Body Fluids Flashcards
Normal amniotic fluid volume
800-1200ml
Major contributor to the AF volume after 1st trimester of pregnancy
Fetal urine
Neural tube effects (spina bifida) causes which: polyhydramnios (>1200ml) or oligyhydramnios (<800ml)
Poly
Membrane leakage and urinary tract deformities causes which: oly or poly
Oligohydramnios
Collection of amniotic flud
Amniocentesis
Up to how many ml is collected during amniocentesis
30 ml
Genetic defects such as trisonomy 21/down syndrome test on amniotic fluid is collected during which trimester
2nd
Fetal lung maturity and fetal hemolytic disease test on amniotic fluid is collected when
3rd trimester
HcG and Inhibin A is ______ on down syndrome
Increased
Specimen handling of amniotic fluid:
Test for fetal lung maturity: placed on ______ during deliver, ______ during storage, to prevent loss phospholipids
Ice, refrigerated or frozen
Specimen handling of amniotic fluid for cytogenetic studies
Kept at room tempt or 37 C
Specimen handling of amniotic fluid for HDN test
Protected from light
Maternal urine:
Urea
Creatinine
> 300 mg/dl
>10 mg/dl
Amniotic fluid vs maternal urine:
Protein
Glucose
+ -
+ -
Normal color of amniotic fluid
Colorless
Yellow amniotic fluid
HDN/bilirubin
Dark green amniotic fluid
Meconium
1st fetal bowel movement
Meconium
Dark red brown amniotic fluid
Fetal death
Most frequent complication of early delivery
RDS
7th most common cause of morbidity and mortality in the premature infant
RSD
RSD is caused by insufficiency of ________ production
Phospholipids
Reference test for fetal lung maturity
L/S ratio
Tested for alveolar stabilty
Lecithin
Serves as control (due to constant production)
Sphingomyelin
L/S ratio is measured using ________
TLC
Ratio of L/S indicating mature lungs
> 2.0
Blood or meconium causes false ______ on L/S test
Increase
Immunologic test for phosphatidyl glycerol
Amniostat-flm
RSD test not affected by blood or meconium
Amniostat-FLM
Reagent used in foam stability (foam/shake test)
95% ethanol
Steps in foam stability test
Amniotic + 95% ethanol —–> shake for ____ —–> stand for ______
Shake = 15 mins Stand = 15 mins
Indication of mature fetal lungs (+) in foam stability test
Foam/bubbles
Is the friction experienced by a single particle undergoing diffusion because of its interaction with its environment at micrometer length scale
Microviscosity
Microviscosity is measured through _____
Fluorescence polarization
Storage form alveolar surfactants/phospholipids
Lamellar body
Site of lamellar body production
Type 2 pneumocytes
Pneumocytes is similar in shape to what cell
Platelets
Lamellar body count meaning adequate FLM
> 32,000/uL
O. D. _____ nm for lamellar bodies
650
O. D in LBC. of ______ equivalent to: L/S ratio of >2.0
> 0.150
Amniotic fluid crea prior to 36 weeks’ gestation
1.5 to 2.0
Amniotic fluid creatinine in 36 weeks (9months)
> 2.0
OD for bilirubin or HDN
OD 450
Od 450 is plotted on _______
LILEY GRAPH
Nonaffected/mildly affected on liley graph
Zone 1
Moderately affected fetus (requires close monitoring)
Zone 2
Severely affected fetus (requires intervetion)
Zone 3
Hemoglobin peaks at what OD in liley graph
410 nm
A birth defect where there is incomplete closing of the back bone membranes around the spinal cord
Spina bifida
Is the absence of a major portion of the brain, skull, and scalp that occurs during embryonic
Anecephaly
Screening test for NTD
AFP
Confirmatory test for NTD
ACHE
Where is hcG produced
Syncytiotrophoblast
When the hCG peeks
1st trimester
HcG sub unit specific for HcG
Beta
HCG subunit for identical subunits such as LH TSH, FSH
Alpha
Principle of home based hcg pre test
Enzyme immunoassay
Specimen for homebased preg test
First morning urine
Cuttof point of home based preg test
25 mIU/mL
Anti-hcg source in preg test kit
Rabbit
HCG bioassay that uses female frog
Hogben
Hcg bioassay that uses male toad
Galli-mainini
Positive result in hogben
Oogenesis
Positive result in galli-mainini
Spermatogenesis
What causes fern like crystal formation in fern test
Protein, sodium chloride
The oldest test of amniotic fluid is for what
Evaluate HDN severity
Atleast what should be the specific gravity of urine for pregnancy testing
1.015
As early as how many days after conception can ELISA give positive reaction
15 days
Mixture of plasma, electrolytes, mucin and water
Tracheobronchial secretions
Requirement for acceptable sputum specimen
<10 SEC/LPF
> 25 WBC/LPF
Prefered sample for routine test of sputum
First morning
Specimen for sputum volume measurement
24 hr
Sputum specimen collect for pediatric patients
Throat swab
Specimen collect of sputum for non cooperative patients
Sputum induction
Specimen collection of sputum for delibitated/unconscious patients
Tracheal aspiration
Methods of sputum preservation
Refrigeration
10% formalin
Red or bright red colored sputum
Fresh blood, hemorrhage, TB or bronchiectasis
Anchovy sauce or rusty brown colored sputum
Old blood, pneumonia, gangrene
Olive green or grass green sputum
Cancer
Black colored sputum
Dust or dirt, carbon, charcoal, anthracosis, smoking
Rusty (WITH PUS)
Lobar pneumonia
Rusty WITHOUT PUS
Congestive heart failure
Currant, jelly-like sputum
Klebsiella pneumoniae infection
Yellow or gray material, size of a pinhead, produces foul odor when crushed
Dittrich’s plug
Hard concretion in a bronchus
Bronchiliths
Most common cause of broncholiths or lungs tones
Histoplasmosis
Layer formation of sputum
Top
Middle
Bottom
Frothy mucus
Opaque, water material
Pus, bacteria, tissues
Colorless, hexagonal, double pyramid, often needlelike and arises from disentegration of eosinophils
Charcot-leyden crystals
Microscopic structure: Coiled mucus strands in a sputum
Curshmann’s spiral
Mistaken as blastomyces in a sputum
Myelin globules
Hemosiderin-laden macrophage found on sputum in a CHF
Heart failure cells
Angular black granules in a sputum found on smokers
Carbon-laden cells
Clusters of columnar epithelial cells found on sputum
Creola bodies
Elements found on sputum on bronchial asthma
Creola bodies
Curshmann’s spiral
Charcot-leyden crystala
Dittrich’s plug
Bronchoalveolar lavage is important for the diagnosis of _______ in immunocompromised patients
Pneumocystis carinnin. (P. jiroveci)
Most predominant cells seen in BAL
Alveolar macrophage
Most important single component of sputum viscosity
Sialic acid
Stain that best delineates the cysts of P. jiroveci
Grocott’s methenamine silver stain
Sweat is used to diagnose what disease
Cystic fibrosis (mucovosidosis)
Specific test for CF
Gibson and cooke pilocarpine iontophoresis
What induces sweat in gibson and cooke
Pilocarpine + mild current
Sweat Na ans Cl values diagnostic of CF
> 70 mEq/L
Na and Cl values for borderline CF
40 mEq/L
3rd major body fluid
CSF
Outer layer of the meninges
DAP
Portion of the brain and spinal cord where the csf flows
Subarachnoid space
Produces CSF by selective filtration
Choroid plexus
Rate of Choroid plexus production of csf
20 ml/hr
Reabsorbs csf
Arachnoid villi/granulations
Up to how many ml of CSF can be collected
20 ml
Method of csf collection
Lumbar puncture
Where is lumbar puncture done
Between 3rd, 4th or, 5th lumar vertebrae
CSF tube number, test, and storage
1 = chem/sero = freezer 2 = microbio = room tempt 3 = hematology = refrigerator 4 = micro or sero (dependes on test)
True or false
Excess csf fluid should be discarded
False (should be frozen until no further use)
Arrangement of testing if only one tube of csf is collected
Micro - - - - > hema - - - - - > Chem/sero
Csf total volume for adults
90-150
Total csf for neonates
10-60 ml
Normal csf appearance
Crystal clear
Erythropages is present which (traumatic tap or intracranial hemorrhage
Intracranial
D-dimer is positive where (traumatic trap or intracranial hemorrhage)
IH
Pellicle formation in csf is associated with what
Tubercular meningitis
CSF dilution:
- Clear
- Sl. Hazy
- Hazy
- Sl. Cloudy
- Cloudy
- Bloody/turbid
Clear
1: 10
1: 20
1: 100
1: 200
1: 10,000
Rbc count correction for every _____ wbc seen
-1 rbc for every 700
Method of csf consentration
cytocentrifugation
How big is the diameter of the monolayer of cells in cytocentrifugation of csf
6mm
_____ is added in cytocentrifugation to increase yield
30% albumin
Predominant cells CSF
Lymph and mono
Adult ratio of Lympho to mono in csf
70:30
What is predominant cell in csf of neonates
Monocytes
80%
Normal CSF protein in adults
15-45mg/dl
Major csf protein
Albumin
Prefered method in turbidimetric protein determination of csf
Trichloroactetic acid
Precipitates both globulins and albumin in protein determination of CSF
Trichloroactetic acid
Precipitates albumin only
SSA
Normal value of CSF/Serum albumin ratio
<9
CSF/Serum albumin ratio of complete damage to BBB
> 100
Normal value of csf IgG index
<0.77
Presence of what protein in csf indicates myelin sheath destruction
MBP
Specimen for blood glucose should be drawn ______ hours prior to spinal tap
2 hours