exam topics

Question 1

37. Biochemical and cytological evaluation of the body cavity fluids, interpretation of results

Answer 1

BIOCHEMICAL EVALUATION: 
-Albumin/globulin ratio 
-Creatinine, urea concentration 
-Alpha-amylase, lipase
-LDH activity 
-Triglycerol (TG) / Cholesterol (chol) ratio 
CYTOLOGICAL ANALYSIS 
a) inflammatory (exudate)
- septic: bacteria, fungi, rickettsia
- non septic
b) non-inflammatory
- reactive (transudate) 
- neoplastic (modified transudate)

Question 2

38. CSF evaluation – methods and interpretation

Answer 2

-Physical examination: Color, turbidity, Coagulation
-Cell count:
o Native sample: burker chamber or Fuchs-Rosenthal chamber
o Nucleated cell count: turk solution into liquor CSF
o Haemocytometer
-Cytology evaluation
o Preparation of smear
o Major cell types: Small lymphocytes, Macrophages, epithelial cells, Neutrophils granulocyte
o Causes of neutrophil pleocytosis
o Causes of high eosinophil granulocyte count
o Causes of the proliferation of mixed cell population
o Appearance of neoplastic cells
o Ultrasensitive protein concentration analysis
o Pandy method
-Glucose concentration examination
-Lactate concentration
-Enzyme activity examination

Question 3

33. Examine the protein content of the urine sample and explain the methods, how to determine WBCs excreted with the urine!

Answer 3

Methods:
-Test strips
-Refractometric method: 
-Sulphosalicylic acid method 
-Heller test 
-Spectrophotometric method 
-Urine protein: creatinine ratio UPC
-Determination of Bence jones proteins
-Microalbuminura
Causes of proteinuria:
1. Pre-renal (non-renal) causes
o Physiological or bening proteinuria
o Pathological
2. Real proteinuria – nephrogenic
o Selective proteinuria 
o Non-selective proteinuria
3. Pseudo-proteinuria (proteinuria spuria)
o Physiological
o Pathological
-These can be differentiated by centrifuging
Pus - pyuria - Methods:
-Donne-test: NaOH (bubbles)
-Microscopic evaluation the sediment

Question 4

30. Determination of ketone bodies in different biological samples, evaluation of blood lipid and cholesterol concentrations and interpretation of changes

Answer 4

-Detect acetone and acetoacetate: Ross reaction (nitroprussid, NH4-sulphate, Na2CO3: white to purple)
Blood lipid - Evaluate presence of lipaemia
•Freeze-reheat-centrigufe: differentiate chylomicrons (post prandial) from other lipids
•Causes of hyperlipidaemia
•Causes of decreased lipid content
•Lipid absorption test
Blood cholesterol: detection of incr fat mobilisation
•Interpretation:
o Hypocholesterolaemia
o Hypercholesterolaemia

Question 5

28. Methods to determine glomerular function and their interpretation

Answer 5

1. BUN - Blood Urea Nitrogen concentration
   - Urea-colour test
   - Enzymatic urea method
2. Creatinine concentration in plasma
   - Jaffe method: yellow-orange complex w. picric acid on alkaline pH
   - Enzymatic method: creatinase/creatininase where red kinon derivate is prod.
3. Plasma urea : plasma creatinine ratio
4. Creatinine clearance: C (clearance) = U x V/P
5. Urinary total protein : Creatinine ratio
   - Objective protein measurements: Biuret reaction, ultrasensitive protein measurement
   - Specific protein determination: electrophoresis, immune-electrophoresis, western-blot analysis

Question 6

32. Evaluation of the urine sample with test strip, characterization of the test-zones on the test strip

Answer 6

Sampling:
1. Free catch sample 
2. Catheterisation
3. Cystocentesis
Test strip
-Blood - Benzidine test 
-Urobilinogen 
-Ketones - nitroprusside reagent 
-Protein - brome-phenol-blue
-Nitrite - alpha-naphthylamine (Griess-Liosvay´s reagent)
-Glucose - GOD/POD reagents 
-pH 
-Specific gravity - precipitated polyelectrolyte