3 MIDTERMS - CLINICAL MICRO Flashcards

1
Q
  • For overall evaluation of renal function
  • Permits a detailed, in-depth assessment of
    renal status with an easily obtained specimen.
  • Serves as a quick indicator of an individual’s
    glucose status and hepatic or biliary function.
A

URINALYSIS

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2
Q
  • A test used to check how well the kidneys are
    working. Specifically, it estimates how much
    blood passes through the glomeruli each
    minute.
A

GLOMERULAR FILTRATION RATE (GFR)

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3
Q

Tests Performed in Routine Urinalysis:

A
  • Specimen collection
  • Physical examination
  • Chemical examination
  • Microscopic examination
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4
Q

TYPE OF SPECIMEN
– Most preferred sample
particularly for protein analysis; more
concentrated from overnight retention in the
bladder.

A
  • Early morning urine
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5
Q

TYPE OF SPECIMEN

Collected any time of the day;
for routine analysis.

A
  • Random urine
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6
Q

TYPE OF SPECIMEN

– For glucose
determination.

A
  • Fasting/Post-prandial urine
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7
Q

TYPE OF SPECIMEN

– For clearance test.

A
  • Timed urine
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8
Q

– Relates to eating of food

A

Prandial

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9
Q

measures the glucose
level after having a meal or eating. 2 hours after eating,
urine sample for testing postprandial glucose level is
taken. At least 75 grams of carbohydrates.

A

Postprandial urine glucose test

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10
Q

– From 24 hr urine

A

Creatinine clearance test

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11
Q

measures the glucose
level after having a meal or eating. 2 hours after eating,
urine sample for testing postprandial glucose level is
taken. At least 75 grams of carbohydrates.

A
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12
Q

METHOD OF COLLECTION OF URINE

A
  • Clean midstream catch
  • Catheterization

Keeping your labia spread open, urinate a small
amount into the toilet bowl, then stop the flow of
urine. Hold the urine cup a few inches (or a few
centimeters) from the urethra and urinate until the cup
is about half full.

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13
Q

SPECIMEN HANDLING
* Must be analyzed within ___ of collection
(room temperature).
* If delayed: Ref at ___°C for not more than 8
hour

A

1 hour
2-8

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14
Q

EFFECTS OF UNPRESERVED URINE
* Bacterial multiplication will cause ____

A

false positive
(+) nitrite test.

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15
Q
  • pH alkalinization: leads to cast degeneration
    and red cell lysis
A
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16
Q

: leads to cast degeneration
and red cell lysis

A
  • pH alkalinization
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17
Q

PHYSICAL EXAMINATION

  • A rough indication of the state of hydration of
    an individual.
  • The ___ of the urine, the more
    concentrated it will be. This signals that one
    has to drink plenty of water because he/she
    may already be dehydrated.
A
  1. COLOR

darker the color

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18
Q

PHYSICAL EXAMINATION

  • Has little diagnostic significance and is not
    included in the routine laboratory result.
  • Urine is ___
  • Suggestive of the freshness of the urine sample
A

ODOR

aromatic

19
Q

PHYSICAL EXAMINATION

  • Also known as clarity or transparency
  • Refers to the degree of cloudiness in a urine
  • Depends on the pH and the presence of
    dissolved solids
20
Q

PHYSICAL EXAMINATION

  • Indicates balance between fluid ingestion and
    water lost from lungs, sweat and intestines
21
Q

Optimal volume for accurate ru

A

10-12 mL aliquot

22
Q

Absence of urine output

23
Q

Scanty urine excretion

24
Q

Excessive urine excretion

25
Normal adult volume
750-2000 mL/24 hr
25
Normal adult volume
750-2000 mL/24 hr
26
SPECIFIC GRAVITY * Normal values:
1.005 – 1.030
26
* Indication of the density of a fluid depending on the concentration of dissolved total solids. * Marker of the amount of hydration/dehydration of an individual. * The darker the urine, the ___ * Urinometer and refractometer
SPECIFIC GRAVITY higher its specific gravity.
27
___ SG = Diabetes mellitus, congestive heart failure, dehydration, adrenal insufficiency, liver disease, and nephrosis ___ SG = Diabetes insipidus, pyelonephritis, and glomerulonephritis
High Low
28
* Refers to the logarithm of the hydrogen ion concentration. * A quantity representing the power to which a fixed number (the base) must be raised to produce a given number.
pH
29
* Chemical test: Ø Acidity – Ph
less than 7
29
Ø Alkalinity– Ph
greater than 7
29
* Contains test pads impregnated with reagents that specifically react with a test analyte and register a specified color change. * Change in color in the pad is then compared to a comparator chart to determine the result.
REAGENT STRIP METHOD
30
* Average of at least 10 microscopic fields
CELLULAR ELEMENTS
31
* Average count per high power field * Glomerulonephritis, severe exercise, menstrual blood contamination, and renal calculi obstruction
RBC: “HEMATURIA”
32
* Average count per high power field * Pyelonephritis, UTI, and inflammation
WBC : “PYURIA”
33
* Cells sloughed off the lining of the nephrons and urinary tract.
EPITHELIAL CELLS
34
* Formed by the precipitation of urine salts subjected to changes in pH, temperature or concentration * May collect and aggregate together to form renal stone or “calculus” Ø Crystine Ø Calcium oxalate Ø Uric acid Ø Triple-Phosphate (Struvite)
CRYSTALS: “CRYSTALLURIA”
35
* Formed within distal convoluted tubule and collecting duct. * Hyaline, granular, and cellular
CASTS
36
MISCELLANEOUS ELEMENTS Often encountered in urine of both male and female but are usually not reported (sexual intercourse or nocturnal emissions).
Spermatozoa
37
Protein material produced by glands and epithelial cells in the genitourinary tract. Thread-like structures with low refractive index requiring observation under subdued light
Mucus threads
38
Gram (-) coliforms Escherichia coli and Proteus sp.
Bacteria
39
Enterobius vermicularis, Trichomonas vaginalis, Schistosoma haematobium
Parasites
40
Budding RBC-like cells (diabetes mellitus and vaginal moniliasis).
Yeast cells (Candida albicans)