F1: Semen Analysis (Part 3: Macroscopic and Microscopic Examination) Flashcards
(108 cards)
1
Q
MACROSCOPIC EXAMINATION
Macroscopic examination involves 5 parameters, what are those?
A
- Appearance/ Color
- Volume
- Liquefaction Time
- Viscosity
- pH
VALVP
2
Q
APPEARANCE/COLOR
Identify color based on description of appearance:
Gray white/pearly white translucent w/ musty odor or chlorox like smell
MACROSCOPIC EXAMINATION
A
Normal
3
Q
APPEARANCE/COLOR
Identify color based on description of appearance:
WBCs which indicate infection
MACROSCOPIC EXAMINATION
A
Turbid
4
Q
APPEARANCE/COLOR
Identify color based on description of appearance:
indicate low sperm count
MACROSCOPIC EXAMINATION
A
Clear
5
Q
APPEARANCE/COLOR
Identify color based on description of appearance:
indicate urine contamination, prolonged abstinence, medications
MACROSCOPIC EXAMINATION
A
Yellow
6
Q
APPEARANCE/COLOR
Identify color based on description of appearance:
Flavin
MACROSCOPIC EXAMINATION
A
Gray
7
Q
APPEARANCE/COLOR
Identify color based on description of appearance:
RBCs
MACROSCOPIC EXAMINATION
A
red
8
Q
APPEARANCE/COLOR
Yellow color of sperm
a. Urine contamination
b. Prolonged abstinence
c. Medication
d. ALL
e. a and b
f. b and c
g. nOTA
MACROSCOPIC EXAMINATION
A
d. ALL
9
Q
VOLUME
Semen is measured in what container and how many mL of increments?
MACROSCOPIC EXAMINATION
A
container: clean graduated cylinder in 0.1 mL increments
10
Q
VOLUME
Identify if Normal, Low volume, High volume
2-5 mL per ejaculate
MACROSCOPIC EXAMINATION
A
Normal
11
Q
VOLUME
Identify if Normal, Low volume, High volume
- Non-adherence to 2-day abstinence
- Infertility
- Problem in the seminal vesicle
MACROSCOPIC EXAMINATION
A
Low volume
12
Q
VOLUME
Identify if Normal, Low volume, High volume
Signifies prolonged abstinence
MACROSCOPIC EXAMINATION
A
HIgh volume
13
Q
LIQUEFACTION TIME
Identify if Normal liquefaction time or Prolonged liquefaction time
30 – 60 minutes after collection
MACROSCOPIC EXAMINATION
A
Normal liquefaction time
14
Q
LIQUEFACTION TIME
Identify if Normal liquefaction time or Prolonged liquefaction time
Indicates deficiency in prostatic enzymes
MACROSCOPIC EXAMINATION
A
Prolonged liquefaction time
15
Q
LIQUEFACTION TIME
T or F
SPecimen should be analyzed before liquefaction
MACROSCOPIC EXAMINATION
A
F (should be analyzed after liquefaction)
16
Q
LIQUEFACTION TIME
If after 2 hours specimen has not liquefied, what (2) reagents should be added?
MACROSCOPIC EXAMINATION
A
- Dulbecco’s phosphate-buffered saline
- Proteolytic enzymes (alphachymotrypsin bromelain)
17
Q
LIQUEFACTION TIME
T or F
Liquefaction should be timed
MACROSCOPIC EXAMINATION
A
T
18
Q
VISCOSITY
T or F
To observe viscosity, pour the specimen and observe how it pours OR by using pasteur pipette
MACROSCOPIC EXAMINATION
A
T
19
Q
VISCOSITY
Identify if Normal or Highly viscous
Pours like droplets
MACROSCOPIC EXAMINATION
A
Normal
20
Q
VISCOSITY
Identify if Normal or Highly viscous
Droplets with threads of >2cm
MACROSCOPIC EXAMINATION
A
Highly viscous
21
Q
VISCOUS
Rating of 0 or 4 ?
Watery
MACROSCOPIC EXAMINATION
A
0
22
Q
VISCOUS
Rating of 0 or 4 ?
Gel-like
MACROSCOPIC EXAMINATION
A
4
23
Q
VISCOUS
T or F
Viscosity can also be reported as low, normal, or high viscosity
MACROSCOPIC EXAMINATION
A
T
24
Q
VISCOUS
Highly clumped and viscous semen indicates what motility ?
MACROSCOPIC EXAMINATION
A
slower sperm motility
25
# pH
pH of semen can be detected by what (2) methods?
| MACROSCOPIC EXAMINATION
* pH pad of urinalysis reagent strip
* pH paper
26
# pH
Identify if **High pH, Normal pH, Low pH**
indicates infection (reproductive tract)
| MACROSCOPIC EXAMINATION
High pH
27
# pH
Identify if **High pH, Normal pH, Low pH**
7.2 – 8.0
| MACROSCOPIC EXAMINATION
Normal
28
# pH
Identify if **High pH, Normal pH, Low pH**
* Increased prostatic fluid
* Obstruction of the ejaculatory duct
* Problem in the seminal vesicle
| MACROSCOPIC EXAMINATION
Low pH
29
# MICROSCOPIC EXAMINATION
Microscopic examination involves 3 parameters, what are those?
* Motility
* Morphology
* Count
30
# SPERM CONCENTRATION/COUNT
Identify if **Normal sperm concentration**, **Borderline concentration**, **Normal sperm count**:
20-250 Million sperm/mL
| MICROSCOPIC EXAMINATION
Normal sperm concentration
31
# SPERM CONCENTRATION/COUNT
Identify if **Normal sperm concentration**, **Borderline concentration**, **Normal sperm count**:
10-20 Million/mL
| MICROSCOPIC EXAMINATION
Borderline concentration
32
# SPERM CONCENTRATION/COUNT
Identify if **Normal sperm concentration**, **Borderline concentration**, **Normal sperm count**:
At least 40 Million/ejaculate
| MICROSCOPIC EXAMINATION
Normal sperm count
33
# SPERM CONCENTRATION/COUNT
Formula of sperm count?
| MICROSCOPIC EXAMINATION
Concentration x Volume
34
# SPERM CONCENTRATION/COUNT
Common dilution is?
| MICROSCOPIC EXAMINATION
1:20
35
# SPERM CONCENTRATION/COUNT
Common dilution of 1:20 is achieved using what equipment?
| MICROSCOPIC EXAMINATION
## Footnote
tatlo
Mechanical (positive-displacement) pipette/Automatic pipette/ WBC pipette
## Footnote
Pwede RBC pipette pero mahirap gamitin dahil white(semen) to white(background), mahihirapan basahin
36
# SPERM CONCENTRATION/COUNT
T or F
Dilution is done to mobilize sperm prior to counting
| MICROSCOPIC EXAMINATION
F (dilution is to **immobilize sperm** before counting)
37
# SPERM CONCENTRATION/COUNT
What are the (3) diluting fluids used?
| MICROSCOPIC EXAMINATION
* Sodium bicarbonate
* Formalin
* Chilled water
* Saline
38
# SPERM CONCENTRATION/COUNT
Most common which dissolves mucus
| MICROSCOPIC EXAMINATION
## Footnote
(3) diluting fluids used
Sodium bicarbonate
39
# SPERM CONCENTRATION/COUNT
Most common which immobilizes sperm
| MICROSCOPIC EXAMINATION
## Footnote
(3) diluting fluids used
Formalin
40
# SPERM CONCENTRATION/COUNT
Used to kill sperm to stop motility
| MICROSCOPIC EXAMINATION
## Footnote
(3) diluting fluids used
Chilled water
41
# SPERM CONCENTRATION/COUNT
* Used in counting sperm cells
* Only the mature cells are counted, not the immature “round cells”
| MICROSCOPIC EXAMINATION
Neubauer chamber
42
# SPERM CONCENTRATION/COUNT: Neubauer chamber
T or F
In neubauer chamber, count the round cells and not the cells with head or tail
| MICROSCOPIC EXAMINATION
F (reverse; count cells with **head or tail or MATURE CELLS**, NOT the **round cells or IMMATURE CELLS**)
43
# SPERM CONCENTRATION/COUNT
This defines the square's boundary (black line, left panel)
| MICROSCOPIC EXAMINATION
middle of the 3 lines
44
# SPERM CONCENTRATION/COUNT: Neubauer chamber
T or F
All spermatozoa within the central square are counted, as well as those with their heads between the 2 inner lines (white circles), including whose heads lie between the outer 2 lines (black circles)
| MICROSCOPIC EXAMINATION
F (All spermatozoa within the central square are counted, as well as those with their heads between the 2 inner lines (white circles), but **not those whose heads lie between the outer 2 lines (black circles)**)
45
# SPERM CONCENTRATION/COUNT: Neubauer chamber
is counted only if that line is the lower or left-hand line of the square (white circle, middle panel) but not if it is the upper or right hand line of the square
| MICROSCOPIC EXAMINATION
A spermatozoon with most of its head lying on the central line
46
# SPERM CONCENTRATION/COUNT: Neubauer chamber
Sperm concentration per mL formulation
| Using 2 WBC squares
## Footnote
MICROSCOPIC EXAMINATION
Sperm concentration per mL =
no. of cells counted x DF (20) x 1,000 / no. of squares (2) x volume of 1 square (0.1)
OR
no. of cells counted x DF (20) x 1,000 / no. of squares (2)
| no. of cells x 20 x 1,000 / 2 x 0.1
## Footnote
MICROSCOPIC EXAMINATION
47
# SPERM CONCENTRATION/COUNT: Neubauer chamber
Simplified concentration per mL formula
| Using 2 WBC squares
## Footnote
MICROSCOPIC EXAMINATION
no. of cells counted x 100,000
48
# SPERM CONCENTRATION/COUNT: Neubauer chamber
T or F
When using 5 RBC squares one should load one side of hemocytometer
| Using 5 RBC squares
## Footnote
MICROSCOPIC EXAMINATION
f (Load **both sides of hemocytometer**)
49
# SPERM CONCENTRATION/COUNT: Neubauer chamber
After loading both sides, sample should be allowed to settle for how many minutes?
| MICROSCOPIC EXAMINATION
3 to 5 minutes
50
# SPERM CONCENTRATION/COUNT: Neubauer chamber
After settling, two counts should be?
| MICROSCOPIC EXAMINATION
Averaged
51
# SPERM CONCENTRATION/COUNT: Neubauer chamber
T or F
Average of 2 counts should agree within 10%
| MICROSCOPIC EXAMINATION
T
52
# SPERM CONCENTRATION/COUNT: Neubauer chamber
If average of 2 counts do not agree, what should one do?
| MICROSCOPIC EXAMINATION
repeat dilution and counting multiply the counted
sperm by 1,000,00
53
# SPERM CONCENTRATION/COUNT: Neubauer chamber
Sperm concentration per mL formulation
| Using 5 RBC squares
## Footnote
MICROSCOPIC EXAMINATION
Sperm concentration per mL = no. of cells counted x DF (20) x 1,000 / no. of sqaures (5) x volume of 1 square (0.004)
| no. of cells x 20 x 1,000 / 5 x 0.004
54
# SPERM CONCENTRATION/COUNT: Neubauer chamber
Simplified concentration per mL formula
| Using 5 RBC squares
## Footnote
MICROSCOPIC EXAMINATION
no. of cells counted x 1,000,000
55
# SPERM CONCENTRATION/COUNT: Neubauer chamber
* for counting sperm cells
* Uses a cover plate with 1mm2 grid divided into 100 squares
* undiluted specimen
* No additional factors are necessary for calculation
* number of spermatozoa counted in any strip of 10 squares of the grid indicates their concentration in
millions/mL
| MICROSCOPIC EXAMINATION
Makler counting chamber
56
# SPERM CONCENTRATION/COUNT
**Makler counting chamber**
a. cover plate with 1mm grid divided into 1000 squares
b. diluted specimen
c. additional factors
d. ALL
e. NOTA
| MICROSCOPIC EXAMINATION
e. NOTA
## Footnote
a. cover plate with **1mm2** grid divided into **100 squares**
b. **undiluted **specimens
c. **NO additional factors**
57
# SPERM CONCENTRATION/COUNT
How are number of spermatozoa counted?
| MICROSCOPIC EXAMINATION
## Footnote
MAKLER COUNTING CHAMBER
any strip of 10
squares of the grid
| concentration in millions/mL
58
# SPERM CONCENTRATION/COUNT
Causes of low sperm count could be because of (3) factors, what are those?
| MICROSCOPIC EXAMINATION
## Footnote
MAKLER COUNTING CHAMBER
Medical causes, Environmental causes, Health and lifestyle and other causes
59
# SPERM CONCENTRATION/COUNT
Medical, Environmental, Health/Lifestyle/other causes?
* Varicocele
* Ejaculation problems
* Anti-sperm Antibodies
* Tumors
* Undescended testicles
* Defects of tubules that transport sperm
* Chromosome defects
* Certain medications
* Prior surgeries
| MICROSCOPIC EXAMINATION
## Footnote
MAKLER COUNTING CHAMBER
Medical causes
60
# SPERM CONCENTRATION/COUNT
Medical, Environmental, Health/Lifestyle/other causes?
* Industrial chemicals
* Heavy metal exposure
* Radiation or X-rays
* Overheating the testicles
| MICROSCOPIC EXAMINATION
## Footnote
MAKLER COUNTING CHAMBER
Environmental causes
61
# SPERM CONCENTRATION/COUNT
Medical, Environmental, Health/Lifestyle/other causes?
* Drug use
* Alcohol use
* Tobacco smoking
* Emotional stress
* Weight
| MICROSCOPIC EXAMINATION
## Footnote
MAKLER COUNTING CHAMBER
Health/Lifestyle/other causes
62
# SPERM MOTILITY
T or F
Sperm must penetrate the cervical mucosa to the uterus, fallopian tubes and ovum
| MICROSCOPIC EXAMINATION
## Footnote
MAKLER COUNTING CHAMBER
T
63
# SPERM MOTILITY
Sperm motility can be detected using what (2) methods?
* Hanging drop method
* Sperm vitality
64
# SPERM MOTILITY: 2 detection methods
* Undiluted, well mixed and fully-liquefied semen
* 10ul and 22 X 22 coverslip, concave slide
* % of motile sperm cells ( >50% within 1 hour)
| MICROSCOPIC EXAMINATION
Hanging drop method
65
# SPERM MOTILITY: 2 detection methods
volume of sample and what size of coverslip?
| Hanging drop method
## Footnote
MICROSCOPIC EXAMINATION
sample volume: 10 uL
coverslip size: 22x22 (concave)
66
# SPERM MOTILITY: 2 detection methods
Afer addition of samples, sample should be allowed to stand for how many minutes?
| Hanging drop method
## Footnote
MICROSCOPIC EXAMINATION
1 minute
67
# SPERM MOTILITY: 2 detection methods
Specimens detected through hanging drop method should be observed in how many high power fields?
| Hanging drop method
## Footnote
MICROSCOPIC EXAMINATION
in 20 high power fields
68
# SPERM MOTILITY: 2 detection methods
Normal % of motile sperm cells within 1hour?
| Hanging drop method
## Footnote
MICROSCOPIC EXAMINATION
>50% within 1 hour
69
# SPERM MOTILITY: 2 detection methods
**Identify Grade** based on WHO criteria and Sperm motility
**WHO Criteria:** a
**Sperm Motility:** Rapid, straight line motility
| Criteria for Hanging drop method
## Footnote
MICROSCOPIC EXAMINATION
4.0
70
# SPERM MOTILITY: 2 detection methods
**Identify Grade** based on WHO criteria and Sperm motility
**WHO Criteria:** b
**Sperm Motility:** Slower speed, some lateral movement
| Criteria for Hanging drop method
## Footnote
MICROSCOPIC EXAMINATION
3.0
71
# SPERM MOTILITY: 2 detection methods
**Identify Grade** based on WHO criteria and Sperm motility
**WHO Criteria:** b
**Sperm Motility:** Slow forward progression, noticeable lateral movement
| Criteria for Hanging drop method
## Footnote
MICROSCOPIC EXAMINATION
2.0
72
# SPERM MOTILITY: 2 detection methods
**Identify Grade** based on WHO criteria and Sperm motility
**WHO Criteria:** c
**Sperm Motility:** No forward progression
| Criteria for Hanging drop method
## Footnote
MICROSCOPIC EXAMINATION
1.0
73
# SPERM MOTILITY: 2 detection methods
**Identify Grade** based on WHO criteria and Sperm motility
**WHO Criteria:** d
**Sperm Motility:** No movement
| Criteria for Hanging drop method
## Footnote
MICROSCOPIC EXAMINATION
0
74
# SPERM MOTILITY: 2 detection methods
Give interpretation based on result of sperm motility:
>50% within 1 hour
| Sperm Motility Interpretation hanging drop
## Footnote
MICROSCOPIC EXAMINATION
Normal
75
# SPERM MOTILITY: 2 detection methods
Give interpretation based on result of sperm motility:
Motile in categories a, b, and c
| Sperm Motility Interpretation hanging drop
## Footnote
MICROSCOPIC EXAMINATION
50% or more
76
# SPERM MOTILITY: 2 detection methods
Give interpretation based on result of sperm motility:
show progressive motility (a and b)
| Sperm Motility Interpretation Hanging drop
## Footnote
MICROSCOPIC EXAMINATION
25% or more
77
# SPERM MOTILITY: 2 detection methods
T or F
One should observe immobile sperm and cliumps or antibodies when using hanging drop method
| Sperm Motility Interpretation Hanging drop
## Footnote
MICROSCOPIC EXAMINATION
T
78
# SPERM MOTILITY: 2 detection methods
If there is high percentage of immobile sperm, what test could be performed?
| Sperm Motility Interpretation Hanging drop
## Footnote
MICROSCOPIC EXAMINATION
Sperm
vitality testing
79
# SPERM MOTILITY: 2 detection methods
Clumping of sperm indicates possible presence of?
| Sperm Motility Interpretation Hanging drop
## Footnote
MICROSCOPIC EXAMINATION
Sperm
agglutinins
80
# SPERM MOTILITY: 2 detection methods
Progressive motility, Nonprogressive motility, Immotility?
Sperm moving linearly or in large circle
| Alternative Sperm Grading Criteria OF Hanging drop
## Footnote
MICROSCOPIC EXAMINATION
Progressive motility
| PM
81
# SPERM MOTILITY: 2 detection methods
Progressive motility, Nonprogressive motility, Immotility?
Sperm moving in an absence of progression
| Alternative Sperm Grading Criteria OF Hanging drop
## Footnote
MICROSCOPIC EXAMINATION
Nonprogressive motility
| NP
82
# SPERM MOTILITY: 2 detection methods
Progressive motility, Nonprogressive motility, Immotility?
No movement
| Alternative Sperm Grading Criteria OF Hanging drop
## Footnote
MICROSCOPIC EXAMINATION
Immotility
| IM
83
# SPERM MOTILITY: 2 detection methods
Motility must be specified as?
| Hanging drop
## Footnote
MICROSCOPIC EXAMINATION
Total Motility (PM and NP) or Progressive Motility (PM)
84
# SPERM MOTILITY: 2 detection methods
Familiarize the parameters detected by Computer-Assisted Semen Analysis (CASA)
| Hanging drop
## Footnote
MICROSCOPIC EXAMINATION
* Sperm velocity and trajectory – direction of motion
* Sperm concentration
* Sperm morphology
85
# SPERM MOTILITY: 2 detection methods
* Performed using Bloom’s Test or Eosin/Nigrosin Test
* Done in cases of infertility where the sperm count is normal but has decreased motility
* Evaluate 100 sperm cells
Sperm vitality (viability)
86
# SPERM MOTILITY: 2 detection methods
T or F
Sperm vitality or viability is perfromed in cases of infertility where sperm count is abnormal and have decreased motility
| SPERM VITALITY (VIABILITY)
## Footnote
MICROSCOPIC EXAMINATION
F (**NORMAL sperm count**, but decreased motility)
87
# SPERM MOTILITY: 2 detection methods
Interpret based on description of appearance:
* Not infiltrated by eosin
* Remain bluish white in color
| SPERM VITALITY (VIABILITY)
## Footnote
MICROSCOPIC EXAMINATION
Living sperm cells
88
# SPERM MOTILITY: 2 detection methods
Interpret based on description of appearance:
Red (stained by eosin)
| SPERM VITALITY (VIABILITY)
## Footnote
MICROSCOPIC EXAMINATION
Dead sperm
| SPERM VITALITY (VIABILITY)
89
# SPERM MOTILITY: 2 detection methods
Interpret based on description of appearance:
Defective flagellum
| SPERM VITALITY (VIABILITY)
## Footnote
MICROSCOPIC EXAMINATION
High number of vital but
immobile cells
90
# SPERM MOTILITY: 2 detection methods
Interpret based on description of appearance:
Epididymal pathology
| SPERM VITALITY (VIABILITY)
## Footnote
MICROSCOPIC EXAMINATION
High number of immotile
and nonviable cells
91
# Sperm Morphology
Observe for head and tail morphology under what objective?
| MICROSCOPIC EXAMINATION
Oil Immersion
Objective (OIO)
92
# Sperm Morphology
How many sperms are evaluated?
| MICROSCOPIC EXAMINATION
200 sperms
93
# Sperm Morphology
T or F
In sperm morphology, one should take not of normal and abnormal forms
| MICROSCOPIC EXAMINATION
T
94
# Sperm Morphology
(3) stains used in sperm morphology?
| MICROSCOPIC EXAMINATION
* Papanicolaou
* Giemsa
* Hematoxylin
| PGH
95
# Sperm Morphology: Preparation of normal semen smear
angle of slide when dragging spcimen?
| MICROSCOPIC EXAMINATION
45 degrees
96
# Sperm Morphology
What are the (3) distinct parts?
| MICROSCOPIC EXAMINATION
1. Head
2. Middle piece
3. Tail
97
# Sperm Morphology
* For ovum penetration
* Oval shaped head approximately 5 µm long and 3 µm wide
* Acrosomal cap: approximately (40-70%) ½
| (3) distinct parts
## Footnote
MICROSCOPIC EXAMINATION
Head
98
# Sperm Morphology
T or F
Head is 3 um long and 5 um wide
| (3) distinct parts
## Footnote
MICROSCOPIC EXAMINATION
F (head is 5 um long, 3um wide)
99
# Sperm Morphology
Acrosomal cap occupies how big of the head?
| (3) distinct parts
## Footnote
MICROSCOPIC EXAMINATION
½
of head (40-70%)
100
# Sperm Morphology
* 7 um
* Contains mitochondria that provide energy for flagellar tail motion
| (3) distinct parts
## Footnote
MICROSCOPIC EXAMINATION
Middle piece
101
# Sperm Morphology
* For motility
* 40- 45 µm long
| (3) distinct parts
## Footnote
MICROSCOPIC EXAMINATION
Tail
102
# Sperm Morphology
Head or Tail abnormalities?
will result to poor ovum penetration
| Abnormalities
## Footnote
MICROSCOPIC EXAMINATION
Head abnormalities
103
# Sperm Morphology
Head or Tail abnormalities?
affect motility of the sperm
| Abnormalities
## Footnote
MICROSCOPIC EXAMINATION
Tail abnormalities
104
# Sperm Morphology
This abnormality causes the sperm head to bend backward and interfere with motility
| Abnormalities
## Footnote
MICROSCOPIC EXAMINATION
Abnormally long neckpiece
105
# Sperm Morphology
What are the (3) methods used for analysis of sperm morphology
* Kruger's-strict criteria
* Computer-assisted semen analysis (CASA)
* SQA-V Sperm quality analyzer
106
# Sperm Morphology
* Recommended by WHO but not routinely performed
* A system of evaluating sperm morphology using morphometry and stage micrometer
* Strictly measures the head, neck, tail, acrosomal head and
vacuoles
* Normal forms (strict criteria): 14%
* Normal forms (routine criteria): 30%
| (3) methods used for analysis of sperm morphology
## Footnote
MICROSCOPIC EXAMINATION
Kruger's-strict criteria
107
# Sperm Morphology
Tests for:
* Sperm velocity and trajectory (direction of motion)
* Sperm concentration
* Sperm morphology
| (3) methods used for analysis of sperm morphology
## Footnote
MICROSCOPIC EXAMINATION
COMPUTER-ASSISTED SEMEN ANALYSIS (CASA)
108
# Sperm Morphology
* Automatic results in 75 seconds
* Measures Motility (PM+NP)
* Immotility (IM)
* % Normal Morphology
* Average velocity (VELOCITY)
* Sperm Motility Index (SMI)
* Total sperm concentration (TSC)
* Motile sperm concentration (MSC)
* Progressively motile sperm
concentration (PMSC)
| (3) methods used for analysis of sperm morphology
## Footnote
MICROSCOPIC EXAMINATION
SQA-V SPERM QUALITY ANALYZER
