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Urinalysis > Chapter 7 > Flashcards

Chapter 7 Flashcards

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1
Q

3rd part of routine urinalysis-

A

microscopic examination of the urinary sediment

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2
Q

Identification of insoluble substances (formed elements)- (11)

A

-Red blood cells (RBCs)
-White blood cells (WBCs)
-Epithelial cells
-Casts
-Bacteria
-Yeast
-Parasites
-Mucus
-Spermatozoa
-Crystals
-Artifacts

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3
Q

Microscope analysis is subject to several procedural variations- (4)

A

-The methods by which the sediment is prepared
-The volume of sediment actually examined
-The methods and equipment used to obtain visualization
-The manner in which the results are reported

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4
Q

Microscopic is performed based on-

A

physical & chemical results

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5
Q

Parameters considered significant for microscopic screenings include- (7)

A

-Color
-clarity
-blood
-protein
-nitrite
-leukocyte esterase
-possibly glucose

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6
Q

Special populations for microscopic examinations- (6)

A

-pregnant women
-pediatric
-geriatric
-diabetic
-immunocompromised
-renal patients

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7
Q

CLSI recommendations for microscopic examinations- (3)

A

-Requested by the physician
-Laboratory-specified population
-Any abnormal physical or chemical result

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8
Q

examine prepared specimens when- (2)

A

-fresh
-preserved

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9
Q

Formed elements in specimen examination- (4)

A

-RBCs
-WBCs
-casts disintegrate in dilute
-alkaline urine

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10
Q

refrigerating specimens precipitates-

A

crystals & can obscure other elements

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11
Q

Less contamination (epithelial cells) from a ________ specimen-

A

midstream clean-catch

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12
Q

Thoroughly mix specimen before-

A

decanting to the centrifuge tube

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13
Q

Standard amount of urine usually centrifuged-

A

10 – 15 mL

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14
Q

Quantities <12 mL of urine should be-

A

documented

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15
Q

Standardize speed and time of centrifugation should be-

A

consistent

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16
Q

ideal relative centrifuge force (RFC)-

A

5 minutes at RCF of 400

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17
Q

RCF corrects for variations in the diameter of-

A

centrifuge heads

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18
Q

Volume of sediment examined-

A

0.5 to 1.0 mL

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19
Q

Sediment must be resuspended via-

A

gentle agitation

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20
Q

Vigorous agitation of specimens must be-

A

avoided

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21
Q

Volume of sedimentation placed on microscopic slide should be-

A

consistent

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22
Q

Glass Slide method for volume of sediment examined- (3)

A

-recommended volume is 20 uL
-22x22 glass cover slip
-do not overflow cover slip (heavier elements/casts flow outside)

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23
Q

Microscopic analysis of urine has been improved substantially with-

A

commercial slide systems

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24
Q

CLSI recommends these systems together with-

A

standardization of all phases of the methodology

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25
Commercial systems: KOVA- (5)
-Calibrated centrifuge tubes -special slides to control volume -decanting pipettes -grids for better quantitation
26
Microscopic examination of sediment should be performed in a consistent manner & include-
observation of a minimum of 10 fields under low (10x) & 10 high (40x) fields
27
low power for examination of sediment- (2)
-casts, general composition -Scan edges for casts with glass slide method
28
high power for examination of sediment-
identification of type
29
initial focusing for examination of sedimentation- (2)
-low power, reduced light -Focus on epithelial cell, not artifacts that are in a different plane
30
adjustments used for examination of sedimentation-
fine adjustment continuously for best view
31
reporting the examination is consistent within-
the lab
32
Reporting the Examination casts-
average per lpf
33
Reporting the Examination for RBCs/WBCs-
average per hpf
34
Reporting the Examination for Epithelial cells, crystals, etc., in semiquantitative terms- (3)
-Few, moderate, many -1+, 2+, 3+, 4+ -Followed by /lpf or /hpf
35
RBCs physical urinalysis correlations-
turbidity red color
36
RBCs chemical urinalysis correlations- (2)
-+ blood -+ protein
37
RBCs physical urinalysis exceptions- (2)
-number -hemolysis
38
WBCs physical urinalysis correlations-
turbidity
39
WBCs chemical urinalysis correlations- (3)
-+protein -+ nitrite -+LE
40
WBCs exceptions urinalysis correlations-
-number -lysis
41
epithelial cells physical urinalysis correlations-
turbidity
42
epithelial cells exceptions urinalysis correlations-
number
43
casts chemical urinalysis correlations-
+ protein
44
casts exceptions urinalysis correlations-
number
45
bacteria physical urinalysis correlations-
turbidity
46
bacteria chemical urinalysis correlations- (3)
-pH -+nitrite -+leukocytes
47
bacteria exceptions urinalysis correlations-
number & type
48
crystals physical urinalysis correlations- (2)
-turbidity -color
49
crystals chemical urinalysis correlations- (2)
-pH -+ bilirubin
50
crystals exceptions urinalysis correlations-
number & type
51
Sediment appearance influenced by- (4)
-Cells and casts in various stages of development and degeneration -Distortion of cells and crystals by the chemical content of the specimen -The presence of inclusions in cells and casts -Contamination by artifacts
52
sedimentation stains Increases-
overall visibility of sediment using bright-field microscopy
53
sediment stains Imparts identifying characteristics of cellular structures- (3)
-Nuclei -Cytoplasm -Inclusions
54
Sternheimer-Malbin stain consists of- (2)
-crystal violet -Safranin O
55
most frequent supravital stain used in urinalysis-
Sternheimer-Malbin stain
56
Sternheimer-Malbin stain increases-
refractive index
57
Sternheimer-Malbin stain is commercially available as- (2)
-Sedi-Stain -KOVA stain
58
0.5% solution of toluidine blue enhancement of-
nuclear detail
59
Touluidine blue is useful in the differentiation between- (2)
-WBCs -renal tubular epithelial cells
60
2% acetic acid will enhance- (2)
-WBC -epithelial cells
61
2% acetic acid method cannot be used for initial sediment analysis because-
RBCs are lysed by acetic acid
62
most common type of microscopy performed in urinalysis-
bright-field microscopy
63
Other types of microscopy that are useful for examining urine sediment include- (5)
-phase contrast -polarizing -dark field -fluorescence -interference contrast
64
All microscopes are designed to-
magnify small objects
65
Compound bright-field microscope- (2)
-used primarily in urinalysis -consists of two-lens system
66
Components of two-lens system- (2)
-the oculars, objectives -the coarse & fine-adjustment knobs
67
Illumination system contains- (3)
-Light source -condenser -field and iris diaphragms
68
Binocular Field of view is determined by-
eyepieces
69
binocular 10x adjusts for-
interpupillary distance
70
Binocular Field of View is the diameter of-
the circle of view when looking through the oculars
71
Objectives of the microscope are adjusted to be-
near the specimen (UA sediment magnifications)
72
Microscope objectives of used routinely in lab-
10× (low power, dry), 40× (high power, dry)
73
Final magnification of an object is the product of-
the objective magnification times the ocular magnification
74
Microscope objectives are inscribed with info that describes their characteristics include- (5)
-Type of objective -magnification -numerical aperture -microscope tube length -cover-slip thickness to be used
75
Length of the objectives attached to the nosepiece varies with magnification by-
changing the distance between the lens and the slide when they are rotated
76
Only minimum adjustment for Parfocal when-
switching among objectives
77
The distance between the slide and the objective is controlled by- (2)
-the coarse -fine focusing knobs
78
Coarse focus-
initial focusing
79
Fine focus-
sharpen image, focusing after changing magnification
80

Urinalysis (7 decks)

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