Final Exam Study Guide Flashcards by Alex Olsen

Reasons amniotic fluid is collected during pregnancy

fetal lung maturity
antenatal diagnosis of genetic and congenital disorders
fetal distress - Rh
HDN
sex of baby

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15-18 wk gestation, collection of amniotic fluid for what

antenatl diagnosis of genetic and congential disorders

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Define oligohydraminos

decreased amount of amniotic fluid associated with congenital malforamtion and premature rupture of the membranes

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What would be the reason for protecting amnioti fluid from light

to protect bilirubin if present

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When present in amniotic fluid, fetal cells are adversly effected by what

refrigeration

amount of urobilinogen; hemolyzes fetal rbcs that occur in HDN

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

normal; colorless or very pale yello, turbid depending on stage of pregnancy
early; little particulate matter
late; increase amount of fetal cells, hair, etc

abnormal
yellow/amber; due to presence of bilirubin
green; meconium
red/pink; presence of blood

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Four test done to evaluate surfactants present to the fetal pulmonary system

L/S ratio; lecithin/sphingomyelin
PG; phosphotidylglyceral
FSI; foam stability index
Microviscosity

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Compare L/S ratio and PG, what would indicate fetal lung maturity

L/S is >20 but PG is present; effected by presence of blood and meconium

PG is not effected; if absent could indicate maturity but in diabetes

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Three zones of Liley’s graph

III; fetal failure, severe hemolysis, death
II; moderate hemolysis
I; normal, minimally effected fetus

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Non inflammatory
disturbance on oncatic pressure
clear
no clots
few cells
SG less than 1.015
TP 3.0

Transudates

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inflammator
increase in capillary membrane permeability
increase of absorption of fluid in lymph system
cloudy
clots
many cells
SG greater than 1.015
TP greater than 3.0

exudates

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Three biochemical indicators that are used to evaluate the secretory function of the prostate. Which one can positively ID a fluid as seminal fluid and is useful in sexual assault cases?

Zinc
citric acid
acid phosphotase-pos ID seminal fluid

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4 reason for a semen analysis to be ordered

evaluate infertility
follow up vasectomy
evaluation on quality for donation
forensic applications

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Which structures contribute secretions to seminal fluid

testes
epididymis
seminal vesicles
prostate gland

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What is the normal concentration of seminal fluid?
Is the concentration within a single individual constant?
If not, what factors might influence concentration?
Is concentration important in determining infertility?

20-250 million/mL
No, dependent upon period of sexual abstinence
Viral infections, stress, abstinence
Not as important as their other characteristics

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What percentage of sperm with normal morph is considered normal or acceptable?
How is sperm morph determined?

50% or more
Stained smear of fresh specimen
All or one region of the sperm, its size, shape or both by micro ID and supravital stain

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What parameter of sperm analysis is directly related to and provides a check of the motility evaluation? How?

Viability; distinguishes dead from non motile

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What is the normal pH of seminal fluid?
What might a pH of <7.2 indicate
What might a pH >7.8 indicate

7.2-7.8
>7.2 abnormality of the epididymis, vas deferens or seminal vesicles
>7.8 infection in male reproductive tract

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Testing fructose in seminal fluid reflects the secretory functions of what?
Functional integrity?

seminal vesicales

ejaculatory ducts and vas deferens

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What is the primary function of seminal fluid

transport spermatzoa

Specimen collection requirements for semen analysis

sensitivity and professionalism
written and verbal instructions should be provided
must be received in lab within an hour
protected from extreme temps (keep 20-40C)
witnin a 3 month period, 7 days apart
abstain for 2-7 days

Length of time for normal specimen to liquefy
after liquefication what fluid does it resemble?
what would be abnormal liquefication?

30 minutes
becomes watery
any delay >60 minutes is abnormal and must be reported

Motility should be evaluated within how many minutes following collection?

within 60 minutes

Explain characteristics of normal synovial fluid

pale yellow color, colorless, clear
normally clear
very viscous
no clots
syrupy

Is fibrinogen a normal constituent of synovial fluid

Does hyaluronate affect the turbidity of synovial fluid? Name things that may cause turbidity

No | WBC, RBC, synoviocytes, crystals, fat droplets and cellular debri

Why should synovial fluid be examined ASAP? | Which component, if present, might be most adversly affected by delay in exam?

Crystals can form during storage | WBCs can phagocytize crystals

During micro exam of synovial fluid what anticoagulant should be used? Why should others be avoided?

sodium heparin | to prevent artifacts

Name diluent used for synovial fluid microscopic exam

0.85% saline

A joint disease process is indicated by what

>25% neutrophils

What type of microscopy differentiates synovial fluid crystals? How?

compensated polarized based on colors produced when crystals are oriented parallel or perpendicualr to axis yellow parallel, gout MSD/uric crystals

Indicators that signify septic synovial fluid

``` yellow green color low viscosity cloudy increase WBC >50,000 > 40mg/dL plasma glucose difference ```

Which crystals are usually seen in pt with gout

monosodium urate monohydrate/MSU/uric acid

MSU calcium pyrophosphate dihydrate cholesterol crystals

All are birefringent

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

glucose | uric acid

If a bloody CSF is received, what are some steps to determine if its a traumatic tap or an acutal hemorrhage

hemorrhage; blood is same throughout each tube, xanthochomian supernatant traumatic tap; blood lessens in each tube, clear supernatant

Define xanthochromia

yellow discoloration due to red cell pigments

Does fibrinogen normally pass the BBB

First tube of lumbar puncture should be used for what

chemical, immunological

a predominance of lymphocytes in CSF is suggestive of which meningitis

viral neutrophils; bacterial meningitis

normal CSF glucose range

50-80 mg/dL | decreased in meningitis

normal CSF protein range

15-45 mg/dL | increased in meningitis

CSF glucose compared to plasma glucose

CSF glucose is 60-70% or 2/3 of the plasma concentration

pleocytosis in realtion to CSF

increase amount of cells in CSF

normla CSF wbc range for adult, child and newborns

Adult; 0-5 cell/uL child; 0-10 cells/uL newborn; up to 0 cells/uL

two cells that may be seen in normal CSF fluid

lymphs and monos

Normal range of lactate in CSF | Normal levels found in what meningitis

10-22 mg/dL | viral

Diagnostic tool for bacterial meningitis

Gram stain for rapid presumptive