Flashcards in Urinalysis/S lab lab Deck (133):
3 yr m-neutered canine
1) WBC-65.0 x 10^3
2) RBC-1.95 x 10^6
3) Hb-5.85 g/dl
4) HCT 16.3%
5) MCV 83fl
6) MCHC 35.8 g/dl
1) severe leukocytosis
2) severe anemia
3) severe anemia
4) severe anemia
5) slightly increased
RBC: Anemia with 3+ polychromasia, suspect regenerative but need retic count to confirm because of increased polychromataphils, spherocytes seen and agglutination
WBC: Severe leukocytosis with hypersegmented neutrophilia, an increase in reactive lymphocytes, and over 5 nRBCs
Conclusion: Severe anemia-suspect regenerative anemia with severe leukocytosis, hypersegmented neutrophilia, and nucleated RBCs
When recording a RBC differential what do you write in size?
1) if anisocytosis-micro/macrocytic
2) field of view-OIF
3) degree 2+
When recording a RBC differential what do you write in shape?
When recording a RBC differential what do you write in color?
When recording a RBC differential what do you write in distribution?
1) mild/severe rouleaux, agglutination, anemia
When recording a RBC differential what do you write in abnormalities/inclusions?
1) more than 5nRBCs 3/NRBCs/100 WBC
2) reactive lymphocytes
check for any in feathered edge first
platelets: WNL, thrombocytosis, thrombocytopenia
quantity: #/OIF-adequate, increased, decreased
morphology: micro/macroplatelets with degree
estimate: #/microliter dog 417/10=41.7=42 42/OIF 42 x 15,000=630,000/microliter
Formula for corrected WBC count:
WBC(65,000) x 100/ 100 +nRBCS(9)
Normal values for urine SG
What is isosthenuria and when is it seen?
isosthenuria occurs when the urine SG is approaches that of glomerular filtrate (1.008-1.012), animals with renal disease
What is the normal transparency of urine? There is one exception what species is it?
its transparent or clear, equines
How can noting the odor of urine be beneficial?
It can indicate or give a clue to a disease, sweet-diabetes, ammonia-cystitis
An excess of urea or other nitrogenous wastes in the blood as a result of kidney insufficiency
Under what conditions may urine be foamy?
When urine is shaken it produces a greenish-yellow foam
Why do you make buffy coat smears? What do you see in a buffy coat?
to see mast cells, WBCs and platelets
What method of collection is preferred for a microscopic examination, why?
The best samples for sedimentation are morning samples or samples collected after several hours of water deprivation because such samples are more concentrated and the chances of finding formed elements are increased-cystocentesis
What are the components of urine sediment?
casts, crystals, epithelial cells, RBCs, WBCs, mucus threads and in males/recently bred females spermatoza
What does a positive ketone indicate with abnormalites? What is also positive with ketones and what does it indicate?
(metabolism of fat) excessive amounts of fat catabolism to provide energy its associated with diabetes mellitus so also glucose would be positive
Determine in your labs normal volume to be analyzed and if it is different?
make a notation
Always note method of _______
Refractometer calibrated to ______ with distilled water
What do you note in macroscopic?
color(yellow, light/dark yellow, amber, red, brown, colorless)
clarity(cloudy, turbid, flocculent-degrees slightly, moderate, marked/severe)
odor(normal, strong, rancid, ammonia)
How do you remove excess urine from reagent pad?
tilting strip on paper towel
For sediment how many mls do you place in a conical tube?
What do you centrifuge at and for how long?
1200rpm for 5/6mins
Decant all the supernatant but _____ml
T/F After centrifuging to mix the sediment you must mix it with the reserved supernatant by swirling it.
When looking at a microscopic urine sample what do you do first? (4 things)
1) scan on low power, low light source for casts and crystal
2) observe for clumps of epithelial
3) casts-differentiate and record #/LPF (if only a few are seen you may note #/HPF)
4) crystals-differentiate and record #/LPF (if only a few are seen you may note #/HPF)
When looking at a microscopic urine sample what do you do second?
1) observe at least 10 fields
2) high power and slightly higher amount of light
How do you record?
What is another name for triple phosphate?
How do you record?
Epithelium- differentiate and record #/HPF
Bacteria- rods or cocci grade 1-3+
Misc- note the presence of sperm, budding yeast, mucus, debris, etc
T/F Sometimes RBC and WBC are TNTC but they have to be too numerous to count.
What does a positive bilirubin indicate? What animal is it abnormal to see any in?
indicates a low renal threshold (spills over easily) and maybe indicative of some disorder that has the potential to produce jaundice, cats
If the test is positive for blood what does that indicate?
tests for blood in urine detect hematuria, hemoglobinuria, and myglobinuria in urine
What is the difference between hematuria and hemoglobinuria?
hematuria: presence of intact RBCs in urine, usually a sign og disease causing bleeding somewhere in the urogenital tract
hemoglobinuria: presence of free hemoglobin in urine, usually indicates intravascular hemolysis
What type of crystal do you see in the urine of animals poisoned with ethylene glycol (antifreeze)?
calcium oxalate-calcium monohydrate crystals
Why is it important to gently flick sediment to resuspend it?
to prevent breaking of fragile elements
Why is a midstream sample preferred to initial stream specimens?
It's best because it's less likely to be contaminated by cells, bacteria, and debris from external genital surfaces
Why is it important not to centrifuge the urine for to long or too high of a speed? How should the centrifuged be stopped and why?
Excessive force compacts the sediment and may distort or disrupt formed elements. You must wait for the centrifuge to fully stop spinning in order to stop it.
Why is it important to mix a urine sample before it is transferred to the centrifuge tube?
it should be well mixed to evenly distribute the elements
Describe a left shift.
An increase in neutrophilic bands in the bloods
Describe how you record toxicity.
Degree and quantity:
1) dohle bodies
2) cytoplasmic vaculization
3) cytoplasmic basophilia
5) toxic granulation
Canine patient 2 yrs old (interpret and write correct lab values)
RBC: 6.0 x 10^6
WBC: 33.3 x 10^3
PCV: 37-55% WNL
Hb: 8-15g/dl WNL
RBC: 5-10 WNL
WBC: 6-15 increase sever leukocytosis
Platelet: 160-625 decreased sever thrombocytopenia
What 2 objectives are used to observe urine sediment and describe the light used?
Start with 10x and very low light, move to 40x making it slightly brighter
What is observed and maybe counted when observing urine sediment with the 10x objective?
crystals, casts, epithelial cells, parasites
RBCs and WBCs in a urine sediment are evaluated using what objective lens?
When doing buffy coat smears what cell are you looking for?
The SG of urine can be affected by several things. List at least three.
1) the animal's water intake
2) the time and frequency of when they urinate (morning urine is more concentrated)
The SG is affected by what organ dysfunction?
the kidney (renal dysfunction)
Regarding platelets observed on a differential-what do you have to record?
1) any in the feathered edge and distribution
2) morphology (macro/micro/megathrombocytes)
3) quantity (adequate, increased, or decreased)
Write a sentence describing the RBC morphology:
1) size: anisocytosis 2+
2) shape: target cells 1+
3) color: polychromasia 3+, hypochromasia 1+
4) distribution: mod anemia
5) abnormalities: HJB 2+
RBC statement: The animal is mod anemic-suspect regenerative but need retic count to confirm because there is a severe polychromasia increase as well as a severe increase in howell-jolly bodies with moderate hypochromasia
You observe 8nRBcs, how do you record it?
8 nRBCs/100 WBCs
What do you need to do when you observe 8 nRBCs and why?
Correct the WBC count because it will falsely elevate it from confusing the nRBCs as WBCs
wbc- 13.9 x 10^3
seg: 0.72 x 13,900=10,008, WNL
bands: 0 WNL
lympho: 0.17 x 13,900=2,363, WNL
mono: 0.03 x 13,900=417, WNL
eos: 0.08 x 13,900= 1,112, WNL
wbc- 13.9 x 10^3
rbc- 2.7 x 10^6
platelet 499,00-distribution normal, mod number of giant platelets seen
RBC morphology: hypochromasia 2+, anisocytosis 2+, polychromasia 2+
rbc(5-8.5): severe anemia
hb(12-18): severe anemia
hct(37-55): severe anemia
mcv(60-77): slightly elevated
overall conclusion: Animal is severely anemic based on the RBC count, Hb, and pcv. Suspect regenerative because of polychromasia 2+, but need reticulocyte count to confirm.
Indicate the information gained from each of the following chemical components of the urine dipstick-blood
detects intact RBCs, hemoglobinuria(lysed rbc), and myoglobin(breakdown of muscle)
Indicate the information gained from each of the following chemical components of the urine dipstick-protein
low SG and positive protein indicates renal disease, active(sediment, RBC, WBC, epithelial, sperm) vs inactive(sediment, glomerular filtration disease, protein spilling over to urine)
Indicate the information gained from each of the following chemical components of the urine dipstick-pH
alkaline greater than 7, acidic less than 7 (1-14) measures ion concentration
Indicate the information gained from each of the following chemical components of the urine dipstick-ketone
catabolism of fat, glucose may also be positive if ketones are positive and indicate diabetes mellitus
Indicate the information gained from each of the following chemical components of the urine dipstick-glucose
above the renal threshold, can indicate diabetes mellitus
Indicate the information gained from each of the following chemical components of the urine dipstick-bilirubin
indicates presence of bile, 1+ in a dog is normal, indicates hemalysis or liver disease, indicates low renal threshold
What is normally found on an ear cytology?
cornified squamous epithelial cells, wax, yeast, bacteria
What frequently causes otitis externa? Some of its characteristics?
yeast(malassezia pachydermatis), peanut shaped, round or elliptical shaped, >10/HPF is an overgrowth
What spore forming bacteria can cause diarrhea? Characteristics?
Clostridium perfringes, gas "bubble," safety pin appearance
What factor greatly influences the pH of an animal's urine? If urine is left standing at room temperature what happens to the pH?
depends on the animal's diet, the urine pH will have decreased glucose and bilirubin, increased pH, crystal formation with increased turbidity, breakdown of casts and RBCs
What is the renal threshold for glucose? What can cause false reading of glucose in the urine? What species in particular?
170-180mg/dl, false positives may result for glucose after the use of various drugs(asorbic acid, morphine, salicylates, pencilin), cats
What are the three types of epithelium seen in urine sediment? What anatomical part do they originate from?
1) squamous-urethra, vagina, vulva, prepuce
2) transitional-bladder, ureters, renal pelvis, proximal urethra
3) renal-renal tubules
Has ring form and cocci form, causes anemia, epicellular on feline RBCs, causes feline infectious anemia
Describe how an imprint smear should be cleaned before imprinting?
the lesion should then be cleaned with a saline moistened surgical sponge
Describe how the swab technique is performed?
1) area is swabbed with a sterile isotonic fluid, such as 0.9% saline
2) premoistened swab with saline
3) roll swab in a single stroke in layers down the length of a clean slide
4) make 2 or 3 rows, air dry slide before staining
A cat weighs 15# over a 24-hour period she produced 320ml of urine. Is that normal or abnormal volume?
6.8kg x 20ml=136ml
6.8kg x 40ml= 272ml
When making a squash preparation, what happens if pressure is applied?
it can cause excessive cell rupturing, making the sample unable to be interpreted
What type of anticoagulant is used for fluid collection?
Write out the word, the compound, main source, and what organ affected, possible cause or problem: ALB
Write out the word, the compound, main source, and what organ affected, possible cause or problem: ALKP
1) Alkaline phosphatase
Write out the word, the compound, main source, and what organ affected, possible cause or problem: ALT
1) Alanine aminotransferase
5) corticosteroids, anticonvulsants (medications)
Write out the word, the compound, main source, and what organ affected, possible cause or problem: AMYL
Write out the word, the compound, main source, and what organ affected, possible cause or problem: BUN
1) Blood urea nitrogen
4) if kidney not functioning properly, kidney disease (prerenal, renal, postrenal)
Write out the word, the compound, main source, and what organ affected, possible cause or problem: CA
Write out the word, the compound, main source, and what organ affected, possible cause or problem: CREA
3) skeletal muscle
Write out the word, the compound, main source, and what organ affected, possible cause or problem: GLOB
Write out the word, the compound, main source, and what organ affected, possible cause or problem: GLU
Write out the word, the compound, main source, and what organ affected, possible cause or problem: LIPA
Write out the word, the compound, main source, and what organ affected, possible cause or problem: PHOS
Write out the word, the compound, main source, and what organ affected, possible cause or problem: TBIL
1) Total Bilirubin
Write out the word, the compound, main source, and what organ affected, possible cause or problem: TP
1) Total Protein
3) muscle cells/liver
Write out the word, the compound, main source, and what organ affected, possible cause or problem: Na
3) cation of extraceullar fluid
Write out the word, the compound, main source, and what organ affected, possible cause or problem: K
3) cation of intracellular fluid
Write out the word, the compound, main source, and what organ affected, possible cause or problem: Cl
3) extracellular anion
Write out the word, the compound, main source, and what organ affected, possible cause or problem: CHOL
What are the four possible results of a gram stain?
1) gram positive
2) gram negative
What is the primary stain for the Gram stain? The Acid Fast Stain?
Gram: Crystal Violet
Acid: DMSO and (Carbon Fuchsin)
What is the counterstain for the Gram stain? Acid Fast Stain?
Gram: Fuchsin or Safranin
Acid: Methylene blue
What are some reasons for the gram variable reactions?
1) Genetics (some cells will have more a certain chemical, teichoic acid, in their cell wall)
2) Age of colonies (colonies should be stained within 18-24hrs or inoculation as older colonies can develop variable amount of teichoic acid in their cell wall)
3) Type of growth medium (some media do not contain the proper nutrients to support normal cell wall growth
4) Technique (smears too think or too thick unevenly made or poor staining will cause a variable reaction)
What is the best method to obtain a urine specimen?
When is only a sufficient amount to perform the analysis removed?
when a patient is experiencing dysuria, anuria, and oliguria
What kinds of specimens are obtained for quantitative and qualitative analysis?
quantitative: 24hr sample collection
qualitative: voided, expression, catheritization, cystocentesis
Why is sending the urine to a reference lab for routine analysis contraindicated?
because the amount of time it takes to be sent can effect the urine results
Discuss the reasons for SG to be increased or decreased.
increased: acute renal disease, shock, dehydration, increased fluid loss, diminished water intake
decreased: pyometra, increased fluid intake, diabetes insipidus, diuretic therapy, disease where kidney cannot reabsorb water
What is coagulase? How is it related to pathogenicity?
Coagulase is an enzyme that coagulates plasma. The coagulse test is performed on Catalse positive bacteria; it will help differentiate the different members of the genus from Staphylococcus aureus.
Why would old cultures stain gram negative?
because spore formation occurs and cell wall degeneration
Suppose you viewed a stained sample from a pure colony of bacteria and the field revealed red and purple cocci. Adjacent cells were not always the same color. What do you conclude? What is the preferred test to confirm gram reaction?
A gram-variable reaction has occurred, KOH test
The ____ test can be performed to check the gram rxn in the event of a gram-variable rxn
Since bacteria cannot be identified from gram staining, why would a physician perform a gram stain on a sample before prescribing an antibiotic?
To give the clinician an idea about the proper spectrum of antibiotics from the gram + or gram -
Why is MacConkey agar inoculated with urine sample?
MacConkey is always used and suppresses the growth of gram-positive bacteria
Why are the special loops used-what makes them different from the regular inoculating loops?
The size of the calibrated loop holds more urine (0.001 mls of urine) so you can get a greater quantity of bacteria
How can one determine the Gram stain reaction of a bacterium without staining the colony? How does it work?
Differential media, makes a distinction between bacteria by using biochemical reactions
Why is it important to quantitate the amount of bacteria in a urine sample?
because there will always be some flora either from the urethra or from the skin, counting methods should be utilized to take these microbes into account
List all the reasons that the culture results do not correlate with the patient signs.
1) possibly drugs/medication
4) timing of the culture
5) incorrect technique
6) incorrect staining
What is an agar?
a type of solidifying agent, much like gelatin
Gram positive bacteria will have ____ layer, and retain the primary stain. Gram negative bacteria only have ____ layer and are colored by the counterstain.
What is the purpose of the streak plate?
easiest method of getting isolated colonies
Once a bacteria has been identified as gram negative, there are many ways to identify them. One of the easiest and most rapid is the _____.
The _____ test is performed on catalase positive bacteria.
UV rays may help identify dermatophyte
False positives for wood's lamp?
Pseudomonas sp, scales, lint, sebum, dandruff, crusts and topical medications
Intoxication caused by ingestion of food contaminated
Most common systemic mycosis of dogs
Multicellular fungi(mold) that form tubular filaments
Tangled mass of hyphae
Mold is aerobic/anerobic?
_______ formed at the free end of the hyphae
1) ________-Various shapes, Arise directly from hyphae
2) ________-Large, multicompartmented cells of various shapes, Orginate from conidiospores as singles, pairs or clusters
What from the bacteria, if present, cause hemolysis & will show signs of this on blood agar?
____ hemolysis is when there is partial destruction of RBC’s & hemoglobin & produces a greenish discoloration around the colonies on a blood agar plate.
____ hemolysis is when there is complete destruction resulting in a clearing around the growth on a blood agar plate.
____ hemolysis is when there is no hemolysis & therefore no change of the medium.
___________ is the most common pathogen associated with bacterial skin infections in the dog.
Staphylococcus is gram _____ and E. col is gram _______.
Blood agar supports growth of most ______. MAC supports only _____
g+ & g-, g-
______ is a test which uses antibiotic-impregnated wafers to test whether particular bacteria are susceptible to specific antibiotics. (resistant, intermediate, zone of inhibition)