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RMT BY MARCH 2017!!! > Clinical Microscopy > Flashcards

Clinical Microscopy Flashcards

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1
Q

Shorter urethra –> higher chance of UTI

A

Females (3-4cm)

Males (20cm)

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2
Q

1 kidney = _____ number of nephrons

A

1M-1.5M

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3
Q

Part of the nephron that acts as a sieve

A

Glomerulus

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4
Q

Glomerulus allows the filtration of substances with molecular weight of

A

Less than 70000 daltons

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5
Q

Major site of renal absorption

A

Proximal Convoluted Tubule

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6
Q

Part of the nephron impermeable to water

A

Ascending loop of Henle

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7
Q

Hormone that regulates water reabsorption in CT and DCT

A

Anti-diuretic hormone / Vasopressin

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8
Q

Endocrine gland that acts as storage of hormones produced by other glands

A

Post Pituitary Gland

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9
Q

Characterized by deficiency of Anti-diuretic hormone

A

D. insipidus

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10
Q

Major mineralocorticoid

A

Aldosterone

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11
Q

Function of aldosterone

A

Regulate reabsorption of sodium ions

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12
Q

First to be affected by renal disease

A

Tubular reabsorption

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13
Q

Gold standard for clearance test

A

Inulin

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14
Q

Preferred test/s for tubular reabsorption

A

Specific gravity and osmolarity test

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15
Q

Active/Passive Transport

- Glucose

A

Active transport

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16
Q

Active/Passive Transport

- Amino acid

A

Active Transport

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17
Q

Active/Passive Transport

- Water

A

Passive transport

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18
Q

Major organic organic component of urine

A

Urea

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19
Q

Major inorganic organic component of urine

A

Chloride

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20
Q

Principal salt in urine

A

NaCl

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21
Q

Method of collection for anaerobic culture

A

Suprapubic aspiration

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22
Q

Influenced by both number and density of particles in the solution

A

Specific gravity

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23
Q

Influenced by only the number of particles in solution

A

Osmolarity

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24
Q

Causes freezing point depression

A

High osmolarity

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25
Drop in the freezing point with 1Osm/kg water
1.86C
26
Urine collection method for prostatic infection
Glass Technique / Three-glass technique
27
Tube collection for three-glass technique
1: first portion of voided urine 2: middle portion = midstream clean catch 3: urine after prostate massage
28
Volume of urine for drug specimen collection
30-45mL in a 60mL container
29
Optimal temperature for drug specimen
32.5-37.7C
30
Type of urine specimen for routine and qualitative analysis
Occasional/single/random
31
Type of urine specimen for quantitative analysis
Timed
32
Type of urine specimen for urobilinogen
Timed - afternoon specimen (2-4PM)
33
Type of urine specimen for nitrite determination
Timed - 4hrs
34
Ideal specimen for routine urinalysis
First morning clean catch
35
Type of urine specimen for pregnancy test
First morning
36
Type of urine for glucose determination
Fasting/second morning
37
Changes in unpreserved urine : color
Modified or darkened due to red-ox metabolism
38
Changes in unpreserved urine : clarity
Decreased due to pot of urates and amorphous phosphates and increase in bacterial count
39
Changes in unpreserved urine : odor
Increased due to ammonia build-up
40
Changes in unpreserved urine : pH
Increased due to ammonia build-up
41
Changes in unpreserved urine : glucose
Decreased due to glycolysis
42
Changes in unpreserved urine : ketones
Decreased
43
Changes in unpreserved urine : bilirubin
Decreased because it is light sensitive
44
Changes in unpreserved urine : urobilinogen
Decreased due to transition to oxidation to urobilin
45
Changes in unpreserved urine : nitrite
Increased due to bacteria multiplication
46
Changes in unpreserved urine : RBC/WBC
Decreased due to disintegration at high pH
47
Changes in unpreserved urine : bacteria
Increased
48
Most common physical method of preservation
Refrigeration
49
Chemical preservative for urine culture
Boric acid
50
Chemical preservative for addis count
Formalin
51
Chemical preservative for urine glucose
Sodium fluoride or benzoic acid
52
Disadvantage of refrigeration as a method of preservation
Precipitates amorphous urates and phosphates
53
Preservation method/technique that does not interfere with chemical tests
Refrigeration
54
Preservative that preserves protein and formed elements well and does not interfere with routine analyses other than pH
Boric Acid
55
Preservative that can act as a reducing agent,thus can interfere with different chemical tests
Formalin
56
Volume of urine specimen for urinalysis
10-15mL in a 50mL capacity container | Average of 12mL
57
Normal volume range of 24hour urine
600-2000mL
58
An increase in daily urine volume of greater than 2.5L/day in adults
Polyuria
59
Cases in which polyuria occurs
- increased fluid intake - diuretic medication and drinks - nervousness - Diabetes mellitus - Diabetes insipidus
60
A decreased in urine output of less than 400mL/day in adults
Oliguria
61
Failure of the kidneys to produce urine due to complete obstruction
Anuria
62
> 500mL, with specific gravity less than 1.018, urine output at night
Nocturia | - seen in pregnancy
63
Increase in fluid intake causes pale urine and a [decrease/increase] of specific gravity
Decrease
64
Differentiate diabetes mellitus from diabetes insipidus
Both cause an increase in volume but the specific gravity of the urine in DM is increased compared to the decrease in DI
65
Roughly indicates degree of hydration and should correlate with the urine specific gravity
Urine color
66
Specific term for yellow pigment in urine
Urochrome
67
Major pigment in urine
Urochrome
68
Specific term for green pigment in urine
Uroerythrin
69
Uroerythrin attaches to ______, producing a pink color t the sediment
Uroerythrin attaches to urates ----> amorphous urates
70
Specific term for urine pigment that is dark yellow or orange in color
Urobilin
71
A urine pigment that the production is dependent on the body's metabolic state
Urochrome
72
Urine pigment that is an oxidation product of of urobilinogen, and imparts an orange-brown color to standing urine
Urobilin
73
White foam in dark yellow to orange urine
- concentrated urine | - presence of proteins
74
Color of urine in diabetes mellitus and diabetes insipidus
Pale yellow
75
Color of urine in the presence of bilirubin
Dark yellow with yellow foam
76
Treatment for UTI that renders the urine viscous and with yellow foam
Pyridium
77
Yellow-green color of urine
Bilirubin oxidized to biliverdin
78
Color of urine in Pseudomonas infection
Green
79
Color of urine the presence of indican
Blue-green
80
Most common abnormal urine color
Red
81
Color of the urine in the presence of RBC
Cloudy red
82
Color of the urine in the presence of Hemoglobin
Clear red
83
Color of the urine in the presence of Myoglobin
Clear red
84
Color of the urine in the presence of porphyrin
Red/purplish) | (lead porphyria may render colorless/normal urine
85
Color of the urine in lead porphyria
Normal (pale yellow)
86
What is deficient in Alkaptonuria
Homogentisic acid oxidase deficiency
87
Color of the urine in the presence of RBCs oxidized as metHb
Brown-Black
88
Color of the urine in the presence of mepacrime (antimalaria)
Yellow
89
Color of the urine in the presence of rifampin
Bright orange-red
90
Viewing of urine
Against white background using adequate light source
91
Describe clear urine
Transparents; no visible particulates
92
Describe hazy urine
Few particulates, print easity seen through urine
93
Describe cloudy urine
Many particulates, print is blurred through urine
94
Describe turbid urine
Print cannot be seen through urine
95
Describe milky urine
May precipitate or clot
96
Pathologic causes of turbidity
``` RBCs WBCs Bacteria Yeast Non-squamous epithelial cells Abnormal crystals Lymph fluid Lipids ```
97
Non-pathologic causes of turbidiy
``` Squamous cells Mucus Amorphous crystals Semen and/or spermatozoa Decal contamination Radiographic contrast media Talcum powder Vaginal cream ```
98
Substances correlated to acidic urine
Amorphous urates | Radiographic contrast media
99
Substances correlated to alkaline urine
Amorphous phosphates | Carbonates
100
Substances found in urine that are soluble in heat
Amorphous urates | Uric acid crystals
101
Substances found in urine that are soluble in dilute acetic acid
RBCs Amorphous phosphates Carbonates
102
Substances found in urine that are insoluble in dilute acetic acid
WBCs Bacteria Yeast Spermatozoa
103
Substances found in urine that are soluble in ether
Lipids Lymphatic fluid Chyle
104
Color of urine with bilirubin-biliverdin
Yellow green with yellow foam OR beer-brown with yellow foam
105
Color of urine with fuscin (food with additive/food coloring)
Red
106
Color of urine with bilifuscin (unstable hemoglobin)
Red-brown
107
Color of urine with methemoglobin
Brown-black rendering an acidic pH
108
Specific gravity of isothenuria
1.010 (glomerular filtrate)
109
Determination of specific gravity that measures total solutes of the urine and its refractive indices
Refractometry
110
Refractometry is compensated to ________ and needs corrections for __________
Compensated to TEMPERATURE (15-38C) and needs corrections for GLUCOSE AND PROTEIN
111
Compensation for the specific gravity from refractometry
1g/dL glucose = - 0.004 | 1g/dL protein = - 0.003
112
Substances for the calibration of refractometry
Distilled water (1.000) 5% NaCl (1.022 +/- 0.001) 9% sucrose (1.034+/- 0.001)
113
Refractometry reading is [lower/higher] than urometer by [value]
Lower by 0.002
114
Urometer needs corrections for __________
TEMPERATURE | +/- 0.001 for every 3C the specimen is above/below the calibration temperature (20C) respectively
115
Principle of the reagent strip test for specific gravity of urine
pKa change of a polyelectrolyte (dissociation constant)
116
Principle of the Harmonic oscillation densitometry
Frequency of sound waves entering a solution will change in proportion to the density of the solution
117
Normal pH of (random) sample urine
4/5 - 5.0
118
Conditions that cause acidic urine
``` Emphysema Diabetes mellitus Starvation Dehydration Acid-producing bacteria High protein diet Cranberry juice ```
119
Conditions that cause alkaline urine
``` Vomiting Renal tubular acidoses Vegetarian diet Old specimen Urease-profucing bacteria ```
120
Odor of urine with Proteus
Urease-producing bacteria --> ammoniacal
121
Odor of urine with DM
Fruity/sweet due to metabolism of ketones
122
Rancid butter odor of urine
Due to tyrosinemia
123
Rotting fish odor of urine
Trimethylaminouria
124
Sweaty feet odor of urine
Isovoleric acidemia
125
Mousy odor of urine
PKU
126
Cabbage odor of urine
Methionine malabsorption
127
Bleach odor of urine
Contamination
128
Sulfur odor of urine
Cystine disease
129
Major serum protein found in urine
Albumin
130
Normal protein levels of urine
<10mg/dL or 100 mg/24 hours
131
Conditions leading to pre-renal proteinuria
- Intravascular hemolysis (Hb) - Muscle injury (Myoglobin) - Sever infection and inflammation (APRs) - Multiple myeloma (proliferation of Igs by plasma cells)
132
Glomerular disorders leading to renal proteinuria
- Diabetic nephropathy (not detected by routine reagent strip) - Orthostatic or postural proteinuria (due to pressure on renal veins)
133
Tubular disorders leading to renal proteinuria
- Fanconi's dis - Toxic agents/heavy metals - Severe viral infections
134
Conditions leading to post-renal proteinuria
Lower UTI/inflammations
135
Tests for proteinuria
- Protein Reagent Strip (+ blue-green) | - Sulfosalicyclic Acid Precipitation Test (clumps)
136
Renal threshold for glucose
160-180mg/dL
137
Hyperglycemia associated glucosuria
``` * Glucose is high in BOTH blood and urine* DM Pancreatic cancer Cushing's syndrome Acromegaly Hyperthyroidism Stress Gestational diabetes ```
138
Renal associated glucosuria
* NORMAL blood glucose; HIGH urine glucose* Fanconi's syndrome Advanced renal disease Pregnancy
139
Tests for glucosuria
- Reagent Strip (+ blue-green) - Copper Reduction Test (+ brick red) - Glucose oxidase and clinitest reactions
140
Significance of ketones in the urine
- inability to metabolize glucose (DM) - increased loss of carbs (vomiting) - inadequate intake of carbs (starvation and malabsorption)
141
Hematuria
RBC in urine --> cloudy red appearance
142
Hemoglobinuria
Intravascular hemolysis --> clear red appearance
143
Myoglobinua
Rhabdomyolysis --> muscle destruction --> clear red appearace
144
Hemoglobinuria vs Myoglobinuria : Plasma examination
Hb: Pink/Red (high CK and aldolase) Myoglobin: yellow (low haptoglobin)
145
Hemoglobinuria vs Myoglobinuria : Blondheim's test (ammonium sulfate)
Hb: Clear supernatant; neg. reagent strip Myoglobin: Red supernant; pos. reagent strip
146
Significance of bilirubin (conjugated) in urine
Early indication of liver disease
147
Micral Test: - Test for - Principle
Test for proteinuria (glomerular - renal) | Principle: Enzyme immunoassay
148
Sulfosalicyclic acid precipitation test - Test for - Principle
Test for general proteinuria | Principle: Cold precipitation (reacts equally to all forms of protein)
149
Principle for the reagent strip for proteinuria
Protein error of ndicators
150
Principle for the reagent strip for glucosuria
Double sequential enzyme reaction | + blue-green
151
Copper reduction test - test for - principle
Test for glucose to reduce copper sulfate with alkali and heat - color change progressing from negative blue through green, yellow, and orange/red
152
Principle of reagent strip for ketones in urine
Sodium nitroprissude reaction | + purple
153
Principle for reagent strip for hemoglobinuria
Pseudoperoxidase activity of hemoglobin | + blue/green
154
Principle for reagent strip for bilirubinuria
Diazo reaction | + tan or pink-purple
155
Ictotest
More sensitive to bilirubin in urine and less subjective to interfering substances
156
Principle for reagent strip for urobilinogen
Ehrlich's reaction | + = red azodye
157
Watson Schwartz Test
For differentiating urobilinogen and porphobilinogen - urobilinogen is soluble to both butanol and chloroform - porphybilinogen is insoluble
158
Rapid screening test for urine porphobilinogen (> 2mg/dL)
Hoesch test
159
Principle for Hoesch test
Inverse ehrlich's test
160
Substances tested for the detection of bacteriuria
Nitrite
161
Principle for reagent strip for nitrite
Greiss reaction (Gram-negative bacteria have nitroreductase) + = uniform pink azodye = 100,000 orgm/mL
162
Significance of leukocyte in urine
UTI | Inflammation
163
Principle for the reagent strip for leukocyte in urine
Leukocyte esterase (detect all WBCS except lymphocytes) + puple azodye
164
Microscopic examination of urine : bright-field microscopy
Routine U/A
165
Microscopic examination of urine : polarizing microscopy
ID of cholesterol in oval fat bodies, fatty acids, crystals
166
Microscopic examination of urine : phase-contrast microscopy
Visualization of elements with low RI
167
Microscopic examination of urine : dark-field microscopy
Treponema pallidum
168
Microscopic examination of urine : interference-contrast
Produced 3F image and layer-by-layer imaging
169
Stemheimer-Malbin stain
ID WBCs, epithelial cells, and casts
170
Toluidine Blue
Differentiate WBCs
171
Lipid Stains (Oil Red O, Sudan III)
ID free fat droplets
172
Gram stain
ID bacterial casts
173
Hansel Stain
ID eosinophils
174
Prussian blue stain
Hemoderisin (yellow-brown)
175
HYALINE CAST - reporting - disease and other conditions
``` Average per LPF Congestive heart failure Strenuous exercise Heat exposure Emotional stress ```
176
RBC CAST - reporting - disease and other conditions
Average per 10 HPF Glomerulonephritis (bleeding within nephron) Strenuous exercise
177
WBC CAST - reporting - disease and other conditions
Average per 10 HPF Pyelonephritis (inflamm of renal tubule) Acute interstitial nephritis
178
BACTERIAL CAST - reporting - disease and other conditions
RFMM per HPF | Pyelonephritis
179
RTE CAST - reporting - disease and other conditions
Average per 10 HPF Renal tubule destruction Acute tubular necrosis
180
MALTESE CROSS appearace
Oval fat bodies Fatty casts Starch
181
GRANULAR CAST | - disease and other conditions
Glomerulonephritis Pyelonephritis Stress and exercise
182
FATTY CAST | - disease and other conditions
Nephrotic syndrome Toxic tubular necrosis Diabetes mellitus Crush injuries
183
WAXY CAST | - disease and other conditions
Chronic renal failure | Stasis of urine flow
184
BROAD CAST | - disease and other conditions
``` Extreme urine stasis Renal failure (destruction of tubular walls) ```
185
Most common type of broad cast
Granular and waxy cast
186
Most common urinary sediment in renal calculi
CaOx
187
Least common urinary sediment in renal calculi
Cysteine

RMT BY MARCH 2017!!! (6 decks)

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