Final Exam Study Guide Flashcards
Reasons amniotic fluid is collected during pregnancy
fetal lung maturity antenatal diagnosis of genetic and congenital disorders fetal distress - Rh HDN sex of baby
15-18 wk gestation, collection of amniotic fluid for what
antenatl diagnosis of genetic and congential disorders
Define oligohydraminos
decreased amount of amniotic fluid associated with congenital malforamtion and premature rupture of the membranes
What would be the reason for protecting amnioti fluid from light
to protect bilirubin if present
When present in amniotic fluid, fetal cells are adversly effected by what
refrigeration
amount of urobilinogen; hemolyzes fetal rbcs that occur in HDN
explain what you might find when performing a physical exam of amniotic fluid, including color and turbidity
normal; colorless or very pale yello, turbid depending on stage of pregnancy
early; little particulate matter
late; increase amount of fetal cells, hair, etc
abnormal
yellow/amber; due to presence of bilirubin
green; meconium
red/pink; presence of blood
Four test done to evaluate surfactants present to the fetal pulmonary system
L/S ratio; lecithin/sphingomyelin
PG; phosphotidylglyceral
FSI; foam stability index
Microviscosity
Compare L/S ratio and PG, what would indicate fetal lung maturity
L/S is >20 but PG is present; effected by presence of blood and meconium
PG is not effected; if absent could indicate maturity but in diabetes
Three zones of Liley’s graph
III; fetal failure, severe hemolysis, death
II; moderate hemolysis
I; normal, minimally effected fetus
Non inflammatory disturbance on oncatic pressure clear no clots few cells SG less than 1.015 TP 3.0
Transudates
inflammator increase in capillary membrane permeability increase of absorption of fluid in lymph system cloudy clots many cells SG greater than 1.015 TP greater than 3.0
exudates
Three biochemical indicators that are used to evaluate the secretory function of the prostate. Which one can positively ID a fluid as seminal fluid and is useful in sexual assault cases?
Zinc
citric acid
acid phosphotase-pos ID seminal fluid
4 reason for a semen analysis to be ordered
evaluate infertility
follow up vasectomy
evaluation on quality for donation
forensic applications
Which structures contribute secretions to seminal fluid
testes
epididymis
seminal vesicles
prostate gland
What is the normal concentration of seminal fluid?
Is the concentration within a single individual constant?
If not, what factors might influence concentration?
Is concentration important in determining infertility?
20-250 million/mL
No, dependent upon period of sexual abstinence
Viral infections, stress, abstinence
Not as important as their other characteristics
What percentage of sperm with normal morph is considered normal or acceptable?
How is sperm morph determined?
50% or more
Stained smear of fresh specimen
All or one region of the sperm, its size, shape or both by micro ID and supravital stain
What parameter of sperm analysis is directly related to and provides a check of the motility evaluation? How?
Viability; distinguishes dead from non motile
What is the normal pH of seminal fluid?
What might a pH of <7.2 indicate
What might a pH >7.8 indicate
7.2-7.8
>7.2 abnormality of the epididymis, vas deferens or seminal vesicles
>7.8 infection in male reproductive tract
Testing fructose in seminal fluid reflects the secretory functions of what?
Functional integrity?
seminal vesicales
ejaculatory ducts and vas deferens
What is the primary function of seminal fluid
transport spermatzoa
Specimen collection requirements for semen analysis
sensitivity and professionalism
written and verbal instructions should be provided
must be received in lab within an hour
protected from extreme temps (keep 20-40C)
witnin a 3 month period, 7 days apart
abstain for 2-7 days
Length of time for normal specimen to liquefy
after liquefication what fluid does it resemble?
what would be abnormal liquefication?
30 minutes
becomes watery
any delay >60 minutes is abnormal and must be reported
Motility should be evaluated within how many minutes following collection?
within 60 minutes
Explain characteristics of normal synovial fluid
pale yellow color, colorless, clear normally clear very viscous no clots syrupy
Is fibrinogen a normal constituent of synovial fluid
NO
Does hyaluronate affect the turbidity of synovial fluid? Name things that may cause turbidity
No
WBC, RBC, synoviocytes, crystals, fat droplets and cellular debri
Why should synovial fluid be examined ASAP?
Which component, if present, might be most adversly affected by delay in exam?
Crystals can form during storage
WBCs can phagocytize crystals
During micro exam of synovial fluid what anticoagulant should be used? Why should others be avoided?
sodium heparin
to prevent artifacts
Name diluent used for synovial fluid microscopic exam
0.85% saline
A joint disease process is indicated by what
> 25% neutrophils
What type of microscopy differentiates synovial fluid crystals? How?
compensated polarized
based on colors produced when crystals are oriented parallel or perpendicualr to axis
yellow parallel, gout MSD/uric crystals
Indicators that signify septic synovial fluid
yellow green color low viscosity cloudy increase WBC >50,000 > 40mg/dL plasma glucose difference
Which crystals are usually seen in pt with gout
monosodium urate monohydrate/MSU/uric acid
MSU
calcium pyrophosphate dihydrate
cholesterol crystals
All are birefringent
What analytes are present in synovial fluid at concentrations equal to blood plasma levels
glucose
uric acid
If a bloody CSF is received, what are some steps to determine if its a traumatic tap or an acutal hemorrhage
hemorrhage; blood is same throughout each tube, xanthochomian supernatant
traumatic tap; blood lessens in each tube, clear supernatant
Define xanthochromia
yellow discoloration due to red cell pigments
Does fibrinogen normally pass the BBB
No
First tube of lumbar puncture should be used for what
chemical, immunological
a predominance of lymphocytes in CSF is suggestive of which meningitis
viral
neutrophils; bacterial meningitis
normal CSF glucose range
50-80 mg/dL
decreased in meningitis
normal CSF protein range
15-45 mg/dL
increased in meningitis
CSF glucose compared to plasma glucose
CSF glucose is 60-70% or 2/3 of the plasma concentration
pleocytosis in realtion to CSF
increase amount of cells in CSF
normla CSF wbc range for adult, child and newborns
Adult; 0-5 cell/uL
child; 0-10 cells/uL
newborn; up to 0 cells/uL
two cells that may be seen in normal CSF fluid
lymphs and monos
Normal range of lactate in CSF
Normal levels found in what meningitis
10-22 mg/dL
viral
Diagnostic tool for bacterial meningitis
Gram stain for rapid presumptive
