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MTAP 1 > AUBF (Macro, Chem, Micro) > Flashcards

AUBF (Macro, Chem, Micro) Flashcards

1
Q

Included in PHYSICAL examination of urine

A

Color
Clarity
SG - now included in rgt strip

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2
Q

pigment present in urine that gives a yellow color (Thudichum)

A

Urochrome (normal pigment)

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3
Q

pink pigment, most evident in spx that have been REFRIGERATED, resulting in precipitation of AMORPHOUS URATES

A

uroerythrin

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4
Q

result of uroerythrin + urates in ACIDIC pH

A

pink urine sediment

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5
Q

oxidation product of UROBILINOGEN (normal urinary constituent), imparts an orange-brown (amber) color to urine that is NOT FRESH (longer standing)

A

Urobilin

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6
Q

pigment that may also be an indicator of hemolysis if extremely increased

checked: urobilinogen, bilirubin

A

urobilin

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7
Q

urine with amorphous urates in ACID pH

A

forms PINK precipitate

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8
Q

urine with amorphous phosphates in ALK pH

A

white precipitate

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9
Q

urine color:
oxidation of porphobilinogen to porphyrins

A

red
portwine

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10
Q

urine color:
heme biosynthesis problem —> porphyrias (enzyme deficiencies)

A

red
portwine

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11
Q

urine color:
melanoma
alkaptonuria

A

black

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12
Q

oxidation of melanogen (colorless pigment) to melanin (black pigment) - produced in excess

A

MELANOMA

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13
Q

condition with excreted BLACK urine

A

melanoma
(not alkaptonuria - only imparts black color during standing)

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14
Q

condition excreted as normal urine color and became BLACK during standing

A

alkaptonuria

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15
Q

homogentisic acid (metabolite phenylalanine) - imparts black color to ALK urine from person with inborn metabolism

A

alkaptonuria

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16
Q

metabolic problem in BABIES
inc pH (alk)

A

alkaptonuria

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17
Q

urine color:
pseudomonas inf

A

green
(pyoverdin)

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18
Q

urine color: clorets

A

blue-green
(pyocyanin)

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19
Q

what must be done before assessing urine clarity

A

MIX WELL

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20
Q

Reporting of urine clarity

A

Clear
Hazy
Cloudy
Turbid
Milky

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21
Q

Urine clarity:
no visible particulate
transparent

A

clear

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22
Q

Urine clarity:
FEW particulates,
print easily seen

A

hazy

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23
Q

Urine clarity:
MANY particulates,
print blurred

A

cloudy

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24
Q

Urine clarity:
print cannot be seen

A

turbid

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25
Q

Urine clarity:
may precipitate or be clotted (egg white-like) may be due to inc. lipid profile

A

milky

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26
Q

non-pathologic cause of urine TURBIDITY

A

squamous EC (contaminated collection)
mucus
amorphous phosphates, urates, carbonates
RCM
talcum powder
semen, spermatozoa
fecal contam
vaginal creams

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27
Q

pathologic cause of urine TURBIDITY

A

RBC
WBC
Bacteria
Yeast
Non-squamous EC (RTE cells)
Abnormal crystals
Lymph fluid (chyluria)
Lipids

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28
Q

differentiate hematuria from hemoglobinuria

A

hematuria: intact RBC microscopically
hemoglobinuria: hemolyzed RBC microscopically

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29
Q

eval of urine conc. (solutes present in urine)

A

SG

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30
Q

random urine sample SG

A

1.015-1.030

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31
Q

determine whether spx conc. is adequate to ensure chem test accuracy

A

SG

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32
Q

SG of water

A

1.000

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33
Q

SG of RCM

A

1.040
(differential to chole crystals)

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34
Q

SG: isosthenuric

A

1.010

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35
Q

SG: hyposthenuric

A

<1.010

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36
Q

SG: hypersthenuric

A

> 1.010

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37
Q

Current urine SG measurement methods

A

Refractometry
Osmolality
Reagent strip

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38
Q

principle of Refractometry

A

refractive index (read intersection betw. blue and white portion)

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39
Q

principle of Osmolality

A

changes in colligative properties by particle no.

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40
Q

principle of reagent strip

A

pKa changes of polyelectrolyte by ions present

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41
Q

Methods for manual SG measurement

A

Refractometer
Urinometer

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42
Q

measurement that requires temperature adjustment

A

urinometer
(5/9 ; F -32)

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43
Q

measurement that requires NO temperature adjustment

A

refractometer

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44
Q

calibration of manual SG measurement

A

subtract 0.003 for every 1 g of PROTEIN
subtract 0.004 for every 1 g of GLUCOSE

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45
Q

MACROSCOPIC screening for BLOOD seen microscopically

A

color

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46
Q

MACROSCOPIC screening for hematuria vs hemoglobinuria/myoglobinuria and pathologic and nonpathologic cause of turbidity seen microscopically

A

CLARITY

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47
Q

aka myoglobinuria

A

rhabdomyolysis

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48
Q

Hemoglobinuria vs. Hematuria vs. Myoglobinuria

A

Hemoglobinura: CLEAR, red
Hematuria: TURBID, red
Myoglobinuria: coca-cola like

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49
Q

MACROSCOPIC/CHEM SCREENING TEST for RBC, RBC casts seen microscopically

A

Blood

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50
Q

MACROSCOPIC/CHEM SCREENING TEST for casts and cells seen microscopically

A

protein

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51
Q

MACROSCOPIC/CHEM SCREENING TEST for bacteria and WBCs

A

nitrite

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52
Q

MACROSCOPIC/CHEM SCREENING TEST for WBCs, WBC cast, bacteria

A

Leukocyte esterase
(has the longest reading time - 120s)

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53
Q

MACROSCOPIC/CHEM SCREENING TEST for yeast seen microscopically

A

glucose

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54
Q

glucose in urine

A

glucosuria (ex. presence of yeast)

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55
Q

INCREASED
CHANGES IN UNPRESERVED URINE

A

“p(a)BaON”

  • pH (alk)
  • bacteria
  • odor (ammoniacal)
  • nitrite
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56
Q

DECREASED
CHANGES IN UNPRESERVED URINE

A

clarity
glucose
ketones
bilirubin
urobilinogen
RBCs, WBCs, Casts
Trichomonas

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57
Q

what happen to urine COLOR during long standing (unpreserved)? reason?

A

modified/darkened

Reason: oxidation or reduction of metabolites (urobilinogen —> urobilin “amber”)

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58
Q

what will happen to CLARITY during long standing of unpreserved urine?
reason?

A

turbid (decreased)

reason: bacterial growth and precipitation of amorphous materials

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59
Q

what will happen to GLUCOSE during standing in unpreserved urine? reason?

A

decreased

reason: glycolysis, bacterial use

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60
Q

what will happen to KETONES during standing in unpreserved urine? reason?

A

decreased (highly volatile, requires freshly voided urine for accurate measurement)

reason: volatilization, bacterial metabolism

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61
Q

what will happen to BILIRUBIN during standing in unpreserved urine? reason?

A

decreased

Reason: light exposure, photo oxidation to biliverdin

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62
Q

what will happen to UROBILINOGEN during standing in unpreserved urine? reason?

A

decreased

Reason: oxidation to urobilin “amber”

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63
Q

what will happen to RBC, WBC, casts during standing in unpreserved urine? reason?

A

decreased

Reason: disintegration in dilute ALK urine

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64
Q

what will happen to TRICHOMONAS during standing in unpreserved urine? reason?

A

decreased

Reason: loss of motility, death (if disintegrated, resembles WBC)

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65
Q

loss of motility and disintegration of trichomonas resembles?

A

WBCs

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66
Q

what will happen to ODOR during standing in unpreserved urine? reason?

A

increased (ammoniacal)

Reason: bacterial multiplication (urea —> ammonia)

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67
Q

what will happen to pH during standing in unpreserved urine? reason?

A

increased (alk)

reason: breakdown of urea to ammonia by urease-producing bacteria or CO2 loss

ex: alkaptonuria

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68
Q

what will happen to NITRITE during standing in unpreserved urine? reason?

A

increased

Reason:
- multiplication of NITRATE- reducing bacteria
- bacterial contamination

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69
Q

what will happen to BACTERIA during standing in unpreserved urine? reason?

A

increased

Reason: multiplication

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70
Q

cause of AROMATIC urine odor

A

NORMAL!!

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71
Q

cause of FOUL, AMMONIA-LIKE urine odor

A

Bacterial decomposition
UTI

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72
Q

cause of FRUITY SWEET urine odor

A

Ketones (Starvation, DM, Vomiting)

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73
Q

cause of MAPLE SYRUP urine odor

A

MSUD (inborn error of metabolism)

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74
Q

cause of MOUSY urine odor

A

Phenylketonuria (PKU)

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75
Q

cause of RANCID urine odor

A

tyrosinemia

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76
Q

cause of SWEATY FEET urine odor

A

isovaleric acidemia

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77
Q

cause of CABBAGE urine odor

A

Methionine malabsorption

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78
Q

cause of BLEACH urine odor

A

Contamination

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79
Q

cause of ROTTING FISH urine odor

A

trimethylaminuria

“galunggong-like” odor

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80
Q

Benedict’s test is only appropriate for?

A

glucose and other reducing sugars (except SUCROSE - nonreducing)

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81
Q

Principle of benedict’s test

A

Copper reduction

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82
Q

Benedict’s test reaction

A

Cupric ions (Cu2+) + reducing sugar —heat + alkali –> carboxylic acid + Cuprous oxide (Cu2O)

Cupric ions - blue solution
reducing sugar - in urine
Cuprous oxide - indicator that gives brick red ppt

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83
Q

ratio of benedict’s soln to urine

A

1:1

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84
Q

Negative (-) Benedict’s test

A

No color change, remains BLUE

85
Q

Trace (+/-) Benedict’s test

A

Green opacity
No precipitate

86
Q

+1 Benedict’s test

A

Green solution
Yellow precipitate

87
Q

+2 Benedict’s test

A

Green to yellow solution
Yellow precipitate

88
Q

+3 Benedict’s test

A

Muddy orange solution
Yellow precipitate

89
Q

+4 Benedict’s test

A

Orange to brick red precipitate

90
Q

Urine chem test for PROTEIN

A

Sulfosalicylic Acid precipitation (SSA) test

91
Q

Principle of SSA

A

Precipitation of urine protein by STRONG acid

92
Q

A cold precipitation test that reacts equally with all forms of protein

A

SSA test

93
Q

Explain SSA test procedure

A
  1. 3 mL of 3% SSA reagent to 3 mL centrifuged urine (1:1)
  2. Mix by inversion and observe cloudiness/turbidity
  3. Grade the degree of turbidity
94
Q

Protein measured if SSA test shows negative turbidity

A

<6 mg/dL

95
Q

Protein measured if SSA test shows trace turbidity

A

6-30 mg/dL

96
Q

Protein measured if SSA test shows 1+ turbidity

A

30-100 mg/dL

97
Q

Protein measured if SSA test shows 2+ turbidity

A

100-200 mg/dL

98
Q

Protein measured if SSA test shows 3+ turbidity

A

200-400 mg/dL

99
Q

Protein measured if SSA test shows 4+ turbidity

A

> 400 mg/dL

100
Q

Describe turbidity in SSA test if the protein is <6 mg/dL

A

NEGATIVE
No increase in turbidity

101
Q

Describe turbidity in SSA test if the protein is 6-30 mg/dL

A

Trace (+/-)
Noticeable turbidity

102
Q

Describe turbidity in SSA test if the protein is 30-100 mg/dL

A

1+
Distinct turbidity, NO granulation

103
Q

Describe turbidity in SSA test if the protein is 100-200 mg/dL

A

2+
Turbidity, granulation, NO flocculation

104
Q

Describe turbidity in SSA test if the protein is 200-400 mg/dL

A

3+
Turbidity, granulation, flocculation

105
Q

Describe turbidity in SSA test if the protein is >400 mg/dL

A

4+
Clumps of protein

106
Q

Classic test for differentiating UROBILINOGEN and PORPHOBILINOGEN

A

Watson-Schwartz Test

107
Q

Reagents used in Watson-Schwartz test

A

Chloroform
Butanol

108
Q

location of Chloroform in Watson-Schwartz test

A

BOTTOM

109
Q

location of Butanol in Watson-Schwartz test

A

UPPER

110
Q

Chloroform: Soluble
Butanol: Soluble

A

Urobilinogen

111
Q

Chloroform: Insoluble
Butanol: Insoluble

A

Porphobilinogen

112
Q

Chloroform: Insoluble
Butanol: SOLUBLE

A

Other Ehrlich reacting compounds

113
Q

Watson-Schwartz test
Color if SOLUBLE

A

RED

114
Q

Watson-Schwartz test
Color if INSOLUBLE

A

YELLOW

115
Q

Analyte:
Heat & Acetic Acid
Nitric Acid test

A

Albumin/Protein

116
Q

End result:
Heat & Acetic Acid
Nitric Acid test

A

Turbidity

117
Q

Analyte:
Benedict’s test

A

Glucose and other reducing sugar

118
Q

End result:
Benedict’s test

A

Brick-red precipitate

119
Q

Analyte:
Heat Precipitation Test

A

Bence Jones Protein

120
Q

End result:
Heat Precipitation test

A

Turbidity

121
Q

Analyte:
Rothera

A

Ketones

122
Q

End result:
Rothera

A

Red purple

123
Q

Analyte:
Gunning

A

Ketones

124
Q

End result:
Gunning

A

Iodoform crystals (microscopic)

125
Q

Analyte:
Gerhadt

A

Ketones

126
Q

End result:
Gerhadt

A

Bordeaux red

127
Q

Analyte:
Seliwanoff

A

Levulose

128
Q

End result:
Seliwanoff

A

Orange –> red

129
Q

Analyte:
Rubner

A

Lactose

130
Q

End result:
Rubner

A

Brick-red precipitate

131
Q

Analyte:
Gmelin

A

Bile

132
Q

End result:
Gmelin

A

Play of colors (green, red, yellow)

133
Q

Analyte:
Smith

A

Bile

134
Q

End result:
Smith

A

Green RING

135
Q

Analyte:
Ehrlich

A

Urobilinogen

136
Q

End result:
Ehrlich

A

Cherry red

137
Q

Analyte:
Schlesinger

A

Urobilin

138
Q

End result:
Schlesinger

A

Fluorescent GREEN

139
Q

Analyte:
Obermayer

A

Indican

140
Q

End result:
Obermayer

A

Indigo BLUE –> Indigo RED

141
Q

Analyte:
Guaiac

A

Hemoglobin

142
Q

End result:
Guaiac

A

Blue junction

143
Q

Analyte:
Ammonium Sulfate

A

Hemoglobin

144
Q

End result:
Ammonium Sulfate

A

HGB precipitation

145
Q

Analyte:
Thormalen

A

Melanin

146
Q

End result:
Thormalen

A

Prussian Blue

147
Q

Analyte:
Sulkowitch

A

Calcium

148
Q

End result:
Sulkowitch

A

Turbidity

149
Q

Analyte:
Fantus

A

Chloride

150
Q

End-result:
Fantus

A

White precipitate

151
Q

Microalbumin testing (immunologic tests)

A

Micral test
Immunodip

152
Q

Micral test principle

A

Enzyme Immunoassay

153
Q

Sensitivity of Micral test

A

0-10 mg/dL

154
Q

Reagents used in Micral test

A

Gold-labeled Ab
B-galactosidase
Chlorophenol red galactoside

155
Q

Interference in Micral and Immunodip

A

FALSE NEGATIVE due to DILUTED URINE

156
Q

ImmunoDip principle

A

Immunochromographics

157
Q

Sensitivity of ImmunoDip

A

1.2 - 8.0 mg/dL

158
Q

Reagents used in ImmunoDip

A

Ab-coated BLUE LATEX particles

159
Q

Normal protein excreted by the body

A

<10 mg/dL
100 mg/24 hrs

160
Q

Albumin level of 20-200 mg/L in urine indicating kidney damage

A

Microalbuminuria

161
Q

Albumin level of >200 mg/L in urine

A

Albuminuria

162
Q

Urine must be delivered and tested within ___ hours

A

2 hours

163
Q

Causes precipitation of amorphous urates/phosphates, and other non-pathologic crystals in urine

MOST COMMON method of urine preservation

A

Refrigeration

164
Q

This may cause some crystals to dissolve

A

Warming at 37C

165
Q

Recommended type of urine spx

A

MIDSTREAM CLEAN CATCH URINE (morning, concentrated)

166
Q

standard amount of urine

A

10-15 mL

167
Q

frequently used urine vol in laboratory

A

12 mL

168
Q

urine container capacity

A

50 mL

169
Q

T/F
Report if urine vol is not adequate (<10 mL) but always check the medical diagnosis

A

TRUE

170
Q

Daily urine output

A

1200-1500 mL (600-2000 mL)/day

171
Q

decreased urine output
what are the volumes?

A

OLIGURIA

Infants: <1 mL/kg/hr
Children: <0.5 mL/kg/hr
Adult: <400 mL/day

172
Q

cessation or failure of kidneys to produce urine

A

ANURIA

173
Q

T/F

Kidneys excrete 2-3x more in day than night

A

T

174
Q

Increased urine output at NIGHT

A

NOCTURIA

175
Q

Increased urine output daily
What are the volumes?

A

POLYURIA

Children: 2.5-3.0 mL/kg/day
Adult: >2.5 L/day

176
Q

Urine centrifugation

A

5 mins
400 RCF or 1,500 RPM

177
Q

Volume of urine after removal of supernatant following centrifugation

A

0.5 - 1 mL
(uniform amt of urine and sediment)

178
Q

Volume of sediment examined

A

20 uL (0.02 mL)

179
Q

Purpose of examining urine sediment in LPO

A

view CASTS
ascertain the general composition of sediments

180
Q

Purpose of examining urine sediments in HPO

A

Identification of urinary sediments

181
Q

This method may affect casts reading wherein they have the tendency to locate near the edges of the cover slip. What is recommended to eliminate this?

A

Conventional Glass Slide method
Remedy: scanning of coverslip parameter

182
Q

Point of reference in examining urine sediment

A

Epithelial cells (largest)

183
Q

Reported as ave. no. per LPF

A

casts

184
Q

Reported as ave. no. per 10 HPF

A

RBC
WBC

185
Q

Reported as semiquantitative (rare, few, moderate, many / 1+, 2+, 3+, 4+)

A

EC
Crystals
Other sediments

186
Q

Most frequently used stain in UA

A

Sternheimer-malbin stain

187
Q

Components of Sternheimer-malbin stain

A

Crystal violet
Safranin O

188
Q

Commercially available Sternheimer-malbin stain

A

Sedi stain
KOVA stain

189
Q

Delineates structures and contrasting colors of the nucleus and cytoplasm

A

Sternheimer-malbin stain

190
Q

used to confirm the presence of TAG, neutral fats, and chole

ID free fat droplets and lipid-containing cells and casts

A

Lipid stains (Oil red O, Sudan III) + Polarizing microscope

191
Q

color of TAG and neutral fats using Lipids stains

A

orange-red

192
Q

T/F
Oil red O and Sudan III cannot help visualize CHOLE alone. It requires polarizing microscope.

A

T

193
Q

Used for ID of bacterial casts, which can be confused from granular casts

A

Gram stain

194
Q

Components of Gram stain

A

Crystal violet (primary stain)
Iodine (mordant)
Alcohol (decolorizer)
Safranin (secondary stain)

195
Q

Gram (+) bacteria color:
Gram (-) bacteria color:

A

Gram (+) bacteria color: purple/violet
Gram (-) bacteria color: pink/red

196
Q

preferred stain for urinary EOSINOPHILS in cases of DRUG-INDUCED ALLERGIC RXN producing inflammation of the renal interstitium

A

Hansel stain

197
Q

Components of Hansel stain

A

Methylene Blue
Eosin Y

198
Q

Stain for Iron (hemosiderin granules: blue)
Stains positive during hemolysis and bleeding

A

Prussian blue stain

199
Q

identifies YELLOW-BROWN granules of hemosiderin in cells and casts

A

Prussian blue stain

200
Q

T/F
The type of microscopy used depends on the specimen type, refractive index, and ability to image unstained living cells

A

T

201
Q

objects appear dark against a light BG
MOST FREQUENTLY USED in clin lab

A

Bright-field microscopy

202
Q

type of microscopy that aids in Treponema pallidum ID

A

Dark-field microscopy

203
Q

enhances visualization of elements with LOW refractive indices, such as:

HYALINE CASTS
MIXED CELLULAR CASTS
MUCUS THREADS
TRICHOMONAS

A

Phase-contrast microscopy

204
Q

Aids in ID of cholesterol in oval fat bodies, fatty casts, and crystals

A

Polarizing microscopy

205
Q

Allows visualization of naturally fluorescent microorg or those stained by a fluorescent dye including labeled Ag and Ab

A

Fluorescence microscopy

206
Q

Produces a 3D microscopy image and layer by layer imaging

A

Interference contrast

207
Q

Frequently performed independently of routine UA for detection of malignancies of the LOWER urinary tract

A

CYTODIAGNOSTIC URINE TESTING

208
Q

Stain used in cytodiagnostic urine testing

A

papanicolaou stain (provides additional method for detecting and monitoring RENAL DISEASE)

MTAP 1 (13 decks)

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