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Analysis of Urine and Other Body Fluids > Chapter 9 - Amniotic Fluid & hCG > Flashcards

Chapter 9 - Amniotic Fluid & hCG Flashcards

1
Q

Primary fxns of amniotic fluid

A

Cushion, allows fetal movement, stabilizes temp, proper lung dev’t

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2
Q

The amniotic fluid volume comes from?

A

Fetal urine & lung fluid

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3
Q

Normal amniotic fluid colume at 3rd trimester

A

800-1200 mL

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4
Q

Major contributor to the AF volume after the 1st trimester of pregnancy

A

Fetal urine

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5
Q

Increased amniotic fluid volume

A

Polyhydramnios

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6
Q

Volume of amniotic fluid during polyhydramnios

A

> 1200 mL

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7
Q

Decreased amniotic fluid volume

A

Oligohydramnios

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8
Q

Amniotic fluid volume during oligohydramnios

A

<800 mL

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9
Q

Determine whether the ff will cause polyhydramnios or oligohydramnios:

  1. Neural tube defects
  2. Increased fetal swallowing of urine
  3. Decreased swallowing of urine
  4. Membrane leakage
  5. Urinary tract deformities
  6. Cardiac arrhythmias
  7. Congenital malformations
  8. Chromosomal abnormalities
  9. Congenital infections
  10. Fetal structure anomalies
  11. Umbilical cord compression
  12. Premature amniotic membrane rupture
A
  1. Poly
  2. Oligo
  3. Poly
  4. Oligo
  5. Oligo
  6. Poly
  7. Oligo
  8. Poly
  9. Poly
  10. Poly
  11. Oligo
  12. Oligo
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10
Q

Method of collection for amniotic fluid

A

Amniocentesis

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11
Q

Up to _____ amniotic fluid collected in sterile syringe

A

30 mL

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12
Q

Used to assess genetic defects like trisomy 21

A. 2nd trimester amniocentesis
B. 3rd trimester amniocentesis

A

A

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13
Q

Used to assess fetal lung maturity

A. 2nd trimester amniocentesis
B. 3rd trimester amniocentesis

A

B

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14
Q

Used to assess fetal hemolytic dse (HDN)

A. 2nd trimester amniocentesis
B. 3rd trimester amniocentesis

A

B

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15
Q

Enumerate the parameters of quadruple screening tests prior to performing amniocentesis

A

AFP, hCG, UE3, inhibin A

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16
Q

Spn placed on ice on delivery, kept refrigerated or frozen

A. Test for fetal lung maturity
B. Test for cytogenetic studies
C. Test for HDN

A

A

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17
Q

Spn protected from light

A. Test for fetal lung maturity
B. Test for cytogenetic studies
C. Test for HDN

A

C

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18
Q

Spn kept at room temp or at 37 deg C

A. Test for fetal lung maturity
B. Test for cytogenetic studies
C. Test for HDN

A

B

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19
Q

Detects ruptured amniotic membranes, also used to diagnose early pregnancy (increased estrogen)

A

Fern test

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20
Q

Amniotic fluid vs maternal urine more reliable analytes to diff between the two

A

Urea (BUN), crea

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21
Q

Diff amniotic fluid from maternal urine using its urea & crea values

A

Amniotic urea <30, amniotic crea <3.5 ; maternal urine urea >300, maternal urine crea >10

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22
Q

Spn used for fern test

A

Vaginal fluid

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23
Q

Positive result for fern test

A

Fern-like crystals

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24
Q

Presence of fern-like crystals in fern test means:

A

That the spn contains amniotic fluid

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25
Amniotic fluid color 1. Normal 2. Traumatic tap 3. HDN 4. Meconium 5. Fetal death
1. Colorless 2. Blood-streaked 3. Yellow 4. Dark green 5. Dark red-brown
26
1st fetal bowel movement
Meconium
27
What is tested for fetal lung maturity
Phospholipids
28
Most freq complication of early delivery
Respiratory distress syndrome
29
Respiratory distress syndrome is the ____ (first, second, third, etc) most common cause of morbidity and mortality in the premature infant
7th
30
Resp distress syndrome is caused by insufficiency of _____ production & fetal lung immaturity
Lung surfactant (phospholipids)
31
Reference method for testing FLM
L/S ratio
32
Phospholipid for alveolar stability
Lecithin
33
Phospholipid that serves as a control (due to constant production)
Sphingomyelin
34
L/S ratio is measured using ____
TLC
35
Regarding L/S ratio: Ratio of ____ = mature fetal lungs
> or = 2.0
36
Which phospholipid increases as the fetal lung matures? A. Lecithin B. Sphingomyelin
A
37
Immunologic test for phosphatidylglycerol
Amniostat-FLM
38
Adv of amniostat-FLM over L/S ratio
Amniostat-FLM is not affected by blood or meconium
39
Disadv of L/S ratio testing
Cannot be done on spn contaminated by blood or meconium
40
Disadv of amniostat FLM
Production of PG is delayed among diabetic mother
41
Rgt used for foam stability (foam/shake test)
95% ethanol
42
During foam stability, the spn and 95% ethanol is shaken for how long?
15 secs
43
regarding foam stability: After shaking for 15 secs, it is left standing for how long?
15 mins
44
Positive test for foam stability indicating mature fetal lungs
Foam/bubbles
45
The presence of phospholipids _____ microviscosity (inc/dec)
Dec
46
The friction experienced by a single particle undergoing diffusion bec of its interaction w/ its environment at the micrometer length scale
Microviscosity
47
Microviscosity is measured by
Fluorescence polarization
48
What is measured in microviscosity test?
Surfactant to albumin (S/A) ratio
49
Dye bound to surfactant had ____ (decreased/longer) fluorescence & ____ (high/low) polarization
Longer; low
50
Dye bound to albumin had ____ (decreased/longer) fluorescence & ____ (high/low) polarization
Decreased, high
51
______ produce alveolar surfactants stored in the form of ______.
Type II pneumocytes; lamellar bodies
52
Lamellar body diameter is similar to that of platelets, therefore, LBC can be obtained w/ the use of:
Platelet channel of hematology analyzers
53
_____ lamellar body count = adequate FLM
>32 000/uL
54
Test used to measure FLM: OD ____nm
650
55
The higher the lamellar body count, the ____(higher/lower) the OD (absorbance)
Higher
56
OD of ____ is equivalent to L/S ratio of > or = 2.0 & the presence of PG
> or = 0.150
57
Parameter used to test for fetal age
Creatinine
58
_____ amniotic fluid crea = prior to 36 weeks gestation
1.5-2.0
59
_____ amniotic fluid crea = 36 wks (9 mos)
> or = 2.0
60
Test for HDN
OD 450
61
Instrument used in OD 450
Spectro
62
Absorbance is increased at 450 nm A. Normal B. HDN
B
63
Reults of OD 450 is plotted on a ____
Liley graph
64
Moderately affected fetus (requires close monitoring) A. Zone I B. Zone II C. Zone III
B
65
Nonaffected/mildly affected fetus A. Zone I B. Zone II C. Zone III
A
66
Severely affected fetus (requires intervention) A. Zone I B. Zone II C. Zone III
C
67
Screening test for neural tube defects
AFP
68
Is a birth defect where there is incomplete closing of the backbone & membranes around the spinal cord
Spina bifida
69
Is the absence of a major portion of the brain, skull, and scalp that occurs during embryonic dev’t
Anencephaly
70
Confirmatory test for neural tube defects
Acetylcholinesterase
71
hCG is produced by
Syncytiotrophoblast cells
72
hCG peaks during ____ trimester of pregnancy
1st
73
AFP is ____ (inc/dec) in Down syndrome
Dec
74
AFP is ____ in neural tube defects
Inc
75
2 subunits of hCG
Alpha & beta
76
hCG subunit that confers specificity for hCG
Beta
77
Principle of the home-based hCG preg test kit
Enzyme imunoassay
78
Spn for homebased hCG preg test kit
1st morning urine
79
Cut off point for home based hCG preg test kit
25 mIU/mL
80
Anti-hCG source
Rabbit
81
Identify the ff HCG bioassay Animal used: female frog mode of injection: lymph sac Positive result: oogenesis Sensitivity: 75-100 IU/mL
Hogben
82
Identify the ff HCG bioassay Animal used: male frog mode of injection: subcutaneous Positive result: spermatogenesis Sensitivity: variable
Galli-Mainini
83
Identify the ff HCG bioassay Animal used: virgin female rabbit mode of injection: marginal ear vein Positive result: corpora lutea & corpora hemorrhagica Sensitivity: 10-15 IU/mL
Friedmann/Hoffmann
84
Amniotic fluid is present in the ____, a membranous sac that surrounds the fetus
Amnion
85
The ____ is the ultimate source of amniotic fluid water and solutes
Placenta
86
Fern-like crystal formation in Fern test is caused by ____ & ____ in the spn
Protein & sodium chloride
87
The oldest routinely performed lab test on AF evaluates the _____
severity of fetal anemia due to HDN
88
The major protein produced by the fetal liver during early gestation
AFP
89
____ normally appears in mature lungs & allows the alveoli to remain open throughout the cycle of inhalation and exhalation
Surfactant
90
____ keeps the alveoli from collapsing by _____ (increasing/decreasing) surface tension & allows them to inflate with air more easily
Surfactant
91
ELISA are very sensitive, giving positive rxns as early as ___ days after conception
10
92
Urine spn for preg testing should have a specific gravity of ____
at least 1.015

Analysis of Urine and Other Body Fluids (18 decks)

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