clinical microscopy Flashcards
(138 cards)
1
Q
color change due to drugs: orange
A
PIR
Phenazopyridine
Isoniazid
Rifampicin
2
Q
color change due to drugs: blue
A
MIA
Methylene blue
Indomethacin
Amitriptyline
3
Q
color change due to drugs: purple
A
Rifampicin
4
Q
color change due to drugs: brown
A
CLMN Chloroquine Levodopa Metronidazole Nitrofurantoin
5
Q
color change due to drugs: black
A
MPM (many pa mention)
Metronidazole
Methyl dopa
Phenol derivatives
6
Q
color change due to drugs: white
A
Propofol
7
Q
color change due to drugs: green
A
Vitamin B12
8
Q
color change due to drugs: red/pink
A
CTR
Cloropromazine
Thioridazine
Rifampin
9
Q
color change due to drugs: blue green
A
Propofol
Rifampicin
10
Q
food that affects urine color: bright yellow
A
riboflavin
11
Q
the different clarity of urine:
A
hazy, cloudy, turbid, milky
12
Q
little particulates but urine print is seen
A
hazy
13
Q
many particulates and urine is blurred
A
cloudy
14
Q
urine print cannot be seen
A
turbid
15
Q
many particulates and clotted
A
milky
16
Q
turbidity: nonpathological
A
mucus spermatozoa contrast media fecal contamination squamous epithelial cell amorphous urates, phosphates & carbonates
17
Q
turbidity: pathological
A
bacteria yeast rbc wbc lymphatic fluid and lipids abnormal crystals
18
Q
soluble in dilute acetic acid
A
RAC
RBCS
Amorphous urates
Carbonates
19
Q
insoluble in dilute acetic acid
A
SBYW Sperm Bacte Yeast WBCs
20
Q
soluble in alkaline urine
A
Amorphous phosphate and carbonates
21
Q
soluble in acid urine
A
Amorphous urates & contrast media
22
Q
soluble in ether
A
LCL
lipid
chyle
lymphatic fluid
23
Q
soluble with heat
A
amorphous urates & uric acid crystals
24
Q
normal urine odor
A
nutty/aromatic
25
ammonia is the odor when keeping urine due to _________?
breakdown of urea
26
sweet fruity odor
ketones (DM, vomitting, starvation)
27
mousy odor
phenylketonuria
28
pungent odor
asparagus, onion, garlic (food)
29
bad, unpleasant odor/ foul, ammonial-like
UTI
| bacterial contamination
30
maple syrup
maple syrup urine disease: where body cannot breakdown amino acids
31
bleach odor
contamination
32
cabbage like odor
methionine malabsorption
33
sweaty feet odor
isovaleric acidemia
34
ranch
cystine disorder
35
rancid
tyrosinemia
36
urine volume at night and its specific gravity
more than 700 ml ; 1.018
37
specific gravity of first-morning urine/specimen
>1.020
38
normal range of specific gravity
1.005 to 1.030
39
normal sample range SG
1.010 to 1.025
40
differentiate isothenuric, hyposthenuric, hypersthenuric
iso: 1.010
hypo: <1.010
hyper: >1.010
41
sg for neonates
1.012
42
SG for infants
1.002 - 1.006
43
sg for adults
1.003-1.030
44
tool used for measuring specific gravity
urinometer
45
tool that measures the refractive index of the solution
urine refractometer
46
principle of refractometer
RI can be compared to the velocity of a light in air to the velocity of light in the solution; velocity of light in the sol. is dependent on the amount of particles dissolved in the concentration
47
advantage of refractometer
only 2-3 drops of urine is needed
48
causes of isosthenuria
chronic renal diseases
impairment of renal function
sg of urine is like plasma infiltrate
49
causes of hyposthenuria
```
DI
drinking too much fluids
kidney diseases
glomerulonephritis
pyelonephritis (umakyat bacteria from bladder to kidney)
```
50
causes of hypersthenuria
```
loss of fluid
less fluid intake (water)
adrenal insufficiency
particles in the urine
hepatic disease
congestive heart failure
```
51
pH of urine/average person pH
4.6-8.0
| 5-6
52
pH is useful for ______ and _______
acid base status and crystal identification
53
in acid base balance, the lungs are responsible for excreting _______ while kidneys are for _________
lungs: volatile waste - CO2
kidneys: non-volatile acid - uric acid
54
if blood pH is too acidic
more acids are secreted in urine; this is done by the secretion NH4, hydrogen phosphate and weak oganic acids
55
if blood pH is too alkaline
less acid is secreted in the urine; this is done by reabsorbing bicarbonate from convoluted tubes then attach to H ions to have carbonic acid therefore regulating pH levels
56
what makes urine acidic
a. high protein diet
b. accumulation of CO2 in the body
c. diabetes mellitus where ketones decrease pH
57
what makes urine alkaline
a. uti
b. bacterial contamination
c. hyperventilation / loss of CO2
d. use of NaHCO3 and K citrate in treating bacterial contamination
e. diet high in veg., citrus fruits and dairy products
58
abnormal alkaline urine is caused by
```
SKUAd
Severe vomitting
Kidney disease
UTI
Asthma
```
59
abnormal acidic urine
```
severe lung disease (emphysema)
uncontrolled DM
high protein diet
dehydration
starvation
diarrhea
```
60
which fruit is a good remedy for UTI
cranberry (the only fruit that can produce acidic urine)
61
alkaline urine patients with renal calculi (kidney stones) are made up of _____
calcium PHOSPHATE
| magnesium ammonium PHOSPHATE
62
pH is measured by
pH reagent strip (5-9)
63
indicators used in pH strip
methyl red - 4-6 (red to yellow)
| bromthymol blue 6-9 (yellow to blue)
64
major protein found in the urine; also reabsorbed by tubules
albumin
65
this happens due to excess/vigorous exercise, dehydration or fever
proteinuria
66
does not indicate kidney disease
prerenal proteinuria
67
increase levels of low molecular weight plasma filtrates such as
hemoglobin, myoglobin and acute-phase proteins
68
conditions associated with prerenal proteinuria
hemoglobinuria
myoglobinuria
acute phase proteinuria
69
damage in the glomerulus or tubules which increases the amount of albumin, rbcs and wbcs in urine
renal proteinuria
70
diseases associated with renal proteinura
```
SLE
Streptococcal glomerulonep
Toxic heavy metals
Viral infection
Pre-eclampsia & hypertension
Strenuous exercise
Microalbuminuria
```
71
Microalbuminuria is seen where?
Seen in diabetic nephropathy when kidneys are damaged due to a patient with DM
72
proteins are added in the urine when passed through vagina prostate, urethra and such
postrenal proteinuria
73
conditions associated with postrenal
bacterial and fungal infection - produce exudate containing proteins
menstruation, injury, prostatic fluid, spermatozoa - contributes to proteins
74
benign proteinuria seen in young patients
orthostatic or postural proteinuria
75
microalbuminuria also increases the _______
risk of cardiovascular diseases
76
the significant level of microalbum is
20-200microgram/min or 30-300 mg/24hr
77
albumin creatinine ratio in microalbuminuria is
>3.4mg/mmol
78
are monoclonal LIGHT CHAIN IMMUNOGLOBULINS; seen in patient w/ multiple myeloma
bence jones proteins
79
how to detect BJP?
turbid urine at 40-60C then clear at 100C = positive
80
causes of prerenal proteinuria
MuSIM
Multiply myeloma
Severe infection
Intravascular hemolysis
Muscular injury
81
renal proteinuria: glomerular disorders
```
amyloidosis
hypertension
pre-eclampsia
dehydration
diabetic nephropathy
```
82
renal proteinuria: tubular
toxic agents
heavy metal
fanconi's syndrome
viral infections
83
postrenal proteinuria
```
vaginal secretions
SPERMATOZOA
menstrual contamination
prostatic fluid
infections and inflammation
trauma and injury
```
84
detects urine protein
urine dipstick
85
trace positive reaction
15-30mg/dL
86
4+ positive reaction
2g/dL
87
Trace proteinuria
10-30 mg/dL
88
what type of urine specimen is required for microalbuminuria?
first morning specimen
89
```
report of proteinuria:
1+
2+
3+
4+
```
```
1+ = 30 mg/dl
2+ = 100 mg/dl
3+ = 300 mg/dl
4+ = >1000 mg/dl
```
90
precipitation method of detecting proteinuria
sulfosalicylic acid
91
another precipitation method applied in automation
TCA (trichloroacetic acid)
92
normal range in TCA test
0.05-0.1g/24 hr
93
buffer used in heat coagulatoin test
5M acetate buffer which is composed of anhydrous sodium acetate & glacial acetic acid
94
orthostatic/postural proteinuria reporting
negative: first specimen
positive: second specimen
95
heat and acid: positive, negative, false positives and false negatives
positive: albumin, globulins, bence jones
false negatives: highly alkaline urine
false positives: confused with PO4 and urates, drug metabolites (s, t, p)
96
reagent strip: positive, negative, false positives and false negatives
positive: albumin only
false negative: highly diluted urine, high salt concentration
false positive: skin disinfectants
97
sulfosalicylic: positive, negative, false positives and false negatives
positive: globulins, glycoproteins, albumin, bence jones
false negatives: highly alkaline urine
false positives: confused with PO4 and urates, drug metabolites (s, t, p, c, c)
98
used to differentiate glomerular and tubular dysfunction
beta-2-microglobulin
99
normal level of glucose in a healthy individual
100 mg/dl or less
100
what is the value of the renal threshold
160-180mg/dl
101
convoluted tubule responsible for reabsorbing glucose filtered by glomerulus
proximal convoluted tubule
102
which convoluted tubule is responsible for releasing the excess glucose not absorbed by the proximal CT?
distal CT
103
hormone responsible for converting glucose to glycogen? aka glycogenesis
insulin
104
refers to the breakdown of glycogen to glucose
glycogenolysis
105
inhibitor of insulin secretion
epinephrine
106
epinephrine is secreted during
myocardial infarction, cerebrovascular diseases, stress
107
renal glycosuria may be seen in patients with
RG-FOE
end-stage renal disease
fanconi's syndrome
osteomalacia
108
copper sulfate is reduced by alkaline and heat to cuprous oxide; this detects every reducing substances in the urine (general)
copper reduction method
blue: negative
green, yellow, orange/red: positive
109
this detects specific glucose in the urine
glucose-oxidase method
110
chromogens added to H2O2 (when oxidized so glucose to gluconic acid)
KI - green to brown
| Tetramethylbenzidine - yellow to green
111
copper reduction method is also known as
benedicts reaction :D
112
false positive in benedict's reaction
```
vit c
salicylates
homogentisic acid
antibiotics
levodopa
contrast media
```
113
glucose oxidase false negative
homogentisic acid
many amount of salicylate
vit c
114
conditions associated with renal glycosuria
```
diabetes
iv fluids
adrenal gland diseases
liver damage
kidney diseases
pregnant woman (normal)
```
115
condition where hormones act against insulin
hyperglycemia
116
conditions where hyperglycemia is seen
```
pancreatitis
pancreatic disorder
acromegaly
cushings syndrome
pheochromocytoma
```
117
3 intermediate products of ketones from lipolysis
acetone 2&
acetoacetate 20%
B-hydroxybutyric acid 78%
118
READ & UNDERSTAND WAG MO TO KAKALIMUNTAN
for patients with diabetes, if their kidneys are damaged (diabetic nephropathy), they won't be able to use glucose and so fats are broken down (lipolysis) this leads to DECREASE REESTERIFICATION and INCREASES PLASMA FREE FATTY ACIDS which INCREASES KETONE BODIES
119
what happens when re-esterification happens?
plasma free fatty acids undergo esterification to form triglycerides to be converted to LDL
LDL is stored in the liver
120
ketones arent measurable in the urine since .....
they broke down into CO2 and H2O
121
fat metabolism where fats are broken down instead of carbohydrates are seen in patients with
DM
Vomitting
Starvation
122
deficiency in insulin
ketonuria
123
ketonuria excretes ____, ____, and ______ to have ketoacidosis
Na
K
Ca
124
If DM is not treated to the point where ketonuria exists, he/she may have
acidosis
| diabetic coma
125
patient with DM has ________ odor in their breath
fruity odor due to acetone from the lungs
126
ketone strip test is reported as?
negative - 0
small amounts - 10
moderate amounts - 30
large amounts - 80
127
test where ketone bodies are measured through sodium nitroprusside reaction
ketone strip test
128
what can we measure in ketone strip test?
acetoacetate+ acetone since hindi reactive si b-hydroxybutyric acid
129
in ketone strip test, the color changes from what?
lavender to maroon (purple)
130
in rothera's test, what composes the powder being used
sodium nitroprusside
sodium carbonate
ammonium sulfate
131
explain rothera's test
add 0.5g of powder to the slide and add 2 drops of urine
positive: change color from lavender to purple
132
abnormal ketonuria happens when ______
uncontrolled diabetes
low carbo diet
starvation
alcoholism
133
ketones are seen in fasting after ____ hours
after 18 hours
134
high glucose in pregnant woman and low ketone in pregnant woman
T or F
T
135
what indicates when urine is colorless?
kidney disease or diabetes mellitus
136
what indicates when urine is amber/orange
bilirubin
137
which is responsible for the dark yellow color when dehydrated?
bilirubin or urobilin
138
responsible for the pink color of urine when at lower temperature
uroerythrin
