Lab Practical 1 Flashcards by avery t.

Specimen Containment

and labeling

Leak proof, dry, clear
Label the container not the lid because of mix ups
- Name
- Pt ID
- Date and time of collection

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Specimen Processing

Time, storage, what changes

Time: deliver within 2 hours
Fridge: amorph crystals will form
- Reheat to room temp before analyzing
- Preservatives may be used

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Purpose For Random Collection

Routine screening

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Purpose For First Morning Collection

Purpose For Routine

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Purpose For Midstream Clean Catch

Routine screening, bacterial culture

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Purpose For Catheterized

Bacterial culture

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Purpose For Suprapubic Aspirate

Bacterial culture
Cytology

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Purpose For Drug Specimen Collection

Drug Testing
- Requires chain of custody

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Preservatives: Refrigeration

Pros, cons, commennts

Pros: no interference with chemical tests
Cons: raises specific gravity, precips more amorph crystals
Comments: prevents bacterial growth 24 hours

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Preservatives: Boric Acid

Pros, cons, comments

Pros: preserves protein, formed elements
Cons: inhibits bacterial growth
Comments: keeps pH at 6.00

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Preservatives: Formalin

pros, cons

Pros: sediment
Cons: interferes with copper reduction; glucose, blood, leuk esterase on reagent strip

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Preservatives: Sodium Fluoride

pros, cons

Pros: prevents glycolysis, good for drug analysis
Cons: inhibits glucose, blood, leuk esterase on reagent strip

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Changes at Room Temp For >2 Hours: pH and Glucose

pH: increases
- breakdown of urea to ammonia if bacteria are present

Glucose: decreases
- GLycolysis if bacteria utilize glucose

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Changes at Room Temp For >2 Hours: Nitrite

Increases
- if bacteria reduces nitrite

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Changes at Room Temp For >2 Hours: Urobilinogen and Bacteria

Urobilinogen: decrease because of oxidization to urobilin
Bacteria: increase due to multiplying

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Changes at Room Temp For >2 Hours: Ketones and Bilirubin

Ketones: decrease, evaporation
Bilirubin: Decrease, oxidation to biliverdin when exposed to light

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Changes at Room Temp For >2 Hours: Turbidity and Color

Turbidity: increase due to amorph
Color: can change

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Changes at Room Temp For >2 Hours: Cells and Casts

Cells and casts: decrease/disintegrate in dilute alkaline urine

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Normal Crystals

7 and basic description, ph

Calcium oxalate: square with x, dumbell, ovoid, long, octahedral, acidic
Triple phosphate: long, alkaline
Ammonium biurate: brown fuzzy round, thorny apple, old urine alkaline
Uric acid: brown cylinder or lemon, acidic
Hippuric acid: very long, pointed ends, acidic
Calcium phosphate: prisms in a cluster, alkaline
Ca carbonate: dumbell, alkaline

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Amorph

Two types, ph

Normal
Amorph urate: acidic
Amorph phosphate: alkaline

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Abnormal Crystals

7, descrip, ph

Bilirubin: brown fine needles, acidic
Cholesterol: clear plates, notched edges, acidic
Cystine: clear hexagon, acidic
Leucine: dark tree trunk, acidic
Tyrosine: large needle cluster sheaves, acidic
Sulfa: drug, brown dumbell needles, acidic
Drug crystals: most are big needles, can be clustered

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Correlations: Leukocytes

Infection
- Kidneys
- UTI
- Bacteria most common

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Correlations: Nitrite

UTI
- Bacteria
- Bladder

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Correlations: Urobilinogen

Liver cell damage, or increased bilirubin excretion to intestines

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Correlations: Protein

Kidney disease (glomerular)

Correlations: PH

Acidic can be caused by kidney disease or diet

Correlations: Blood

Infection or disease in kidney or bladder

Correlations: Specific Gravity ## Footnote radiographic dye?

High specific gravity: kidney's ability to concentrate urine in relation to plasma **> 1.035: radiographic dye**

Correlations: Ketones

Diabetes, low carb, starvation

Correlations: Bilirubin

Liver damage

Correlations: Glucose

Diabetes mellitus Tubular

How many CSF tubes to be collected and how much

4 tubes, 10-20 mls

CSF tubes and where they're sent in order, and storage if STAT tests cant be performed

1. Chem - fridge or freeze 2. Micro - room temp 3. Heme - fridge

When should cell counts be performed for a CSF specimen and why?

ASAP, cells deteriorate within 2 hours of collection

Why are CSF cell counts done manually

Automated instruments have a minimum range and sometimes CSF has too few cells to register an accurate count

Normal CSF appearance, cell count, and diff count

- Clear/colorless - 0-5 wbc/ul - Lymphs and monos, mononuclear cells

Causes for clear but bloody CSF

RBCs - hemorrhage or traumatic tap - 200-400 RBC/ul might appear clear

Milky or cloudy CSF

Bacteria, WBCs, protein

Clotted CSF

Protein, usually from traumatic tap

Xanthochromic CSF

Hgb, bilirubin

Pleural fluid location and specimen collection

- Lungs, chest wall - Thoracentesis

Peritoneal, ascitic fluid location and collection

- Abdominal wall/pelvic cavity - Paracentesis, peritoneocentesis

Pericardial fluid location and collection

- Around the heart - Paracardiocentesis

Synovial fluid composition

Similar to plasma, ultrafiltrate of plasma

What makes synovial fluid viscous

Hyaluronic acid

Synovial fluid tubes for department tests

- Heme: EDTA - Micro: heparin - Chem/immuno: not anticoagulant tube

MSU crystals

Needle Negative birefringence - Gout - parallel: yellow - perp: blue

CCPD crystals

Blunt, positive birefringence - Pseudogout - Parallel: blue - Perp: yellow

Liquefaction in semen

Fresh semen clotted then liquifies again between 15-30 minutes

How does viscosity of semen affect sperm quality

Too viscous (>2 cm thread test) and incomplete liquefaction impedes sperm motility

Semen pH

7.2-7.8 slightly alkaline

How to calculate sperm concentration

number of sperm heads x dilution x 1,000,000 = sperm concentration /ml

How to calculate sperm count

number of sperm heads x dilution x 1,000,000 x specimen volume

Normal sperm concentration and count

Concentration: >20 mil per ml Count: >40 mil per ml

How long to eval sperm motility

Within 1 hour or else motility decreases - 50% or more sperm should be motile in categories a,b,c or 25% in a/b

Sperm motility categories

**4 (a):** rapid, straight line motility **3 (b):** slower, some lateral movement **2 (b):** slow forward, lateral movement **1 (c):** no forward progression **0 (d):** no movement

What are lining cells in CSF called

Choroid plexus cells - dont count in the diff

What are lining cells in synovial fluid called

Synoviocytes

Lining cells in amniotic fluid

SECs

Lining cells in serous fluid

Mesothelial cells

Troubleshooting: crypto vs poor slide

poorly spun lymphs can look smashed and like cryptococcus, remake the slide or other clues like pt history

Lab Practical 1 Flashcards

(61 cards)