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Clinical Microscopy Flashcards

1
Q

Potentially harmful microorganism

A

Biological hazards

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2
Q

Transmission of microorganisms

A

Chain of infection

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3
Q

Essential in preventing the spread of infection

A

Chain of infection

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4
Q

Chain of infection requires a continuous link between:

A
  1. Source
  2. Mode (means) of transmission
  3. Susceptible host
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5
Q

6 components of the chain of infection
“IREMES”

A
  1. Infectious agent
  2. Reservoir
  3. Exit portal
  4. Mode of transmission
  5. Entry portal
  6. Susceptible host
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6
Q

3 routes of infection

A
  1. Inhalation
  2. Ingestion
  3. Direct inoculation or skin contact
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7
Q

Personal Protective Equipment

A
  1. Gloves
  2. Fluid-resistant gowns
  3. Eye and face shields
  4. Countertop shields
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8
Q

______ is the primary method of infection transmission

A

Hand contact

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9
Q

The best way to break the chain of infection

A

Handwashing

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10
Q

When hands are visibly soiled, wash hands with ___

A

soap and water

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11
Q

When hands are not visibly soiled, apply ___

A

alcohol based hand-rub (sanitizer)

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12
Q

Handwashing procedure
1. Wash hands with ___
2. Apply antimicrobial soap.
3. Rub to form a lather, create _____, and loosen debris
4. Thoroughly clean between fingers, and up to the wrist for at least ____
5. Rinse hands in a ____ position
6. Dry with a paper towel
7. Turn off faucets with a clean paper towel to prevent recontamination .

A
  1. warm water
  2. friction
  3. 15 (or 20) seconds
  4. Downward
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13
Q

Handwashing song

A

Happy Birthday 2x

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14
Q

All biological wastes, except urine, must be placed in appropriate containers labeled with the_____ symbol

A

Biohazard

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15
Q

The accepted BIOHAZARD label is _____

A

Fluorescent orange

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16
Q

Discard urine by pouring it into a _____
Avoid splashing, and then flush with water

A

laboratory sink

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17
Q

Empty urine containers can be discarded as ____

A

nonbiologically hazardous waste

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18
Q

Disinfection of the sink using a ________ should be performed ______

A

1:5 or 1:10 dilution of sodium hypochlorite; daily

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19
Q

Disinfection eliminates many or all pathogenic microorganisms, except _____

A

bacterial spores

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20
Q

A 1:10 dilution of sodium hypochlorite is prepared by adding _______
effective for 1 month; used for disinfecting countertops and spills

A

1 part of sodium hypochlorite to 9 parts of water

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21
Q

The basic outline of the biohazard symbol is a plain trefoil, which is _____ equally like in a triple Venn diagram with the overlapping parts erased. The diameter of the overlapping part is equal to half the radius of the three circles.

A

three circles overlapping each other

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22
Q

Sharp objects are disposed of in ___

A

puncture resistant containers

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23
Q

Color of puncture-resistant containers

A

red

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24
Q

Type of hazard where procedures using radioisotopes are performed

A

Radioactive hazards

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25
Q

True or false.
The best method of radioactive waste disposal is to store the used radioactive material in a locked, marked room until the background count is down to 10 half-lives for radioiodine,

A

True

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26
Q

Best first aid for chemical spills

A

Flush the are with amounts of water for at least 15 minutes then seek medical attention

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27
Q

For alkali or acid burns in the eye, wash out eye thoroughly with ____ for ____

A

running water for 15 minutes.

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28
Q

DO not neutralize chemicals that come in contact with the skin.
Acid spills on floors can be neutralized and the soaked up with wet rages or spill pillows

A

Both statements are True

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29
Q

Proper handling of chemicals “AW!”

A

Acid to water

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30
Q

What will happen when water is added to acid

A

explosion

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31
Q

The National Fire Protection Association (NFPA) Hazardous Materials Classification uses numbers from ____ to classify hazard severity, with 4 representing extremely hazardous.

A

0 to 4

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32
Q

Yellow Quadrant
Reactivity or Stability Hazard

“SUVSM”

A

0 = Stable
1 = Unstable if heated
2 = Violent chemical change
3 = Shock and heat may deteriorate/detonate
4 = May deteriorate/detonate

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33
Q

White Quadrant
Specific Hazard

A

OXY = Oxidizer
ACID = Acid
ALK = Alkali
COR = Corrosive
W = Use no water
Radiation

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34
Q

Blue Quadrant
Health Hazard

“NSHED”

A

0 = Normal material
1 = Slightly hazardous
2 = Hazardous
3 = Extreme danger
4 = Deadly

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35
Q

Red Quadrant
Flammability hazard

A

0 = Will not burn
1 = Above 200 deg F
2 = Below 200 deg F
3 = Below 100 deg F
4 = Below 73 deg F

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36
Q

Degree of Hazards (Hazard Index)

“No SMS Ex’s”

A

0 = No/Minimal hazard
1 = Slight Hazard
2 = Moderate hazard
3 = Serious hazard
4 = Extreme / Severe Hazard

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37
Q

All electrical equipment is grounded in a ____ to avoid electric shock

A

3-pronged plug

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38
Q

If electrical shock occurs, never touch the person or the equipment involved. T/F

A

T

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39
Q

Flammable chemicals should be stored in safety cabinets and ____ away from heat sources

A

explosion-proof refrigerators

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40
Q

laboratory fire drills are held

A

Annually

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41
Q

When fire is discovered, RACE

A

Rescue anyone in immediate danger
Activate the institutional fire alarm system
Close all doors to potentially affected areas
attempt to Extinguish the fire, if possible; exit the area

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42
Q

To operate the fire extinguisher, PASS

A

Pull the pin
Aim at the base of the fire
Squeeze handles
Sweep nozzle side to side

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43
Q

Fire type and fire extinguisher for ordinary combustibles: paper, cloth, rubbish, plastic, wood

A

Fire Type A
Extinguisher: Water, dry chemical, loaded steam

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44
Q

Fire type and fire extinguisher for flammable liquids: alcohol, ether, grease, gasoline, paints, oil

A

Fire Type B
Extinguisher: Dry chemical, carbon dioxide, halon foam

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45
Q

Fire type and fire extinguisher for electrical equipment and motor switches

A

Fire Type C
Extinguisher: Dry chemical, carbon dioxide, halon - best

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46
Q

Fire type and fire extinguisher for flammable metals: mercury, magnesium, sodium, lithium

A

Fire Type D
Extinguisher: Metal X, sand; dry powder; fought by firefighters only

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47
Q

Fire type and fire extinguisher for detonation (Arsenal fire)
E for Explosives

A

Fire Type E
Extinguisher: Allowed to burn out and nearby materials protected

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48
Q

Fire Type and fire extinguisher for cooking media: grease, oils, fats

A

Fire Type K
Extinguisher: Liquid designed to prevent splashing and cool the fire

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49
Q

Key Notes:

A

Water (A)
Dry chemicals (ABC)
Carbon dioxide (BC)
Halon (BC)
Dry chemical extinguishers (ABC) are the most common all-purpose extinguishers
Class D and E fires should be handled only by trained personnel

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50
Q

General precautions - Physical hazards

A
  1. Avoid running in rooms and hallways
  2. Watch for wet floors
  3. Bend knees when lifting heavy objects
  4. Keep long hair pulled back
  5. Avoid dangling jewelry
  6. maintain clean, organized work area
  7. Wear closed-toe shoes
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51
Q

Miscellaneous Hazard Information

A
  1. Ergonomic work hazards are work-related and include strain due to repeated positions
  2. Cryogenic hazards are hazards due to extremely low temperatures
  3. Mechanical hazards include centrifuges, refrigerators, autoclaves, homogenizers, and glasswares
  4. Centrifuge accidents or improper removal of rubber stopper from test tubes may produce aerosols
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52
Q

Weighs approximately 150 g and measures 12.5 cm x 6 cm x 2.5 cm (length, width, depth)

A

Kidney

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53
Q

How long is the ureter?

A

25 cm

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54
Q

Site when approximately 150 ml urine accumulates; a nerve reflex is initiated

A

Bladder

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55
Q

4 cm long in women and 24 cm long in men`

A

Urethra

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56
Q

About every ______, small amounts of urine are emptied into the bladder from the ureters

A

10-15 seconds

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57
Q

___ is actually a fluid biopsy of the kidney

A

Urine

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58
Q

Basic structural and functional unit of the kidney

A

Nephron

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59
Q

How many nephrons are there in each kidney?

A

1 to 1.5 Million nephrons

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60
Q

2 Types pf nephron

A

Cortical and Juxtamedullary Nephrons

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61
Q

Consists of glomerulus and renal tubules

A

Nephrons

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62
Q

Order of Urine formation

A
  1. Glomerulus
  2. PCT
  3. LH
  4. DCT
  5. CD
  6. Calyx
  7. Renal Pelvis –> Ureter –> Bladder –> Urethra
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63
Q

Renal Blood Flow:
The kidneys receive ___ of the total cardiac input

A

25%

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64
Q

Total Renal Blood FLow

A

1,200 mL/min

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65
Q

Total Renal Plasma Flow

A

600 - 700 mL/min

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66
Q

Order of renal blood flow

A
  1. Renal artery (blood in)
  2. Afferent arteriole
  3. Glomerulus
  4. Efferent arteriole
  5. Peritubular capillaries
  6. Vasa recta
  7. Renal vein (blood out)
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67
Q

In the order of renal blood flow, where is reabsorption and secretion takes place

A

Peritubular capillaries

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68
Q

What part of the renal blood flow does the countercurrent mechanism takes place

A

Vasa recta

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69
Q

The working portion of the kidney

A

Glomerulus

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70
Q

Coil of approx. 8 capillary lobes (capillary tuft) located within the Bowman’s capsule

A

Glomerulus

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71
Q

Attached to the glomerular basement membrane are the ____

A

Podocytes (epithelial cells)

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72
Q

Glomerulus resembles a _____

A

Sieve

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73
Q

Glomerulus serves as a non-selective filter of plasma substances with a MW of _____

A

< 70,000 Da

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74
Q

Approximately ______ of the filtered plasma volume is actually excreted as urine

A

1%

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75
Q

3 parts of the glomerular filtration barrier

A
  1. Capillary endothelium
  2. Trilayer basement membrane
  3. Filtration diaphragm
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76
Q

GFM with large open pores

A

Capillary endothelium

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77
Q

GFM: lamina rara, lamina densa, lamina rara externa

A

Trilayer basement membrane

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78
Q

Found between the podocytes of Bowman’s space

A

Filtration diaphragm

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79
Q

SG of Glomerular filtrate

A

1.010

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80
Q

Substances that are filtered out in the glomerulus

“SWAGU”

A

Salt
Water
Amino acids
Glucose
Urea

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81
Q

pH of albumin

A

<4.9

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82
Q

Why is albumin not excreted in the urine?

A

It is not filtered by the glomerulus (has a shield of negativity because they repel each other (albumin is negatively charged, tho it is only 69kda)

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83
Q

First function to be affected in renal disease

A

Tubular reabsorption

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84
Q

When the plasma concentration of a substance that is normally completely reabsorbed reaches an abnormally high level, the filtrate concentration exceed the ______ of the tubules, and the substance begins appearing in the urine

A

Maximal reabsorptive capacity (Tm)

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85
Q

_____ is the plasma concentration at which active transport stops

A

Renal threshold

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86
Q

Renal threshold for glucose

A

160 - 180 mg/dL

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87
Q

Alter urine concentration

A

PCT, LH, DCT, CD

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88
Q

Major site (65%) of reabsorption of plasma substances

A

PCT

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89
Q

Renal concentration begins in the _______

A

Descending and ascending LH

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90
Q

Solute concentration is highest in the _____

A

LH (renal medulla)

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91
Q

_____ is a selective urine concentration process in the ascending and descending loops of Henle

A

Countercurrent mechanism

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92
Q

The ____ is highly impermeable to water

A

Ascending LH

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93
Q

“DAM” collects water, so does the

A

Descending LH

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94
Q

“ASIN” - ding loop reabsorbs

A

ASIN (salt), but NOT water

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95
Q

Substances that are reabsorbed via active transport

A

Glucose, amino acids, salts
Sodium
Chloride

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96
Q

Substance Location
Glucose, amino acids, salts
Sodium
Chloride

A

GAS - PCT
Sodium - PCT and DCT
Chloride - Ascending LH

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97
Q

Substances that are reabsorbed via passive transport

A

Water
Urea
Sodium

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98
Q

Substance and their location
Water
Urea
Sodium

A

Water - PCT, descending LH, CD
Urea - PCT, ascending LH
Sodium - Ascending LH

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99
Q

The movement of substance across cell membranes into the bloodstream by electrochemical energy

A

Active transport

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100
Q

The movement of molecules across a membrane by diffusion because of a physical gradient

A

Passive transport

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101
Q

Regulates water reabsorption in the DCT and CD

A

Antidiuretic hormone (ADH/ Vasopressin)

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102
Q

Regulates sodium reabsorption in the DCT

A

Aldosterone

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103
Q

Increased body hydration = Decreased ADH = ____ Urine volume

A

Increased

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104
Q

Decreased body hydration = Increased ADH = ____ Urine volume

A

Decreased

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105
Q

Diabetes insipidus = ____ Deficiency

“DI = Daming Ihi”

A

ADH

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106
Q

SIADH = ___ Excess

A

ADH

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107
Q

T or F
Effects of Angiotensin II
Release of Aldosterone and ADH (Increase water and sodium reabsorption
Vasoconstriction (Increased blood pressure)
Corrects renal blood flow

A

T

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108
Q

T or F
The juxtaglomerular apparatus consists of the JG cells (which produce renin) in the afferent arteriole, and the macula densa (which detects decrease in BP) of the DCT

A

T

109
Q

Action of RAAS:
Dilates the ___ and constricts the ___

A

afferent arteriole; efferent arteriole

110
Q

Action of RAAS:
Stimulates __ reabsorption in the PCT

A

Sodium

111
Q

Action of RAAS:
Triggers the adrenal cortex to release ____ to cause sodium reabsorption and potassium excretion in the DCT and CD

A

aldosterone

112
Q

Action of RAAS:
Triggers release of ____ by the hypothalamus to stimulate water reabsorption in the CD

A

anti-diuretic hormone

113
Q

One of the functions of tubular secretion is the regulation of the ____ in the body through secretion of hydrogen ions (in the form of NH4 and H2PO4)

A

Acid-base balance

114
Q

Blood pH

A

7.4

115
Q

Another function of the tubular secretion is the elimination of waste products not filtered by the glomerulus.
T or F

A

T

116
Q

Major site for removal of nonfiltered substances

A

Proximal convoluted tubule

117
Q

It is in the PCT where H ions are secreted in exchange for Na ions, which are reabsorbed with HcO3 into the plasma.
T or F

A

T

118
Q

Failure to produce an acid urine due to inability to secrete hydrogen ions

A

Renal Tubular Acidosis

119
Q

Acidic blood pH
Alkaline urine

A

Renal Tubular Acidosis

120
Q

An example of test for glomerular filtration is the clearance tests

A

T

121
Q

used to evaluate glomerular filtration

A

Clearance tests

122
Q

Measure the rate at which the kidneys are able to remove a filterable substance from the blood

A

Glomerular Filtration Test

123
Q

Examples of glomerular filtration tests

A
  1. Urea
  2. Creatinine
  3. Inulin
  4. Beta microglobulin
  5. Radioisotopes
  6. Cystatin C
124
Q

Obsolete clearance test

A

Urea clearance test

125
Q

Most common clearance test

A

Creatinine

126
Q

Gold standard or reference method clearance test

A

Inulin (MW: 5,200 Da)

127
Q

Better marker for renal tubular function than of GFR

A

Beta2-microglobulin (MW 11,800 Da)

128
Q

Alternative for creatinine clearance

A

Cystatin C (MW: 13, 359 Da)

129
Q

Formula of creatinine clearance

A

(UV / P) x (1.73 m2/ A)

U = Urine creatinine (mg/dL)
P = Plasma creatinine
V = Urine volume
A = Body Surface area

130
Q

Reference ranges for creatinine clearance

A

Males = 107 - 139 mL/min
Females = 87 - 107 mL/min

131
Q

Measure of the completeness of a 24-hour urine collection

A

Creatinine clearance

132
Q

What is the greatest source of error in any clearance procedure utilizing urine?

A

The use of improperly timed urine specimens

133
Q

Around ___ of creatinine is secreted by the renal tubules

A

7 - 10%

134
Q

Detect and monitor kidney disease (recent studies)

A

Estimated GFR

135
Q

Estimated GFR formula developed by Cockgroft and Gault

A

Ccr = [(140 - age) (body weight in kg) / 72 x serum creatinine in mg/dl] x 0.85 (if female)

136
Q

What are the variables included in the estimated GFR formula by Cockgroft and Gault

A

Age
Body wt in kg
Sex

“ABS”

137
Q

Modification of Diet in Renal Disease (MDRD) System Formula

A

See notes for reference

138
Q

What are the variable included in the MDRD system formula?

A

Ethnicitiy
BUN
Serum albumin

“EBS”

139
Q

MDRD- IDMS (Isotope Dilution Mass Spectrometry) Traceable formula

A

See notes for reference

140
Q

Formula for GFR recommended by the National Kidney Disease Education Program (NKDEP)

A

MDRD- IDMS (Isotope Dilution Mass Spectrometry) Traceable formula

141
Q

Tests for Tubular Reabsorption

A

Concentration Tests
- Obsolete tests (Fishberg, Mosenthal test)
- Recently used tests (Specific gravity, Osmolality)

OFM
RSO

142
Q

Used to evaluate tubular reabsorption

A

Concentration test

143
Q

A tubular reabsorption test wherein the patient is deprived of fluid for up to 24 hours

A

Fishberg test

144
Q

Urine SG after 12-hr restricted fluid diet is about ___ or more (Fishberg test)

A

1.022 or more

145
Q

Urine SG after 24-hr restricted fluid diet is about ___ or more (Fishberg test)

A

1.026 or more

146
Q

A tubular reabsorption test wherein the patient maintains normal diet and fluid intake.

A

Mosenthal test

147
Q

Compares day and night urine in terms of volume and SG

A

Mosenthal test

148
Q

Tubular reabsorption test influenced by the number and density of particles in a solution

A

Specific Gravity

149
Q

Influenced by the number of particles in a solution (Tubular reabsorption test)
More preferred than SG determination
More precise than osmolarity because it does not vary with temperature

A

Osmolality

150
Q

Osmolality include the methods of

A

Freezing point osmometry and Vapor pressure osmometry

151
Q

NV for urine osmolality

A

1-3x (275 to 900 mOsm/kg) than of serum (275 to 300 mOsm/kg)

152
Q

Tests for tubular secretion and renal blood flow

A

P-aminohippuric acid (PAH) test
Phenolsulfonphthalein (PSP) test
Other measurements used (urine pH, titratable acidity, urinary ammonia)

153
Q

Most commonly used (reference method) test for tubular secretion and renal blood flow

A

P-aminohippuric acid (PAH) test

154
Q

First illustrated medical book printed.

A

Fasciculus Medicinae

155
Q

During the Middle Ages, disease was thought to result from the imbalance of ____, reflected by one of the urine colors

A

Humours

156
Q

4 temperaments/ humours

A

Sanguineous (blood)
Choleric (yellow bile)
Phlegmatic (phlegm)
Melancholic (black bile)

157
Q

The ____ of urine was used by the Babylonians and Egyptians to detect diabetes

A

Taste test

158
Q

Hindu physicians noticed that ____ attracted ants

A

honey urine

159
Q

Uroscopy; first documented the importance of sputum examination

A

Hippocrates

160
Q

Albuminuria by boiling urine

A

Frederik Dekkers

161
Q

Wrote a book about “pisse prophets” (charlatans)

A

Thomas Bryant

162
Q

Examination of urine sediment

A

Thomas Addis

163
Q

Introduced urinalysis as part of doctor’s routine patient examination

A

Richard Bright

164
Q

Urochrome (history)

A

Ludwig Thudichum

165
Q

CSF (history)

A

Domenico Cotugno

166
Q

Phenylketonuria (history)

A

Ivan Folling

167
Q

Alkaptonuria (history)

A

Archibald Garrod

168
Q

Orthostatic or cyclic proteinuria

A

Frederick William Pavy

169
Q

Cystine calculi (history)

A

William Wollaston

170
Q

Benedict’s reagent (history)

A

Stanley Benedict

171
Q

Urine composition

A

95 - 97% water
3 - 5% solids (60 grams = Total Solids in 24 hours)

172
Q

Total solids

A

35 grams organic
25 grams inorganic

173
Q

Urine component - Total solids (organic component)

A

Urea (major)
Creatinine (2nd)
Hippurate
Uric acid
CHO
Pigments
fatty acids
mucins
enzymes
hormones

174
Q

Urine component - total solids (inorganic components

A

Chloride (major) > sodium > potassium
Sodium chloride (principal salt)
sulfate
phosphate
ammonium
magnesium
calcium

175
Q

Urine specimen for routine and qualitative urinalysis
Ideal for cytology studies (ONLY IF with prior hydration and exercise 5 mins before collection!)

A

Random/ Occasional / Single

176
Q

Ideal specimen for routine urinalysis and pregnancy testing (hCG)
Often preferred for cytology studies / cytodiagnostic urine testing

A

First morning

177
Q

Most concentrated and most acidic urine specimen - allows well preservation of cells and casts

A

First morning

178
Q

Urine specimen for the evaluation of orthostatic proteinuria

A

First morning

179
Q

Patient voids before going to bed, and immediately on rising from sleep collects urine specimen

A

First morning

180
Q

2nd voided urine after a period of fasting

A

Second morning/Fasting

181
Q

Urine specimen for glucose determination

A

Second morning/Fasting

182
Q

Urine specimen for diabetic screening or monitoring
Preferred for testing glucose

A

2-hr post-prandial

183
Q

Optimal with blood samples in glucose tolerance test

A

Glucose tolerance

184
Q

At least 2 voided collection
Series of blood and urine samples are collected at a specific time intervals to compare concentration of a substance in urine with its concentration in the blood
Used in the diagnosis of diabetes

A

Fractional specimen

185
Q

For routine screening and bacterial culture

A

Midstream clean catch

186
Q

Patient should thoroughly cleanse his glans penis or her urethral meatus before collection

A

Midstream clean catch

187
Q

May be urethral or ureteral urine specimen
For bacterial culture

A

Catheterized

188
Q

Abdominal wall is punctured, and urine is directly aspirated from the bladder
Bladder urine for anaerobic bacterial culture and urine cytology

A

Suprapubic

189
Q

Use of soft, clear plastic bag with adhesive
Sterile specimen obtained by catheterization or suprapubic aspiration
Urine collected from diaper is NOT recommended for testing

A

Pediatric specimen

190
Q

Urine specimen for prostatic infection
1. First portion of voided urine
2. Middle portion of voided urine
3. Urine after prostatic massage

A

Three-glass technique

191
Q

tube number that serves as the control for bladder and kidney infection for the three-glass technique

A

2

192
Q

Prostatitis (infected prostate) how many WBC and bacteria are seen

A

Number of WBC and bacteria in the 3rd specimen is 10x greater than that of the 1st

193
Q

T or F
If control is positive for WBC and bacteria, the results from the 3rd specimen are considered invalid

A

T

194
Q

Four glass method of urine collection method which consists of bacterial cultures of the initial voided urine (VB1), midstream urine (VB2), expressed prostatic secretions (EPS), and a post-prostatic massage urine specimen (VB3)

A

Stamey-Meares Test for Prostatitis

195
Q

In the Stamey-Meares test for prostatitis, urethral infection or inflammation is tested for by the ___

A

initial voided urine

196
Q

In the Stamey-Meares test for prostatitis, urinary bladder infection is tested for by the ___

A

Midstream urine

197
Q

The ______ are cultured and examined for white blood cells in the Stamey-Mears prostatitis test

A

Prostatic secretions

198
Q

Having more than ____ WBCs per high power field is considered abnormal in the Stamey-Mears test

A

10 to 20

199
Q

4 types of timed urine specimen

A
  1. 24-hour
  2. 12-hour
  3. 4-hour
  4. Afternoon (2-4PM)
200
Q

In the 24-hour urine, at the start time, the patient empties bladder into toilet, then all subsequent urine is collected.
At end time, patient empties bladder into collection container
Requires preservative - it depends on the test performed

A

24-hour

201
Q

Type of urine specimen for Addis Count

A

12-hour

202
Q

Type of urine specimen for nitrite determination
Urine remains in bladder for at least 4 hours before voiding

A

4-hour

203
Q

Type of urine specimen for urobilinogen determination

A

Afternoon (2-4pm)

204
Q

Process providing documentation of proper sample ID from the time of collection to the receipt of laboratory results

A

Chain of Custody

205
Q

Required urine volume for drug specimen collection

A

30 - 45 ml

206
Q

Container capacity for drug specimen collection

A

60 ml

207
Q

Temperature for drug specimen. Checked within 4 minutes; if out of range, record temperature and contact supervisor immediately

A

32.5 deg C - 37.7 deg C

208
Q

Added to the toilet water reservoir to prevent specimen adulteration

A

Blueing agent (dye)

209
Q

pH of a possibly adulterated urine specimen for drug testing

A

> 9

210
Q

Specific gravity of a possibly adulterated urine specimen for drug testing

A

SG <1.005

211
Q

Urine containers should have a wide base, and has an opening of at least ___. The wide base prevents spillage, and a _____ opening is an adequate target for urine collection.

A

4 cm

212
Q

24-hr urine containers should hold up to ___ and may be colored to protect light sensitive analytes.

A

3L

213
Q

Addition of urine before the start of 24-hour collection period causes ____ results

A

False increased

214
Q

Failure to include urine at the end of 24-hour collection period causes ___ results

A

False decreased

215
Q

When both routine UA and culture are requested, the ____ should be performed first

A

culture

216
Q

Following collection, urine specimens should be delivered to the laboratory promptly and tested within ____.; ideally within ___

A

2 hours; 30 minutes

217
Q

Physical, chemical, and microscopic characteristics of a urine specimen begin to change ___

A

As soon as possible

218
Q

Changes in unpreserved urine (increased)

A

pH
Bacteria
Odor
Nitrite

“pBaON”

219
Q

Darkened / modified in unpreserved urine

A

Color

220
Q

Decreased in unpreserved urine

A

Clarity
Glucose
Ketones
Bilirubin
Urobilinogen
RBC/WBC/Cast
Trichomonas
Proteins

221
Q

Urea –Urease—> Ammonia ; loss of CO2

A

pH

222
Q

Increased due to multiplication in unpreserved urine

A

Bacteria, Nitrite

223
Q

Urea –Urease—> Ammonia

A

Odor

224
Q

Oxidation or reduction of metabolites happen leading to darkened or modified changes in unpreserved urine

A

Color

225
Q

Bacterial multiplication; precipitation of amorphous material –> decreased

A

Clarity

226
Q

Decreases due to glycolysis

A

glucose

227
Q

Volatilization and bacterial metabolism –> decreased

A

Ketones

228
Q

Light exposure/photo oxidation to biliverdin

A

Bilirubin (CB)

229
Q

Disintegrate in dilute alkaline urine

A

RBC, WBC, Casts

230
Q

Loss of motility; death; possible misidentification as WBCs

A

Trichomonas

231
Q

Least affected parameter in unpreserved urine

A

Protein

232
Q

What are the ideal characteristics of a urine specimen

A

Bactericidal, inhibit urease, preserve elements, no interference

233
Q

Urine preservative
Adv: Does not interfere with chemical tests
Disadvantage: Raises SG by hydrometer; Precipitates amorphous phosphates and urates

A

Refrigeration

234
Q

Preservative of choice for routine UA and urine culture (up to 24 hours0
Prevents bacterial growth for 24 hours

A

Refrigeration

235
Q

Urine preservative
Preserves glucose and sediments well
Disadvantage: Interferes with acid precipitation test for protein

A

Thymol

236
Q

Preserves protein and formed elements well
Does not interfere with routine analyses other than pH
Disadvantage: May precipitate crystals when used in large amounts

A

Boric acid

237
Q

Keeps pH about 6.0
Bacteriostatic at 18 g/L;
For culture transport, C&S
Interfere with drug and hormone analyses

A

Boric acid

238
Q

Excellent sediment preservative
Disadvantage: Reducing agent;
interferes with chemical tests for glucose, blood, leukocytes & copper reduction

A

Formalin (Formaldehyde)

239
Q

Preservative that does not interfere with routine tests
-Floats on urine surface and clings to pipettes and testing materials
-Best all round preservative

A

Toluene

240
Q

Preservative that prevents glycolysis
-Good preservative for drug analysis
-May use sodium benzoate instead of fluoride for reagent strip testing

A

Sodium fluoride

241
Q

Preservative that does not interfere with routine tests
-Causes an odor change
-use 1 drop/ounce of specimen

A

Phenol

242
Q

Preservative that is convenient when refrigeration not possible
-May contain one of more of the preservatives including sodium fluoride

A

Commercial preservative tablets

243
Q

Preservative that contains collection cup, C & S preservative tube or UA tube

A

Urine Collection Kits

244
Q

Preservative wherein the sample is stable at room temperature for 48 hours; preserves bacteria
-Preservative is boric acid and may not be used for UA

A

Gray C & S tube

245
Q

Preservative that is stable for 72 hours at room temperature
-Instrument compatible
-Bilirubin and urobilinogen may be decreased if specimen is exposed to light and left at RT
-Preservative is sodium propionate

A

Cherry red/Yellow top tube

246
Q

Preservative that preserves cellular elements
-Used for cytology studies (50 mL urine)

A

Saccamano fixative
(50% ethanol + 2% carbowax)

247
Q

Normal urine (24 hours) volume

A

600 to 2000 mL

248
Q

Average volume of urine (24 hours)

A

1200 to 1500 mL

249
Q

Night urine output

A

< 400 mL

250
Q

Urine day:night ratio

A

2-3:1

251
Q

Container capacity (UA)

A

50 mL

252
Q

required volume of urine for routine UA

A

10 to 15 mL (ave: 12 mL)

253
Q

Polyuria

A

> 2000 mL/24 hours

254
Q

Causes of polyuria

A

Increased fluid intake
Diuretics, nervousness
Diabetes mellitus
Diabetes insipidus

255
Q

Oliguria

A

< 500 mL/24 hrs
< 400 mL/day

256
Q

Causes of oliguria

A

Dehydration
Renal diseases
Renal calculi or tumor

257
Q

Anuria

A

< 100 ml/ 24 hours

258
Q

Causes of anuria

A

Complete obstruction
Toxic agent
Decreased renal blood flow

259
Q

Excretion of more than 500 mL of urine at night

A

Nocturia

260
Q

SG of nocturia

A

< 1.018

261
Q

Any increase in urine excretion

A

Diuresis

262
Q

Rough indicator of the degree of hydration

A

Urine color

263
Q

Correlates with urine SG

A

Urine color

264
Q

Normal urine color

A

Colorless to deep yellow

265
Q

Abnormal urine color

A

Red or red brown

266
Q

Urine color determination

A

Look down through the container against a white background

267
Q

-Major pigment of urine
-lipid soluble pigment that is a product of endogenous metabolism

A

Urochrome

268
Q
A

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