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CLINICAL MICROSCOPY > CM LECTURE / Sir Errol Coderes > Flashcards

CM LECTURE / Sir Errol Coderes Flashcards

1
Q

Chain of infection require a continuous link between:

A

“SMS”

Source
Method of transmission
Susceptible host

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2
Q

What are the 6 components of the chain of infection?

A

“IREMES”

Infectious agent
Reservoir
Exit of portal
Mode of transmission
Entry portal
Susceptible host

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3
Q

Personal protective equipment

A

Gloves
Gowns
Eye and face shields
Countertop shields

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4
Q

The primary method of infection transmission

A

Hand contact

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5
Q

The best way to break the chain of infection or best way to prevent infection

A

Handwashing

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6
Q

Handwashing procedure

A

Wet hands with warm water
Apply antimicrobial soap
Rub to form a lather, create FRICTION and loosen debris
Thoroughly clean between fingers, including thumbs, under fingernails and rings, and up to the wrist for at least 15 or 20 seconds
Rinse hands in a DOWNWARD position
Dry with a paper towel
Turn off faucet with a clean paper towel to prevent contamination

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7
Q

If hands are visibly soiled, ______

A

Wash hands

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8
Q

If hands are NOT visibly soiled, ______

A

Apply sanitizer

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9
Q

The handwashing song

A

Happy Birthday Song (twice)

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10
Q

All biological waste, must be placed in appropriate containers labeled with _______ symbol, except _____.

A

Biohazard; Urine

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11
Q

The accepted biohazard label is _______ color

A

Fluorescent Orange

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12
Q

Discard urine by pouring it into the ________ , avoid splashing , and then flush with water

A

Laboratory sink

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13
Q

True or False.
Empty urine containers can be discarded as nonbiologically hazrdous waste

A

TRUE

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14
Q

Disinfection of the sink using a _________ should be done ______

A

1:5 or 1:10 dilution of Sodium Hypochlorite (10% bleach) ; Daily

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15
Q

_______ eliminates many or all pathogenic microorganisms, except the bacterial spores

A

Disinfection

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16
Q

Disinfectant is effective for ______

A

1 month

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17
Q

The basic outline of the biohazard symbol is a plain trefoil, which is ___________ .

A

Three circles overlapping each other equally

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18
Q

Sharps are disposed in _________

A

Red puncture-resistant containers

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19
Q

An accidental needlestick must be reported to the ______

A

Supervisor

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20
Q

Best first aid for Chemical spills

A

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

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21
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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22
Q

True or False.
Neutralize chemical that come in contact with the skin

A

FALSE

DO NOT NEUTRALIZE chemicals that come in contact with the skin

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23
Q

True or False.
Acid spills on floors can be neutralized and then soaked up with wet rags or spill pillows

A

True

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24
Q

In chemical handling always add _____ to _____

A

Always add ACID to WATER, to avoid plashing. An explosion can occur if water is added to acid

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25
Q

Color of Reactivity / Stability hazard in the NFPA symbol

A

Yellow

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26
Q

Color of Specific hazard in the NFPA symbol

A

White

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27
Q

Color of Health hazard in the NFPA symbol

A

Blue

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28
Q

Color of Flammability / Fire hazard in the NFPA symbol

A

Red

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29
Q

In reactivity or stability hazard, what number is classified as violent chemical change

A

Number 2

“SUV in SM”
0 - Stable
1 - Unstable if heated
2 - Violent Chemical Change
3 - Shock and heat may detonate
4 - May detonate / detonate

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30
Q

In health hazard, what number is classified as extreme danger

A

Number 3

“NSHED”
0 - Normal
1 - Slightly hazardous
2 - Hazardous
3 - Extreme danger
4 - Deadly

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31
Q

In flammability or fire hazard, what number is classified as below 73 F

A

Number 4

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

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32
Q

Degree of hazard classified as number 3

A

Serious

“No SMS Ex”

0 - No / minimal
1 - Slight
2 - Moderate
3 - Serious
4 - Extreme / severe

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33
Q

True or False.
Do NOT operate electrical equipments with wet hands

A

True

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34
Q

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

A

3-pronged plug

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35
Q

If electrical shock occurs, never touch the person or the equipment involved. What are the three things you should do? (In order)

A

TURN OFF the circuit breaker
UNPLUG the equipment
MOVE the equipment

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36
Q

Flammable chemicals should be stored in _______ and _______ away from heat sources.

A

Safety Cabinets and Explosion-proof Refrigerators

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37
Q

All laboratory personnel must be involved in laboratory fire drills at least _______

A

Annually / once a year or every year

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38
Q

When fire is discovered what should you do?

A

“RACE”

Rescue
Alarm
Contain
Extinguish / Evacuate / Exit

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39
Q

To operate a fire extinguisher …

A

“PASS”

Pull
Aim
Squeeze
Sweep

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40
Q

Type of fire: Ordinary combustible solids

A

Class A fire

“A tigas” — solids

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41
Q

Type of fire: Flammable liquids

A

Class B fire

“B-asa”— liquids

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42
Q

Type of fire: Electrical equipment

A

Class C fire

“eleCtrical” — eleCtric

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43
Q

Type of fire: Flammable metals

A

Class D fire

“meDals” — metals

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44
Q

Type of fire: Detonation (Arsenal Fire)

A

Class E fire

“E-xplosives” — detonate/explode

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45
Q

Type of fire: Cooking media like oils, fats …

A

Class K fire

“K-itchen”

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46
Q

Water can be used as fire extinguisher for what class of fire?

A

Class A fire

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47
Q

Dry chemical can be used as fire extinguisher for what class of fire?

A

Classes A, B and C fire

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48
Q

Dry chemical and halon can be used as fire extinguisher for what class of fire?

A

Classes B and C fire

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49
Q

The most common all purpose extinguisher

A

Dry Chemical Extinguisher

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50
Q

Type of fire/s that should be handled only by trained personnel

A

Class D and Class E fire

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51
Q

These hazards are work-related and include strain due to repeated positions

A

Ergonomic Hazards

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52
Q

These are hazards due to extremely low temperatures

A

Cryogenic Hazards

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53
Q

These hazards include centrifuges, refrigerators, autoclaves, homogenizers, and glasswares

A

Mechanical Hazards

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54
Q

Centrifuge accidents or improper removal of rubber stopper from test tubes may produce _____

A

Aerosol

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55
Q

The kidney weighs _____ and measures ____ in length, ____ in width and _____ in depth

A

The kidney weighs 150 g, and measures 12.5 cm x 6 cm x 2.5 cm

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56
Q

How long is the ureter in cm?

A

Ureter is 25 cm long

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57
Q

Bladder when approximately _____ ml urine accumulates a nerve reflex is initiated

A

150 ml

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58
Q

Urethra is ___ cm long in men and ___ cm long in men

A

Urethra is 4 cm long in women and 24 cm long in men

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59
Q

About how many seconds does small amounts of urine are emptied into the bladder from the ureters

A

10 - 15 seconds

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60
Q

True or False.
Urine is actually a fluid biopsy of the kidney

A

True

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61
Q

It is the basic structural and functional unit of the kidney

A

Nephron

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62
Q

How many nephrons are there in PER kidney

A

1 to 1.5 million nephrons per kidney

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63
Q

Two types of nephron

A

Cortical and Juxtamedullary nephrons

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64
Q

Order of Urine Formation

A

“Go Pro LDC CaRe”

Glomerulus
Proximal Convoluted Tubule (PCT)
Loop of Henle
Distal Convoluted Tubule (DCT)
Collecting Duct
Calyx
Renal Pelvis ( “ RUBU “ Renal pelvis — Ureter — Bladder — Urethra )

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65
Q

In renal blood flow, the kidneys receive ____ % of the total cardiac output

A

25 %

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66
Q

Total renal blood flow = ____

A

1200 mL / min

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67
Q

Total renal plasma flow = _____

A

600 - 700 mL / min

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68
Q

Renal blood flow order

A

“RAGE PVR”

Renal Artery (blood in)
Afferent Arteriole
Glomerulus
Efferent Arteriole
Peritubular Capillaries
Vasa recta
Renal Vein (blood out)

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69
Q

The “working portion” of the kidney

A

Glomerulus

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70
Q

Resembles a sieve

A

Glomerulus

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71
Q

Non-selective filter of plasma substances with MW of ____

A

<70 kDa

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72
Q

Approximately ___ % of the filtered plasma volume is actually excreted in the urine

A

1 %

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73
Q

Albumin is negative, unless at pH ___

A

< 4.9

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74
Q

Glomerular filtrate specific gravity = ____

A

1.010

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75
Q

The first function to be affected in renal disease

A

Renal tubular reabsorption

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76
Q

The plasma concentration at which active transport stops

A

Renal Threshold

77
Q

Renal threshold for glucose

A

160 - 180 mg/dL

78
Q

True or False.
PCT, LH, DCT & CD alter urine concentration

A

True

79
Q

It is the major site (65 %) of reabsorptiion of plasma substances

A

PCT

80
Q

Renal concentration begins in the _____ and ____

A

Descending and Ascending LH

81
Q

Solute concentration is highest in the ____

A

LH (Renal Medulla)

82
Q

It is highly impermeable to water

A

Ascending Loop of Henle

83
Q

Reabsorbs water

A

Descending Loop of Henle

84
Q

Reabsorbs salt, but NOT water

A

Ascending Loop of Henle

85
Q

Active transport substnaces

A

Glucose
Amino acids
Salts
Sodium
Chloride

86
Q

Passive transport substances

A

Water
Urea
Sodium

87
Q

It is the movement of a substance across cell membranes into the bloodstream by electrochemical energy

A

Active Transport

88
Q

It is the movement of molecules across a membrane by diffusion because of a physical gradient

A

Passive Transport

89
Q

It regulates water reabsorption in the DCT and CD

A

ADH / Vasopressin

90
Q

Condition associated to ADH deficiency

A

Diabetes Insipidus

91
Q

Condition associated with ADH excess

A

SIADH (Syndrome of Inappropriate ADH secretion

92
Q

Regulates sodium reabsorption in the DCT

A

Aldosterone

93
Q

Converts angiotensinogen to angiotensin I

A

Renin

94
Q

Inactive form

A

Angiotensin I

95
Q

Converts angiotensin I to angiotensin II

A

ACE (Angiotensin Converting Enzyme)

96
Q

Effects of angiotensin II

A

Release of Aldosterone and ADH ( Increases Sodium and Water Reabsorption )
Vasoconstriction (Increase Blood Pressure )
Corrects renal blood flow

97
Q

Cells that produces the renin in the afferent arteriole

A

JG cells

98
Q

Detects decrease in BP

A

Macula Densa

99
Q

Actions of RAAS

A

Dilates afferent arteriole and constricts efferent arteriole
Stimulates sodium reabsorption in the PCT
Triggers adrenal cortex to release aldosterone to cause sodium reabsorption and potassium excretion in the DCT and CD
Triggers release of ADH by the hypothalamus o stimulate water reabsorption in the CD

100
Q

Two major functions the renal tubular secretion

A

Regulation of acid-base balance in the body through secretion by hydrogen ions
Elimination of waste products not filtered by the glomerulus

101
Q

The major site or removal of nonfiltered substances

A

PCT

102
Q

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

A

Renal Tubular Acidosis

103
Q

Blood pH in RTA

A

Acidic

104
Q

Urine pH in RTA

A

Alkaline / Basic

105
Q

Used to evaluate glomerular filtration

A

Clearance Tests

106
Q

Most common clearance test

A

Creatinine

107
Q

Gold standard or reference method for clerance tests

A

Inulin

108
Q

Better marker of renal tubular function than GFR

A

Beta 2 -microglobulin

109
Q

It is a measure of the completeness of a 24 hr urine collection

A

Creatinine Clearance

110
Q

By far the greatest source of error in any clearance procedure utilizing urine is ____

A

The use of improperly timed urine specimens

111
Q

Around ___ % of creatinine is secreted by the renal tubules

A

7-10 %

112
Q

Useful to detect and monitor kidney disease

A

eGFR ( Estimated GFR )

113
Q

Variables in the estimated GFR formula developed by Cockgroft and Gault

A

Age
Sex
Body Weight in kg

114
Q

Variables in MDRD System formula

A

Ethnicity
BUN
Serum Albumin

115
Q

Recommended formula by the NKDEP for GFR

A

MDRD - IDMS

116
Q

Used to evaluate tubular reabsorption

A

Concentration Test

117
Q

A test wherein patient is deprived of fluid for up to 24 hrs

A

Fishberg Test

118
Q

Test wherein patient maintains normal diet and fluid intake

A

Mosenthal Test

119
Q

Recently used tests for tubular reabsorption, influenced by the number and density of particles in a solution

A

Specific Gravity

120
Q

Recently used tests for tubular reabsorption, influenced by the number of particles in a solution, more accurate and preferred than SG determiantion

A

Osmolality

121
Q

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

A

PAH test (p-aminohippuric acid)

122
Q

Discovered uroscopy, one who first documented the importance of sputum examination

A

Hippocrates

123
Q

Discovery of albuminuria by boiling urine

A

Frederik Dekkers

124
Q

He wrote a book about “pisse prophets” (charlatans)

A

Thomas Bryant

125
Q

Introduced examination of urine sediment

A

Thomas Addis

126
Q

Introduced urinalysis as part of doctor’s routine patient examination

A

Richard Bright

127
Q

Discovered urochrome

A

Ludwig Thudichum

128
Q

Cerebrospinal fluid

A

Domenico Cotugno

129
Q

Phenylketonuria

A

Ivan Folling

130
Q

Alkaptonuria

A

Archibald Garrod

131
Q

Orthostatic or cyclic proteinuria

A

Frederick William Pavy

132
Q

Cystine Calculi

A

William Wollaston

133
Q

Benedict Reagent

A

Stanley Benedict

134
Q

Urine is composed of ___ % water and ____ % solids

A

95-97 % water and 3-5 % solids

135
Q

Total solids in urine for 4 hrs

A

60 grams solids = 35 g organic and 25 g inorganic

136
Q

Major organic component of urine

A

Urea

137
Q

Major inorganic component of urine

A

Chloride > Sodium > Potassium

138
Q

Principal salt in urine composition

A

NaCl ( sodium chloride )

139
Q

Type of specimen used for routine screening tests and qualitative urinalysis, ideal for cytologic studies only if with prior hydration and exercise 5 mins before collection

A

Random / Occasional / Single

140
Q

Ideal specimen for routine screening / urinalysis and pregnancy testing ,often preferred for cytology studies / cytodiagnostic urine testing, most concentrated and most acidic and use for evaluation of orthostatic proteinuria

A

First Morning

141
Q

2nd voided urine after a period f fasting, use for glucose determination

A

Second Morning / Fasting

142
Q

Type of specimen used for diabetic screening or monitoring and is preferred for testing glucose

A

2-Hour Post-Prandial

143
Q

Used in the diagnosis of diabetes

A

Fractional Specimen

144
Q

For routine screening and bacterial culture (OPD) ,and patients should thoroughly cleanse his glans penis or her urethral meatus before collection

A

Midstream Clean Catch

145
Q

May be urethral or ureteral, and is used for bacterial culture

A

Catheterized

146
Q

Abdominal wall is punctured, and urine is directly aspirated from the bladder, bladder urine for anaerobicbacterial culture and cytology

A

Suprapubic Aspiration

147
Q

Used for prostatic infection

A

Three Glass Technique

1 — first portion
2 — middle portion
3 — Urine after post massage

148
Q

If the number of WBCs and bacteria in the 3rd spx is 10x greater than aht of the 1st

A

Prostatitis

149
Q

Serves as a control for bladder and kidney function

A

2nd specimen

150
Q

The four glass method used for prostatitis

A

Stamey-Meares Test

151
Q

Number of WBCs in Stamey-Meares Test that is considered to be abnormal

A

10 - 20 WBCs

152
Q

Specimen used for Addis count (for quantitation of urine sediments)

A

12 hour urine

153
Q

Specimen used for nitrite determination

A

4 hour specimen

154
Q

Specimen used for urobilinogen determination

A

Afternoon

155
Q

Process providing documentation of proper ample ID from the time of collection to the receipt of lab results

A

COC ( Chain of Custody )

156
Q

Required urine volume for drug specimen

A

30 - 45 mL

157
Q

Urine container capacity for drug specimen

A

60 mL

158
Q

Urine temperature for drug specimen

A

32.5 - 37.7 C

159
Q

Added to the toilet water reservoir to prevent specimen adulteration in drug specimen collection

A

Bluing Agent ( dye )

160
Q

Urine in drug specimen collection may possibly adulterated if pH is ____ and SG is ____.

A

ph > 9 and SG is < 1.005

161
Q

Urine containers should have a wide base and has an opening of at least ___ cm

A

4 cm

162
Q

24 hr urine containers should hold up to ____ and maybe ____ to protect light sensitive analytes

A

3 L ; colored

163
Q

Addition of urine before the start of 24 hr collection period causes _____

A

False Increased Results

164
Q

Failure to include urine at the end of 24 hr collection period causes ____

A

False Decreased Results

165
Q

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

A

Culture

166
Q

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

A

2 hrs; 30 mins

167
Q

Physical, chemical and microscopic characteristics of urine specimen begin to change as soon as it is ____

A

As soon as it is VOIDED

168
Q

Increased in unpreserved urine

A

“PaBaON”

pH
Bacteria
Odor
Nitrite

169
Q

Darkened or modified in unpreserved urine

A

Color

170
Q

Decreases in unpreserved urine

A

“CGe Kay BURT”

Clarity
Glucose
Ketones
Bilirubin
Urobilinogen
RBCs / WBCs / Casts
Trichomonas

171
Q

Preservative of choice for routine UA and routine culture, prevents bacterial growth for 24 hrs, but it precipitate amorphous phosphates and urates

A

Refrigeration

172
Q

Preserves protein and formed elements ell, and does not interfere with routine analyses other than pH, it is bacteriostatic a 18 g/L , and is used for culture transport and C&S, but it interferes with drug and hormone analyses

A

Boric Acid

173
Q

The excellent sediment preservative, it is the preservative of choice for Addis Count

A

Formalin or Formaldehyde

174
Q

It prevents glycolysis, good preservative for drug analysis

A

Sodium Fluoride

175
Q

Preserves cellular elements, and is used or cytology studies ( 50 mL urine )

A

Saccomano Fixative ( 50 % ethanol and 2 % carbowax )

176
Q

Urine volume normal range (24 hrs)

A

600 - 2000 mL

177
Q

Urine volume average ( 24 hrs )

A

1200 - 1500 mL

178
Q

Night urine output

A

< 400 mL

179
Q

Urine Volume Day:Night ratio

A

2 - 3 : 1

180
Q

Container capacity for UA

A

50 mL

181
Q

Required urine volume for routine UA

A

10 - 15 mL ( average: 12 mL )

182
Q

Increased urine volume

A

Polyuria ( > 2000 ml / 24 hrs )

183
Q

Decreased urine volume

A

Oliguria ( < 400 - 500 mL / 24 hrs )

184
Q

Complete cessation of urine flow

A

Anuria ( < 100 mL /24 hrs )

185
Q

Excretion of more than 500 mL of urine at night

A

Nocturia

186
Q

Any increase in urine excretion

A

Diuresis

187
Q

It is the rough indicator of the degree of hydration

A

Urine color

188
Q

Normal urine color

A

Colorless to deep yellow

189
Q

Most common abnormal color of urine

A

Red / Red brown

CLINICAL MICROSCOPY (1 decks)

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