CLINICAL MICROSCOPY Flashcards
The yellow color of urine is caused by the presence of a pigment, which Thudichum named
Urochrome
Urochrome levels is standing urine sample at room temperature
Increase
S.G of urine in patient with Diabetes mellitus
Increase/ Hypersthenuria
S.G of urine in patient with Diabetes insipidus
Decrease/ Hyposthenuria
Produces yellow foam in urine when shaken
Bilirubin and Phenazopyridine (Pyridium)
Produces white foam in urine when shaken
Protein/albumin
Major ORGANIC substance in urine
Urea
Major INORGANIC substance in urine
Chloride
The single most useful substance that identifies a fluid as urine is its uniquely high _________ concentration (approximately 50 times that of plasma)
Creatinine
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
Specific gravity
Principle of refractometer
Refractive index
Refers to the index of the velocity of light in air / velocity of light in solution
Refractive index
Preservative:
Most common and easiest Can be used for microbiological studies PRECIPITATES AMORPHOUS CRYSTALS
Refrigeration (up to 24 hours)
Preservative:
Does not interfere with routine test
Toluene and Phenol
Preservative:
Excellent sediment preservative Fixative for Addis counting
Formalin
Preservative:
For automated instrument
Yellow plain UA
Preservative:
For culture and sensitivity and protein testing
Boric acid
Preservative:
Used for cytology
Saccomano (preferred) and Formalin
Preservative:
Catecholamines (e.g epinephrine)
Concentrated HCL
Preservative:
For quantitative analysis of steroids, hormones,
Acids (HCl, glacial acetic acid)
Saccomano fixative
50% ETHANOL + 2%CARBOWAX (POLYETHYLENE GLYCOL)
Analyte least affected or unaffected in unpreserved urine
Protein / albumin
Trichomonads on unpreserved urine will ______ due to loss of characteristic motility and death
Decrease
Urine colors:
Carotene
Orange
Urine colors:
Phenol when oxidized
blue-green or Green
Urine colors:
Phenol derivatives
Black or Brown (Brunzel)
Urine colors:
Rifampin
red or orange red
Urine colors:
Myoglobin (25mg/dl), RBC, and beets
Red
Urine colors:
Porphyrin
Port-wine or Burgundy Red
Urine colors:
Fucsin /aniline dye in candy
Red
Urine clarity reporting:
No visible particulates, transparent
CLEAR
Urine clarity reporting:
Few particulates, print easily seen through urine
HAZY
Urine clarity reporting:
Many particulates, print blurred through urine
Cloudy
Urine clarity reporting:
Print cannot be seen through urine
Turbid
Urine clarity reporting:
May precipitate or be clotted
Milky
Lab correlation in urine turbidity:
Amorphous urates, radiographic contrast media
Acidic urine
Lab correlation in urine turbidity:
Amorphous phosphates, carbonates
Alkaline urine
Lab correlation in urine turbidity:
Amorphous urates, uric acid crystals
Soluble with heat
Lab correlation in urine turbidity:
RBCs, Amorphous phosphates, carbonates
Soluble in dilute acetic acid
Lab correlation in urine turbidity:
WBCs, Bacteria, yeast, spermatozoa
Insoluble in dilute acetic acid
Lab correlation in urine turbidity:
Lipids, lymphatic fluid,chyle
Soluble in ether
Specimen volume
10 to 15 ml (average of 12ml)
Container capacity
50 ml
Types of specimen for glucose monitoring
a. first morning urine sample
b. second morning urine sample
c. 2-hours post prandial urine sample
Types of specimen for culture and sensitivity
a. Midstream clean catch
b. Catheterized urine sample
c. Suprapubic aspiration (especially for anaerobic microbes)
Used to differentiate kidney infections
Catheterized, ureteral collection technique
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.
Pediatric collection bag
For ease and convenience, routine screening. It is collected at any time, usually during daytime hours, and without prior patient preparation
Random urine
Used for quantitative measurements of analyte that shows diurnal/circardian variation (e.g hormones, proteins, glomerular filtration rate)
Time specimens
To obtain an accurate timed specimen, the patient must begin and end the collection period with an
empty bladder
In Time Specimens, All specimens should be _________ during the collection period and may also require addition of a chemical preservative
refrigerated or kept on ice
Preferred specimen for Urobilinogen measurement
Afternoon urine
(2pm to 4pm)
Urine specimen for cytology
Suprapubic aspiration
First morning
Random urine “clean catch” with prior hydration
often preferred for cytology studies because the number of epithelial cells present can be significant
First morning
ideal for cytology
Random urine “clean catch”
Ideal specimen for screening microalbuminuria
12 hours urine specimen
For diagnosis of PROSTATIC INFECTION
Three glass collection
In three glass collection, what container is the first portion of urine?
1st container
In three glass collection, what container is for the midstream portion?
2nd container
In three glass collection, what container is the last portion of urine with prostatic fluid?
3rd container
a device used to measure urine S.G in the base of refractive index
Refractometer
Specimen volume for refractometer
1 drop
Requires correction for glucose and protein
Refractometer
A weighted float attached to a scale
Urinometer
How much urine volume does the urinometer requires?
10 to 15 ml
Requires correction for temp, glucose, and protein
Urinometer
Based on the principle that the frequency of a sound wave entering a solution changes in proportion to the density of the solution
Harmonic oscillation densitometry
It is rarely used today despite its ability to accurately and precisely determine urine specific gravity with linearity up to 1.080
Harmonic oscillation densitometry
the term to describe urine with a S.G of 1.010
Isosthenuric
term to describe urine with S.G of <1.010
Hyposthenuric/Diluted urine
term to describe urine with S.G of
> 1.010
Normal random urine S.G
1.002 to 1.035
Condition Associated with urine S.G of greater than 1.035 or >1.040
Radiographic contrast dye/x-ray film, Dextran, and plasma expanders
Principle:
Refractive index
Refractometer
Principle:
Density
Urinometer / Hydrometer and Harmonic oscillation densitometry
Principle:
pKa changes of a polyelectrolyte
Reagent strip
In refractometer and Urinometer S.G reading, for every 1 gram of glucose you need to subtract ___-
0.004
In refractometer and Urinometer S.G reading, for every 1 gram of protein you need to subtract
0.003
Formula for S.G Dilution = Diluted S.G x dilution Example: A specimen diluted 1:5 with a reading of 1.010 would have an actual S.G of__
1.050
Odor of urine
Urinod
Odor of urine:
Asparagus, Garlic, Onion ingestion UTI, or increase urinary urea
Pungent odor or distinctive
Odor of urine:
DM, and ketones
Fruity
Odor of urine:
PKU
Mousy, musty, or Barny
Odor of urine:
Acute tubular necrosis
Odorless
Odor of urine:
Asparagus, garlic, and egg
Mercaptan
Odor of urine:
Cystinuria
Sulfur / rotten egg
Odor of urine:
Trimetylaminuria
Galunggong/ fishy odor/rotten fish
Odor of urine:
AROMATIC, FRAGRANT
NORMAL
Odor of urine:
UTI, Bacterial decomposition
AMMONIA-Like, Fetid
Odor of urine:
MSUD
Maple syrup/ Caramel sugar
Odor of urine:
Tyrosinemia
Rancid
Odor of urine:
Isovaleric acidemia
Sweaty feet
Odor of urine:
Methionine malabsorption
Cabbage, HOPS
Odor of urine:
CONTAMINATION
BLEACH
Odor of urine:
Hawkinsinuria
Swimming poo
Odor of urine:
Hydroxymethylglutaric aciduria
Cat Urine
Odor of urine:
Multiple carboxylase deficiency
Tom Cat
