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PMLS FINALS > Clinical Microscopy > Flashcards

Clinical Microscopy Flashcards

1
Q

Performance of physical, chemical, and microscopic analysis on non-blood body fluids such as urine, semen, serous fluids, and synovial fluid

A

Clinical Microscopy

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2
Q

Clinical Microscopy is a performance of __________, __________, and __________________ on non-blood body fluids such as _______, _______, _____________, and _______________

A

physical

chemical

microscopic analysis

urine

semen

serous fluids

synovial fluid

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3
Q

Brief historical background of urinalysis (11)

A

a. Hippocrates

b. Rufus of Ephesus

c. Isaac Judaeus

d. Middle Ages

e. Thomas Bryant

f. Jean Baptiste van Helmont

g. Frederik Dekker

h. Thomas Addis

i. Richard Bright

j. 1930’s

k. Reagent Strips (Urine Test Strip)

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4
Q

Wrote a book on “uroscopy”

A

Hippocrates (15th century)

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5
Q

Made the first description of hematuria as the presence of blood in the urine

A

Rufus of Ephesus (50 AD)

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6
Q

Rufus of Ephesus made the first description of ____________ as the presence of blood in the urine

A

Hematuria

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7
Q

Considered one of the founders of the origins of nephrology

A

Isaac Judaeus (900 AD)

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8
Q

Isaac Judaeus wrote ________________, which detailed the concepts of urine formation, urinary sediments, and urine characteristics in relation to diseases.

A

Kitab al Baul (Book of Urine)

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9
Q

Isaac Judaeus wrote Kitab al Baul (Book of Urine), which detailed the concepts of _________, _________, ________, in relation to diseases

A

urine formation
urinary sediments
urine characteristics

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10
Q

Physicians concentrated their efforts very intensively on the art of uroscopy, receiving instruction in urine examination as part of their training

A

Middle Ages

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11
Q

When do the color charts had been developed that described the significance of ____ different colors

A

1140; 20

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12
Q

In the middle ages, chemical testing of urine involved _________, and ________ for glucose

A

“ant testing” “taste testing”

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13
Q

Charlatans without medical credentials began offering health-related predictions of patients using their urine samples

A

Pisse prophets

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14
Q

He published a book that exposed the scam offered by the “pisse prophets”

A

Thomas Bryant (1627)

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15
Q

Thomas Bryant’s revelations uncovered in his book inspired the passing of the first ___________ in England

A

medical licensure laws

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16
Q

Introduced the gravimetric analysis of urine by weighing a number of 24-hour urine specimens. No significant conclusions were derived from his measurements

A

Jean Baptiste van Helmont

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17
Q

Helmont introduced the ________________ of urine by weighing a number of _________ urine specimens.

A

gravimetric analysis

24-hour

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18
Q

True or False: Helmont’s analysis brought significant conclusions derived from his measurements

A

False

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19
Q

He discovered albuminuria by boiling urine; observed that proteins in the urine precipitated when boiled with acetic acid

A

Frederik Dekker

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20
Q

What did Dekker discover by boiling urine?

A

Albuminuria

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21
Q

He first attempted to standardize the quantitation of formed elements in urine microscopic analysis

A

Thomas Addis

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22
Q

It used a hemocytometer to count the number of RBCs, WBCs, casts, and epithelial cells present in a 12-hour urine sample

A

Addis count

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23
Q

Introduced the concept of urinalysis as part of a doctor’s routine patient examination

A

Richard Bright (1827)

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24
Q

Revealed the presence of albumin in heated urine samples

A

Richard Bright (1827)

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25
Q

Studied renal diseases and clearly established the overall correlation of edema, albumin in urine, and diseased kidneys observed after death

A

Richard Bright (1827)

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26
Q

Bright

A
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27
Q

Bright studied renal diseases and clearly established the overall correlation of ________, ________, and ___________ observed after death

A

edema, albumin in urine, diseased kidneys

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28
Q

1930s

A

The number and complexity of the tests performed in a urinalysis had reached a point of impracticality, and urinalysis began to disappear from routine examinations

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29
Q
  • Rescued routine urinalysis by making chemical and physical examination of urine samples easier
  • 1950s: Urine test strips were first made on industrial scale and offered commercially
  • 1964: The company Boehringer Mannheim (today Roche) launched its first Combur test strips
A

Reagent Strips (Urine Test Strip)

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30
Q

When did urine test strips were first made on industrial scale and offered commercially

A

1950s

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31
Q

What company in 1964 launched its first Combur test strips

A

Boehringer Mannheim (today Roche)

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32
Q

Routine work in the Clinical Microscopy Section

A

Midstream Clean-Catch Method

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33
Q

Common Collection Method:
a. Patients must be provided instructions for cleansing. Mild antiseptic towelettes are recommended as cleansing materials
* Patients are instructed to wash their hands before beginning the collection
* Male patients should clean the glans penis. For uncircumcised patients, they should withdraw the
foreskin
* Female patients should separate the labia and clean the urinary meatus and surrounding area
b. After cleansing, patients are to void first into the toilet, then collect an adequate amount of urine in a
sterile container, and finish voiding into the toilet

A

Midstream Clean-Catch Method

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34
Q

What are the recommended as cleansing materials?

A

Mild antiseptic towelettes

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35
Q

Patients are instructed to ___________ before beginning the collection

A

wash their hands

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36
Q

Method for male patients are required to clean the ___________

A

glans penis

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37
Q

For uncircumcised patients, they should withdraw the ________

A

foreskin

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38
Q

Method for female patients should separate the _________ and clean the ____________ and the surrounding area

A

labia, urinary meatus

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39
Q

ii. What are the factors to consider in the physical examination of urine

A

Color, Clarity, Specific Gravity, Odor

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40
Q

To examine urine color, examine the specimen under a ___________, looking down against what background?

A

good light source

white

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41
Q

5 normal urine colors

A

straw, pale yellow, yellow, dark yellow, & amber (relatively dehydrated states)

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42
Q

Pigments that are responsible for urine coloration

A

Urochrome, Uroerythin, Urobilin

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43
Q

Responsible for the yellow color of urine

A

Urochrome

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44
Q

A pink pigment that is most evident in refrigerated specimens as a result of amorphous urates precipitation

A

Uroerythrin

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45
Q

Uroerythrin is a pink pigment due to?

A

amorphous urates precipitation

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46
Q

An orange-brown color to urine samples that is an indication of not fresh

A

Urobilin

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47
Q

Refers to the transparency/turbidity of a urine specimen

A

clarity

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48
Q

True or False: The amount of turbidity will correspond to the amount of material observed during microscopic examination

A

True

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49
Q

True or False: Clarity is examined in a clear container while holding it in front of a light source

A

True

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50
Q

Clarity
Reporting: No visible particulates

A

Clear

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51
Q

Considered normal for a turbidity in midstream clean-catch urine

A

Clear

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52
Q

Clarity
Reporting: Transparent

53
Q

Clarity
Reporting: Few particulates

54
Q

Clarity
Reporting: print easily seen in urine

55
Q

Clarity
Reporting: Few particulates, print easily in urine

56
Q

Clarity
Reporting: Many particulates

57
Q

Clarity
Reporting: print blurred through urine

58
Q

Clarity
Reporting: Many particulates, print blurred through urine

59
Q

Clarity
Reporting: Print cannot be seen through urine

60
Q

Clarity
Reporting: May precipitate or be clotted

61
Q

Different reportings in the clarity of urine

A

Clear, Hazy, Cloudy, Turbid, Milky

62
Q

An indicator of concentration of dissolved material in the urine

A

Specific Gravity

63
Q

Specific gravity is affected by both _____ & _____ of particles in the solution

A

number & size

64
Q

It is affected by both number & size of particles in a solution

A

Specific Gravity

65
Q

Normal urine specific gravity (random)

A

Random 1.003 to 1.035

66
Q

Normal urine specific gravity (24-hour sample)

A

24-hour urine sample: 1.015-1.025

67
Q

<1.003

A

Probably not a urine sample

68
Q

Range of sample that is probably not a urine

69
Q

> 1.035

A

Radiographic contrast media

70
Q

Range of sample that is a radiographic contrast media

71
Q

2 methods of measuring specific gravity

A

Direct measurement using urinometers (hydrometer)

Indirect measurement using refractometer which measures refractive index of the urine sample

72
Q

A direct method that measures urine using?

A

Urinometer (hydrometer)

73
Q

An indirect method that measures urine using?

A

refractometer - measures refractive index

74
Q

An incidental observation

75
Q

It is not a part of a routine urinalysis

76
Q

Odor: Aromatic

A

Cause: Normal

77
Q

Odor: Foul

A

Cause: Bacterial decomposition, UTI

78
Q

Odor: Ammonia-like

A

Cause: Bacterial decomposition, UTI

79
Q

Odor: Foul, ammonia-like

A

Cause: Bacterial decomposition, UTI

80
Q

Odor: Fruity

A

Cause: Ketones (diabetes mellitus, starvation, vomiting)

81
Q

Odor: Sweet

A

Cause: Ketones (diabetes mellitus, starvation, vomiting)

82
Q

Odor: Fruity, Sweet

A

Cause: Ketones (diabetes mellitus, starvation, vomiting)

83
Q

Odor: Maple syrup

A

Cause: Maple syrup urine disease

84
Q

Odor: Mousy

A

Cause: Phenylketonuria

85
Q

Odor: Rancid

A

Cause: Tyrosinemia

86
Q

Odor: Sweaty feet

A

Cause: Isovaleric acidemia

87
Q

Odor: Cabbage

A

Cause: Methionine malabsorption

88
Q

Odor: Rotting fish

A

Cause: Trimethylaminuria

89
Q

Odor: Bleach

A

Cause: Contamination

90
Q

Odor: Unusual

A

Cause: Ingestion of onions, garlic, and asparagus

91
Q

Odor: Pungent

A

Cause: Ingestion of onions, garlic, and asparagus

92
Q

Odor: Unusual or Pungent

A

Cause: Ingestion of onions, garlic, and asparagus

93
Q

Cause: Normal odor

A

Odor: Aromatic

94
Q

Cause: Bacterial decomposition, UTI

A

Odor: Foul, ammonia-like

95
Q

Cause: Ketones (Diabetes mellitus, starvation, vomiting)

A

Odor: Fruity, Sweet

96
Q

Cause: Maple syrup urine disease

A

Odor: Maple Syrup

97
Q

Cause: Phenylketonuria

A

Odor: Mousy

98
Q

Cause: Tyrosinemia

A

Odor: Rancid

99
Q

Cause: Isovaleric acidemia

A

Odor: Sweaty feet

100
Q

Cause: Methionine malabsorption

A

Odor: Cabbage

101
Q

Cause: Trimethylaminuria

A

Odor: Rotting fish

102
Q

Cause: Contamination

A

Odor: Bleach

103
Q

Cause: Ingestion of onions, garlic, asparagus

A

Odor: Unusual or Pungent

104
Q

True or False: Genetically precipitated people can smell the odor which is produced by asparagus in urine samples

A

False.
*Studies have shown that although everyone who eats asparagus produces urine samples with an odor, only genetically PREDISPOSED people can smell the odor

105
Q

Commonly assessed in the Chemical Examination of Urine

A

Specific Gravity, pH, Protein, Glucose

Others:
Ketones
Blood
Bilirubin
Urobilinogen
Nitrite
Leukocyte esterase

106
Q

Chemical parameters of urine samples are assessed using what?

A

Reagent strips

107
Q

It is consists of chemical-impregnated absorbent pads attached to a plastic strip

A

Reagent Strips

108
Q

A color-producing chemical reaction takes place when the absorbent pad comes in contact with urine

A

Reagent Strips

109
Q

True or False: Reactions are interpreted by comparing the color produced on the pad with a chart supplied by the manufacturer

110
Q

2 major types of reagent strips

A

Multistix (Siemens Medical Solutions Diagnostics)
Chemstrip (Roche Diagnostics)

111
Q

Reagent strip made by Siemens Medical Solutions Diagnostics

112
Q

Reagent strip by Roche Diagnostics

113
Q

What is tested in the chemical parameters of urine when specific gravity is involved

A

its physical property

114
Q

Normal Urine pH (random, first morning, normal protein diet)

A

Random: 4.5 to 8.0
First Morning urine samples: 5.0 to 6.0
With normal protein diet: 4.5 to 6.5

115
Q

Normal Urine pH (Random)

A

Random: 4.5 to 8.0

116
Q

Normal Urine pH (First morning urine samples)

A

First Morning urine samples: 5.0 to 6.0

117
Q

Normal Urine pH (Normal protein diet)

A

With normal protein diet: 4.5 to 6.5

118
Q

Normal Urine protein

A

<10 mg/dL OR <100 mg/24 hours
Henry: 150 mg/24 hours

119
Q

Normal Urine glucose

A

15 mg/dL
Fasting: 2 to 20 mg/dL per 100 mL urine

120
Q

Normal Urine glucose (fasting)

A

Fasting: 2 to 20 mg/dL per 100 mL urine

121
Q

How many urine sediments from a centrifuged urine sample is placed on a glass slide?

A

20 µL (some labs use one or two drops)

122
Q

True or False: After the urine sample is placed, a cover slip is then placed on top of the slide after observing the sample

A

False

A cover slip is then placed on top of the slide BEFORE observing the sample

123
Q

What objectives are used in the microscopic examination of urine samples

A

Low power objective
High power objective

124
Q

What are the assessed elements seen in the microscopic examination of urine

A

Cellular elements
Urinary crystals
Casts
Mucus threads
Bacteria
Other miscellaneous elements

125
Q

Cellular elements seen in microscopic examination of urine

A

Cellular elements: Red blood cells, white blood cells, epithelial cells (normal and pathologic variations)

126
Q

It is an element found only in the urinary sediment that are unique to the kidney

127
Q

It is formed within the kidney at the lumens of the distal convoluted tubule and collecting ducts

128
Q

Casts are formed within the kidney at the?

A

Lumens of the distal convoluted tubule and collecting ducts

129
Q

Examples of other miscellaneous elements found on a microscopic examination of urine

A

Yeast cells, parasites, spermatozoa

PMLS FINALS (2 decks)

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