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l1 Flashcards

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1
Q

What is urine?

A

An ultrafiltrate of plasma

Urine is produced by the kidneys and is primarily composed of water and solutes.

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2
Q

What is the normal composition of urine?

A

95% water, 5% solutes

Solute variations can occur due to diet, activity, metabolism, endocrine factors, and body position.

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3
Q

What is the major organic solute in urine?

A

Urea

Urea is derived from the metabolism of amino acids and accounts for 60%-90% of nitrogenous material in urine.

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4
Q

What are the typical amounts of urea, creatinine, and uric acid in urine?

A
  • Urea: 25.0-35.0 g
  • Creatinine: 1.5 g
  • Uric Acid: 0.4-1.0 g

These values can vary based on diet and health.

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5
Q

Define anuria.

A

Cessation of urine flow

This condition indicates severe kidney damage or decreased renal blood flow.

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6
Q

What is oliguria?

A

Decrease in urine output

Defined as less than 1 ml/kg/hr for infants, less than 0.5 ml/kg/hr for children, and less than 400 ml/day for adults.

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7
Q

What is nocturia?

A

Increased urine excretion at night

Normally, urine excretion is 2-3 times more during the day.

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8
Q

Define polyuria.

A

Increase in daily urine volume

Associated with conditions like diabetes mellitus and can be artificially induced by diuretics, caffeine, and alcohol.

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9
Q

What is the usual daily urine volume?

A

1200-1500 mL

The normal range for urine volume is between 600-2000 mL.

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10
Q

What are the grounds for urine specimen rejection?

A
  • Unlabeled containers
  • Non-matching labels and requisitions
  • Contaminated specimens

Laboratories have written policies that specify these grounds.

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11
Q

What is the ideal preservative for urine specimens?

A

Bactericidal, inhibits urease, preserves formed elements, does not interfere with chemical testing

Routine preservation is done through refrigeration, especially for culture specimens.

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12
Q

What is a random urine specimen?

A

Most common type received, collected at any time

Results may be altered by dietary intake and activity.

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13
Q

What is the purpose of a first morning specimen?

A

Ideal screening specimen due to its concentration

It is collected immediately upon rising and delivered to the lab within 2 hours.

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14
Q

What is a fasting specimen?

A

Second specimen voided after fasting for 8 hours

This specimen is recommended for glucose monitoring.

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15
Q

What does a 2-hour postprandial specimen monitor?

A

Insulin therapy

Results can be compared with fasting urine specimen and blood test results.

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16
Q

What is the principle of a refractometer?

A

Measures the refractive index of urine

It determines the concentration of solutes by measuring the velocity of light passing through the solution.

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17
Q

What does urine clarity refer to?

A

Transparency or turbidity of a specimen

Normal reporting includes clear, hazy, cloudy, turbid, and milky.

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18
Q

What does the color of urine indicate?

A

Varies from almost colorless to black

Abnormal colors suggest bleeding, liver disease, or infection.

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19
Q

What is the typical odor of fresh urine?

A

Faintly aromatic

Older urine can smell like ammonia, while certain metabolic disorders can produce distinctive odors.

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20
Q

What is the significance of urine specific gravity?

A

Indicates urine concentration

Changes in specific gravity can reflect hydration status.

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21
Q

What is the procedure for determining urine color and clarity?

A

Use a well-mixed specimen, view against a white background

Maintain adequate room lighting for accurate evaluation.

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22
Q

What is the procedure for a midstream clean-catch specimen?

A

Wash hands, clean genitalia, void into toilet first, then into container

This method minimizes contamination.

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23
Q

What is the purpose of a chain of custody in drug specimen collection?

A

Documentation from collection to lab results

It ensures the specimen’s integrity and withstands legal scrutiny.

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24
Q

What is the principle behind a refractometer?

A

Refractive Index

Measures velocity of light in air versus velocity of light in a solution.

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25
What are the advantages of using a refractometer?
* Temperature compensation not needed * Small specimen size: 1 or 2 drops * Less affected by particle size
26
What is the methodology for using a refractometer?
* Drop of urine placed on prism * Focus on light source, and read scale * Wipe off prism between specimens
27
What is the routine chemical examination of urine primarily conducted with?
Reagent strips consisting of chemical-impregnated absorbent pads.
28
What parameters are typically assessed in a routine urine chemical examination?
* Protein * pH * Glucose * Specific gravity
29
What are the two major types of reagent strips?
* MULTISTIX (Siemens Healthcare Diagnostics) * CHEMSTRIP (Roche Diagnostics)
30
Fill in the blank: Reagent strips provide a _______ analysis.
semi-quantitative
31
What steps should be followed in the reagent strips technique?
* Dip strip briefly into specimen * Remove excess urine * Blot edge of strip * Wait specified time * Compare color reaction to manufacturer's chart
32
True or False: Enzyme reactions on reagent strips are based on room temperature readings.
True
33
What is required for quality control of reagent strips?
* Run positive and negative controls at least once per 24 hours * Record control results
34
What is the purpose of the Watson-Schwartz differentiation test?
Differentiation among urobilinogen, porphobilinogen, and Ehrlich reactives.
35
What types of cells are identified in a microscopic examination of urine?
* Red blood cells (RBCs) * White blood cells (WBCs) * Epithelial cells
36
What are the types of casts identified in urine microscopy?
* Hyaline * Cellular cast * Granular (Coarse / fine) * Waxy
37
What is the ideal centrifugation time and speed for urine sediment preparation?
5 min at relative centrifugal force (RCF) of 400.
38
What should be done post-centrifugation to handle urine specimens?
* Aspirate rather than pour off urine * Mix sediment gently
39
What is the minimum volume of urine required for sediment examination?
10–15 mL
40
What are the types of stains used in microscopic examination of urine?
* Sternheimer-Malbin * Toluidine Blue * Gram Stain * Hansel Stain * Prussian Blue Stain
41
What is the function of the Sternheimer-Malbin stain?
Identifies WBCs, epithelial cells, and casts.
42
What is fecalysis primarily used for?
Examination of stool specimens for ova and parasites.
43
What is the smallest acceptable amount of stool required for parasitic study?
2 to 5 grams or pea size.
44
What precautions should be taken to avoid contamination during stool collection?
* Use a clean, dry, sterile wide-mouthed container * Avoid urine contamination * Do not retrieve stool from toilet bowl water
45
How soon should a freshly collected stool sample be submitted to the laboratory?
Within 1 hour after collection.
46
Fill in the blank: The typical stool collection protocol consists of _______ specimens.
THREE
47
What should be included on the specimen container label?
Patient's name, identification number, physician's name, and date/time of collection.
48
What is the ideal time for transporting a specimen to the laboratory after collection?
Within 1 hour after collection
49
What should be included in the labeling of a specimen container?
Patient's name, identification number, physician's name, date and time of sample collection
50
What type of bag should specimens be placed in for transport to the laboratory?
ZIP LOCK PLASTIC BAG
51
What is the recommended time frame for examining liquid stool specimens?
Within 30 minutes of passage
52
How many stool samples should be examined before excluding parasites?
Three samples
53
What is the daily stool weight threshold for diagnosing diarrhea?
>200 g stool weight per day
54
What are the mechanisms of diarrhea?
* Secretory * Osmotic * Altered motility
55
What indicates sugar malabsorption in fecal testing?
pH <5.6
56
Name one cause of secretory diarrhea.
Microbial infections such as E. coli or Vibrio cholerae
57
What is osmotic diarrhea caused by?
Incomplete digestion or reabsorption of food
58
What is a common symptom of altered motility in diarrhea?
Irritable bowel syndrome
59
What is the purpose of the direct fecal smear (DFS) technique?
To study living parasites such as motile protozoa and helminth eggs
60
What is the significance of fecal leukocytes in stool examination?
>3 Neutrophils/hpf is significant
61
What does a fecal occult blood test detect?
Hidden blood in stool
62
What color indicates blood from the upper GI tract in feces?
Black, tarry
63
What is the principle behind the fecal occult blood test?
Pseudoperoxidase activity of hemoglobin
64
What dietary restrictions should be followed before a fecal occult blood test?
* No red meat * No horseradish * No melons * No raw broccoli, cauliflower, radishes, turnips * No aspirin or anti-inflammatory agents for 7 days * Avoid vitamin C and iron for 3 days
65
What is the function of the seminal vesicles in semen production?
Provide nutrients for sperm and fluid
66
What is the normal volume range for semen?
2-5 mL
67
What is the normal pH range for semen?
7.2-8.0
68
What is evaluated in sperm morphology?
Head, neck, midpiece, tail
69
What is the critical component of sperm for fertilization?
Sperm morphology
70
What is the purpose of semen analysis?
Investigation of fertility and identification of treatment options
71
What are the two main types of examinations performed in semen analysis?
* Macroscopic examination * Microscopic examination
72
What is the significance of sperm motility in semen analysis?
Need to have sperm with forward, progressive movement
73
What is the normal percentage of motile sperm within 1 hour?
>50%
74
What does a sperm count of >20 million/ml indicate?
Normal sperm concentration
75
What is the purpose of the eosin-nigrosin stain in sperm viability testing?
To differentiate living and dead sperm
76
What is the normal value for sperm viability?
75% living
77
What is a common method for semen collection?
Masturbation into a clean sample cup
78
What should be avoided when collecting a semen sample?
Lubricated, anti-spermicidal condoms
79
What is the normal liquefaction time for semen?
30 to 60 minutes
80
What should be recorded on the laboratory analysis form for semen analysis?
* Period of abstinence * Sample collection completeness * Time interval from collection to analysis
81
What is the normal sperm count per ejaculate?
>40 million
82
What indicates a problem if the semen viscosity is too high?
Infertility, incomplete collection
83
What does 'living' correspond to in semen analysis?
Motility ## Footnote Motility refers to the ability of sperm to move effectively.
84
What is the normal color of semen?
Gray-white/Pearly white ## Footnote The color can indicate the health of the sperm.
85
What is the normal odor of semen?
Musty/bleach like ## Footnote The odor can also provide insights into the quality of the semen.
86
What is the normal liquefaction time for semen?
30-60 minutes ## Footnote Liquefaction is the process by which semen changes from a gel-like state to a liquid state.
87
What is the normal volume of semen?
2-5 ml ## Footnote Volume is an important parameter in evaluating semen quality.
88
What is the normal viscosity of semen?
Pours in droplets ## Footnote Viscosity affects sperm motility and overall fertility.
89
What is the normal pH range for semen?
7.2-8.0 ## Footnote The pH level can influence the survival of sperm in the female reproductive tract.
90
What is the normal sperm concentration in semen?
>20 million/ml ## Footnote Sperm concentration is crucial for assessing male fertility.
91
What is the normal sperm count per ejaculate?
>40 million/ejaculate ## Footnote Higher sperm counts are generally associated with better fertility potential.
92
What is the normal motility percentage of sperm within 1 hour?
>50% ## Footnote Motility is a key factor in determining the likelihood of successful fertilization.
93
What is the minimum quality rating for sperm?
>2.0 or a, b, c ## Footnote Quality ratings assess the overall health and viability of sperm.
94
What is the minimum percentage of normal forms for sperm morphology?
>14% normal forms (strict criteria) ## Footnote Morphology evaluates the shape and structure of sperm, which is important for fertility.

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