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Urinalysis > Final Exam > Flashcards

Final Exam Flashcards

1
Q

For what four reasons might amniotic fluid be collected during pregnancy?

A

genetic and congenital disorders, lung maturity, sex determination, and assessment of fetal distress due to infection or Rh/other isoimmunization

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2
Q

At what stage of pregnancy would amniocentesis be performed for the detection of genetic or congenital disease?

A

15-18 weeks

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3
Q

What is oligohydraminos?

A

deficiency of amniotic fluid

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4
Q

Why would amniotic fluid need to be protected from light sources?

A

preserving any bilirubin that is present

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5
Q

When present in amniotic fluid, fetal cells are adversely affected by what?

A

refrigeration

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6
Q

What is the normal color and turbidity of amniotic fluid?

A

pale yellow, slightly cloudy (depending on stage of pregnancy)

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7
Q

What would cause amniotic fluid to appear dark yellow or amber?

A

bilirubin

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8
Q

What would cause amniotic fluid to appear green?

A

meconium

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9
Q

What would cause amniotic fluid to appear pink?

A

blood

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10
Q

What is associated with amniotic fluid that is dark red-brown?

A

fetal death

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11
Q

What four tests are done to evaluate the surfactants present to the fetal pulmonary system?

A

lecithin : sphingomyelin (L/S) ratio; phosphatidyl glycerol (PG); foam stability index; microviscosity

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12
Q

In regards to the L/S ratio and PG determination, what indicates fetal lung maturity?

A

L/S ratio >/= 2.0 (affected by blood and meconium); PG needs to be present (not affected by any other factors)

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13
Q

What is important to remember about the PG factor?

A

lack of PG with an L/S ratio >2 can suggest lung maturity, but this can also be seen in diabetics

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14
Q

What do the three zones mean in reference to the delta A540 and the Liley’s 3-zone chart.

A

Zone 1: normal; Zone 2: moderate hemolysis; Zone 3: severe hemolysis (fetus will die without intervention)

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15
Q

What are the appearance and characteristics of transudates?

A

usually clear, do not contain clots, contains few cells, specific gravity

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16
Q

What are the appearance and characteristics of exudates?

A

cloudy, contains clots and many cells, specific gravity >1.015, and total protein >3.0

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17
Q

What is the difference between transudates and exudates in terms of their causes?

A

transudates are non-inflammatory and usually the result of oncotic pressure; exudates are inflammatory and usually secondary to disease states

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18
Q

Name the three biochemical indicators used to evaluate the secretory function of the prostate, including which one can positively identify seminal fluid and is useful in cases of sexual assault (*).

A

acid phosphatase*, zinc, citric acid

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19
Q

What are four reasons for a physician to order a semen analysis?

A

fertility determinations, forensic applications, donation purposes, vasectomy follow-up

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20
Q

Which structures contribute secretions to seminal fluid?

A

seminal vesicles, testes, prostate gland, epididymis

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21
Q

What is the normal concentration of seminal fluid?

A

20-250 million sperm per mL (cc)

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22
Q

Is the normal concentration of seminal fluid constant within a single individual, and what factors might influence concentration?

A

no; abstinence, viral infections, and stress can all affect concentration

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23
Q

Is concentration the most important factor in fertility determinations?

A

no

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24
Q

What percentage of sperm with normal morphology is considered normal or acceptable?

A

> /= 50%

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25
Q

How is sperm morphology determined?

A

stained smears of a fresh specimen

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26
Q

What parameter of a semen analysis is directly related to and provides a check of the motility evaluation (include how)?

A

viability; distinguishes dead from immobile

27
Q

What is the normal pH of seminal fluid?

A

7.2-7.8

28
Q

What might a pH

A

congenital aplasia of vasa deferentia and seminal vesicles or epididymis

29
Q

What might a pH of >7.2 indicate?

A

reproductive tract infection

30
Q

What does testing fructose in seminal fluid reflect?

A

secretory function of the seminal vesicles and the functional integrity of the ejaculatory duct and vasa deferentia

31
Q

What is the primary function of seminal function?

A

transport of sperm

32
Q

What are the requirements for the collection of a specimen for semen analysis?

A

collected after 48-72 hours of abstinence (no longer than one week); patient must be given a private room (can only be collected through masturbation); collected in a wide-mouth clean container that is properly labeled and delivered to the lab within 30-60 minutes, kept warm; if more than one specimen is requested, should be collected over a 3 month period, at least 7 days apart

33
Q

What is the normal length of time (in minutes) for a semen specimen to liquefy?

A

30-60 minutes

34
Q

What does the viscosity resemble after liquefaction, and what is considered abnormal liquefaction?

A

resembles water; process takes longer than 60 minutes

35
Q

Motility should be evaluated within how many minutes following collection?

A

60 minutes

36
Q

Explain the color, clarity, viscosity, and clot formation of normal synovial fluid.

A

colorless/pale yellow, clear; use “string test” - 5cm string before breaking considered normal; should not contain clots

37
Q

Is fibrinogen a constituent of normal synovial fluid?

A

no

38
Q

Does hyaluronate affect the turbidity of synovial fluid? What other factors may affect turbidity?

A

no; red cells, white cells, crystals, synoviocytes, fat, and cellular debris

39
Q

Why should a synovial fluid be examined as soon as possible?

A

crystals can form or break down during refrigeration, and white cells can phagocytize crystals

40
Q

Which anticoagulant should be used on synovial fluids for microscopic examination purposes, and why should other anticoagulants be avoided?

A

sodium heparin; others can cause artifacts

41
Q

Which diluent should be used for synovial fluid if necessary?

A

0.85% NaCl (blood bank saline)

42
Q

A joint disease process is indicated by what?

A

presence of >25% neutrophils

43
Q

What type of microscopy differentiates synovial fluid crystals based on their birefringence, and how is this achieved?

A

compensated polarized microscopy; based on colors achieved (yellow or blue) when crystals are oriented parallel or perpendicular to the axis

44
Q

Which crystal appears yellow when parallel to the axis and blue when perpendicular to the axis, and what disease is associated with it?

A

monosodium urate monohydrate (MSU, uric acid); gout

45
Q

Which crystal appears blue when parallel to the axis and yellow when perpendicular to the axis, and what disease is associated with it?

A

calcium pyrophosphate dihydrate; pseudogout

46
Q

Are monosodium urate, calcium pyrophosphate dihydrate, and cholesterol crystals all birefringent?

A

yes

47
Q

Which analytes are present in synovial fluid at concentrations equal to blood plasma levels?

A

glucose and uric acid

48
Q

If a bloody CSF is received in the lab, what steps can be taken to determine if it is due to traumatic tap or from the patient having actually hemorrhaged?

A

look at all tubes in order of collection (if the amount of blood decreases from tube to tube, it is probably from traumatic tap; if the amount is about the same, hemorrhage is indicated); spin down all tubes - xanthochromic supernatant is indicative of hemorrhage, clear supernatant is indicative of traumatic tap

49
Q

What is xanthochromia?

A

pigment in the supernatant from lysed red cells

50
Q

Does fibrinogen normally pass through the blood-brain barrier?

A

no

51
Q

According to the lumbar puncture procedure, what is the first CSF tube collected used for?

A

chemical and immunologic testing

52
Q

A predominance of lymphocytes within CSF indicated which type of meningitis?

A

viral

53
Q

What are the normal ranges for glucose and protein in normal CSF?

A

glucose: 50-80 mg/dL, protein: 15-45 mg/dL

54
Q

What condition would decreased glucose and increased protein in CSF indicate?

A

meningitis

55
Q

What is the concentration of glucose in CSF in relation to the concentration in plasma?

A

60-70% or 2/3

56
Q

Define pleocytosis as it relates to CSF?

A

increase in the number of cells

57
Q

Can an increased number of white cells within CSF cause xanthochromia?

A

no

58
Q

What are the normal white cell counts of CSF in adults, children, and newborns?

A

adults: 0-5 cells/uL, children: 0-10 cells/uL, newborns: 0-30 cells/uL

59
Q

What two cell types are considered normal if seen in the CSF from an adult?

A

lymphocytes and monocytes

60
Q

A predominance of neutrophils within CSF indicates which type of meningitis?

A

bacterial

61
Q

What is the normal range for lactate in CSF?

A

10-22 mg/dL

62
Q

Normal lactate levels can be found in the CSF of patients with what type of meningitis?

A

viral

63
Q

Which procedure frequently provides a rapid presumptive diagnosis of bacterial meningitis?

A

Gram stain

Urinalysis (4 decks)

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