Final Flashcards
Four reasons amniotic fluid is collected during pregnancy
parent with known chromosomal abnormality, elevated maternal alpha-fetoprotein, fetal distress, pulmonary maturity, sex determination, predicting HDN
Amniotic fluid is collected in early pregnancy most likely to determine what?
genetic and congenital disorders
What is the definition of oligohydraminos?
abnormally decreased amounts of amniotic fluid
What would be the reason for protecting amniotic fluid from light?
to protect light-sensitive bilirubin if present
When present in amniotic fluid, fetal cells are adversely affected by what?
refrigeration
What might you find when performing a physical examination of amniotic fluid?
normally colorless or very pale yellow; degree of particulate matter depends on stage of pregnancy
What are the four tests done to evaluate the surfactants present to the fetal pulmonary system?
lecithin sphingomyelin (L/S), FSI, microviscosity, and phosphatidylglycerol
Using and comparing the L/S ration and the PG determinations, what would indicate fetal lung maturity?
L/S ration >2.0 is fetal lung maturity
What does zone 1 mean on a Liley’s 3 zone chart?
normal
What is transudates?
non-inflammatory caused by disturbances by hydrostatic or oncotic pressure
Three biochemical indicators that are used to evaluate the secretory function of the prostate.
Zinc, citric acid, and acid phosphatase
What biochemical indicator can positively identify a fluid as seminal fluid and useful in ages of sexual assault?
acid phosphatase
Four reasons for a physician to order a semen analysis
evaluate evaluate fertility, forensic applications, semen donation, and vasectomy follow-up
Which structures contribute secretions to seminial fluid?
seminal vesicles, prostate gland, testes, and epididymis
What is normal concentration of a normal seminal fluid?
20-250 million/mL
Is a single person’s seminal fluid concentration constant?
not constant in a single individual
What factors influence seminal fluid concentration?
depends on periods of sexual abstinence, viral infections, and stress
Is seminal fluid concentration the most important factor when determining infertility?
no
What percentage of sperm with normal morphology is considered normal or acceptable?
50% or more sperm with normal morphology is acceptable
How is sperm morphology determined?
evaluated by smears of fresh semen, can be stained
What parameter of a semen analysis is directly related to and provides a check of the motility evaluation?
viability
How is semen motility evaluated?
distinguishes dead from immotile
What is the normal pH of seminal fluid?
7.2-7.8 is the normal range for pH of seminal fluid
What might a pH of <7.2 of seminal fluid indicate?
abnormality of the epididymis, vas deferent, or seminal vesicles
What might a pH of >7.8 of seminal fluid indicate?
infection in male reproductive tract
Testing fructose in seminal fluid reflects the secretory function of what?
seminal vesicles
Testing fructose in seminal fluid reflects the functional integrity of what?
the ejaculatory ducts and vas deferens
What is the primary function of seminal fluid?
transports sperm
What are the requirements for the collection of a specimen for semen analysis?
must be collected and given to lab within one hour of collection and protected from extreme temperatures
What is the normal length of time for semen specimens to liquefy?
within 30 minutes semen begins to liquefy
After liquefaction, the viscosity closely resembles what other fluid?
closely resembles water
What would be considered abnormal liquefaction of semen?
takes greater than 60 minutes to liquefy
Motility of seminal fluid should be evaluated within how many minutes following collection?
60 minutes
What color, clarity, viscosity, and clot formation is for normal synovial fluid?
Colorless or pale yellow, clear, extremely viscous, no clots
Is fibrinogen a normal constituent of normal synovial fluid?
No
Does hyaluronate affect the turbidity of a synovial fluid specimen?
No
Name some things that might cause a synovial fluid to be turbine in appearance
RBCs WBCs, fat droplets, synoviocytes, crystals, cellular debris
Why should a synovial fluid be examined ASAP
crystals are pathognomonic and can form during storage or WBCs can phagocytize the crystals
The synovial fluid should be placed in a tube containing which anticoagulant?
sodium heparin
Why should other anticoagulants be avoided for synovial fluid?
other anticoagulants can form artifacts
Name the diluent that should be used if a synovial fluid needs to be diluted for microscopic exam
0.85% saline
A joint disease process is indicated by what?
Neutrophils >25%
What type of microscopy differentiates synovial fluid crystals based on their birefringence?
a wet prep using both direct and compensated polarizing microscopy
How is birefringence achieved of synovial fluid crystals?
based on the colors, blue or yellow, produced when the crystals are oriented perpendicular or parallel to the axis (yellow parallel)
Indicators that synovial fluid should be classified as septic
Yellow-green color, low viscosity, WBCs high, >40 mg/dL plasma synovial glucose difference
Which crystal is usually seen in patients with gout?
monosodium urate monohydrate
Is monosodium urate crystals birefringent?
yes
Are calcium pyrophosphate dihydrate crystals birefringent?
yes
Are cholesterol crystals birefringent?
yes
Which analytes are present in synovial fluid at concentrations equal to blood plasma levels?
Glucose and uric acid
How do you determine if a bloody CSF fluid is caused by a traumatic tap or if the patient hemorrhaged?
is the amount of blood the same in all the tubes?
What is xanthochromia?
yellow discoloration due to RBC pigment
does fibrinogen normally pass through the blood-brain barrier?
no
What should the first tube collected during a lumbar puncture procedure be used for?
chemical and immunologic
A predominance of lymphocytes within CSF indicates which type of meningitis?
viral meningitis
What are the normal ranges for glucose in a normal CSF?
50-80 mg/dL
What are the normal ranges for protein in a normal CSF?
15-45 mg/dL
What condition would a decreased glucose and increased protein indicate?
meningitis
What is the amount of glucose in CSF compared to plasma concentration?
60-70% or 2/3
What is pleocytosis as it relates to CSF?
increase in number of cells in CSF
Does an increased number of leukocytes within CSF cause xanthochromia?
no
An uneven distribution of blood in the CSF collection tubes most likely indicates what?
traumatic tap
What is the normal CSF WBC cell count for adults?
0-5 cells/microL
What is the normal CSF WBC cell count for children?
0-10 cells/microL
What is the normal CSF WBC cell count for newborns?
0-30 cells/microL
In adult CSF cell counts, what two cell types are considered normal?
lymphocytes and monocytes
A predominance of neutrophils within CSF indicates which type of meningitis?
bacterial meningitis
What is the normal range for lactase in CSF>
10-22 mg/dL
Normal lactate levels are often found in patients with what type of meningitis?
viral
Which procedure frequently provides a rapid presumptive diagnosis of bacterial meningitis?
Gram stain
What does pinkish to red color mean for amniotic fluid?
blood
What does green color mean for amniotic fluid?
meconium
What does yellow or amber color mean for amniotic fluid?
bilirubin
Is L/S ration affected by meconium?
yes
In regards to PG determination, what indicates fetal lung maturity?
PG present
Is PG affected by meconium?
no
What does zone 2 mean in reference to Liley’s 3 zone chart?
moderate hemolysis
What does zone 3 mean in reference to Liley’s 3 zone chart?
severe hemolysis
What is exudate?
inflammatory, caused by increased capillary permeability or decreased lymphatic reabsorption, usually secondary to disease
Describe transudates
usually clear, no clots, few cells
What is the specific gravity of transudates?
<1.015
What is the total protein of transudates?
<3.0
describe exudates
cloudy, can have clots, lots of cells
What is the specific gravity of exudates
> 1.015
What is the total protein of exudates?
> 3.0
