397-502 Flashcards
- Liquefaction within 30 to 60 minutes
- Volume 2 to 5 mL
- pH 7.2 to 8
- Sperm morphology: at least 200 sperms should be evaluated
- Sperm viability test: Modified Bloom’s (eosin-nigrosin)
- Motility is evaluate in approximately 20 high-power fields
- Sperm concentration: newer edition Strasinger >20 M to 250 M per mL (old edition: 20 M to 160 M per mL)
- Sperm count ≥ 40 M per ejaculate*
- Most common dilution is 1:20 prepared using a MECHANICAL (positive-displacement) rather than a Thoma pipette
- Minimum motility of 50% with a rating of 2.0 after 1 hour is considered normal
- Fructose ≥ 13 umol per ejaculate
- Specimens for fructose should be tested within 2 hours or FROZEN to prevent fructolysis
- RAPE, presence of sperm:
Enhancing specimen with XYLENE and examining under PHASE MICROSCOPY
ACP
Seminal glycoprotein p30 (prostatic specific antigen [PSA]), which is present even in the absence of sperm
ABO, DNA
- Motile sperm can be detected for up to 24 hours after intercourse, whereas nonmotile sperm can persist for 3 days. As the sperm die off, only the heads remain and may be present for 7 days after intercourse.
SYNOVIAL FLUID
- Volume less than 3.5 mL
- Normal: clear and pale yellow
- Able to form 4 to 6 cm string
- Less than 2,000 RBCs/uL
- Less than 200 WBCs/uL
- Glucose less than 10 mg/dL lower than the blood glucose
SEROUS FLUID: TRANSUDATES AND EXUDATES
- Most reliable differentiation: Fluid-to-blood ratios for protein and LD
- WBC counts greater than 1,000/uL and RBC counts greater than 100,000/uL are indicative of an exudate
PLEURAL FLUID
- Pleural fluid cholesterol greater than 60 mg/dL or a pleural fluid to serum cholesterol ratio greater than 0.3 provides a reliable information that the fluid is an exudate
- Fluid to serum total bilirubin ratio of 0.6 or more also indicates the presence of an exudate
- Pleural fluid pH lower than 7.3 may indicate the need for chest-tube drainage, in addition to antibiotics in cases of pneumonia. The finding of pH as low as 6 indicates esophageal rupture that is allowing the influx of gastric fluid
PERITONEAL FLUID
422. RBC counts GREATER THAN 100,000/uL are indicative of BLUNT TRAUMA INJURIES
- Normal WBC counts are less than 500 cells/uL and the count increases with bacterial peritonitis and cirrhosis
- CA 125 antigen, source is from OVARIES, FALLOPIAN TUBES or ENDOMETRIUM
FECAL ANALYSIS
425. Large intestine is capable of absorbing approximately 3,000 mL of water
426. Most representative, for fecal fats; 3-day stool collection
- Muscle fibers: slide is examined for 5 minutes. Only undigested fibers are counted, and the presence of more than 10 is reported as increased
- Bleeding in excess of 2.5 mL/150 gram of stool is considered pathologically significant
- Normal stool pH is between 7 and 8
- pH below 5.5 in cases of CARBOHYDRATE DISORDERS
COMPLETE BLOOD COUNT
431. SCREENING PROCEDURE that is helpful in the diagnosis of many diseases, it is one indicator of the body’s ability to fight disease, it is used to MONITOR the effects of drug and radiation therapy, and it may be employed as an INDICATOR OF PATIENT’S PROGRESS in certain diseased states such as infection or anemia.
HEMATOCRIT
432. TRAPPED PLASMA: amount of plasma that still remains in RBC portion after the microhematocrit
has been spun. Increased in macrocytic anemias, spherocytosis, thalassemia, hypochromic anemia and sickle cell anemia
- When comparing spun hematocrit results obtained on an electronic cell counter, the spun hematocrit results vary from 1 to 3% HIGHER because of this trapped plasma (unless cell counter has been calibrated).
- Anticoagulated blood should be centrifuged within 6 hours of collection when the blood is stored at room temperature.
- Overanticoagulation: FALSELY LOW due to shrinkage of cells
- Air bubbles denote poor technique but do not affect the results
- Incomplete sealing of the microhematocrit tubes: FALSELY LOW
- Inadequate centrifugation of the microhematocrit tubes or allowing the tubes to stand longer than several minutes after centrifugation: FALSELY ELEVATED
- Hematocrit may be expressed in either of two ways (1) as percentage, e.g., 42% or (2) as a decimal point, e.g., 0.42.
WHITE BLOOD CELLS COUNT
440. Count above 11 x 10 9th/L is termed LEUKOCYTOSIS
- Mix the Thoma pipet for approximately 3 minutes (Brown) to ensure hemolysis and adequate mixing [Rodak 10 minutes] PLEASE FOLLOW RODAK, 10 MINUTES.
- Manual counts, no more than 10-cell variation between the four squares
PLATELET COUNT
443. Prolonged BT and poor clot retraction are found when there is marked thrombocytopenia
444. EDTA: decreased platelet clumping but increased MPV
- If concentration of EDTA exceeds 2mg/mL of whole blood, platelets may SWELL AND THEN FRAGMENT, causing invalidly higher count
- Using Rees-Ecker diluting fluid, the platelet count must be completed within 30 minutes of diluting in order to ensure against platelet DISINTEGRATION
- 1% ammonium oxalate, the dilution is stable for 8 hours
ERTHROCYTE SEDIMENTATION RATE
448. Macrocytes tend to settle more rapidly than microcytes
449. Anisocytosis and poikilocytosis: falsely lower ESR
- Agglutination: more rapid sedimentation rate
- In severe anemia: ESR IS MARKEDLY INCREASED
The ESR of patients with severe anemia is of little diagnostic value, because it will be falsely elevated.
SUGAR WATER TEST
452. Citrated whole blood
453. In anemia, the hemolysis may be slightly increased in PNH negative specimens
- Use of defibrinated blood may cause positive results due to the hemolysis of traumatized RBCs
- Test should be performed WITHIN 2 HOURS of obtaining the specimen
SUCROSE HEMOLYSIS TEST
456. Citrated whole blood
457. Increased hemolysis (<10%) may be found in leukemia or myelosclerosis
458. PNH: 10% to 80% hemolysis
ACID SERUM TEST
459. Whole blood defibrinated
460. When patient has received blood transfusions, less lysis occurs because of the presence of normal transfused red blood cells
461. Thyroxine conversion factor (µg/dL to nmol/L) 12.9
