Exam 4 Flashcards
What diluent is used for RBC counts
commercial isotonic diluents
Isotonic saline
Hyaluronidase buffer
What diluents are used in WBCs
hypotonic saline, turk’s solution, dilute acetic acid
What does hyaluronidase
an enzyme that eliminates the viscosity of synovial fluids by depolymerizing hyaluronic acid
prevents clot formation
What is cytocentrifugation
the preferred technique for slide preparation for diff
body fluid is filtered in a chamber with filter paper
placed into cytocentrifuge
What are the 3 meninges
dura mater- touch outer near bone
arachnoid- middle layer, looks like spider web
pia mater- inner layer, adheres to neural tissues
Which meninges does CSF flow through
subarachnoid space
What is the CSF
bathes the brain and spinal cord, protects it and supports them and provides a transport medium for nutrients and metabolic wastes
What is the blood brain barrier
interface between blood and CSF, reduces the passage of substances from the blood plasma into the CSF
What is the procedure for collecting spinal fluid
lumbar puncture- needle directly inserted into spine
List out the tubes that are collected in CSF and where they go
1- chem and immuno
2-microbial
3- heme
sterile, sequentially labeled
What is pleocytosis
increased number of cells in CSF, makes it cloudy
What is xanthochromia
yellow color to CSF
You have a CSF with blood in it
it does not clot
It is xanthochromic
the amount of blood is the same in all tubes
hemosiderin is present
Hermorrhage
You have a CSF with blood in it
It did not clot
it shows streaking blood
the color looks normal
no hermosiderin present
traumatic tap
What do the following forms of pleocytosis mean
Neutrophilic
lymphocytic
monocytic
eosinophilic
Neutrophilic- early viral, fungal, tubercular, parasitic infection
lymphocytic- viral, fungal, tubercular, syphilitic meningitis
monocytic-tb, or fungal meningitis, chronic bacterial, rupture of cerebral abscess
eosinophilic- parasitic and fungal infection, allergic rx to shunt or injection
What cells predominate in the CSF
lymphs and monocytes
Explain what electrophoresis on CSF can show the presence of
albumin, transferrin, transthyretin
How does albumin get into the CSF
must cross blood-brain barrier
What is the normal albumin CSF/ serum index
<9
the higher above 9 the more impairment of the barrier
Formula for CSF/albumin index
= albuminCSF/ Albumin serum
What are the 4 protein bands present in normal CSF pattern
TTR
albumin
Transferrin
Tau transferrin
faint alpha and IgG
What is the purpose of electrophoresis of CSF
to detect oligoclonal bands in the gamma region
What does it mean if oligoclonal bands are in the CSF but not the serum
highly suggests multiple sclerosis
What does it mean to have oligoclonal bands in both CSF and serum
lymphoproliferation disorders
What band IDs a fluid as CSF
T transferrin, unique to CSF
What does a normal CSF protein pattern look
has a Beta 2 region of T transferrin,
abnormal- has oligoclonal bands at the end
What is the normal total volume of CSF in adults
and neonates?
adults: 85-150mL
neonates: 10-60mL
What is the normal CSF glucose range?
lactate?
protein?
serum albumin?
WBC and RBC?
glucose: 50-80
lactate: 10-22
protein: 15-45
serum albumin: <9
IgG index 0.30-0.7
WBCs 0-5
RBCs not present
What is the most common cause of blood and plasma proteins in CSF
traumatic punture
What does an increased IgG in CSF mean?
multiple sclerosis
What does a decreased CSF glucose mean
could be meningitis in 50% of people how decreased glucose
What do lactate levels indicate about meningitis
low lactate- viral
high lactate- other causes
What is the function of semen
transportation of sperm
What is the function of the testes
keep temp for sperm
secrete sperm and testosterone
regulate follicle stimulating hormone and luteinizing hormone
What is the function of Sertoli cells
regulate sperm production
What is the function of interstitial cells of Leydig
production and secretion of testosterone
What is the path of semen in the reproduction tract starting in the testes
testes (sertoli cells)
Epididymus
vas deferens
ejactulatory ducts
prostate gland
urethra
What temp should semen specimen be kept at
warmed to body temp, received within 1 hour
What does normal sperm look like
gray-white opalescent, watery, coagulum liquifies within 30 min, any more than 60 min is abnormal
What is the normal ejaculate volume
2-5mL
What is a sperm motility test
50% + sperm should be moving and show forward progression
What is the normal sperm concentration
20-250 million sperm/ mL
What dilution is used on sperm counts
1: 20
What is included in a sperm count
the total number of sperm in the entire ejaculate
What is the sperm count formula
sperm count= sperm concentration x volume of ejaculate
What is the sperm morphology test
looks at measurement of sperm head length, width, circumference and area
What are the 3 distinct areas of sperm
head midpiece, tail
What is the normal head size of a sperm
1.5-1.75 length to width ratio
What a sperm vitality test
looking for live vs deaad sperm
those who take up stain are dead
those who do not take up stain are alive
What stain is used for vitality test
eosin-nigrosin stain
What are the normal results for vitality
50%+ should be alive, do not take up stain
What is the normal pH of sperm
7.2-7.8
What is the acid phosphatase sperm test
should be in high concentrations, can be used to determine if rape occurred
What is in seminal vesicle fluid
makes up 70% of ejaculate and is high in flavin
What is in prostatic fluid
makes up 25% of ejaculate
made of citiric acid, enzymes, proteins, zinc
What component of ejaculate
allows if to coagulate
allows for liquification
is used to evaluate prostate function
proteins
proteolytic enzymes
zinc
What is the most commonly performed fecal test in chemistry
occult blood
What is occult blood used for
to find colorectal cancer
What is steatorrhea
increased fecal lipids
What is the main function of the SI
digestion and absorption of foodstuffs
What is the main function of the LI
absorption of water, sodium and chloride
What is scybala
small hard sperical masses in poop
What causes constipation
too much water absorbed from slow moving feces
What causes watery stools / diarrhea
too much water or not enough absorption
Diarrhea with increased solute secretions
secretory diarrhea
Diarrhea with increased osmotically active solutes in the intestinal lumen
osmotic diarrhea
Diarrhea with increase in intestinal motility
intestinal hypermotility
What is maldigestion? and malabsorption? what do each indicate
maldigestion- cant convert food into absorbable materials, could be pancreatic and hepatic disease
malabsorption- can digest but can’t absorb processed food, could be parasitic, mucosal, hereditary, drugs, surgery
What is acute diarrhea? and chronic?
within 1-2 weeks
more than 4 weeks
What does chronic bloody diarrhea indicate
and chronic watery diarrhea?
bloody- IBD, ulcerative colitis of Chron’s
watery- celiac, tropical sprue and colitis
What does it mean if diarrhea ceases upon fasting?
What does it mean if diarrhea persists despite fasting?
fasting- malabsorption or digestion- pancreatic disease, lactose intolerance
non fasting- secretory issue
pale, greasy, bulky, spongy, pasty and very foul smelling poop
steatorrhea
What is fecal fat determination for?
to differentiate steatorrhea from diarrhea
What gives stool its color
bile pigments, urobilins
What is acholic stool?
pale or clay colored, caused by inhibited bile secretion
What is a fecal WBC test
to see if WBC in feces, could indicate inflammation
detect lactoferrin
noninflammatory diarrheal conditions do Not have ____
neutrophils
What is a qualitative fecal fat test?
and quantitative?
qualitative- microscopic test, looks for orange to red color- neutral fats like triglycerides
quantitative- measures total fecal fat content
What does it mean to have a normal neutral fecal fat test and increased total fat
malabsorption
What does it mean to have an increased neutral fat in the first slide?
maldigestion
What is creatorrhea
increased fecal meat fivers- related to impaired digestion
undigested food
How to tell if there is bleeding in the upper GI tract ?
and in the lower GI tract?
upper- dark mahogany colored stool
lower- bright red coating surface of stool
What is melena
dark or black stool due to presence of blood
What is the Apt fecal test
hemoglobin in feces
What is the percent of fat retention formula
percent fat retention = dietary fat- fecal fat/ dietary fat x 100
What is the lactose intolerance test
if lactose intolerance pH is decreased
What is the oral tolerance test
test to see if there is an enzyme deficiency in intestines
What is the FOBT
looks for bleeding only in lower GI tract
