Clinical Microscopy Flashcards
Performance of physical, chemical, and microscopic analysis on non-blood body fluids such as urine, semen, serous fluids, and synovial fluid
Clinical Microscopy
Clinical Microscopy is a performance of __________, __________, and __________________ on non-blood body fluids such as _______, _______, _____________, and _______________
physical
chemical
microscopic analysis
urine
semen
serous fluids
synovial fluid
Brief historical background of urinalysis (11)
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)
Wrote a book on “uroscopy”
Hippocrates (15th century)
Made the first description of hematuria as the presence of blood in the urine
Rufus of Ephesus (50 AD)
Rufus of Ephesus made the first description of ____________ as the presence of blood in the urine
Hematuria
Considered one of the founders of the origins of nephrology
Isaac Judaeus (900 AD)
Isaac Judaeus wrote ________________, which detailed the concepts of urine formation, urinary sediments, and urine characteristics in relation to diseases.
Kitab al Baul (Book of Urine)
Isaac Judaeus wrote Kitab al Baul (Book of Urine), which detailed the concepts of _________, _________, ________, in relation to diseases
urine formation
urinary sediments
urine characteristics
Physicians concentrated their efforts very intensively on the art of uroscopy, receiving instruction in urine examination as part of their training
Middle Ages
When do the color charts had been developed that described the significance of ____ different colors
1140; 20
In the middle ages, chemical testing of urine involved _________, and ________ for glucose
“ant testing” “taste testing”
Charlatans without medical credentials began offering health-related predictions of patients using their urine samples
Pisse prophets
He published a book that exposed the scam offered by the “pisse prophets”
Thomas Bryant (1627)
Thomas Bryant’s revelations uncovered in his book inspired the passing of the first ___________ in England
medical licensure laws
Introduced the gravimetric analysis of urine by weighing a number of 24-hour urine specimens. No significant conclusions were derived from his measurements
Jean Baptiste van Helmont
Helmont introduced the ________________ of urine by weighing a number of _________ urine specimens.
gravimetric analysis
24-hour
True or False: Helmont’s analysis brought significant conclusions derived from his measurements
False
He discovered albuminuria by boiling urine; observed that proteins in the urine precipitated when boiled with acetic acid
Frederik Dekker
What did Dekker discover by boiling urine?
Albuminuria
He first attempted to standardize the quantitation of formed elements in urine microscopic analysis
Thomas Addis
It used a hemocytometer to count the number of RBCs, WBCs, casts, and epithelial cells present in a 12-hour urine sample
Addis count
Introduced the concept of urinalysis as part of a doctor’s routine patient examination
Richard Bright (1827)
Revealed the presence of albumin in heated urine samples
Richard Bright (1827)
Studied renal diseases and clearly established the overall correlation of edema, albumin in urine, and diseased kidneys observed after death
Richard Bright (1827)
Bright
Bright studied renal diseases and clearly established the overall correlation of ________, ________, and ___________ observed after death
edema, albumin in urine, diseased kidneys
1930s
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
- 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
Reagent Strips (Urine Test Strip)
When did urine test strips were first made on industrial scale and offered commercially
1950s
What company in 1964 launched its first Combur test strips
Boehringer Mannheim (today Roche)
Routine work in the Clinical Microscopy Section
Midstream Clean-Catch Method
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
Midstream Clean-Catch Method
What are the recommended as cleansing materials?
Mild antiseptic towelettes
Patients are instructed to ___________ before beginning the collection
wash their hands
Method for male patients are required to clean the ___________
glans penis
For uncircumcised patients, they should withdraw the ________
foreskin
Method for female patients should separate the _________ and clean the ____________ and the surrounding area
labia, urinary meatus
ii. What are the factors to consider in the physical examination of urine
Color, Clarity, Specific Gravity, Odor
To examine urine color, examine the specimen under a ___________, looking down against what background?
good light source
white
5 normal urine colors
straw, pale yellow, yellow, dark yellow, & amber (relatively dehydrated states)
Pigments that are responsible for urine coloration
Urochrome, Uroerythin, Urobilin
Responsible for the yellow color of urine
Urochrome
A pink pigment that is most evident in refrigerated specimens as a result of amorphous urates precipitation
Uroerythrin
Uroerythrin is a pink pigment due to?
amorphous urates precipitation
An orange-brown color to urine samples that is an indication of not fresh
Urobilin
Refers to the transparency/turbidity of a urine specimen
clarity
True or False: The amount of turbidity will correspond to the amount of material observed during microscopic examination
True
True or False: Clarity is examined in a clear container while holding it in front of a light source
True
Clarity
Reporting: No visible particulates
Clear
Considered normal for a turbidity in midstream clean-catch urine
Clear