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Urine Analysis > Exam 5 > Flashcards

Exam 5 Flashcards

1
Q

What are the names of the 3 main cavities in the body

A

lungs- pleural
heart- pericardial
abdominal-peritoneal

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2
Q

What is serous fluid

A

fluid that are an ultrafiltrate of plasma, lubricates membranes and allows for movement of enclosed organs

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3
Q

What are the 4 factors that control serous fluid formation

A

-permeability of capillaries in parietal membrane
-Hydrostatic pressure in capillaries
-oncotic pressure by presence of plasma proteins in capillaries
-absorption of fluid by lymph system

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4
Q

What is effusion

A

accumulation of fluid in a body cavity, abnormal or pathologic

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5
Q

What is paracentesis

A

percutaneous puncture of a body cavity to pull out the fluid

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6
Q

What is thoracentesis
pericardiocentesis
peritonecentesis

A

thora- collection of plueral fluid
pericardio-collection of pericardial fluid
peritoneal- collection of peritoneal fluid

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7
Q

What is ascites

A

an effusion/ accumulation of fluid in the peritoneal cavity

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8
Q

What is abnormal to see in serous fluid

A

blood or fibrinogen

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9
Q

What type of fluids are transudate and exudate ?

A

pleural and peritoneal

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10
Q

Distinguish if transudate or exudate

increased hydrostatic pressure
decreased oncotic pressure

In pleural fluid

A

transduate

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11
Q

Distinguish if transudate or exudate

increased capillary permeability
decreased lymphatic absorption

A

Exudate

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12
Q

Transudate or exudate?

CHF
hepatic cirrhosis
nephrotic syndrome

A

transudate

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13
Q

Transudate or exudate

infections
neoplasms
trauma
inflammatory conditions

A

exudate

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14
Q

Transudate is ___ in protein and LDH

Exudate is ___ in protein and LDH

Both cause

A

trans- low
exu- high

fluid in pleural space

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15
Q

Transudate or exudate

clear, yellow, no clots

A

transduate

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16
Q

Transudate or exudate

cloudy, yellow to red, clotted

A

exudate

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17
Q

A cloudy paracentesis fluid indicates

A

a large number of WBCs, chyle, lipids

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18
Q

pleural or peritoneal fluid it a milky appearance indicates

A

chyle

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19
Q

What is chyle

A

an emulsion of lymph and chylomicrons

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20
Q

What is a chylous effusion

A

caused by an obstruction of or damage to the lymphatic system

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21
Q

What are chylous effusions associated with in the pleural cavity? and the peritoneal?

A

pleural- tumors
peritoneal- thrombosis, obstruction to lymphs

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22
Q

____ elevated triglyceride level with chylomicrons present

______ low triglyceride level with NO chylomicrons

chylous or pseudochylous

A

chylous

pseudochylous

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23
Q

How to tell if blood in serous fluid is due to traumatic tap or hemorrhage

A

traumatic tap- blood decreases and clots

hemorrhage- distributed blood, no clotting

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24
Q

What is the normal WBC count in transudate and exudate

A

trans- <1000
exudate > 1000

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25
Q

___ predominate in exudates and ____ predominate in effusions

A

neutrophils

lymphocytes

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26
Q

it is ___ to see macrophages and mesothelial cells in serous fluid
It is ___ to see plasma cells

A

normal
abnormal

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27
Q

What patients tend to have malignant cells in effusions

A

pts with neoplastic disease

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28
Q

What are the characteristics of malignant cells that help ID them

A

can be clumped
jagged nuclei
uneven chromatin
many nuclei
basophilic and has vacuoles

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29
Q

What are the TP and LD ratios

A

total protein and lactate dehydrogenase

help determine if transudate or exudate

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30
Q

What are the TP and LD formulas

A

TP= TP fluid/ TP serum
LD= LD fluid/ LD serum

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31
Q

What ratio of TP and LD mean transudate

A

TP<0.5 and LD < 0.6

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32
Q

What ratio of TP and LD mean exudate

A

TP >0.5 and LD > 0.6

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33
Q

What are glucose levels supposed to be in serous fluid

A

shouldnt be too low,
if less than 60 or difference between serum and fluid is more than 30 - means the fluid is an exudate

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34
Q

What does a fluid triglyceride of > 100 mean

A

chylous effusion

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35
Q

What does a triglyceride of < 50 mean

A

it is not a chylous fluid,

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36
Q

What does the presence of cholesterol crystals in serous fluid mean

A

pseudochylous effusion

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37
Q

What can cholesterol of pleural fluid help determine

A

differentiate between chylous and pseudochylous effusion

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38
Q

If a fluid to serum cholesterol ratio is > 1, this indicates

A

pseudochylous effusion

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39
Q

What does the pH of pleural fluid help determine

A

if patient hasa parapneumonic effusions

pH <7.30

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40
Q

If the pH of pleural fluid is >7.30

A

effusion will resolve with antibiotics

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41
Q

T or F pericardial and peritoneal fluid pH have a high clinical significance

A

F

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42
Q

Why do serous fluid stains include a acid fast stain

A

looks for tb

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43
Q

Where is synovial fluid located

A

areas where skeleton friction can occur, joints, bursae and tendons

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44
Q

What is the function of synovial fluids what texture does it have

A

sole nutrient source for the metabolically active articular cartilage
viscous

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45
Q

What are the 4 categories of joint disorders

A

noninflammatory
inflammatory
septic
hemorrhagic

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46
Q

What is arthrocentesis

A

percutaneous aspiration fluid from a joint using aseptic technique

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47
Q

What is the normal volume of synovial fluid in a joint

A

0.1-3.5mL

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48
Q

What are the tubes used in synovial fluid analysis and what tests are they used for

A

1 chemistry- lactate, lipids, protein, uric acid, glucose

#2 Microscopic exam, cytology- cell count, diff, crystal ID
#3 Micro- culture

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49
Q

What is the normal color of synovial fluid

A

pale yellow or colorless

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50
Q

What does it mean for synovial fluid to be red or brown

A

trauma

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51
Q

What does it mean for synovial fluid to be green

A

bacterial infection

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52
Q

What are rice bodies and what do they indicate

A

white- free floating particles made of collagen, associated with rheumatoid arthritis

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53
Q

What are ochronotic shards

A

dark pepper looking particles of cartilage that have broken off and are loose in the fluid

54
Q

What gives synovial fluid its viscosity

A

hyaluronate

55
Q

What does hyaluronidase do

A

depolymerizes hyaluronate, makes synovial fluid less viscous, Can be used prior to analysis

56
Q

Is it normal to see fibrinogen in synovial fluid

A

No, synovial fluid should not be clotting, no fbg allowed

57
Q

What is the normal RBC count in synovial fluid

A

<2000

58
Q

What is the normal WBC count in synovial fluid

A

<200 WBC

59
Q

What do increased RBCs in synovial fluid indicate

A

hemorrhage, traumatic procedure

60
Q

What do increased WBCs in synovial fluid indicate

A

bacterial arthritis
and urate gout

61
Q

What are the normal WBC % in synovial fluid diff

A

60% mono
30% lymphs
10% neutrophils

62
Q

What do increased lymphs in synovial fluids mean

A

early RA

63
Q

What do monosodium urate crystals mean in synovial fluid

A

gouty arthritis

64
Q

needle like crystals
yellow parallel
blue perpendicular

A

MSU
gouty arthritis

65
Q

What do calcium pryophosphate dihydrate crystals mean

A

CCPD crystals mean pseudogout

66
Q

What do CPPD crystals look like

A

rhomboid, smaller and blunter than MSU

67
Q

rhomboid crystals that are
blue parallel
yellow perpendicular

A

CPPD crystals
pseudogout

68
Q

What do cholesterol crystals look like, what do they indicate

A

notched corners
chronic inflammation

69
Q

irregular, jagged or serrated edged crystals that look broken in varied sizes, what crystals are these and what do they indicate

A

corticosteroid crystals
indicate previous drug injection into joint

70
Q

What tube tops are used to do synovial fluid specimen

A

sodium heparin or liquid EDTA, these do not form crystals themselves

71
Q

What are do these glucose levels in synovial fluid mean
<20
>20
>40

A

< 20 non inflammation or hemorrhagic
>20 inflammatory
>40 septic condition

72
Q

What are the normal uric acid levels in synovial fluid

A

the same as the levels in blood plasma

73
Q

What does an increased uric acid level in plasma vs synovial fluid mean

A

gout

74
Q

What organism is the most frequent cause of septic arthritis

A

staph aureus

75
Q

What organism is the second most common organism to cause septic arthritis

A

step species

76
Q

What is the difference between vuvlovaginitis and vaginitis

A

vulvo- inflammation of vulva and vagina or vulvovaginal glads
vag- inflammation of vagina only

77
Q

What are the 3 most common causes of

A

bacterial vaginosis
candidiasis
trichomoniasis

78
Q

What tool do we use to collect vaginal secretions and what part of the vagina do we collect from

A

collected with sterile polyester Dacron swaps with a plastic shaft
taken from vaginal fornix and vaginal pool

79
Q

What not to do when collecting vaginal secretion sample

A

dont refrigerate
no cotton or wood shaft swabs

80
Q

What organisms are affected by cotton tipped swabs and wood shafts

A

Chlamydia and Neisseria

81
Q

What is the normal pH of the vagina

A

3.8-4.5

82
Q

What are the predominant bacteria in healthy vaginas

A

lactobacilli

83
Q

What does a vaginal ph that is more than 4.5 mean

A

bacterial vaginosis, trichomoniasis, atrophic vaginitis

84
Q

What is measured in wet mounts for vaginal secretions

A

count RBCs, WBCs, any bacteria, yeast, trichs, clue cells, parabasal, baa, squamous

85
Q

What is normal in a vaginal wet mount

A

WBCs- few
RBCs- none
yeast- occasional
bacteria- lactobacilli only

86
Q

Decribe what lactobacilli look like

A

large, nonmotile GPR

87
Q

How do lactobacilli benefit bagina

A

H2O2 for pH balance protect against proliferation of bacteria

88
Q

What are clue cells

A

epithelial cells that are covered in bacteria, bearded appearance

89
Q

How much of a cell should be covered to be considered a clue cell

A

75%

90
Q

What do clue cells diagnose

A

bacterial vaginosis

91
Q

What are parabasal cells

A

are just bellow the surface of mucosa in vagina, if too many could mean inflammation

92
Q

What are basal cells

A

from the basal layer of the vagina, never normal to see, usually also high WBCs, definitely inflammation

93
Q

pear shaped, unicellular bodies, with an undulating membrane

A

trichomonads

94
Q

Where do trichomonads like to live

A

anaerobic pH of 6

95
Q

T or F- you can diagnose trichomonads on a stained slide

A

F- you can only see them on a non stained wet mount

96
Q

What does a fishy odor after an amine test mean

A

trimethylamine is present changes pH, positive for bacterial vaginosis

97
Q

What is the most common cause of vaginal infections

A

bacterial vaginosis

98
Q

What organisms are most often the cause of BV

A

G. vaginalis and Mobiluncus

99
Q

What is a KOH test for

A

to ID fungal infections

100
Q

What is the most important indicator of BV

A

clue cells

101
Q

What is the second most common cause of vaginitis

A

candidiasis

102
Q

– vulvovaginal itching and soreness, external dysuria, white curdlike discharge

A

candidiasis

103
Q

What does a strawberry looking exocervix mean

A

trichamoniasis

104
Q

in severe cases, patients complain of vaginal dryness, vaginal soreness, dyspareunia, and spotting

A

atrophic vaginitis

105
Q

thin, diffusely red vaginal mucosa with little to no vaginal folding on pelvic exam

A

atrophic vaginitis

106
Q

What is a fetal fibronectic test for

A

to ID women who are at risk of preterm labor

107
Q

What is a PAMG1 test for

A

to find premature rupture of membrane, water breaking

108
Q

What are the 3 reasons we test amniotic fluid

A

find genetic disorders
test pulmonary maturity
monitor fetal anemia caused by infection or isoimmunization

109
Q

The liquid medium that bathes a fetus throughout gestation

A

amniotic fluid

110
Q

membrane composed of a single layer of epithelial cells that surround the fetus

A

amnion

111
Q

what is polyhydramnios

A

abnormally increased amounts of amniotic fluid >1200

112
Q

What is oligohydramnios

A

abnormally decreased amniotic fluid
<800

113
Q

What is the normal amount of amniotic fluid at 37 weeks of gestation

A

800-1200

114
Q

what is amniocentesis

A

procedure for collection of amniotic fluid

115
Q

When do we need to do amniocentesis

A

if a mother is older than 35
if there is a suspected issue with a metabolic disorder, deformity or lung immaturity

116
Q

How should amniotic fluid be transported

A

must be in billirubin light protected container
ASAP
refrigerated

117
Q

What is the normal color of amniotic fluid

A

colorless or pale yellow

118
Q

What does amber yellow colored amniotic fluid indicate

A

HDFN

119
Q

What does green amniotic fluid mean

A

meconium

120
Q

What is RDS

A

respiratory distress syndrome

121
Q

What are lamellar bodies

A

aveolar epithelial cells secrete them

122
Q

What are surfactants

A

lamalar bodies secrete them into aveolar space
prevent aveoli from collapsing, reduce pressure

123
Q

What does an LS ratio tell us

A

<2 immaturity of lungs
>2 maturity of lungs

124
Q

What do PG levels tell us

A

negative- immature
positive low or high- mature

125
Q

What does a lamellar body count tell us

A

> 50,000 mature lungs
< 15,000 immature lungs

126
Q

What does an FSI test tell us

A

shake test
if foam is present when ethanol is added, then adequate surfactants are present, must be stable for 15 min
>0.47 mature

127
Q

What does delta A450 tell us

A

365-550 normal
>450 increased billirubin

128
Q

What are the 3 zones of the liley chart

A

1- normal
2- moderate hemolysis
3- severe hemolysis

129
Q

What are the 4 zones of the Queenan chart

A

lowest- unaffected or mild
intermediate- increased severe anemia
Rh positive- affected
intrauterine death risk- severe hemolytic disease

130
Q

Do we want delta A450 to increase or decrease

A

decreasing is good

131
Q

What 2 things interefere with delta A450 test results

A

meconium
light exposure-billirubin

132
Q

Practice slides

A

Bodyfluids exam PP

Urine Analysis (5 decks)

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