Urinalysis/S lab lab Flashcards Preview

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Flashcards in Urinalysis/S lab lab Deck (133):
1

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

RBC:

WBC:

Conclusion:

1) severe leukocytosis
2) severe anemia
3) severe anemia
4) severe anemia
5) slightly increased
6) WNL
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

2

When recording a RBC differential what do you write in size?

1) if anisocytosis-micro/macrocytic
2) field of view-OIF
3) degree 2+

3

When recording a RBC differential what do you write in shape?

1) spherocytes
2) leptocytes
3) degree
4) field-OIF

4

When recording a RBC differential what do you write in color?

1) polychromasia/hypochromasia
2) degree

5

When recording a RBC differential what do you write in distribution?

1) mild/severe rouleaux, agglutination, anemia
2) field-LPF

6

When recording a RBC differential what do you write in abnormalities/inclusions?

1) more than 5nRBCs 3/NRBCs/100 WBC
2) reactive lymphocytes
3) hypersegmentation
4) field-OIF

7

Recording platelets
platelets:
quantity:
morphology:
estimate:

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

8

Formula for corrected WBC count:

WBC(65,000) x 100/ 100 +nRBCS(9)
5,500,00/109=59,633.027=59,600

9

Normal values for urine SG

dog: 1.019-1.045
cat: 1.020-1.040

10

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

11

What is the normal transparency of urine? There is one exception what species is it?

its transparent or clear, equines

12

How can noting the odor of urine be beneficial?

It can indicate or give a clue to a disease, sweet-diabetes, ammonia-cystitis

13

An excess of urea or other nitrogenous wastes in the blood as a result of kidney insufficiency

azotemia

14

Under what conditions may urine be foamy?

When urine is shaken it produces a greenish-yellow foam

15

Why do you make buffy coat smears? What do you see in a buffy coat?

to see mast cells, WBCs and platelets

16

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

17

What are the components of urine sediment?

casts, crystals, epithelial cells, RBCs, WBCs, mucus threads and in males/recently bred females spermatoza

18

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

19

Determine in your labs normal volume to be analyzed and if it is different?

make a notation

20

Always note method of _______

collection

21

Refractometer calibrated to ______ with distilled water

1.000

22

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)

23

How do you remove excess urine from reagent pad?

tilting strip on paper towel

24

For sediment how many mls do you place in a conical tube?

5 mls

25

What do you centrifuge at and for how long?

1200rpm for 5/6mins

26

Decant all the supernatant but _____ml

0.3-0.5ml

27

T/F After centrifuging to mix the sediment you must mix it with the reserved supernatant by swirling it.

false-tapping

28

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)

29

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

30

How do you record?
RBC-
WBC-

RBC- #/HPF
WBC- #/HPF

31

What is another name for triple phosphate?

struvite

32

How do you record?
Epithelium-
Bacteria-
Misc-

Epithelium- differentiate and record #/HPF
Bacteria- rods or cocci grade 1-3+
Misc- note the presence of sperm, budding yeast, mucus, debris, etc

33

T/F Sometimes RBC and WBC are TNTC but they have to be too numerous to count.

true

34

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

35

If the test is positive for blood what does that indicate?

tests for blood in urine detect hematuria, hemoglobinuria, and myglobinuria in urine

36

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

37

What type of crystal do you see in the urine of animals poisoned with ethylene glycol (antifreeze)?

calcium oxalate-calcium monohydrate crystals

38

Why is it important to gently flick sediment to resuspend it?

to prevent breaking of fragile elements

39

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

40

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.

41

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

42

Describe a left shift.

An increase in neutrophilic bands in the bloods

43

Describe how you record toxicity.

Degree and quantity:
1) dohle bodies
2) cytoplasmic vaculization
3) cytoplasmic basophilia
4) giantism
5) toxic granulation

44

Canine patient 2 yrs old (interpret and write correct lab values)
PCV: 40%
Hb: 13g/dl
RBC: 6.0 x 10^6
WBC: 33.3 x 10^3
Platelet: 43,000

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

45

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

46

What is observed and maybe counted when observing urine sediment with the 10x objective?

crystals, casts, epithelial cells, parasites

47

RBCs and WBCs in a urine sediment are evaluated using what objective lens?

40x

48

When doing buffy coat smears what cell are you looking for?

mast cells

49

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)
3) dehydration/anemia

50

The SG is affected by what organ dysfunction?

the kidney (renal dysfunction)

51

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)

52

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

53

You observe 8nRBcs, how do you record it?

8 nRBCs/100 WBCs

54

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

55

Diff:
wbc- 13.9 x 10^3
seg- 72%
bands- 0%
lympho- 17%
mono- 3%
eos- 8%

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

56

Interpret:
wbc- 13.9 x 10^3
rbc- 2.7 x 10^6
hb- 6.8g/dl
HCT- 22%
MCV- 81fl
MCHC- 30.9
platelet 499,00-distribution normal, mod number of giant platelets seen
RBC morphology: hypochromasia 2+, anisocytosis 2+, polychromasia 2+
Overall conclusion:

wbc(6-15): WNL
rbc(5-8.5): severe anemia
hb(12-18): severe anemia
hct(37-55): severe anemia
mcv(60-77): slightly elevated
mchc(31-36): WNL
platelets: WNL
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.

57

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)

58

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)

59

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

60

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

61

Indicate the information gained from each of the following chemical components of the urine dipstick-glucose

above the renal threshold, can indicate diabetes mellitus

62

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

63

What is normally found on an ear cytology?

cornified squamous epithelial cells, wax, yeast, bacteria

64

What frequently causes otitis externa? Some of its characteristics?

yeast(malassezia pachydermatis), peanut shaped, round or elliptical shaped, >10/HPF is an overgrowth

65

What spore forming bacteria can cause diarrhea? Characteristics?

Clostridium perfringes, gas "bubble," safety pin appearance

66

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

67

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

68

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

69

Has ring form and cocci form, causes anemia, epicellular on feline RBCs, causes feline infectious anemia

Mycoplasma hemofelis

70

Describe how an imprint smear should be cleaned before imprinting?

the lesion should then be cleaned with a saline moistened surgical sponge

71

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

72

A cat weighs 15# over a 24-hour period she produced 320ml of urine. Is that normal or abnormal volume?

15#/2.2kg=6.8181=6.8kg
normal-20-40ml/kg
6.8kg x 20ml=136ml
6.8kg x 40ml= 272ml
abnormal, polyuric

73

When making a squash preparation, what happens if pressure is applied?

it can cause excessive cell rupturing, making the sample unable to be interpreted

74

What type of anticoagulant is used for fluid collection?

EDTA

75

Write out the word, the compound, main source, and what organ affected, possible cause or problem: ALB

1) Albumin
2) protein
3) liver
4) leakage

76

Write out the word, the compound, main source, and what organ affected, possible cause or problem: ALKP

1) Alkaline phosphatase
2) isoenzyme
3) bone/liver
4) liver

77

Write out the word, the compound, main source, and what organ affected, possible cause or problem: ALT

1) Alanine aminotransferase
2) enzyme
3) liver/osteoblast/chondroblast
4) liver
5) corticosteroids, anticonvulsants (medications)

78

Write out the word, the compound, main source, and what organ affected, possible cause or problem: AMYL

1) Amylase
2) enzyme
3) pancreas
4) pancreatitis

79

Write out the word, the compound, main source, and what organ affected, possible cause or problem: BUN

1) Blood urea nitrogen
2) metabolite
3) liver
4) if kidney not functioning properly, kidney disease (prerenal, renal, postrenal)

80

Write out the word, the compound, main source, and what organ affected, possible cause or problem: CA

1) Calcium
2) electrolyte
3) bone

81

Write out the word, the compound, main source, and what organ affected, possible cause or problem: CREA

1) Creatinine
2) metabolite
3) skeletal muscle

82

Write out the word, the compound, main source, and what organ affected, possible cause or problem: GLOB

1) Globulin
2) protein
3) liver
4) liver

83

Write out the word, the compound, main source, and what organ affected, possible cause or problem: GLU

1) Glucose
2) metabolite
3) liver

84

Write out the word, the compound, main source, and what organ affected, possible cause or problem: LIPA

1) Lipase
2) enzyme
3) pancreas

85

Write out the word, the compound, main source, and what organ affected, possible cause or problem: PHOS

1) Phosphorus
2) electrolyte
3) bone

86

Write out the word, the compound, main source, and what organ affected, possible cause or problem: TBIL

1) Total Bilirubin
2) metabolite
3) RBCs/Hgb

87

Write out the word, the compound, main source, and what organ affected, possible cause or problem: TP

1) Total Protein
2) protein
3) muscle cells/liver

88

Write out the word, the compound, main source, and what organ affected, possible cause or problem: Na

1) Sodium
2) electrolyte
3) cation of extraceullar fluid

89

Write out the word, the compound, main source, and what organ affected, possible cause or problem: K

1) Potassium
2) electrolyte
3) cation of intracellular fluid

90

Write out the word, the compound, main source, and what organ affected, possible cause or problem: Cl

1) Chloride
2) electrolyte
3) extracellular anion

91

Write out the word, the compound, main source, and what organ affected, possible cause or problem: CHOL

1) Cholesterol
2) metabolite
3) liver
4) cholestasis

92

What are the four possible results of a gram stain?

1) gram positive
2) gram negative
3) variable
4) determinant

93

What is the primary stain for the Gram stain? The Acid Fast Stain?

Gram: Crystal Violet
Acid: DMSO and (Carbon Fuchsin)

94

What is the counterstain for the Gram stain? Acid Fast Stain?

Gram: Fuchsin or Safranin
Acid: Methylene blue

95

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)

96

What is the best method to obtain a urine specimen?

cystocentesis

97

When is only a sufficient amount to perform the analysis removed?

when a patient is experiencing dysuria, anuria, and oliguria

98

What kinds of specimens are obtained for quantitative and qualitative analysis?

quantitative: 24hr sample collection
qualitative: voided, expression, catheritization, cystocentesis

99

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

100

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

101

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.

102

Why would old cultures stain gram negative?

because spore formation occurs and cell wall degeneration

103

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

104

The ____ test can be performed to check the gram rxn in the event of a gram-variable rxn

KOH

105

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 -

106

Why is MacConkey agar inoculated with urine sample?

MacConkey is always used and suppresses the growth of gram-positive bacteria

107

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

108

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

109

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

110

List all the reasons that the culture results do not correlate with the patient signs.

1) possibly drugs/medication
2) diet
3) stress
4) timing of the culture
5) incorrect technique
6) incorrect staining

111

What is an agar?

a type of solidifying agent, much like gelatin

112

Gram positive bacteria will have ____ layer, and retain the primary stain. Gram negative bacteria only have ____ layer and are colored by the counterstain.

many, one

113

What is the purpose of the streak plate?

easiest method of getting isolated colonies

114

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 _____.

API strip

115

The _____ test is performed on catalase positive bacteria.

coagulase

116

UV rays may help identify dermatophyte

Wood's lamp

117

False positives for wood's lamp?

Pseudomonas sp, scales, lint, sebum, dandruff, crusts and topical medications

118

Intoxication caused by ingestion of food contaminated

Mycotoxicoses(Aspergillus, Penicillium)

119

Most common systemic mycosis of dogs

Histoplasmosis

120

Multicellular fungi(mold) that form tubular filaments

hyphae

121

Tangled mass of hyphae

mycelium

122

Mold is aerobic/anerobic?

strictly aerobic

123

_______ formed at the free end of the hyphae

Conidiospores

124

Conidiospores:
1) ________-Various shapes, Arise directly from hyphae
2) ________-Large, multicompartmented cells of various shapes, Orginate from conidiospores as singles, pairs or clusters

1) Microconidia
2) Macroconidia

125

What from the bacteria, if present, cause hemolysis & will show signs of this on blood agar?

Exotoxins

126

____ hemolysis is when there is partial destruction of RBC’s & hemoglobin & produces a greenish discoloration around the colonies on a blood agar plate.

alpha

127

____ hemolysis is when there is complete destruction resulting in a clearing around the growth on a blood agar plate.

beta

128

____ hemolysis is when there is no hemolysis & therefore no change of the medium.

gamma (y)

129

___________ is the most common pathogen associated with bacterial skin infections in the dog.

Staphylococcus intermedius

130

Staphylococcus is gram _____ and E. col is gram _______.

positive, negative

131

Blood agar supports growth of most ______. MAC supports only _____

g+ & g-, g-

132

______ is a test which uses antibiotic-impregnated wafers to test whether particular bacteria are susceptible to specific antibiotics. (resistant, intermediate, zone of inhibition)

Kirby-Bauer method

133

Describe colony characteristics

Size: pinpoint, medium, large
Color
Density: opaque or transparent
Elevation: raised, flat, convex, droplike
Form: circular, irregular
Consistency: buttery, brittle, sticky
Odor: pungent, sweet
Hemolysis: alpha, beta, gamma, delta