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RMT, 2023 > CLIN. MIC > Flashcards

CLIN. MIC Flashcards

1
Q

Functional Units of Kidney

A

Nephrons

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2
Q

Each kidney contains __nephrons

A

1 to 1.5 million

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3
Q

Each kidney weighs approximately____ or equivalent to 0.5% of total body mass

A

150g

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4
Q

The human kidney receives approximately __of blood pumped through the heart

A

25%

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5
Q

It supplies blood to the kidney

A

Renal artery

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6
Q

The difference of the between the sizes of afferent and efferent arterioles help to creates ___ pressure

A

Hydrostatic pressure

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7
Q

Renal blood flow

A

1200ml/min

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8
Q

Renal plasma flow

A

600-700ml/min

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9
Q

Part of the kidney that resembles as sieve

A

Glomerulus

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10
Q

The glomerulus is a non-selective filter of plasma substances with a molecular weight of less than _____

A

<70,000 Daltons

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11
Q

The system that regulates the flow of blood to and within the glomerulus that also responds to changes in blood pressure

stimulus:

A

Renin-angiotensin
aldosterone system

Stimulus: decrease BP and/or decrease plasma sodium level

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12
Q

found in the DCT, sensor of change in blood pressure

A

Macula Densa cells

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13
Q

found in the afferent arteriole, secretes the Renin enzyme

A

Juxtaglomerular cells

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14
Q

Renal threshold for glucose

A

160-180mg/dl

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15
Q

Value of ADH and urine volume in dehydration state

A

Increase ADH, decrease
urine volume

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16
Q

Passive reabsorption of water takes place in all parts of the nephron except the ________.

A

ALH

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17
Q

Sodium is actively transport in all part of the nephron except in the

A

ALH

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18
Q

The major site of removal of non-filtered substances

A

Kidney tubules

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19
Q

A force that repels molecules with a negative charge even molecules are small enough to pass in the
glomerulus

A

Shield of negativity

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20
Q

Intertwining foot processes found in the glomerulus that inhibits the filtration of large molecules

A

Podocytes

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21
Q

Blood and Urine pH during in cases of metabolic acidosis/Renal tubular acidosis

A

Blood pH: Acidic
Urine pH: Alkaline

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22
Q

The single most useful substance that identifies a fluid as urine is its uniquely high _______level
(approximately 50 times that of plasma).

A

Creatinine

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23
Q

A waste product of muscle metabolism that is produced enzymatically by creatine phosphokinase from
creatine, which links with ATP to produce ADP and energy.

A

Creatinine

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24
Q

The most commonly used clearance test for assessing GFR

A

Creatinine clearance test

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25
Q

By far the greatest source of error in any clearance procedure using urine is the use of _______urine
specimens

A

Improperly timed urine

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26
Q

creatinine clearance results can vary by as much as ________ within a single individual, 24-hour
collections are preferable.

A

15% to 20%

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27
Q

Parameters that are added in Cockroft and Gault formula for computing eGFR

A

BAS!!!!!
Body wt., age, and Sex

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28
Q

Parameters that are added in MDRD formula for computing eGFR
- 4- variables =
- 6- variables =

A

4- variables = Serum creatinine, ethnicity, Age, Sex (SEAS)
6- variables = BUN, Age, Sex, Ethnicity, Serum creatinine, and serum albumin (BASES)

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29
Q

Most frequently used formula for eGFR

A

MDRD

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30
Q

polymer of fructose, is an extremely stable substance that is not reabsorbed or secreted by the tubules

A

Inulin

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31
Q

a small protein (molecular weight 13,359) produced at a constant rate by all nucleated cells. It has potential as a marker for long-term monitoring of renal function its plasma
▪ its plasma concentration is inversely related to GFR. (Increase in blood = Decrease GFR)
▪ The rate of production is not affected by muscle mass, sex, or race

A

Cystatin C

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32
Q

It dissociates from human leukocyte antigens (MHC class I) at a constant rate and is rapidly
removed from the plasma by glomerular filtration.
▪ a better marker of reduced renal tubular function than of glomerular function

A

Beta-2-Microglobulin

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33
Q

An obsolete tubular secretion test

A

PSP dye excretion test

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34
Q

Most commonly used test for renal blood flow and renal secretion

A

P-ammino Hippurate (PAH)

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35
Q

This measures only the number of particles or solute in a solution

A

Osmolality

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36
Q

This measures number and size of particles or solute in a solution

A

Specific Gravity

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37
Q

Normal random urine volume

A

600-2000 mL

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38
Q

decrease urine output

A

Oliguria

<400ml/24 hours

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39
Q

increase in daily urine
output

A

Polyuria

> 2000ml/24hours

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40
Q

increase excretion of
urine/urine output at night

A

Nocturia

> 500 ml at night

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41
Q

Cessation /no urine output
within 24 hours

A

Anuria

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42
Q

can be rather abrupt in onset, as can acute renal failure, or it may be due to a chronic progressive renal disease.

A

Oliguria

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43
Q

Normal urine volume at night

A

<400ml at night

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44
Q

S.G of urine in patient with Diabetes mellitus

A

Increase / Hypersthenuria

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45
Q

S.G of urine in patient with Diabetes insipidus

A

Decrease / Hyposthenuria

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46
Q

The yellow color of urine is caused by the presence of a pigment, which Thudichum named ________

A

Urochrome

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47
Q

Urochrome levels in standing urine sample at room temperature

A

Increase

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48
Q

Produces yellow foam in urine when shaken

A

Bilirubin and Phenazopyridine (Pyridium)

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49
Q

Produces white foam in urine when shaken

A

Protein/albumin

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50
Q

Major organic substance in urine

A

Urea

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51
Q

Major inorganic substance in urine

A

Chloride

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52
Q

Procedure for checking both
urine clarity and Color

A

Mixed sample, View the urine against a white background using adequate room lighting.

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53
Q

Checking for urine color

A

Examine the specimen under a good light source, looking down through the container against a
white background

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54
Q

Checking for urine clarity

A

Visually examining the Mixed specimen while holding it in front of a light source. View through a
newspaper print

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55
Q

Defined as the density of a solution compared with the density of a similar volume of distilled water
(SG 1.000) at a similar temperature

A

Specific gravity

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56
Q

Principle of refractometer
Refers to the index of the velocity of light in air / velocity of light in solution

A

Refractive index

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57
Q

Most common and easiest
Can be used for microbiological studies
PRECIPITATES AMORPHOUS CRYSTALS

A

Refrigeration (up to 24 hours)

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58
Q

Does not interfere with routine test

A

Toluene and Phenol

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59
Q

Excellent sediment preservative
Fixative for Addis counting

A

Formalin

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60
Q

For automated instrument

A

Yellow plain UA

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61
Q

For culture and sensitivity and protein testing

A

Boric acid

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62
Q

Used for cytology

A

Saccomano (preferred) and Formalin (Brunzel,3rd ed.)

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63
Q

Catecholamines (e.g epinephrine)

A

Concentrated HCL

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64
Q

For quantitative analysis of steroids, hormones,

A

Acids (HCl, glacial acetic acid)

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65
Q

For catecholamines, vanillylmandelic acid (VMA), or 5-hydroxyindoleacetic acid (5-HIAA) collections, _____ is added to a 3- to 4-L container

A

10 mL of 6N HCl

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66
Q

Boric acid in a concentration of 1 g/dL preserves urine elements such as estriol and estrogen for up to _______

A

7 days

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67
Q

can be added to 24-hour urine for glucose determinations to inhibit bacterial growth and cell glycolysis but not growth of yeast.

A

Sodium fluoride

68
Q

Saccomano fixative composition

A

50% ETHANOL + 2%CARBOWAX (POLYETHYLENE GLYCOL)

69
Q

Analyte least affected or unaffected in unpreserved urine

A

Protein / albumin

70
Q

Trichomonads on unpreserved urine will ______ due to loss of characteristic motility and death

A

Decrease

71
Q

Carotene urine color

A

Orange

72
Q

Phenol when oxidized urine color

A

blue-green or Green (Brunzel)

73
Q

Phenol derivatives urine color

A

Black or Brown (Brunzel)

74
Q

Rifampin urine color

A

red or orange red

75
Q

Myoglobin (25mg/dl), RBC, and beets urine color

A

Red

76
Q

Porphyrin urine color

A

Port-wine or Burgundy Red

77
Q

Fucsin /aniline dye in candy urine color

A

Red

78
Q

No visible particulates, transparent

A

Clear

79
Q

Few particulates, print easily seen through urine

A

Hazy

80
Q

Many particulates, print blurred through urine

A

Cloudy

81
Q

Print cannot be seen through urine

A

Turbid

82
Q

May precipitate or be clotted

A

Milky

83
Q

Amorphous urates, radiographic contrast media

A

Acidic urine

84
Q

Amorphous phosphates, carbonates

A

Alkaline urine

85
Q

Soluble with heat

A

Amorphous urates, uric acid crystals

86
Q

Soluble in dilute acetic acid

A

RBCs, Amorphous phosphates, carbonates

87
Q

Insoluble in dilute acetic acid

A

WBCs, Bacteria, yeast, spermatozoa

88
Q

Soluble in ether

A

Lipids, lymphatic fluid,chyle

89
Q

Routine urinalysis

Specimen volume:
Container capacity:
Opening of at least:

A

Specimen volume: 10 to 15 ml (average of 12ml)
Container capacity: 50 ml
Opening of at least: 4 to
5 cm

90
Q

Drug testing

Specimen volume:
Container capacity:
Temperature:

A

Specimen volume: 30 to 45ml
Container capacity: 60ml
Temperature:32.5 to 37.7 ‘C within 4 minutes

91
Q

Individual who submits urine specimen for drug testing

A

DONOR /CLIENT

92
Q

Types of specimen for
glucose monitoring

A

a. first morning urine sample
b. second morning urine sample
c. 2-hours post prandial urine sample

93
Q

For Culture and
Sensitivity

A

a. Midstream clean catch
b. Catheterized urine sample
c. Suprapubic aspiration (especially for anaerobic microbes)

94
Q

Used to differentiate kidney infections

A

Catheterized, ureteral collection technique

95
Q

Used with patients (e.g infants and newborn) unable to urinate voluntarily
* the patient is checked every 15 minutes to see if an adequate specimen has been collected.

A

Pediatric collection bag (weigh bag)

96
Q

For ease and convenience, routine screening. It is collected at any time, usually during daytime
hours, and without prior patient preparation

A

Random urine

97
Q

Used for quantitative measurements of analyte that shows diurnal/circardian variation (e.g hormones,
proteins, glomerular filtration rate)

A

Time specimens

98
Q

To obtain an accurate timed specimen, the patient must begin and end the collection period
with an ______.

A

empty bladder

99
Q

All specimens should be ______during the collection period and may also
require addition of a chemical preservative.

A

refrigerated or kept on ice

100
Q

In timed specimen a sufficient aliquot _____ is removed for routine testing and possible repeat or additional
testing; the remainder is discarded

A

50 mL

101
Q

For determination of urine albumin, creatinine, and the albumin-to creatinine ratio is an ideal specimen to
screen for microalbuminuria

A

4 hour or 12 hour urine
specimen

102
Q

Preferred specimen for urobilinogen measurement

A

Afternoon urine (2pm to 4pm)

103
Q

Urine specimen for cytology

A

-Suprapubic aspiration (1st answer niyo ito dahil galing sa Strasinger )
-First morning = often preferred for cytology studies because the number of epithelial cells present can be significant
-Random urine “clean catch” with prior hydration = ideal for cytology

104
Q

One method that can be used to increase the cellularity of the random urine specimen is to
have the patient exercise for __minutes by skipping or jumping up and down before specimen
collection.

A

5 minutes

105
Q

Ideal specimen for screening microalbuminuria

A

12 hours urine specimen

106
Q

For diagnosis of PROSTATIC INFECTION
1st container =
2nd container =
3rd container=

A

Three glass collection

1st container = first portion of urine
2nd container =midstream portion. THIS WILL SERVE AS CONTROL
3rd container= last portion of urine with prostatic fluid

107
Q

a device used to measure urine S.G in the base of refractive index

A

Refractometer

108
Q

Refractometer specimen volume

A

1 to 2 drops

109
Q

Refractometer Calibrating solution

A

a. 3% NaCL = 1.015 +/- 0.001
b. 5%NaCL = 1.022 +/- 0.001
c. 7%NACL = 1.035 +/- 0.001
d. 9% sucrose = 1.034 +/- 0.001

110
Q

A weighted float attached to a scale w/c requires correction for temp, glucose, and protein

A

Urinometer

111
Q

Urinometer specimen volume

A

10 to 15 ml urine volume

112
Q

urinometer is added with a ______
& the reading of urinometer in taken at the _______

A

-spinning motion in the urine sample
-lower meniscus

113
Q

Urinometer calibrating solution

A

Calibrating solution:
a. Water = S.G reading should be 1.000
b. Potassium sulfate= S.G reading should be 1.015

114
Q

Based on the principle that the frequency of a sound wave entering a solution changes in proportion to the density of the solution

A

Harmonic
oscillation
densitometry

115
Q

Harmonic oscillation
densitometry linearity?

A

linearity up to 1.080

116
Q

Harmonic oscillation
densitometry was initially used on a semiautomated urinalysis workstation known as the ______

A

Yellow IRIS

117
Q

Glass tube used in Harmonic oscillation densitometry

A

U-shaped glass tube

118
Q

The frequency (the oscillating cycle period) observed is ______ to the sample density, and a microprocessor converts the frequency to a corresponding specific gravity value.

A

directly
proportionate

119
Q

Isosthenuric is the term to describe urine with a S.G of

A

1.010

120
Q

Hyposthenuric/Diluted urine – term to describe urine with S.G of

A

<1.010

121
Q

Hypersthenuric/Concentrated urine- term to describe urine with S.G of

A

> 1.010

122
Q

Normal random urine S.G

A

1.002 to 1.035

123
Q

Condition Associated with urine S.G of greater than 1.035 or >1.040 (Strasinger ,6th)

A

Radiographic contrast dye/x-ray film,
Dextran, and plasma expanders

124
Q

Methods for measuring
urine S.G (give its principle)

-Refractometer
-Urinometer / Hydrometer
-Harmonic oscillation densitometry
-Reagent strip

A

-Refractive index
-Density
-Density
-pKa changes of a polyelectrolyte

125
Q

In refractometer and Urinometer S.G reading, for every 1 gram of glucose you need to subtract ___-

A

-0.004

126
Q

In refractometer and Urinometer S.G reading, for every 1 gram of protein you need to subtract

A

-0.003

127
Q

Formula for S.G Dilution = (?)

Example: A specimen diluted 1:5 with a reading of 1.010 would have an actual S.G of___

A

Diluted S.G x dilution

1.050

128
Q

Pungent odor or distinctive cause

A

Asparagus, Garlic, Onion ingestion
UTI, or increase urinary urea

129
Q

Fruity odor cause

A

DM, and ketones

130
Q

Mousy, musty, or Barny odor cause

A

PKU

131
Q

Odorless urine cause

A

Acute tubular necrosis

132
Q

Mercaptan cause

A

Asparagus, garlic, and egg

133
Q

Sulfur / rotten egg odor

A

Cystinuria

134
Q

Galunggong/ fishy odor/rotten fish

A

Trimetylaminuria

135
Q

11th parameter of reagent strip

A

Vitamin C

136
Q

Handling and storing of
reagent strip

A

✓ Stored in cool and dry area
✓ Dark container or bottle
✓ Stored at room temp
✓ Stored in opaque, tightly closed container
✓ With dessicant to protect light and moisture

137
Q

To ensure against run –over, blot the ___ of the strip with adsorbent paper and holding the strip
horizontally while comparing it with color chart.

A

Edge

138
Q

When new reagents are prepared, they should be tested in ________ with current “in-use” reagents to
ensure equivalent performance

A

Parallell

139
Q

Bilirubin principle & (+) result & reading time

A

-Diazo reaction
-Violet, tan, or pink
- 30 secs

140
Q

Glucose principle & (+) result & reading time

A

-Double sequential enzymatic reaction
-Potassium iodide
= blue-green to brown
-30secs

141
Q

Ketones principle & (+) result & reading time

A

-Sod. Nitroprusside (Legal’s rxn)
-Purple
-40secs

142
Q

S.G principle & (+) result & reading time

A

-pKa change of polyelectrolyte
-Diluted = blue
Concentrated =yellow
-45secs

143
Q

pH principle & (+) result & reading time

A

-Double indicator system
-Acidic = red to yellow
Alkaline = green to blue
-60secs

144
Q

Protein principle & (+) result & reading time

A

-Protein (sorensen’s) error of indicator
-Blue-green
-60secs

145
Q

Blood principle & (+) result & reading time

A

-Pseudoperoxidase activity of hemoglobin
-Green to blue
-60secs

146
Q

Urobilinogen principle & (+) result & reading time

A

-Ehrlch’s reaction
-Red
-60 secs

147
Q

Nitrite principle & (+) result & reading time

A

-Greiss reaction
-Pink
-60secs

148
Q

Leukocyte principle & (+) result & reading time

A

-Leukocyte esterase
-Purple
-120secs

149
Q

What is the first morning urine pH?

A

5 to 6

150
Q

Normal random urine pH

A

4.5 to 8.0

151
Q

Common reasons for urine pH
greater than 8

A
  1. urine specimen that was improperly preserved
  2. old urine specimen
  3. adulterated specimen (i.e., an alkaline agent was added to the urine after collection)
  4. patient was given a highly alkaline substance (e.g., medication, therapeutic agent)
152
Q

Causes of Acid Urine

A

-Emphysema
-Diabetes mellitus
-Starvation
-Dehydration
-Cranberry juice
-High protein diet
-Presence of acid producing bacteria (E. coli)
-Medications such as Mandelamine and Fosfomycintro
methamine
-Ethylene glycol and methanol
-Chronic lung disease

153
Q

Causes of Alkaline Urine

A

-Renal tubular acidosis
-Hyperventilation
-Vomiting
-Vegetarian diet
-Citrus fruits
-Old specimens
-Presence of urease producing bacteria
-Alkaline tide (during and after following meals)
-Presence of urease producing bacteria (Proteus spp. and
Pseudomonas spp)

154
Q

The reagent strip specific gravity test does not measure the total solute content but only those solutes that are __

A

Ionic

155
Q

S.G of urine with end stage renal disease

A

1.010

156
Q

Normal amount of protein in normal urine

A

less than 10 mg/dL or 100 mg per 24 hours

Henry’s and Brunzel = <150mg/24hrs or 1 to 14mg/dl for 24 hours

157
Q

What is the minimum sensitivity for the detection of albumin the urine strip test?

A

10mg/dl

158
Q

The SSA test is performed on clear supernatant urine following centrifugation. The urine
supernate and the reagent are added together and mixed by inversion. After a ___ minute, room temperature incubation, the tube is inverted and evaluated

A

10minutes

159
Q

The SSA method is sensitive to _____ of protein, regardless of the type of protein present.

A

5 to 10 mg/dL

160
Q

SSA Interferences

-False increase/positive

A

-Radiographic contrast dye/x-ray film
-Drugs (Tulbotamide, Penicillin, Sulfonamide, cepalosphorin)
-para-amino-salicylic acid/Salicylates

161
Q

SSA Interferences

-False decrease/negative

A

-Highly alkaline urine
-Quaternary ammonium compounds (e.g Detergents, and soap)

162
Q

MICROSCOPICALLY, WHA T IS THE SSA PATTERN IF PROTEINS CAUSE A POSITIVE REACTION?

A

Amorphous

163
Q

MICROSCOPICALLY, WHAT IS THE SSA PATTERN IF DRUGS AND RADIOGRAPHIC CONTRAST DYE CAUSE A POSITIVE REACTION?

A

Crystalline

164
Q

It precipitates/coagulates/Insoluble at 40-60’C and dissolves/soluble at 100’C

A

BJP

165
Q

Amyloidosis, pre-eclampsia/eclampsia, and immune complexes is associated with ______

A

Proteinuria

166
Q

Earliest indicator of diabetic nephropathy and kidney problem
refers to the presence of albumin in urine above the normal level but below the detectable
range of conventional urine dipstick methods.

A

Microalbuminuria

167
Q

Albumin Excretion Rate (AER) of microalbuminuria

A

20-200ug/min or 30-300mg/24hrs

RMT, 2023 (3 decks)

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