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urinalysis > final exam > Flashcards

final exam Flashcards

1
Q

name four reasons amniotic fluid is collected during pregnancy?

A

antenatal diagnosis of genetic disorders
assess fetal pulmonary maturity
sex predictions
predicting HDN

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2
Q

if an amniotic fluid is collected early in a pregnancy (ie. 15-18 weeks) it is most likely being collected to determine what?

A

genetic or congenital disorders

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3
Q

what is the definition of oligohydraminos?

A

abnormally decreased amounts of amniotic fluid

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4
Q

what would be the reason for protecting amniotic fluid from light?

A

for chemical examination of bilirubin

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5
Q

when present in amniotic fluid, fetal cells are adversely affected by what?

A

refrigeration

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6
Q

explain what you might find when performing a physical examination of amniotic fluid, including: color and turbidity

A 
color: N= colorless, pale yellow
bilirubin= yellow/amber
mecnoium= green
blood= pink/red
turbidity depends on the stage of pregnancy, as it becomes later in the pregnancy turbidity increases
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7
Q

name the four tests done to evaluate the surfactants present to the fetal pulmonary system

A
  • 3 phospholipids checked: L/S ratio and phosphatidylglycerol present or not present
  • foam stability index (FSI)
  • microviscosity tests
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8
Q

using and comparing the L/S ratio and the PG determination, what would indicate fetal lung maturity?

A

if the L/S ratio is >2.0 and PG present

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9
Q

Transudates

A

noninflammatory caused by disturbances of oncotic pressure

clear, no clots, few cells, SG <1.015, TP = 3.0

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10
Q

name three biochemical indicators that are used to evaluate the secretory function of the prostate. Of these three biochemical indicators, which one can positively identify a fluid as seminal fluid and is useful in cases of sexual assault?

A

zinc, citric acid, acid phosphatase

acid phosphatase

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11
Q

name four reasons for a physician to order a semen analysis

A

-evaluate infertility
-ensure vasectomy effectiveness
-evaluation for semen donation
-forensic applications:
presence in vag. secretions, DNA, finger printing

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12
Q

which structures contribute secretions to seminal fluid?

A

testes, epididymis, seminal vesicles, prostate gland

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13
Q

what is a normal concentration of a normal seminal fluid?

A

20 to 250 million

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14
Q

is the concentration of semen within a single individual constant? if not, what factors might influence concentration?

A

no, abstinence, viral infections, and stress

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15
Q

is concentration the most important factor when determining infertility?

A

no, motility is.

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16
Q

what parameter of a semen analysis is directly related to and provides a check of the motility evaluation? how?

A

viability, to decide if the sperm is not swimming because it’s dead or because it cannot swim

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17
Q

what percentage of sperm with normal morphology is considered normal or acceptable? how is sperm morphology determined?

A

50%

stained smear of fresh specimen

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18
Q

what is the normal pH of seminal fluid?

A

7.2-7.8

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19
Q

what might a pH of <7.2 indicate?

A

abnormality of epididymis , vas deferens, or seminal vesicles

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20
Q

what might a pH of >7.8 indicate?

A

infection in male reproductive tract

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21
Q

testing frucose in seminal fluid reflects the secretory function of the ____ ____ , as well as the functional integrity of the _________ and _____ ____

A

seminal vesicles

ejaculatory ducts and vas deferens

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22
Q

what is the primary function of the seminal fluid?

A

transport spermatoza

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23
Q

explain the requirements for the collection of a specimen for semen analysis?

A
  • masturbation…. obviously…
  • must be recieved within 1 hr. after collection
  • kept at 20-40 C
  • 2 or more samples to analyze for fertility
  • take place within a 3 month period and 7 days apart
  • sexual abstinence 48 hours but no more than 7 days before collection
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24
Q

what is a normal length of time (in minutes) for a semen specimen to liquefy?

A

30 min.

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25
Q

after liquefaction, the viscosity closely resembles that of what other fluid?

A

tiny bit thicker than water

26
Q

what would be considered abnormal liquefaction?

A

outside 60 minutes.

27
Q

motility should be evaluated within how many minutes following collection?

A

60 minutes

28
Q

explain the color, clarity, viscosity, and clot formation of normal synovial fluid

A

color = pale yellow, colorless, or clear
clarity= clear
viscosity = very
clot formation = no clotting

29
Q

is fibrinogen a normal constituent or normal synovial fluid?

A

no

30
Q

does hyaluronate affect the turbidity of a synovial fluid specimen?

A

no

31
Q

Name some things that might cause a synovial fluid to be turbid in appearance?

A 
WBC
RBC
synoviocytes
crystals
fat droplets
cellular debris
32
Q

why should a synovial fluid be examined ASAP? what component might be most adversely affected by a delay in examination?

A

important to exam ASAP b/c crystals can form during storage or WBC will phagocytize crystals already present

33
Q

for microscopic examination purposes, the synovial fluid should be placed in a tube containing which anticoagulant ? why should other anticoagulants be avoided?

A

sodium heparin

to prevent artifacts

34
Q

name the diluent that should be used should a synovial fluid need to be diluted for microscopic exam?

A

0.85% saline

35
Q

a joint disease process is indicated by what?

A

> 25% neutrophils

36
Q

what type of miscroscopy differentiates synovial fluid crystals based on their birefringence? how is this achieved?

A

compensated polarizing microscopy based on the different colors produced when crystals are oriented parallel & perpendicular to the axis of the compensator

37
Q

name some indicators of a synovial fluid that would be classified as septic?

A
  • plasma-synovial glucose difference increase > 40
  • yellow-green
  • white cell increase > 50,000
  • low viscosity
38
Q

which crystal is usually seen in patient with gout?

A

uric acid (yellow to the parallel looking microscopically)

39
Q

are monosodium urate, calcium pyrophosphate dihydrate, and cholesterol crystals all birefringent?

A

yes

40
Q

which analytes are present in synovial fluid at concentrations equal to blood plasma levels?

A

glucose and uric acid

41
Q

if a bloody CSF fluid is recieved in the lab, what are some steps to take to determine if it is a traumatic tap or the patient has actually had a hemorrhage?

A

if 1st tube has greatest amt. of blood –> traumatic tap
if equal distribution of RBCs throughout all tubes –> hemorrhage

centrifuge - colorless supernatant = traumatic tap
xanthochromic supernatant = hemorrhage

42
Q

define xanthochromia

A

yellow discoloration

43
Q

does fibrinogen NORMALLY pass through the blood-brain barrier?

A

no

44
Q

according to the lumbar puncture procedure in your notes, the first tube collected should be used for what type of testing?

A

chemical and immunologic

45
Q

a predominance of lymphocytes within CSF indicates which type of meningitis?

A

viral meningitis

46
Q

what are the normal ranges of glucose within a normal CSF?

A

G= 50-80 mg/dl

47
Q

what condition would a decreased glucose indicate?

A

meningitis

48
Q

the amount of glucose in CSF is approximately ____% or ____ the plasma concentration

A

60-70

2/3

49
Q

define pleocytosis as it relates to CSF

A

increased number of cells in CSF

50
Q

does an increased number of leukocytes within CSF cause xanthochromia?

A

no

51
Q

an uneven distribution of blood in the CSF collection tubes most likely indicates what?

A

traumatic tap

52
Q

give the normal CSF WBC cell counts for adults, children, and newborns.

A 
A= 0-5/ microliters
C= 0-10/ microliters
N= 0-30/ microliters
53
Q

in adults CSF cell counts, what two cell types are considered normal if seen in the fluid?

A

lymphocytes and monocytes

54
Q

a predominance of neutrophils within CSF indicates which type of meningitis?

A

bacterial meningitis

55
Q

what is the normal range for lactate in CSF? Normal lactate levels are often found in patients with what type of meningitis?

A

N= 10-22 / dl

viral

56
Q

which procedure frequently provides a rapid presumptive diagnosis of bacterial meningitis?

A

gram stain

57
Q

is L/S ratio affected by blood and meconium?

A

yes

58
Q

is the PG affected by blood and/or meconium?

A

no

59
Q

exudates

A

inflammatory caused by process that increases capillary permeability in membrane or decrease in absorption off fluid by lymphatic system

cloudy, clots, many cells, SG > 1.015, TP > 3.0

60
Q

Give a description of what three zones mean in reference to the change in alpha 450 and the Liley’s 3 zone chart

A

zone 1 = normal
zone 2 = moderate hemolysis
zone 3 = severe hemolysis - fetus will die without intervention

61
Q

what are the normal ranges for protein within a normal CSF?

A

15-45 mg/ dl `

62
Q

what condition would an increased protein indicated in CSF?

A

meningitis

urinalysis (3 decks)

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