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clinical microscopy Flashcards

1
Q

color change due to drugs: orange

A

PIR
Phenazopyridine
Isoniazid
Rifampicin

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2
Q

color change due to drugs: blue

A

MIA
Methylene blue
Indomethacin
Amitriptyline

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3
Q

color change due to drugs: purple

A

Rifampicin

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4
Q

color change due to drugs: brown

A 
CLMN
Chloroquine
Levodopa
Metronidazole
Nitrofurantoin
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5
Q

color change due to drugs: black

A

MPM (many pa mention)
Metronidazole
Methyl dopa
Phenol derivatives

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6
Q

color change due to drugs: white

A

Propofol

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7
Q

color change due to drugs: green

A

Vitamin B12

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8
Q

color change due to drugs: red/pink

A

CTR
Cloropromazine
Thioridazine
Rifampin

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9
Q

color change due to drugs: blue green

A

Propofol

Rifampicin

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10
Q

food that affects urine color: bright yellow

A

riboflavin

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11
Q

the different clarity of urine:

A

hazy, cloudy, turbid, milky

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12
Q

little particulates but urine print is seen

A

hazy

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13
Q

many particulates and urine is blurred

A

cloudy

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14
Q

urine print cannot be seen

A

turbid

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15
Q

many particulates and clotted

A

milky

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16
Q

turbidity: nonpathological

A 
mucus
spermatozoa
contrast media
fecal contamination
squamous epithelial cell
amorphous urates, phosphates & carbonates
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17
Q

turbidity: pathological

A 
bacteria
yeast
rbc
wbc
lymphatic fluid and lipids
abnormal crystals
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18
Q

soluble in dilute acetic acid

A

RAC
RBCS
Amorphous urates
Carbonates

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19
Q

insoluble in dilute acetic acid

A 
SBYW
Sperm
Bacte
Yeast
WBCs
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20
Q

soluble in alkaline urine

A

Amorphous phosphate and carbonates

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21
Q

soluble in acid urine

A

Amorphous urates & contrast media

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22
Q

soluble in ether

A

LCL
lipid
chyle
lymphatic fluid

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23
Q

soluble with heat

A

amorphous urates & uric acid crystals

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24
Q

normal urine odor

A

nutty/aromatic

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25
Q

ammonia is the odor when keeping urine due to _________?

A

breakdown of urea

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26
Q

sweet fruity odor

A

ketones (DM, vomitting, starvation)

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27
Q

mousy odor

A

phenylketonuria

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28
Q

pungent odor

A

asparagus, onion, garlic (food)

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29
Q

bad, unpleasant odor/ foul, ammonial-like

A

UTI

bacterial contamination

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30
Q

maple syrup

A

maple syrup urine disease: where body cannot breakdown amino acids

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31
Q

bleach odor

A

contamination

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32
Q

cabbage like odor

A

methionine malabsorption

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33
Q

sweaty feet odor

A

isovaleric acidemia

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34
Q

ranch

A

cystine disorder

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35
Q

rancid

A

tyrosinemia

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36
Q

urine volume at night and its specific gravity

A

more than 700 ml ; 1.018

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37
Q

specific gravity of first-morning urine/specimen

A

> 1.020

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38
Q

normal range of specific gravity

A

1.005 to 1.030

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39
Q

normal sample range SG

A

1.010 to 1.025

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40
Q

differentiate isothenuric, hyposthenuric, hypersthenuric

A

iso: 1.010
hypo: <1.010
hyper: >1.010

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41
Q

sg for neonates

A

1.012

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42
Q

SG for infants

A

1.002 - 1.006

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43
Q

sg for adults

A

1.003-1.030

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44
Q

tool used for measuring specific gravity

A

urinometer

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45
Q

tool that measures the refractive index of the solution

A

urine refractometer

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46
Q

principle of refractometer

A

RI can be compared to the velocity of a light in air to the velocity of light in the solution; velocity of light in the sol. is dependent on the amount of particles dissolved in the concentration

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47
Q

advantage of refractometer

A

only 2-3 drops of urine is needed

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48
Q

causes of isosthenuria

A

chronic renal diseases
impairment of renal function
sg of urine is like plasma infiltrate

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49
Q

causes of hyposthenuria

A 
DI 
drinking too much fluids
kidney diseases
glomerulonephritis 
pyelonephritis (umakyat bacteria from bladder to kidney)
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50
Q

causes of hypersthenuria

A 
loss of fluid
less fluid intake (water)
adrenal insufficiency
particles in the urine
hepatic disease
congestive heart failure
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51
Q

pH of urine/average person pH

A

4.6-8.0

5-6

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52
Q

pH is useful for ______ and _______

A

acid base status and crystal identification

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53
Q

in acid base balance, the lungs are responsible for excreting _______ while kidneys are for _________

A

lungs: volatile waste - CO2
kidneys: non-volatile acid - uric acid

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54
Q

if blood pH is too acidic

A

more acids are secreted in urine; this is done by the secretion NH4, hydrogen phosphate and weak oganic acids

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55
Q

if blood pH is too alkaline

A

less acid is secreted in the urine; this is done by reabsorbing bicarbonate from convoluted tubes then attach to H ions to have carbonic acid therefore regulating pH levels

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56
Q

what makes urine acidic

A

a. high protein diet
b. accumulation of CO2 in the body
c. diabetes mellitus where ketones decrease pH

57
Q

what makes urine alkaline

A

a. uti
b. bacterial contamination
c. hyperventilation / loss of CO2
d. use of NaHCO3 and K citrate in treating bacterial contamination
e. diet high in veg., citrus fruits and dairy products

58
Q

abnormal alkaline urine is caused by

A 
SKUAd
Severe vomitting
Kidney disease
UTI
Asthma
59
Q

abnormal acidic urine

A 
severe lung disease (emphysema)
uncontrolled DM
high protein diet
dehydration
starvation
diarrhea
60
Q

which fruit is a good remedy for UTI

A

cranberry (the only fruit that can produce acidic urine)

61
Q

alkaline urine patients with renal calculi (kidney stones) are made up of _____

A

calcium PHOSPHATE

magnesium ammonium PHOSPHATE

62
Q

pH is measured by

A

pH reagent strip (5-9)

63
Q

indicators used in pH strip

A

methyl red - 4-6 (red to yellow)

bromthymol blue 6-9 (yellow to blue)

64
Q

major protein found in the urine; also reabsorbed by tubules

A

albumin

65
Q

this happens due to excess/vigorous exercise, dehydration or fever

A

proteinuria

66
Q

does not indicate kidney disease

A

prerenal proteinuria

67
Q

increase levels of low molecular weight plasma filtrates such as

A

hemoglobin, myoglobin and acute-phase proteins

68
Q

conditions associated with prerenal proteinuria

A

hemoglobinuria
myoglobinuria
acute phase proteinuria

69
Q

damage in the glomerulus or tubules which increases the amount of albumin, rbcs and wbcs in urine

A

renal proteinuria

70
Q

diseases associated with renal proteinura

A 
SLE
Streptococcal glomerulonep
Toxic heavy metals
Viral infection
Pre-eclampsia & hypertension
Strenuous exercise
Microalbuminuria
71
Q

Microalbuminuria is seen where?

A

Seen in diabetic nephropathy when kidneys are damaged due to a patient with DM

72
Q

proteins are added in the urine when passed through vagina prostate, urethra and such

A

postrenal proteinuria

73
Q

conditions associated with postrenal

A

bacterial and fungal infection - produce exudate containing proteins

menstruation, injury, prostatic fluid, spermatozoa - contributes to proteins

74
Q

benign proteinuria seen in young patients

A

orthostatic or postural proteinuria

75
Q

microalbuminuria also increases the _______

A

risk of cardiovascular diseases

76
Q

the significant level of microalbum is

A

20-200microgram/min or 30-300 mg/24hr

77
Q

albumin creatinine ratio in microalbuminuria is

A

> 3.4mg/mmol

78
Q

are monoclonal LIGHT CHAIN IMMUNOGLOBULINS; seen in patient w/ multiple myeloma

A

bence jones proteins

79
Q

how to detect BJP?

A

turbid urine at 40-60C then clear at 100C = positive

80
Q

causes of prerenal proteinuria

A

MuSIM

Multiply myeloma
Severe infection
Intravascular hemolysis
Muscular injury

81
Q

renal proteinuria: glomerular disorders

A 
amyloidosis
hypertension
pre-eclampsia
dehydration
diabetic nephropathy
82
Q

renal proteinuria: tubular

A

toxic agents
heavy metal
fanconi’s syndrome
viral infections

83
Q

postrenal proteinuria

A 
vaginal secretions
SPERMATOZOA
menstrual contamination
prostatic fluid
infections and inflammation
trauma and injury
84
Q

detects urine protein

A

urine dipstick

85
Q

trace positive reaction

A

15-30mg/dL

86
Q

4+ positive reaction

A

2g/dL

87
Q

Trace proteinuria

A

10-30 mg/dL

88
Q

what type of urine specimen is required for microalbuminuria?

A

first morning specimen

89
Q 
report of proteinuria:
1+
2+
3+
4+
A 
1+ = 30 mg/dl
2+ = 100 mg/dl
3+ = 300 mg/dl
4+ = >1000 mg/dl
90
Q

precipitation method of detecting proteinuria

A

sulfosalicylic acid

91
Q

another precipitation method applied in automation

A

TCA (trichloroacetic acid)

92
Q

normal range in TCA test

A

0.05-0.1g/24 hr

93
Q

buffer used in heat coagulatoin test

A

5M acetate buffer which is composed of anhydrous sodium acetate & glacial acetic acid

94
Q

orthostatic/postural proteinuria reporting

A

negative: first specimen
positive: second specimen

95
Q

heat and acid: positive, negative, false positives and false negatives

A

positive: albumin, globulins, bence jones
false negatives: highly alkaline urine
false positives: confused with PO4 and urates, drug metabolites (s, t, p)

96
Q

reagent strip: positive, negative, false positives and false negatives

A

positive: albumin only
false negative: highly diluted urine, high salt concentration
false positive: skin disinfectants

97
Q

sulfosalicylic: positive, negative, false positives and false negatives

A

positive: globulins, glycoproteins, albumin, bence jones
false negatives: highly alkaline urine
false positives: confused with PO4 and urates, drug metabolites (s, t, p, c, c)

98
Q

used to differentiate glomerular and tubular dysfunction

A

beta-2-microglobulin

99
Q

normal level of glucose in a healthy individual

A

100 mg/dl or less

100
Q

what is the value of the renal threshold

A

160-180mg/dl

101
Q

convoluted tubule responsible for reabsorbing glucose filtered by glomerulus

A

proximal convoluted tubule

102
Q

which convoluted tubule is responsible for releasing the excess glucose not absorbed by the proximal CT?

A

distal CT

103
Q

hormone responsible for converting glucose to glycogen? aka glycogenesis

A

insulin

104
Q

refers to the breakdown of glycogen to glucose

A

glycogenolysis

105
Q

inhibitor of insulin secretion

A

epinephrine

106
Q

epinephrine is secreted during

A

myocardial infarction, cerebrovascular diseases, stress

107
Q

renal glycosuria may be seen in patients with

A

RG-FOE
end-stage renal disease
fanconi’s syndrome
osteomalacia

108
Q

copper sulfate is reduced by alkaline and heat to cuprous oxide; this detects every reducing substances in the urine (general)

A

copper reduction method

blue: negative
green, yellow, orange/red: positive

109
Q

this detects specific glucose in the urine

A

glucose-oxidase method

110
Q

chromogens added to H2O2 (when oxidized so glucose to gluconic acid)

A

KI - green to brown

Tetramethylbenzidine - yellow to green

111
Q

copper reduction method is also known as

A

benedicts reaction :D

112
Q

false positive in benedict’s reaction

A 
vit c
salicylates
homogentisic acid
antibiotics
levodopa
contrast media
113
Q

glucose oxidase false negative

A

homogentisic acid
many amount of salicylate
vit c

114
Q

conditions associated with renal glycosuria

A 
diabetes
iv fluids
adrenal gland diseases
liver damage
kidney diseases
pregnant woman (normal)
115
Q

condition where hormones act against insulin

A

hyperglycemia

116
Q

conditions where hyperglycemia is seen

A 
pancreatitis
pancreatic disorder
acromegaly
cushings syndrome
pheochromocytoma
117
Q

3 intermediate products of ketones from lipolysis

A

acetone 2&
acetoacetate 20%
B-hydroxybutyric acid 78%

118
Q

READ & UNDERSTAND WAG MO TO KAKALIMUNTAN

A

for patients with diabetes, if their kidneys are damaged (diabetic nephropathy), they won’t be able to use glucose and so fats are broken down (lipolysis) this leads to DECREASE REESTERIFICATION and INCREASES PLASMA FREE FATTY ACIDS which INCREASES KETONE BODIES

119
Q

what happens when re-esterification happens?

A

plasma free fatty acids undergo esterification to form triglycerides to be converted to LDL

LDL is stored in the liver

120
Q

ketones arent measurable in the urine since …..

A

they broke down into CO2 and H2O

121
Q

fat metabolism where fats are broken down instead of carbohydrates are seen in patients with

A

DM
Vomitting
Starvation

122
Q

deficiency in insulin

A

ketonuria

123
Q

ketonuria excretes ____, ____, and ______ to have ketoacidosis

A

Na
K
Ca

124
Q

If DM is not treated to the point where ketonuria exists, he/she may have

A

acidosis

diabetic coma

125
Q

patient with DM has ________ odor in their breath

A

fruity odor due to acetone from the lungs

126
Q

ketone strip test is reported as?

A

negative - 0
small amounts - 10
moderate amounts - 30
large amounts - 80

127
Q

test where ketone bodies are measured through sodium nitroprusside reaction

A

ketone strip test

128
Q

what can we measure in ketone strip test?

A

acetoacetate+ acetone since hindi reactive si b-hydroxybutyric acid

129
Q

in ketone strip test, the color changes from what?

A

lavender to maroon (purple)

130
Q

in rothera’s test, what composes the powder being used

A

sodium nitroprusside
sodium carbonate
ammonium sulfate

131
Q

explain rothera’s test

A

add 0.5g of powder to the slide and add 2 drops of urine

positive: change color from lavender to purple

132
Q

abnormal ketonuria happens when ______

A

uncontrolled diabetes
low carbo diet
starvation
alcoholism

133
Q

ketones are seen in fasting after ____ hours

A

after 18 hours

134
Q

high glucose in pregnant woman and low ketone in pregnant woman

T or F

A

T

135
Q

what indicates when urine is colorless?

A

kidney disease or diabetes mellitus

136
Q

what indicates when urine is amber/orange

A

bilirubin

137
Q

which is responsible for the dark yellow color when dehydrated?

A

bilirubin or urobilin

138
Q

responsible for the pink color of urine when at lower temperature

A

uroerythrin

internship (2 decks)

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