AUBF PART 2 Flashcards
CSF production in adults
20mL of fluid per hour
CSF is produced in?
Choroid plexus of the two lumbar ventricles and the third and fourth ventricles
CSF flows through the?
Subarachnoid space
Subarachnoid is located between
Arachnoid and pia mater
CSF volume in adults
90 to 150 mL
CSF volume in neonates
10-60 mL
The circulating fluid is reabsorbed back into the blood capillaries in
the?
Arachnoid granulations
Acts as a one way valve to prevent reflux of the csf
Cells of the arachnoid granulation
It is the capillary networks that form the
CSF from plasma by mechanisms of selective filtration under
hydrostatic pressure and active transport secretion
Choroid plexuses
Is CSF an ultrafiltrate of the plasma? Y/N?
No because of the mechanisms of selective filtration under hydrostatic pressure and active transport secretions
A very tight-fitting junctures that prevent the passage of many molecules.
Blood-brain barrier
CSF tubes
Tube 1 - ____
Tube 2 - ____
Tube 3 - ____
Tube 1 - Clinical Chemistry and Serology
Tube 2 - Microbiology
Tube 3 - Hematology
Fourth tube may be drawn for the microbiology laboratory to better exclude skin contamination or for additional serologic test
If only one tube is collected - Microbiology first
CSF tubes temperature
Hematology - ____
Chemistry and Serology - ____
Microbiology - ____
Hematology - Refrigerated
Microbiology - Room temp
Chem and sero - Frozen
Term used to describe CSF supernatant that is pink, orange, or yellow
Xanthochromia
Three visual examinations of the collected specimen to determine if it is a TRAUMATIC TAP
- Uneven blood distribution (More rbc and bloody in Tube 1)
- Clot formation (Because of the introduction of plasma fibrinogen into the specimen)
- Xanthochromic Supernatant (RBC hemolyze in approx. 2hrs. to become noticeable in the CSF)
Normal WBC csf
0-5 WBC/uL
Higher in children with as many as 30 mononuclear cells/uL
Neubauer calculation formula
Number of cells counted × dilution/ Number of cells counted × volume of 1 square = Cells/uL
Where cells are counted in Neubauer
Four corner squares
Used to lyse RBC
3% glacial acetic acid
Used to stain the WBC
Methylene blue
Cells found in normal CSF are composed of
Lymphocytes and Monocytes
70:30 - Lymphocytes: Monocytes (Adult)
70:30 - Monocytes: Lymphocytes (Children)
Presence of increased number of WBC in CSF is called?
Pleocytosis
High neutrophils in WBC count of CSF
Bacterial Meningitis
High lymphocytes and monocytes in WBC count of CSF
Viral, tubercular, fungal, or parasitic meningitis
Major Clinical Significance:
Normal
Viral, tubercular, and fungal meningitis
Multiple sclerosis
Microscopic Findings:
All stages of development may be found
Lymphocytes
Major Clinical Significance:
Bacterial Meningitis
Early case of viral, tubercular, and fungal meningitis
Cerebral hemorrhage
Microscopic Findings:
Granules may be less prominent than in blood
Cells disintegrate rapidly
Neutrophil
Major Clinical Significance:
Normal
Viral, tubercular, and fungal meningitis
Multiple sclerosis
Microscopic Findings:
Found mixed with lymphocytes
Monocytes
Major Clinical Significance:
RBCs in spinal fluid
Microscopic Findings:
May contain phagocytized RBCs appearing as empty
vacuoles or ghost cells, hemosiderin granules, and hematoidin crystals
Macrophages
Major Clinical Significance:
Acute leukemia
Microscopic Findings:
Lymphoblasts, myeloblasts, or monoblasts
Blast forms
Major Clinical Significance:
Disseminated lymphomas
Microscopic Findings:
Resemble lymphocytes with cleft nuclei
Lymphoma cells
Major Clinical Significance:
Multiple sclerosis
Lymphocyte reactions
Microscopic Findings:
Traditional and Classic forms seen
Reactive lymps
Plasma Cells
Major Clinical Significance:
Diagnostic procedures
Microscopic Findings:
Seen in clusters with distinct nuclei and distinct cell
walls
Ependymal, choroidal,
and spindle-shaped
cells
Major Clinical Significance:
Metastatic carcinomas
Primary central nervous system carcinoma
Microscopic Findings:
Seen in clusters with fusing of cell borders and nuclei
Malignant cells
Neutrophils associated with bacterial meningitis may contain?
Phagocytized bacteria
Neutrophils with ____ indicates degenerating cells
Pyknotic nuclei
Neutrophils can resemble NRBCs but Neutrophils have multiple nuclei. NRBCs are seen as a result of a?
Bone marrow contamination during spinal tap
Increased lymphocytes can be seen in cases of both asymptomatic ______?
HIV infection and AIDS
Moderately elevated WBC count (<50 WBC/uL) with increased normal and reactive lymphocytes and plasma cells may indicate what?
Multiple sclerosis or other degenerative neurologic disorders
Seen in the CSF in association with parasitic infections, fungal infections (Coccidioides immitis), and foreign material including medications and shunts
Eosinophil
The purpose of this in the CSF is to remove cellular debris and foreign objects such as RBCs
Macrophages
Macrophages appear within how many hours after RBCs enter the csf?
2-4 hours
Indicates a previous hemorrhage
Macrophages in CSF
Degradation of the phagocytized RBCs results in the appearance of
dark blue or black iron containing hemosiderin granules
Yellow hematoidin crystals represents what?
Further degradation of RBC
Nonpathologically significant cells are most frequently seen
after diagnostic procedures such as
Pneumoencephalography and in fluid obtained from ventricular taps or during neurosurgery
From the epithelial lining of the choroid plexus
Choroidal cells
From the lining of the ventricles and neural canal
Ependymal cells
From the lining cells of the arachnoid
Spindle-shaped cells
Frequently seen as a serious complication
of acute leukemias.
Lymphoblasts, myeloblasts, and monoblasts
Indicates dissemination from the lymphoid tissue
Lymphoma cells
Cells from CNS tumors includes
Astrocytomas, retinoblastomas, and medulloblastomas
Normal CSF protein
15 to 45 mg/dL
higher values are found in infants and people over age 40
Most of CSF protein
Albumin (Same as serum)
Prealbumin
The second most prevalent fraction in CSF
Major beta globulin present
Transferrin
Carbohydrate-deficient transferrin fraction that can only be SEEN in CSF
TAU
Primary CSF gamma globulin
IgG
Only small amount of IgA
___, _____, and _________are not found in the CSF
IgM, fibrinogen, and beta lipoprotein
Most common cause of elevated CSF protein
Meningitis and hemorrhage conditions that damage the Blood-brain barrier
Principles of measuring total CSF protein
Turbidity (Nephelometry) production or dye-binding ability
- Myxedema
- Cushing disease
- Connective tissue
disease - Polyneuritis
- Diabetes
- Uremia
- Meningitis
- Hemorrhage
- Primary CNS tumors
- Multiple sclerosis
- Guillain-Barré syndrome
- Neurosyphilis
- Polyneuritis
Elevated CSF protein
- CSF leakage/trauma
- Recent puncture
- Rapid CSF production
- Water intoxication
Decreased CSF protein
CSF/serum albumin index formula
From the name itself
CSF albumin (mg/dL) / Serum albumin (g/dL)
What index value level represent an intact blood-brain barrer
Index value less than 9
IgG index
(CSF IgG/Serum IgG)/
(CSF albumin/Serum Albumin)
Normal IgG index values
0.70
Represents inflammation within the CNS (electrophoresis)
Oligoclonal bands
What presence that are not present in serum can be a valuable tool in diagnosing multiple sclerosis
Two or more oligoclonal band
Indicates recent destruction of the myelin sheath
Myelin basic protein
Approximate value of CSF glucose to Plasma glucose
60-70%
Glutamine is produced from?
Ammonia and alpha-ketoglutarate
This removes the toxic metabolic waste product ammonia from the CNS
Glutamine
Normal glutamine concentration in the CSF
8 to 18 mg/dL
The concentration of ammonia in the CSF increase, the supply of _____ depletes
Alpha-ketoglutarate
Disturbance in consciousness is seen when glutamine levels are?
more than 35mg/dL
Lactate reference range
10 - 24 mg/dL
Lactate with >35mg/dL
Bacterial meningitis
Decreased CSF glucose is due to
Bacterial, tubercular, and fungal meningitis
Decreased CSF protein is due to
CSF leakage
Increased CSF protein is due to
Meningitis, hemorrhage, MS
Elevated WBC count
Neutrophils present
Marked protein elevation
Markedly decreased
glucose level
Lactate level >35 mg/dL
Positive Gram stain and
bacterial antigen tests
Bacterial Meningitis
Elevated WBC count
Lymphocytes present
Moderate protein
elevation
Normal glucose level
Normal lactate level
Viral Meningitis
Elevated WBC count
Lymphocytes and monocytes
present
Moderate to marked protein
elevation
Decreased glucose level
Lactate level >25 mg/dL
Pellicle formation
Tubercular Meningitis
Elevated WBC count
Lymphocytes and monocytes
present
Moderate to marked protein
elevation
Normal to decreased glucose level
Lactate level >25 mg/dL
Positive India ink with Cryptococcus
neoformans
Positive immunologic test for
C. neoformans
Fungal Meningitis
Organisms most frequently encountered in the CSF
S. pneumoniae, H. influenza, E. coli, N. meningitidis
Organisms that can be encountered in the CSF of the newborn
L. monocytogenes, S. agalactiae
Most sensitive test for syphilis
FTA-ABS
Recommended by the CDC/ Routine
VDRL
Seminiferous tubules of testes
Spermatogenesis (Sperm Production)
Epididymis
Sperm Maturation
Ductus Deferens (vas deferens)
Propel sperm to ejaculation ducts
Seminal Vesicles
Provide nutrients for sperm and fluid
Prostate glands
Provide enzymes and proteins for coagulation and liquefaction
Bulbourethral glands
Add alkaline mucus to neutralize prostatic acid and vaginal acidity
Spermatozoa (Concentration)
5%
Seminal Fluid (Concentration)
60-70%
Prostate Fluid (Concentration)
20%-30%
Bulbourethral glands (Concentration)
5%
Responsible for the gray color of semen
Flavin
When a part of the first portion of the ejaculate is
missing,
The sperm count will be decreased, the pH falsely
increased, and the specimen will not liquefy
When part of the last portion of ejaculate is missing
the semen volume is decreased, the sperm count is falsely increased, the pH is falsely decreased, and the specimen will not clot
Volume (semen)
2-5 mL
Viscosity (semen)
Pours in droplets
pH (semen)
7.2 - 8.0
Sperm concentration (semen)
> 20 million/mL
Sperm count (semen)
> 40 million/ Ejaculate
Motility (semen)
> 50% within 1h
Quality (semen)
> 2.0 or a, b, c
Morphology (semen)
> 14% normal forms (strict criteria)
30% normal forms (routine criteria)
Round cells (semen)
<1 million/ mL
Fresh semen should liquefy in
30 to 60 minutes
Grading of 4.0
WHO criteria a
Rapid, straight-line motility
Grading of 3.0
WHO criteria b
Slower speed, some lateral movement
Grading of 2.0
WHO criteria b
Slow forward progression, noticeable lateral movement
Grading of 1.0
WHO criteria c
No forward progression
Grading of 0
WHO criteria d
No movement
Normal quantity of fructose
> 13 umol/ejaculate
Screening procedure used primarily to detect the presence of IgG antibodies in the sperm
Mixed agglutination reaction test (MAR)
A more specific procedure that can be used to detect the presence of IgG, IgM, and IgA antibodies and demonstrates what area of the sperm the autoantibodies are affecting
Immunobead
Specialized cells in synovial membrane
Synoviocytes
Normal value of Synovial fluid
<3.5 mL
Color of Synovial fluid
Colorless to pale yellow
Clarity of Synovial fluid
Clear
Viscosity of Synovial fluid
Able to form a string 4 to 6 cm long
Leukocyte count in Synovial Fluid
<200 cells/uL
Neutrophil in Synovial Fluid
<25% of the diff count
Crystals in Synovial Fluid
None
Glucose:plasma difference in Synovial Fluid
<10 mg/dL lower than the blood glucose level
Total protein in Synovial Fluid
<3 g/dL
Collection of Synovial fluid by needle aspiration is called?
Arthrocentesis
Degenerative joint disorders,
osteoarthritis (Synovial Fluid)
Noninflammatory
(Synovial Fluid)
Immunologic disorders, rheum -
atoid arthritis, systemic lupus
erythematosus, scleroderma,
polymyositis, ankylosing
spondylitis, rheumatic fever,
Lyme arthritis
Crystal-induced gout,
pseudo gout
Inflammatory
Microbial Infection in Synovial Fluid
Septic
Traumatic injury, tumors, hemophilia, other coag disorders, and anticoagulant overdose in Synovial fluid
Hemorrhagic
Laboratory Findings in Synovial Fluid:
Clear, yellow fluid
Good viscosity
WBCs <1000 L
Neutrophils <30%
Similar to blood glucose
Noninflammatory
Laboratory Findings in Synovial Fluid:
Cloudy, yellow fluid
Poor viscosity
WBCs 2,000 to 75,000 L
Neutrophils >50%
Decreased glucose level
Possible autoantibodies present
Inflammatory w/ immunologic origin
Laboratory findings in Synovial Fluid:
Cloudy or milky fluid
Low viscosity
WBCs up to 100,000 L
Neutrophils <70%
Decreased glucose level
Crystals present
Inflammatory w/ Crystal-induced origin
Laboratory Findings in Synovial Fluid:
Cloudy, yellow-green fluid
Variable viscosity
WBCs 50,000 to 100,000 L
Neutrophils >75%
Decreased glucose level
Positive culture and Gram stain
Septic
Laboratory Findings in Synovial Fluid:
Cloudy, red fluid
Low viscosity
WBCs equal to blood
Neutrophils equal to blood
Normal glucose level
Hemorrhagic
Normal viscous synovial fluid resembles what?
Egg white
Synovial fluid when added to a solution of 2-5% acetic acid, normal synovial fluid will?
Clot
Synovial Fluid clot grading
Good -
Fair -
Low -
Poor -
Good - Solid clot
Fair - Soft clot
Low - Friable clot
Poor - No clot
Negative birefringence in synovial fluid crystals
Monosodium urate and Cholesterol
Positive birefringence in synovial fluid crystals
Calcium pyrophosphate, Calcium oxalate
Positive and Negative birefringence in synovial fluid crystals
Corticosteroid
No birefringence in Synovial fluid crystals
Apatite
Common organism in synovial fluid
Staph, Strep, Haemophilus, and N. gonorrhea
Membrane that lines the cavity wall
parietal membrane
Membrane that covers the organs within the cavity
Visceral membrane
Fluid between membranes that provides lubrication between the parietal and visceral membranes is?
Serous Fluid
Aspiration of fluid in the lungs (pleural)
Thoracentesis
Aspiration of fluid in the heart (pericardial)
Pericardiocentesis
Aspiration of the fluid in the peritoneal (tiyan)
Paracentesis
Congestive heart failure
Salt and fluid retention
Increased capillary hydrostatic pressure
Nephrotic syndrome
Hepatic cirrhosis
Malnutrition
Protein-losing enteropathy
Decreased oncotic pressure
Microbial infections
Membrane inflammations
Malignancy
Increased capillary permeability
Malignant tumors, lymphomas
Infection and inflammation
Thoracic duct injury
Lymphatic obstruction
Disrupts the balance in the regulation of fluid filtration and reabsorption such as the changes in hydrostatic pressure created by congestive heart failure or the hypoproteinemia associated
with the nephrotic syndrome
Transudates
Produced by conditions that directly involve the membranes
of the particular cavity, including infections and malignancies.
Exudates
Appearance: Clear
Fluid:Serum protein ratio: <0.5
Fluid:serum LD ratio: <0.6
WBC count: <1000/uL
Spontaneous clotting: NO
Pleural fluid cholesterol: 45 to 60 mg/dL
Pleural fluid serum cholesterol ratio: <0.3
Pleural fluid bilirubin ratio: <0.6
Serum-ascites albumin gradient: >1.1
Transudate
Appearance: Cloudy
Fluid:Serum protein ratio: >0.5
Fluid:serum LD ratio: >0.6
WBC count: >1000/uL
Spontaneous clotting: Possible
Pleural fluid cholesterol: >45 to 60 mg/dL
Pleural fluid serum cholesterol ratio: >0.3
Pleural fluid bilirubin ratio: >0.6
Serum-ascites albumin gradient: <1.1
Exudate
Pleural fluid cholesterol of ____ or a pleural fluid:serum cholesterol ration of _____ provides reliable information that the fluid is an exudate
Pleural fluid cholesterol of >60mg/dL
Pleural fluid:serum cholesterol ratio of >0.3
Normal and transudate pleural fluids appears as
Clear/Pale yellow
Presence of blood in the pleural fluid can signify a
Hemothorax
Pleural fluid appearance: Turbid, white
Microbial infection (Tuberculosis)
Pleural fluid appearance: Bloody
Hemothorax, Hemorrhagic effusion, Pulmonary embolus, Tuberculosis, Malignancy
Pleural fluid appearance: Milky
Chylous material from thoracic duct leakage
Pseudochylous material from chronic inflammation
Pleural fluid appearance: Brown
Rupture of amoebic liver abscess
Pleural fluid appearance: Black
Aspergillus
Pleural fluid appearance: Viscous
Malignant mesothelioma (Increased hyaluronic acid
Pleural fluid hematocrit is more than 50% of the whole blood hematocrit
Hemothorax
Chylous materials contains high concentration of?
Triglycerides
Pseudochylous material has a high concentration of?
Cholesterol
What staining is strongly positive with chylous material?
Sudan III
This effusion of the pleural fluid contains cholesterol crystals
Pseudochylous
Pericardial Fluid Reference range
10 - 50 mL
Pericardial Fluid Appearance:
Clear, pale yellow
Normal, transudase
Pericardial Fluid Appearance:
Blood-streaked
Infection, malignancy
Pericardial Fluid Appearance:
Grossly bloody
Cardiac puncture, anticoagulant medications
Pericardial Fluid Appearance:
Milky
Chylous and pseudochylous
Pericardial Fluid Additional test:
Increased neutrophils
Bacterial endocarditis
Pericardial Fluid Additional test:
Malignant cells
Metastatic carcinoma
Pericardial Fluid Additional test:
Carcinoembryonic antigen
Metastatic carcinoma
Pericardial Fluid Additional test:
Gram staind and culture
Bacterial Endocarditis
Pericardial Fluid Additional test:
Acid-fast stain
Tubercular effusion
Pericardial Fluid Additional test:
Acid-fast stain
Tubercular effusion
Pericardial Fluid Additional test:
Adenosine deaminase
Tubercular effusion
Most common organisms found in pericardial effusions
Strep, Staph, adenovirus, coxsackie virus
Accumulation of fluid between the peritoneal membranes is called?
Ascites
Ascitic fluid is also known as
Peritoneal fluid
A sensitive test to detect intra-abdominal bleeding in blunt trauma cases
Peritoneal lavage
It is recommended
over the fluid:serum total protein and LD ratios to detect transudates of hepatic origin
Serum-ascites albumin gradient (SAAG)
A difference (gradient) of 1,1 or greater suggests a _____ of hepatic origin in peritoneal fluid
Transudate effusion
What if the appearance of the peritoneal fluid is the diagnosis is normal?
Clear, pale yellow
What is the appearance of the peritoneal fluid is the diagnosis is Microbial infection
Turbid
What is the appearance of the peritoneal fluid is the diagnosis is Bile, gallbladder, pancreatic disorder
Green
What is the appearance of the peritoneal fluid is the diagnosis is Trauma, infection, or malignancy
Blood-streaked
What is the appearance of the peritoneal fluid is the diagnosis is Lymphatic trauma and blockage
Milky
Results of testing of the patient’s peritoneal lavage that has been in blunt trauma
> 100,000 RBCs/uL indicates blunt trauma injury
Peritoneal fluid has <500 cells/uL of WBC
Normal
Peritoneal fluid has >500 cells/uL of WBC
Bacterial, peritonitis, Cirrhosis
Presence of carcinoembryonic antigen in patient’s peritoneal fluid
Malignancy of gastrointestinal origin
Positive in CA125 peritoneal fluid
Malignancy of ovarian origin
Decreased in tubercular peritonitis, and in malignancy
Glucose
Increased in pancreatitis, gastrointestinal perforation (Peritoneal fluid)
Amylase
Increased in gastrointestinal perforation (Peritoneal fluid)
ALP
Bun/Crea is testing for
Ruptured or puctured bladder
GSCS in peritoneal fluid is test for
Bacterial peritonitis
Acid-fast stain and Adenosine deaminase is a test for what in peritoneal fluid
Tubercular peritonitis
What is the composition of the amniotic fluid
Fetal urine and lung fluid
Volume of Amniotic fluid
800 to 1200 mL during the first trimester
Amniotic fluid greater than 1200mL is called?
Polyhydramnios
Amniotic fluid less than 800mL is called?
Oligohydramnios
Indication of fetal distress associated with neural tube disorders.
Can also be secondarily associated with fetal structural anomalies, cardiac arrhytmias, congenital infections, or chromosomal abnormalities
Polyhydramnios
May be associated with congenital malformations, premature rupture of amniotic membranes, and umbilical cord compression resulting in decelerated heart rate and fetal death
Oligohydromnios
Tests for Fetal Well-Being and Maturity
Bilirubin scan
HDN
Tests for Fetal Well-Being and Maturity
AFP
Neural tube disorder
Tests for Fetal Well-Being and Maturity
Lecithin-Sphingomyelin ration
Fetal Lung maturity
Tests for Fetal Well-Being and Maturity
Amniostat-fetal lung maturity
Fetal lung maturity/phosphatidyl glycerol
Tests for Fetal Well-Being and Maturity
Foam stability Index, Optical density 650nm, Lamellar body count
Fetal Lung maturity
AFP and acetylcholinesterase are markers tested for what defects?
Neural tube defect
Creatinine, Urea, and uric acid will be ____
(Amniotic fluid)
Increased
Glucose, and protein concentration ______
(Amniotic fluid)
Decreased
Measurement of amniotic fluid _____ has been used to determine fetal age
Creatinine
36 weeks gestation, amniotic fluid creatinine level is
1.5 - 2.0 mg/dL
Greater than 36 weeks gestation, amniotic fluid creatinine level is
more than 2.0 mg/dL
What test can differentiate amniotic fluid from urine and other body fluids?
Fern test
Collection of amniotic fluid is called?
Amniocentesis
To determine the following: Fetal lung maturity, Fetal distress, HDN, Infection. What week should the pregnancy needs to be to perform Amniocentesis
20 to 42 weeks
Amniocentesis may be indicated at what week for the early treatment or intervention of the following:
*Mother’s age of 35 or older at delivery
* Family history of chromosome abnormalities, such as
trisomy 21 (Down syndrome)
* Parents carry an abnormal chromosome rearrangement
* Earlier pregnancy or child with birth defect
* Parent is a carrier of a metabolic disorder
* Family history of genetic diseases such a sickle cell disease, Tay-Sachs disease, hemophilia, muscular dystrophy,
sickle cell anemia, Huntington chorea, and cystic fibrosis
* Elevated maternal serum alpha-fetoprotein
* Abnormal triple marker screening test
* Previous child with a neural tube disorder such as spina
bifida, or ventral wall defects (gastroschisis)
* Three or more miscarriages
15 to 18 weeks
Maximum level of amniotic fluid that is collected in sterile syringes
30mL
How many mL should be discarded due to it being contaminated by maternal blood, tissue fluid, and cells. (Amniotic Fluid)
2 or 3mL
Fluid for Fetal Lung Maturity should be placed in _____
Ice for delivery
Specimens for cytogenetic studies or microbial studies must be process ______ and maintained at ___________ or _____________
Aseptically, room temperature or body temperature
Amniotic fluid color: Colorless
Normal
Amniotic fluid color: Blood-streaked
Traumatic tap, abdominal trauma, intra-amniotic hemorrhage
Amniotic fluid color: Yellow
Hemolytic disease of the newborn (Due to bilirubin)
Amniotic fluid color: Dark green
Meconium
Amniotic fluid color: Dark red-brown
Fetal death
What test can determine the source of the blood in Amniotic fluid
Kleihauer-Betke test (for fetal hemoglobin)
Most frequent complication of early delivery and is the seventh most common cause of morbidity and mortality in the premature infant
Respiratory Distress Syndrome
Reference method of Fetal Lung Maturity
Lecithin-sphingomyelin ratio
Primary component of the surfactants (Phospholipids, neutral lipids, and protein)
Lecithin
What week of gestation will you see a rise in Lecithin
35th week
Lecithin-Sphingomyelin ratio reference range
less than 1.6 <35 weeks
2.0 or higher >35 weeks
Quantitative measurement of lecithin and sphingomyelin is performed using
Thin-layer chromatography
Replacement of Lecithin-Sphingomyelin Ration
Phosphatidyl glycerol immunoassays and
lamellar body density procedures
Can also be detected after 35 weeks’ gestation. It is another lung surface lipid
Phosphatidyl Glycerol
These are densely packed layers of phospholipids that represent a storage form of pulmonary surfactant
Lamellar bodies
Lamellar bodies are secreted by the type II pneumocytes of the fetal lung at what week?
24 weeks of gestation
Lamellar bodies enters the amniotic fluid at what week
26 weeks of gestation
How many g of feces is excreted in a 24 hour period
Approx. 100-200g
Digestion of ingested proteins, carbohydrates, and
fats takes place throughout the
Alimentary tract
Primary site for final breakdown and reabsorption of digested and ingested proteins
Small Intestine
More than 3000mL of water in the large intestine will cause
Diarrhea
An increase in daily stool weight above 200g
Diarrhea
Caused by poor absorption that exerts osmotic pressure across the intestinal mucosa
Osmotic diarrhea
Also known as impaired food digestion
Maldigestion
Impaired nutrient absorption by the intestine
Malabsorption
Determine the appearance/color of the stool with the ff possible cause:
Upper GI bleeding
Iron therapy
Charcoal
Bismuth (antacids)
Black
Determine the appearance/color of the stool with the ff possible cause:
Lower GI bleeding
Beets and food coloring
Rifampin
Red
Determine the appearance/color of the stool with the ff possible cause:
Bile-duct obstruction
Barium sulfate
Pale yellow,
white, gray
Determine the appearance/color of the stool with the ff possible cause:
Biliverdin/Oral antibiotics
Green
Determine the appearance/color of the stool with the ff possible cause:
Bile-duct obstruction
Pancreatic disorders
Bulky/frothy
Determine the appearance/color of the stool with the ff possible cause:
Intestinal constriction
Colitis
Dysentery
Malignancy
Constipation
Ribbon-like mucus or blood streaked mucus
Microscopic count of neutrophils in smear stained with
methylene blue, Gram stain, or Wright’s stain
Examination for neutrophils
Microscopic examination of direct smear stained with
Sudan III
Qualitative fecal fats
Microscopic examination of smear heated with acetic
acid and Sudan III
Qualitative fecal fats
Pseudoperoxidase activity of hemoglobin liberates oxygen from hydrogen peroxide to oxidize guaiac reagent
gFOBT
Uses polyclonal anti-human antibodies specific for the
globin portion of human hemoglobin
iFOBT
Addition of sodium hydroxide to hemoglobin-containing
emulsion determines presence of maternal or fetal blood
APT test
Emulsified specimen placed on x-ray paper determines
ability to digest gelatin
Trypsin
Immunoassay using an ELISA test
Elastase 1
