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Urinalysis > Chapter 7 > Flashcards

Chapter 7 Flashcards

1
Q

3rd part of routine urinalysis-

A

microscopic examination of the urinary sediment

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2
Q

Identification of insoluble substances (formed elements)- (11)

A

-Red blood cells (RBCs)
-White blood cells (WBCs)
-Epithelial cells
-Casts
-Bacteria
-Yeast
-Parasites
-Mucus
-Spermatozoa
-Crystals
-Artifacts

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3
Q

Microscope analysis is subject to several procedural variations- (4)

A

-The methods by which the sediment is prepared
-The volume of sediment actually examined
-The methods and equipment used to obtain visualization
-The manner in which the results are reported

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4
Q

Microscopic is performed based on-

A

physical & chemical results

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5
Q

Parameters considered significant for microscopic screenings include- (7)

A

-Color
-clarity
-blood
-protein
-nitrite
-leukocyte esterase
-possibly glucose

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6
Q

Special populations for microscopic examinations- (6)

A

-pregnant women
-pediatric
-geriatric
-diabetic
-immunocompromised
-renal patients

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7
Q

CLSI recommendations for microscopic examinations- (3)

A

-Requested by the physician
-Laboratory-specified population
-Any abnormal physical or chemical result

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8
Q

examine prepared specimens when- (2)

A

-fresh
-preserved

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9
Q

Formed elements in specimen examination- (4)

A

-RBCs
-WBCs
-casts disintegrate in dilute
-alkaline urine

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10
Q

refrigerating specimens precipitates-

A

crystals & can obscure other elements

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11
Q

Less contamination (epithelial cells) from a ________ specimen-

A

midstream clean-catch

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12
Q

Thoroughly mix specimen before-

A

decanting to the centrifuge tube

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13
Q

Standard amount of urine usually centrifuged-

A

10 – 15 mL

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14
Q

Quantities <12 mL of urine should be-

A

documented

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15
Q

Standardize speed and time of centrifugation should be-

A

consistent

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16
Q

ideal relative centrifuge force (RFC)-

A

5 minutes at RCF of 400

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17
Q

RCF corrects for variations in the diameter of-

A

centrifuge heads

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18
Q

Volume of sediment examined-

A

0.5 to 1.0 mL

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19
Q

Sediment must be resuspended via-

A

gentle agitation

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20
Q

Vigorous agitation of specimens must be-

A

avoided

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21
Q

Volume of sedimentation placed on microscopic slide should be-

A

consistent

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22
Q

Glass Slide method for volume of sediment examined- (3)

A

-recommended volume is 20 uL
-22x22 glass cover slip
-do not overflow cover slip (heavier elements/casts flow outside)

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23
Q

Microscopic analysis of urine has been improved substantially with-

A

commercial slide systems

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24
Q

CLSI recommends these systems together with-

A

standardization of all phases of the methodology

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25
Q

Commercial systems: KOVA- (5)

A

-Calibrated centrifuge tubes
-special slides to control volume
-decanting pipettes
-grids for better quantitation

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26
Q

Microscopic examination of sediment should be performed in a consistent manner & include-

A

observation of a minimum of 10 fields under low (10x) & 10 high (40x) fields

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27
Q

low power for examination of sediment- (2)

A

-casts, general composition
-Scan edges for casts with glass slide method

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28
Q

high power for examination of sediment-

A

identification of type

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29
Q

initial focusing for examination of sedimentation- (2)

A

-low power, reduced light
-Focus on epithelial cell, not artifacts that are in a different plane

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30
Q

adjustments used for examination of sedimentation-

A

fine adjustment continuously for best view

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31
Q

reporting the examination is consistent within-

A

the lab

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32
Q

Reporting the Examination casts-

A

average per lpf

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33
Q

Reporting the Examination for RBCs/WBCs-

A

average per hpf

34
Q

Reporting the Examination for Epithelial cells, crystals, etc., in semiquantitative terms- (3)

A

-Few, moderate, many
-1+, 2+, 3+, 4+
-Followed by /lpf or /hpf

35
Q

RBCs physical urinalysis correlations-

A

turbidity red color

36
Q

RBCs chemical urinalysis correlations- (2)

A

-+ blood
-+ protein

37
Q

RBCs physical urinalysis exceptions- (2)

A

-number
-hemolysis

38
Q

WBCs physical urinalysis correlations-

A

turbidity

39
Q

WBCs chemical urinalysis correlations- (3)

A

-+protein
-+ nitrite
-+LE

40
Q

WBCs exceptions urinalysis correlations-

A

-number
-lysis

41
Q

epithelial cells physical urinalysis correlations-

A

turbidity

42
Q

epithelial cells exceptions urinalysis correlations-

A

number

43
Q

casts chemical urinalysis correlations-

A

+ protein

44
Q

casts exceptions urinalysis correlations-

A

number

45
Q

bacteria physical urinalysis correlations-

A

turbidity

46
Q

bacteria chemical urinalysis correlations- (3)

A

-pH
-+nitrite
-+leukocytes

47
Q

bacteria exceptions urinalysis correlations-

A

number & type

48
Q

crystals physical urinalysis correlations- (2)

A

-turbidity
-color

49
Q

crystals chemical urinalysis correlations- (2)

A

-pH
-+ bilirubin

50
Q

crystals exceptions urinalysis correlations-

A

number & type

51
Q

Sediment appearance influenced by- (4)

A

-Cells and casts in various stages of development and degeneration
-Distortion of cells and crystals by the chemical content of the specimen
-The presence of inclusions in cells and casts
-Contamination by artifacts

52
Q

sedimentation stains Increases-

A

overall visibility of sediment using bright-field microscopy

53
Q

sediment stains Imparts identifying characteristics of cellular structures- (3)

A

-Nuclei
-Cytoplasm
-Inclusions

54
Q

Sternheimer-Malbin stain consists of- (2)

A

-crystal violet
-Safranin O

55
Q

most frequent supravital stain used in urinalysis-

A

Sternheimer-Malbin stain

56
Q

Sternheimer-Malbin stain increases-

A

refractive index

57
Q

Sternheimer-Malbin stain is commercially available as- (2)

A

-Sedi-Stain
-KOVA stain

58
Q

0.5% solution of toluidine blue enhancement of-

A

nuclear detail

59
Q

Touluidine blue is useful in the differentiation between- (2)

A

-WBCs
-renal tubular epithelial cells

60
Q

2% acetic acid will enhance- (2)

A

-WBC
-epithelial cells

61
Q

2% acetic acid method cannot be used for initial sediment analysis because-

A

RBCs are lysed by acetic acid

62
Q

most common type of microscopy performed in urinalysis-

A

bright-field microscopy

63
Q

Other types of microscopy that are useful for examining urine sediment include- (5)

A

-phase contrast
-polarizing
-dark field
-fluorescence
-interference contrast

64
Q

All microscopes are designed to-

A

magnify small objects

65
Q

Compound bright-field microscope- (2)

A

-used primarily in urinalysis
-consists of two-lens system

66
Q

Components of two-lens system- (2)

A

-the oculars, objectives
-the coarse & fine-adjustment knobs

67
Q

Illumination system contains- (3)

A

-Light source
-condenser
-field and iris diaphragms

68
Q

Binocular Field of view is determined by-

A

eyepieces

69
Q

binocular 10x adjusts for-

A

interpupillary distance

70
Q

Binocular Field of View is the diameter of-

A

the circle of view when looking through the oculars

71
Q

Objectives of the microscope are adjusted to be-

A

near the specimen (UA sediment magnifications)

72
Q

Microscope objectives of used routinely in lab-

A

10× (low power, dry), 40× (high power, dry)

73
Q

Final magnification of an object is the product of-

A

the objective magnification times the ocular magnification

74
Q

Microscope objectives are inscribed with info that describes their characteristics include- (5)

A

-Type of objective
-magnification
-numerical aperture
-microscope tube length
-cover-slip thickness to be used

75
Q

Length of the objectives attached to the nosepiece varies with magnification by-

A

changing the distance between the lens and the slide when they are rotated

76
Q

Only minimum adjustment for Parfocal when-

A

switching among objectives

77
Q

The distance between the slide and the objective is controlled by- (2)

A

-the coarse
-fine focusing knobs

78
Q

Coarse focus-

A

initial focusing

79
Q

Fine focus-

A

sharpen image, focusing after changing magnification

80
Q
A

Urinalysis (7 decks)

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