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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
Q

Amniotic fluid color

  1. Normal
  2. Traumatic tap
  3. HDN
  4. Meconium
  5. Fetal death
A
  1. Colorless
  2. Blood-streaked
  3. Yellow
  4. Dark green
  5. Dark red-brown
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26
Q

1st fetal bowel movement

A

Meconium

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27
Q

What is tested for fetal lung maturity

A

Phospholipids

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28
Q

Most freq complication of early delivery

A

Respiratory distress syndrome

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29
Q

Respiratory distress syndrome is the ____ (first, second, third, etc) most common cause of morbidity and mortality in the premature infant

A

7th

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30
Q

Resp distress syndrome is caused by insufficiency of _____ production & fetal lung immaturity

A

Lung surfactant (phospholipids)

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31
Q

Reference method for testing FLM

A

L/S ratio

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32
Q

Phospholipid for alveolar stability

A

Lecithin

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33
Q

Phospholipid that serves as a control (due to constant production)

A

Sphingomyelin

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34
Q

L/S ratio is measured using ____

A

TLC

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35
Q

Regarding L/S ratio: Ratio of ____ = mature fetal lungs

A

> or = 2.0

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36
Q

Which phospholipid increases as the fetal lung matures?

A. Lecithin
B. Sphingomyelin

A

A

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37
Q

Immunologic test for phosphatidylglycerol

A

Amniostat-FLM

38
Q

Adv of amniostat-FLM over L/S ratio

A

Amniostat-FLM is not affected by blood or meconium

39
Q

Disadv of L/S ratio testing

A

Cannot be done on spn contaminated by blood or meconium

40
Q

Disadv of amniostat FLM

A

Production of PG is delayed among diabetic mother

41
Q

Rgt used for foam stability (foam/shake test)

A

95% ethanol

42
Q

During foam stability, the spn and 95% ethanol is shaken for how long?

A

15 secs

43
Q

regarding foam stability: After shaking for 15 secs, it is left standing for how long?

A

15 mins

44
Q

Positive test for foam stability indicating mature fetal lungs

A

Foam/bubbles

45
Q

The presence of phospholipids _____ microviscosity (inc/dec)

A

Dec

46
Q

The friction experienced by a single particle undergoing diffusion bec of its interaction w/ its environment at the micrometer length scale

A

Microviscosity

47
Q

Microviscosity is measured by

A

Fluorescence polarization

48
Q

What is measured in microviscosity test?

A

Surfactant to albumin (S/A) ratio

49
Q

Dye bound to surfactant had ____ (decreased/longer) fluorescence & ____ (high/low) polarization

A

Longer; low

50
Q

Dye bound to albumin had ____ (decreased/longer) fluorescence & ____ (high/low) polarization

A

Decreased, high

51
Q

______ produce alveolar surfactants stored in the form of ______.

A

Type II pneumocytes; lamellar bodies

52
Q

Lamellar body diameter is similar to that of platelets, therefore, LBC can be obtained w/ the use of:

A

Platelet channel of hematology analyzers

53
Q

_____ lamellar body count = adequate FLM

A

> 32 000/uL

54
Q

Test used to measure FLM: OD ____nm

A

650

55
Q

The higher the lamellar body count, the ____(higher/lower) the OD (absorbance)

A

Higher

56
Q

OD of ____ is equivalent to L/S ratio of > or = 2.0 & the presence of PG

A

> or = 0.150

57
Q

Parameter used to test for fetal age

A

Creatinine

58
Q

_____ amniotic fluid crea = prior to 36 weeks gestation

A

1.5-2.0

59
Q

_____ amniotic fluid crea = 36 wks (9 mos)

A

> or = 2.0

60
Q

Test for HDN

A

OD 450

61
Q

Instrument used in OD 450

A

Spectro

62
Q

Absorbance is increased at 450 nm

A. Normal
B. HDN

A

B

63
Q

Reults of OD 450 is plotted on a ____

A

Liley graph

64
Q

Moderately affected fetus (requires close monitoring)

A. Zone I
B. Zone II
C. Zone III

A

B

65
Q

Nonaffected/mildly affected fetus

A. Zone I
B. Zone II
C. Zone III

A

A

66
Q

Severely affected fetus (requires intervention)

A. Zone I
B. Zone II
C. Zone III

A

C

67
Q

Screening test for neural tube defects

A

AFP

68
Q

Is a birth defect where there is incomplete closing of the backbone & membranes around the spinal cord

A

Spina bifida

69
Q

Is the absence of a major portion of the brain, skull, and scalp that occurs during embryonic dev’t

A

Anencephaly

70
Q

Confirmatory test for neural tube defects

A

Acetylcholinesterase

71
Q

hCG is produced by

A

Syncytiotrophoblast cells

72
Q

hCG peaks during ____ trimester of pregnancy

A

1st

73
Q

AFP is ____ (inc/dec) in Down syndrome

A

Dec

74
Q

AFP is ____ in neural tube defects

A

Inc

75
Q

2 subunits of hCG

A

Alpha & beta

76
Q

hCG subunit that confers specificity for hCG

A

Beta

77
Q

Principle of the home-based hCG preg test kit

A

Enzyme imunoassay

78
Q

Spn for homebased hCG preg test kit

A

1st morning urine

79
Q

Cut off point for home based hCG preg test kit

A

25 mIU/mL

80
Q

Anti-hCG source

A

Rabbit

81
Q

Identify the ff HCG bioassay

Animal used: female frog
mode of injection: lymph sac
Positive result: oogenesis
Sensitivity: 75-100 IU/mL

A

Hogben

82
Q

Identify the ff HCG bioassay

Animal used: male frog
mode of injection: subcutaneous
Positive result: spermatogenesis
Sensitivity: variable

A

Galli-Mainini

83
Q

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

A

Friedmann/Hoffmann

84
Q

Amniotic fluid is present in the ____, a membranous sac that surrounds the fetus

A

Amnion

85
Q

The ____ is the ultimate source of amniotic fluid water and solutes

A

Placenta

86
Q

Fern-like crystal formation in Fern test is caused by ____ & ____ in the spn

A

Protein & sodium chloride

87
Q

The oldest routinely performed lab test on AF evaluates the _____

A

severity of fetal anemia due to HDN

88
Q

The major protein produced by the fetal liver during early gestation

A

AFP

89
Q

____ normally appears in mature lungs & allows the alveoli to remain open throughout the cycle of inhalation and exhalation

A

Surfactant

90
Q

____ keeps the alveoli from collapsing by _____ (increasing/decreasing) surface tension & allows them to inflate with air more easily

A

Surfactant

91
Q

ELISA are very sensitive, giving positive rxns as early as ___ days after conception

A

10

92
Q

Urine spn for preg testing should have a specific gravity of ____

A

at least 1.015

Analysis of Urine and Other Body Fluids (18 decks)

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