLUID, AND PLASMA.

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4
Q

Briefly explain the BASIC principle of osmotic (colloidal) and hydrostatic forces.

A

hydrostatic > water out… osmotic pressure > water in

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5
Q

Accumulation of fluid in the body cavity is called

A

EFFUSION

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6
Q

Effusion are generally classified as either

A

TRANSUDATES or EXUDATES

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7
Q

Birefringence is when a crystal bends the polarized ___ and is classified as being either ___or ___. depending on the alignment.

A

light; positive or negative

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8
Q

The three membranes associated with the CNS are:

A

outer DURA MATER ,
middle ARACHNOID MATER
innermost PIA MATER.

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9
Q

Normal adult CSF protein range

A

15-45 mg/dl

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10
Q

Normal adult CSF Glucose range

A

45-80mg/dl
60-70%

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11
Q

Normal adult CSF WBC range

A

0-5

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12
Q

Normal adult CSF RBC range

A

0/uL

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13
Q

Normal adult CSF Differential

A

70% lymphocytes 30% monocytes

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14
Q

Adding albumin to CSF before cytocentrifugation will increase ___ and will decrease___

A

Cell Yield; cellular Distortion

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15
Q

CSF is generally collected by lumbar puncture between ___ in adults and ___ in small children/infants

A

L3 & L4; L4 & L5

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16
Q

List which tests are performed on CSF tubes 1-4:

A
  1. CHEMICAL ANALYSIS
  2. MICROBIOLOGICAL TESTS
  3. CELL COUNTS
  4. MISCELLANEOUS/ OR SAVE AND FREEZE
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17
Q

Decreasing amount of blood in CSF tubes 1-4 would indicate:

A

TRAUMATIC TAP: uneven blood distribution clot formation and xanthochromic supernatant

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18
Q

.Counts on each side of the Neubeur Hemocytometer chamber must agree within __ of each other or you must __

A

20%; RESTART THE ENTIRE TEST

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19
Q

Which sides are counted when a cell touches the side of a box in the hemocytometer?

A

TOP AND LEFT SIDES. NEVER THE BOTTOM OR THE RIGHT SIDE.

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20
Q

A web-like pellicle in a refrigerated CSF specimen is indicative of

A

TUBERCULAR MENINGITIS.

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21
Q

Nucleated RBCs are seen in the CSF as a result of

A

CONTAMINATION FROM THE BONE MARROW DURING THE SPINAL TAP.

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22
Q

Tau transferrin is normally present in ___ and is used as an indicator of leakage of this into the ___ as a result of ___

A

CSF, nose/ears; trauma

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23
Q

A WBC count of 300/ul - 75% neutrophils, protein 50 mg/dl would suggest a Dx of: ___, with an expected glucose that would be ___

A

BACTERIAL MENINGITIS; < 45-80 mg/dL

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24
Q

Prior to performing a gram stain on CSF, the specimen must be

A

CENTRIFUGED

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25
Q

IgG/Alb index formula

A

(CSF IgG/Serum IgG)/(CSF albumin/ Serum albumin)

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26
Q

The integrity of the blood-brain barrier is measured using the

A

CSF/SERUM ALBUMIN INDEX:<9 = intact BBB

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27
Q

The test of choice to detect neurosyphilis in CSF is

A

VDRL

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28
Q

What is pleocytosis?

A

INCREASED CELLS particularly WBCs.

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29
Q

What IgG/albumin test score is indicative of synthesis of IgG in the CNS?

A

VALUES > 0.70

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30
Q

The major protein component of normal CSF is

A

ALBUMIN

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31
Q

With infection, hemorrhage, obstructions and traumatic tap, the protein level will be

A

Increased

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32
Q

When evaluating the blood-brain barrier, what result (value and test) would indicate that this was intact?

A

INDEX VALUE: <9; CSF/serum albumin index.

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33
Q

Normal body fluid volume of ascites

A

100mL

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34
Q

Normal body fluid volume of Pericardial

A

50mL

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35
Q

Normal body fluid volume of pleural

A

30mL

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36
Q

Normal body fluid volume of CSF adult

A

90-150 mL

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37
Q

Normal body fluid volume of CSF neonate

A

10-60mL

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38
Q

Normal body fluid volume of semen

A

2-5mL

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39
Q

Normal body fluid volume of amiotic

A

1100-1500

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40
Q

Protein electrophoresis of CSF shows an increase of IgG CSF/serum index and two oligoclonal bands not present in the serum. What disease or condition does this indicate?

A

MULTIPLE SCLEROSIS

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41
Q

A decrease CSF / serum glucose ratio less than 0.6 and an increase of lactic acid greater than 35 mg/dl usually indicates:

A

BACTERIAL MENINGITIS

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42
Q

Name of the fluid and the procedure for removal of fluid from lungs

A

pleural fluid; thoracentesis

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43
Q

Name of the fluid and the procedure for removal of fluid from joint

A

synovial fluid; arthrocentesis

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44
Q

Name of the fluid and the procedure for removal of fluid from amniotic sac

A

amniotic fluid; amniocentesis

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45
Q

Name of the fluid and the procedure for removal of fluid from heart

A

pericardial fluid; pericardiocentesis

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46
Q

Name of the fluid and the procedure for removal of fluid from adominal

A

peritoneal fluid (ascites); paracentesis

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47
Q

The protein complex that moistens and lubricates joints and contributes to synovial fluid viscosity is

A

HYALURONIC ACID

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48
Q

What are TWO tests for macroscopic analysis of joint fluid viscosity?

A

STRING TEST and ROPE’S TEST

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49
Q

Why can you NOT use acetic acid to lyse RBC in joint fluid?

A

Hyaluronicc acid is a component of synovial fluid and produces CLOT FORMATION AND CELL CLUMPING

50
Q

When collecting joint or serous fluids, which tubes are used to collect:
cell count
Micro culture
Chemistry

A

EDTA
Sterile tubes/heparinized
Heparin/Clot/Gray

51
Q

List two ways crystals can be prepared from synovial fluid for examination

A

WRIGHT-GIEMSA STAIN AND POLARIZED LIGHT.

52
Q

If a patient has gout, the analyte that is increased is ___, and the crystal that will be seen with polarizing light is

A

uric acid; MSU - monosodium urate crystals

53
Q

A crystal that demonstrates ___birefringence is blue when aligned with the compensator filter and yellow when perpendicular. This crystal is ___

A

positive; CPPD - calcium pyrophosphate dehydrate crystals

54
Q

What is the diagnosis of the patient with the observed crystals that is positive & has calcium pyrophosphate dehydrate crystals

A

Pseudo gout

55
Q

What can be added to a semen sample that doesn’t liquify sperm or a synovial fluid that is too viscous to do a cell ceount?

A

Hyaluronidase

56
Q

What is andrology?

A

Medical specialty dealing with male health, especially reproductive system and urologic problems.

57
Q

Where does the majority of seminal fluid originate?

A

Seminal vesicle

58
Q

How many days does it take to complete the three phases of spermatogenesis?

A

74-90 days

59
Q

What is the purpose of fructose in seminal fluid?

A

Energy for flagella (motility) - makes it possible for sperm to project through the female reproductive tract

60
Q

For voluntary infertility (vasectomy), the ___ is normally severed, with___ consecutive months of no sperm detection before a male is considered infertile.

A

vas deferens; 2

61
Q

Why is the first part of the ejaculate – especially important?

A

Majority of the sperm is there.

62
Q

What is a normal sperm count?

A

20 to 250 million sperm / ml

63
Q

Abstinence shorter than 48 hrs may affect semen analysis by ___ sperm count while continence longer than 5 days may ___the count and decreased ___.

A

decreased; increased; motility

64
Q

Why is a standard condom not recommended for collection of a semen sample?

A

Standard condoms have spermicide

65
Q

What is semen liquefaction?

A

Semen coagulates shortly after ejaculation (viscous) then it liquifies (becomes watery) a “proteolytic process where gel like ejaculated semen becomes watery due to enzymatic activity of the protease

66
Q

How can the presence of acid phosphatase be used forensically?

A

Helps prove secretory exposure in sexual assault cases

67
Q

normal limits on semen analysis: progressive motility

A

> 50% within one hour

68
Q

normal limits on semen analysis: viability

A

> 50-70%

69
Q

normal limits on semen analysis: Normal Morphology

A

> 30% (laboratory dependent)

70
Q

List MACROscopic analysis of semen samples:

A

Liquefaction
Volume
Viscosity
Appearance

71
Q

List MICROscopic analysis of semen samples:

A

Motility
Concentration
Agglutination
Viability
Penetration
Morphology

72
Q

What is the principle of the Eosin-nigrosin stain and when is it normally ordered / performed?

A

Eosin stains dead sperm cells red (live sperm remains unstained) while nigrosin is used for contrast. They are ordered when count is normal but motility is decreased (<25%).

73
Q

What are the three serous fluids?

A

Pericardial fluid, Pleural fluid, Peritoneal fluid

74
Q

State two general reasons for performing serous fluid analysis.

A

To determine if it’s a transudate or an exudate and if it contains chylous or pseudochylous effusions.

75
Q

Body fluid testing should be performed within ___ of collection

A

one hour

76
Q

Why should transudates be differentiated from exudates?

A

Exudates need more testing, need to see if there’s something that you need to follow up on

77
Q

Which 3 tests, when performed together, will differentiate transudates from exudates 100% of the time?

A

Specific gravity, Lactate Dehydrogenase, and TP (total protein)

78
Q

What does a SAAG value of 1.5 indicate?

A

Transudate because its higher than 1.1

79
Q

A transudate serous fluid is from a ___, while an exudates results from a ___

A

systemic; localized

80
Q

A serum ascites albumin gradient (SAAG) of 0.9 indicates

A

Exudate effusion.

81
Q

What does a pH of 6.0 in a pleural fluid indicate?

A

esophageal rupture

82
Q

What is the SAAG cut-off value?

A

1.1

83
Q

Transudates have ___ WBC count, while exudates have ___ count.

A

<1000; >1000

84
Q

A chylous effusion will have a/an ___ triglyceride with a/an ____ cholesterol. A pseudochylous effusion will be the opposite and will have no chylomicrons.

A

high; normal

85
Q

Wasting syndrome is also known as ___ and presents specifically as a ___effusion.

A

cachexia; chylous

86
Q

Elevated amniotic fluid volume is ___ , a decrease is ___.

A

hydramnios; oligohydramnios.

87
Q

What is the relationship between amniotic fluid and fetal lungs?

A

A fetus breathes in amniotic fluid for maturation of the lungs

88
Q

List two ways to differentiate a mother’s urine from amniotic fluid

A

Creatinine and urea will be higher in a mothers urine, and glucose and protein will be higher in amniotic fluid.

89
Q

When is amniocentesis usually collected (gestational weeks - range) ___ not usually collected later than ___ weeks because of

A

15-18 weeks; 20; the baby growing and moving

90
Q

AFP, hCG, uE3, IHA are tests used to predict / show evidence of (give two specific examples /conditions):

A

neural tube defects (anencephaly, spina bifida), down syndrome.

91
Q

The KB test performed on amniotic fluid can be used to differentiate ___ from ___cells, which result from ___ tap vs ___ (respectively)

A

mother; fetal; traumatic tap; hemorrhage

92
Q

A peak of OD in amniotic fluid at ___ nm indicates the presence of ___ while a peak at ___ nm indicates the presence of bilirubin

A

410; oxyhemoglobin; 450; bilirubin

93
Q

Oxyhemoglobin is considered a contaminant and ___ is considered significant for ___

A

bilirubin; HDFN

94
Q

List three methods for evaluating lung maturity significant for ratio,

A

Phosphatidyl glycerol
Amniostat FLM
lecithin

95
Q

What is the Liley graph?

A

Assesses whether or not the risk of premature delivery is worth it. Assesses HDFN and amniotic fluid.
Used to monitor severity of HDFN vs. fetal age or survivability

96
Q

A pregnancy test detects ___ which peaks during the ___ trimester.

A

hcG, first

97
Q

A pregnancy test that is resulted as positive or negative is a ___ test, while one that will give an actual value (number) is a ___ test.

A

Qualitative; Quantitative

98
Q

The predominant bacterial species in a healthy vagina is ___ , while the main cause of bacterial infection is from ___.

A

Lactobacillus; Gardnerella vaginalis

99
Q

A vaginal wet prep sample should be evaluated for presence of (list all three):

A

Trichomonas vaginalis, Candida albicans (budding yeast), and clue cells.

100
Q

If a woman has a vaginal infection, what sample other than a wet prep, may show the presence of the organisms listed above?

A

KOH prep, Gram stain, Amine test

101
Q

Specifically – why should a wet prep be examined within 30 minutes of collection?

A

Trichomonas lose viability after collection and can be easily mistaken for WBCs.

102
Q

A bronchial washing is collected from ___ area while a bronchial lavage is collected from ___ area.

A

proximal; distal

103
Q

The main use of bronchial lavages and washes is with ___ patients.

A

immunocompromised

104
Q

What two tests are commonly performed using saliva.

A

HIV and DNA, nicotine, hormones, allergies, cancer

105
Q

what is one advantage of using a saliva test?

A

No blood draw, can do at home and send in sample

106
Q

All body fluids can potentially carry disease and therefore, they must be considered ___

A

pathogenic

107
Q

Some clinical sites will have the color and clarity of a BF sample entered only once, usually when received in processing.
What is the main advantage of this?

A

Body fluids can change in appearance overtime; it can change in color after oxidation and bacterial growth could change clarity

108
Q

Some clinical sites will have the color and clarity of a BF sample entered only once, usually when received in processing.
Which type of fluid should not be processed in this way? Why?

A

CSF; Its color darkens with oxidation and reduction of molecules and clarity decreases with more bacterial growth and precipitation of amorphous materials

CSF can come in different colors from Traumaticc tap or Xanthrochromic

109
Q

Hemothorax:

A

accumulation of blood in pleural cavity

110
Q

Xanthrochromia

A

Biliruben in CSF from broken down, old rbc, pale yellow color

111
Q

Clue cell

A

vaginal cell; abnormal variation of squamous epithelial cells that have coccobacillus attached to the cell surface.

112
Q

List THREE things that may help you differentiate RBC from WBC when doing a Hemocytometer count

A

Wright’s stain or Methylene Blue stains WBC
Dilute acetic acid will lyse RBCs
Phase microscopy

113
Q

Regarding MESOTHELIAL cells:
In which type of fluid would you expect to see them?

A

Serous (peritoneal, pericardial, and pleural)

114
Q

What are mesothelial cells, and are they normal?

A

They are normal; they make up the lining of the cavities.

115
Q

How can mesothelial be a negative predictor for TB?

A

Mesothelial decreases with TB. TB unlikely if >5% mesothelial in pleural fluid

116
Q

What role does lactobacillus play in the vagina?

A

It maintains a healthy vaginal microbiome & should dominate in a healthy vagina

117
Q

What is the likely cause of a greenish colored amniotic fluid? What would this indicate?

A

This could be due to the baby’s first meconium (bowel movement) and can indicate fetal distress.

118
Q

What test can be used to screen for excess fluid in a knee joint before doing an arthrocentesis?

A

Bulge test

119
Q

How can a sample more than 24 hours old be evaluated for the presence of trichomonas?

A

Positive KOH test and Amine whiff test is indicative of the presence of trichomonas

120
Q

What affect can overfilling or under filling the Hemocytometer chamber have on a cell count?

A

Underfilling/overfilling will alter the cell counts in the reading area and affect the overall count. Underfilling it can decrease cell count.

121
Q

Most body fluid cell counts currently are performed on an autoanalyzer (CBC instrument). Which type of fluid is usually still performed manually? Why?

A

Synovial & CSF - low cell count

122
Q

What is the term for RBC in a body fluid that have a spikey appearance rather than the normal biconcave round morphology?

A

Acanthocyte; creanated

MLT (3 decks)

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