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AUBF > M2: Microscopic Examination (Part 1: Macroscopic Screening) > Flashcards

M2: Microscopic Examination (Part 1: Macroscopic Screening) Flashcards

1
Q

recommends that microscopic examination be performed
when:
- requested by a physician
- when a laboratory specified patient population is being tested
- when any abnormal physical or chemical result is obtained

A

Clinical and Laboratory Standards Institute (CLSI)

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2
Q

The purpose of the microscopic examination of the urinary
sediment is?

A
  • detect and to identify insoluble materials present in the urine
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3
Q

These all contribute formed elements to the urine

4

A
  • Blood
  • Kidney
  • Lower genitourinary tract
  • External contamination
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4
Q

Some components are of no clinical significance and are considered normal unless they are present in increased amounts, what two factors must be consdered in examination of urinary sediment?

A

Identification and quantification of elements

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5
Q

Abnormalities in the physical and chemical portions of the urinalysis play a primary role in the decision to perform a microscopic analysis, thus the use of the term?

A

Macroscopic screening

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6
Q

MACROSCOPIC SCREENING AND MICROSCOPIC CORRELATIONS

Parameters considered significant vary among laboratories?

A
  • Color
  • Clarity
  • Blood
  • Protein
  • Nitrite
  • Leukocyte esterase
  • Glucose (possibly)
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7
Q

MACROSCOPIC SCREENING AND MICROSCOPIC CORRELATIONS

Identify the screening test for the following possible microscopic findings:
RBC (blood)

A

Color (red), cloudy
or turbid

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8
Q

MACROSCOPIC SCREENING AND MICROSCOPIC CORRELATIONS

Identify the screening test for the following possible microscopic findings:
Squamous EC, WBC (confirm pathologic or non-patholpgic cause of turbidity)

A

Clarity: Cloudy or Turbid

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9
Q

MACROSCOPIC SCREENING AND MICROSCOPIC CORRELATIONS

Identify the screening test for the following possible microscopic findings:
Radiographic contrast media (X-ray dye)

A

Specific gravity >1.040

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10
Q

MACROSCOPIC SCREENING AND MICROSCOPIC CORRELATIONS

Identify the screening test for the following possible microscopic findings:
RBCs, RBC casts

A

Blood

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11
Q

MACROSCOPIC SCREENING AND MICROSCOPIC CORRELATIONS

Identify the screening test for the following possible microscopic findings:
Yeast

A

Glucose

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12
Q

MACROSCOPIC SCREENING AND MICROSCOPIC CORRELATIONS

Identify the screening test for the following possible microscopic findings:
WBCs intact or lysed, WBC casts (bacteria in UTI)

A

Leukocyte esterase positive

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13
Q

MACROSCOPIC SCREENING AND MICROSCOPIC CORRELATIONS

Identify the screening test for the following possible microscopic findings:
Bacteria (WBCs in UTI)

A

Nitrite positive

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14
Q

MACROSCOPIC SCREENING AND MICROSCOPIC CORRELATIONS

Identify the screening test for the following possible microscopic findings:
Increased casts and cells

A

Protein positive

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15
Q

SPECIMEN PREPARATION

T or F
Specimens should be examined while fresh or properly preserved.

A

T

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16
Q

SPECIMEN PREPARATION

These formed elements disintegrate rapidly, particularly in dilute alkaline
urine

A

RBCs, WBCs, and hyaline
casts

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17
Q

SPECIMEN PREPARATION

What concentration of urine does RBCs, WBCs, Hyaline casts disintegrate rapidly?

A

Dilute alkaline urine

high ph

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18
Q

SPECIMEN PREPARATION

You bring specimen to what temperature before centrifugation?

A

Room temperature

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19
Q

SPECIMEN PREPARATION

This temperature may cause precipitation of amorphous urates and phosphates and other non-pathologic crystals that can obscure other elements in the urine sediment.

A

Refrigeration

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20
Q

SPECIMEN PREPARATION

This temperature may dissolve some of these crystals

A

Warming specimen to 37 c

prior to centrifuging

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21
Q

SPECIMEN PREPARATION

This method of collection minimizes external contamination of the sediment

A

Midstream clean-catch specimen

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22
Q

SPECIMEN PREPARATION

Dilute random specimens cause what results?

A

False-negative

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23
Q

SPECIMEN PREPARATION

T or F

Shake specimen vigorously before transferring into a centrifuge tube

A

F (MIX specimen well before transferring into a centrifuge tube)

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24
Q

SPECIMEN VOLUME

What is the standard amount of urine that is usually centrifuged in a conical tube?

A

between 10 and 15 mL

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25
Q

SPECIMEN VOLUME

A standard amount of urine, usually between 10 and 15 mL,
is centrifuged in a ?

A

Conical tube

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26
Q

SPECIMEN VOLUME

This range of specimen volume provides an adequate volume from which to obtain representative sample of the elements present in the specimen.

A

10-15 mL of specimen volume

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27
Q

SPECIMEN VOLUME

This specific specimen volume is frequently used ecause
multiparameter reagent strips are easily immersed in
this volume and capped centrifuge tubes are often
calibrated to this volume

A

12-mL volume

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28
Q

SPECIMEN VOLUME

Familiarize the reason why 12mL of specimen volume is frequently used

A
  • multiparameter reagent strips are easily immersed in this volume
  • capped centrifuge tubes are often
    calibrated to this volume
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29
Q

SPECIMEN VOLUME

T or F

If obtaining a 12-mL specimen is not possible, as with
pediatric patients, the volume of the specimen used
should be noted on just the medtech’s mind

A

F (should be reported on report form)

allows the physician to correct the results, if indicated

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30
Q

SPECIMEN VOLUME

T or F

If obtaining a 12-mL specimen is not possible, some laboratories make correction prior reporting

A

T

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31
Q

SPECIMEN VOLUME

For example, if 6-mL of urine was collected and centrifuged, the results are multiplied by what number ?

A

2

para maging 12 ata

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32
Q

CENTRIFUGATION

Centrifugation time?

A

5 minutes

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33
Q

CENTRIFUGATION

Speed of centrifugation?

RCF

A

400 relative centrifugal force (RCF)

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34
Q

CENTRIFUGATION

Speed of centrifugation?

RPM

A

1,500-2,500 RPM

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35
Q

CENTRIFUGATION

This RCF and RPM produces an optimum amount of sediment with the least chance of damaging the elements.

A

RCF: 400 RCF
RPM: 1,500-2,000 RPM

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36
Q

CENTRIFUGATION

To correct for differences in the diameter of centrifuge heads, what is the unit of centrifugation speed preferred to use?

A

Relatice Centrifugal Force (RCF)

than Revolutions per Minute (RPM)

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37
Q

CENTRIFUGATION

RPM value shown on centrifige tachometer can be converted to RCF using nomoframs available in many laboratory manuals or by using what formula?

A

RCF = 1.118 x 10^-5 x radius in cm x RPM ^2

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38
Q

CENTRIFUGATION

Using this will give a false negative result

A

Brake (braking)

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39
Q

CENTRIFUGATION

To prevent biohazardous aerosols, all speciments must be?

A

centrifuged in capped tubes

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40
Q

SEDIMENT PREPARATION

Volume of liquid that should remain in tube after decantation?

A

0.5-1.0 mL

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41
Q

SEDIMENT PREPARATION

T or F

In decantation, vigorously tap repeatedly the lower part of the tube with the finger to mix the sediment

A

F (gently tap repeatedly the lower part of the tube with the finger to mix the sediment)

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42
Q

Concentration factor formula?

A

CF = V of urine centrifuged / Sediment Volume

C = V/S

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43
Q

SEDIMENT PREPARATION

  • relates to the probability of detecting elements present in low quantities
  • used when quantitating the number
    of elements present per milliliter
A

Sediment concentration factor

44
Q

SEDIMENT PREPARATION

To maintain a uniform sediment concentration factor, urine should be (blank) rather than poured off

A

aspirated off

45
Q

T or F

To maintain a uniform sediment concentration factor, urine should ALWAYS be aspirated off rather than poured off

A

F (unless
otherwise specified by the commercial system in use)

Some systems provide pipettes for this purpose.

46
Q

SEDIMENT PREPARATION

After decanting, sediment should be resuspened by doing what motion?

A

gentle agitation

47
Q

SEDIMENT PREPARATION

Resuspension by gentle agitation can be perfomed by using what tool and motion?

A

Commercial-sytem pipette OR repeatedly tapping the tip of the tip of tube with finger

48
Q

SEDIMENT PREPARATION

Calculate the concentration factor (CF) of a 10 mL urine and 0.5 sediment

A

10/0.5
CF = 20

49
Q

VOLUME OF SEDIMENT EXAMINED

When using the conventional glass slide method, what is the recommended volume?

A

20 uL (0.02 mL)

50
Q

VOLUME OF SEDIMENT EXAMINED

When using the conventional glass-slide method, the
recommended volume is 20 µL (0.02 mL) covered by what dimensions of glass cover slip?

A

22 x 22 mm glass cover slip

51
Q

VOLUME OF SEDIMENT EXAMINED

Allowing the specimen to flow outside of the cover slip may result in?

A

loss of heavier elements such as casts

52
Q

VOLUME OF SEDIMENT EXAMINED

control the volume of sediment examined by providing slides with chambers capable of containing a specified volume

A

Commercial systems

53
Q

COMMERCIAL SYSTEM

Closed system for performing fast, clean, accurate,
microscopic urine analysis

A

Commercial system: Cen slide

54
Q

These 2 commercial systems do not require
manual loading of the centrifuged specimen onto a
slide and are considered closed systems that minimize
exposure to the specimen.

A
  • Cen-slide
  • R/S Workstations
55
Q

COMMERCIAL SYSTEM

Provides a specially designed tube that permits direct
reading of the urine sediment

A

Commercial system: Cen slide

56
Q

COMMERCIAL SYSTEM

T or F

decanting, re-suspending, pipetting, sediment
transfer, microscope slides and coverslips are the requirements for cen-slide

A

F (NO decanting)

57
Q

COMMERCIAL SYSTEM

Familiarizie the options provided by the commercials systems: cen slide

A
  • Capped calibrated centrifuge tubes
  • Decanting pipettes (to control sediment volume)
  • Slides (control amount of sediment examined)
  • Produce a consistent monolayer sediment for examination
  • Provide calibrated grids (more consistent quantitation)
58
Q

COMMERCIAL SYSTEM

control sediment volume

options/advantages of using commercial systems

A

Decanting pipettes

59
Q

COMMERCIAL SYSTEM

control amount of sediment examined

options/advantages of using commercial systems

A

Slides

60
Q

COMMERCIAL SYSTEM

more consistent quantitation

options/advantages of using commercial systems

A

calibrated grids

61
Q

EXAMINING THE SEDIMENT

Sediments should be examined for how many fields under LPO and HPO?

A

10-20 fields

62
Q

EXAMINING THE SEDIMENT

T or F

One should examine the sediment under LPO and HPO

A

T

63
Q

EXAMINING THE SEDIMENT

AT what objective should the sediment be examined first to detect casts and ascertain the general composition of the sediment?

A

LPO (10x)

64
Q

EXAMINING THE SEDIMENT

When elements such as casts that require identification are encountered, the setting is changed to?

A

HPO (40x)

65
Q

EXAMINING THE SEDIMENT

HPO

a. Detection of casts
b. Identificationof casts
c. BOTH
d. NEITHER

A

b. Identification of casts

66
Q

EXAMINING THE SEDIMENT

In what area of the slide are casts observed when using conventional glass-slide ?

A

near edges of the cover slip

67
Q

EXAMINING THE SEDIMENT

T or F

If the conventional glass-slide method is being used,
casts have a tendency to locate near the edges of the
cover slip; therefore, high-power scanning of the cover-slip perimeter is recommended

A

F (lOW-POWER SCANNING of perimeter is recommended)

68
Q

EXAMINING THE SEDIMENT

When using bright-field microscopy, examine the sediment
under

level of light

A

reduced or subdued light

69
Q

EXAMINING THE SEDIMENT

T or F

Initial focusing can be difficult with a fluid specimen

A

T

70
Q

EXAMINING THE SEDIMENT

T or F

Care must be taken to ensure that the examination is being performed in the correct plane

A

T

71
Q

EXAMINING THE SEDIMENT

What urine sediment should be used as reference?

A

Epithelial cell (squamous ec yum)

72
Q

EXAMINING THE SEDIMENT

T or F

Once the epithelial cell is located as point of reference, only the coarse adjustment should now be adjusted

A

T (DO NOT
move the coarse adjustment knob anymore)

move mo lang coarse kapag finofocus yung squamous ec

ok? ok

73
Q

EXAMINING THE SEDIMENT

T or F

Focusing on artifacts should be done

A

F (should be AVOIDED)

74
Q

EXAMINING THE SEDIMENT

often larger than the regular sediment elements and cause the microscopist to examine objects in the wrong plane

A

Artifacts

75
Q

EXAMINING THE SEDIMENT

This action aids in obtaining a complete representation of the sediment constituents

A

Continuous focusing with the fine adjustment

76
Q

REPORTING THE MICROSCOPIC EXAMINATION

Familiarize the steps in reporting microscopic examination

A
  1. Count the number microscopic elements in 10 field
  2. Get average
  3. Report according to following standard of reporting
77
Q

REPORTING THE MICROSCOPIC EXAMINATION

One should count the number of microscopic elements in what number of fields?

A

10 fields

78
Q

REPORTING THE MICROSCOPIC EXAMINATION

RBCs, WBCs, crystals, renal tubular cells, yeast, and
bacteria are reported per?

A

reported per HPF (high power field)

79
Q

REPORTING THE MICROSCOPIC EXAMINATION

Squamous epithelial cells, transitional epithelial cells and
casts are reported per

A

reported per LPO (low power field)

80
Q

REPORTING THE MICROSCOPIC EXAMINATION

Memorize the elements reported per HPF

A
  • RBCs
  • WBCs
  • RTE cells
  • Yeast
  • Bacteria

CYB

Cells, yeast, bacteria

81
Q

REPORTING THE MICROSCOPIC EXAMINATION

Memorize the elements reported per LPF

A
  • Squamous EC
  • Transitional EC
  • Casts

Epthelial cells and casts

82
Q

REPORTING THE MICROSCOPIC EXAMINATION

Memorize the elements reported quantitatively

Reported quantitatively (0-2, 2-5,5-10…)

A
  • RBCs
  • WBCs
  • RTE
  • Casts
83
Q

REPORTING THE MICROSCOPIC EXAMINATION

Memorize the elements reported semi-quantitatively

Reported semi-quantitatively (Rare, Few..1+,2+…)

A
  • Squamous EC
  • Crystals
  • Yeast
  • Bacteria
84
Q

REPORTING THE MICROSCOPIC EXAMINATION

Squamous EC is reported as ? (2)

give reported per and reported quanti or semi-quanti

A

reported per LPF
reported semi-quantitatively

85
Q

REPORTING THE MICROSCOPIC EXAMINATION

Cast is reported as ? (2)

give reported per and reported quanti or semi-quanti

A

reported per LPF
reported quantitatively

86
Q

REPORTING THE MICROSCOPIC EXAMINATION

RBCs and WBCs are reported as ? (2)

give reported per and reported quanti or semi-quanti

A

reported per HPF
reported quantitatively

87
Q

REPORTING THE MICROSCOPIC EXAMINATION

Crystals are reported as ? (2)

give reported per and reported quanti or semi-quanti

A

reported per HPF
reported semi-quantitatively

88
Q

REPORTING THE MICROSCOPIC EXAMINATION

Bacteria is reported as ? (2)

give reported per and reported quanti or semi-quanti

A

reporter per HPF
reported semi-quantitatively

89
Q

REPORTING THE MICROSCOPIC EXAMINATION

Budding yeast, mycelial elements, Trichomonas, and sperm are reported as what?

A

rarely reported

90
Q

REPORTING THE MICROSCOPIC EXAMINATION

Squamous EC/LPF
None -
Rare -
Few
Moderate -
Many -

give the values correspondent to the following report

A

None - 0
Rare - 0-5
Few - 5-20
Moderate - 20-100
Many - >100

5, 20, 100

91
Q

REPORTING THE MICROSCOPIC EXAMINATION

Casts/LPF
give the values for reporting

A

None
0-2
2-5
5-10
>10

92
Q

REPORTING THE MICROSCOPIC EXAMINATION

RBC & WBC/HPF
give the values for reporting

A

None
0-2
2-5
5-10
10-25
25-50
50-100
>100 (Too numerous to count)

93
Q

REPORTING THE MICROSCOPIC EXAMINATION

Crystals/HPF
None -
Rare -
Few-
Moderate -
Many -

A

None - 0
Rare - 0-2
Few- 2-5
Moderate - 5-20
Many - >20

94
Q

REPORTING THE MICROSCOPIC EXAMINATION

Bacteria/HPF
None -
Rare -
Few -
Moderate -
Many -

A

None - 0
Rare - 0-10
Few- 10-50
Moderate - 50-200
Many - >200

95
Q

REPORTING THE MICROSCOPIC EXAMINATION

How are abnormal crystals reported?

A

Abnormal crystals ave/ lpf

96
Q

I fyou see this card, pakiaral how to convert LPF/HPF to mL

A

PLLLLSSS

97
Q

CORRELATING RESULTS

T or F

Microscopic results should be correlated with the physical
and chemical findings to ensure the accuracy of the report

A

T

98
Q

CORRELATING RESULTS

Specimens in which the results do not correlate must be
rechecked for both?

A

technical and clerical errors

99
Q

Routine Urinalysis Correlations

Identify what microscopic element:
Physical - turbidity
Physical - (+) blood
Exceptions - number

A

RBC

100
Q

Routine Urinalysis Correlations

Identify what microscopic element:
Physical - Red color
Chemical - (+) protein
Exceptions - Hemolysis

A

RBC

101
Q

Routine Urinalysis Correlations

Identify what microscopic element:
Physical - Turbidity
Chemical - (+) protein
Exceptions - Number

A

WBC

102
Q

Routine Urinalysis Correlations

Identify what microscopic element:
Physical - Turbidity
Chemical -
Exceptions - Number

A

EC

103
Q

Routine Urinalysis Correlations

Identify what microscopic element:
Physical -
Chemical - (+) protein
Exceptions - Number

A

Casts

104
Q

Identify what microscopic element:
Physical - Turbidity
Chemical - (+) Nitrite, (+) Leukocytes
Exceptions - Number and Type

A

Bacteria

105
Q

Identify what microscopic element:
Physical - Turbidity
Chemical - pH
Exceptions - Number and Type

A

Crystals

106
Q

Identify what microscopic element:
Physical - Color
Chemical - (+) bilirubin
Exceptions -

A

Crystals

AUBF (45 decks)

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