Other Body Fluids Flashcards
A tracheobronchial secretion; a mixture of upper and lower respiratory tract
Sputum
Most preferred sample for routine sputum analysis
1st morning
Sputum collection method for unconscious / ventilated patients
Tracheal aspiration
Color of Charcot-Leyden crystals using Wright stain
Pink or purple
% population of lymphocytes in the broncheoalveolar lavage
1-15%
This cell in the broncheoalveolar lavage is elevated in cigarette smokers
Neutrophil
Sweat chloride of >70 mEq/L indicates
Cystic fibrosis
Puncture site when performing CSF lumbar puncture
Between 3rd and 4th / 4th and 5th lumbar vertebrae
Added to CSF to increase cell yield prior to cytocentrifugation
30% albumin
Diluent used for TOTAL CELL COUNT in the CSF
Normal saline
Diluent used for the CSF WBC COUNT
3% acetic acid with methylene blue
Subtract 1 WBC for every _____ RBCs seen in the CSF
700
Predominant normal cells in the CSF
Lymphocytes and monocytes
Normal value for CSF glucose
60-70% of plasma glucose
For an accurate evaluation of CSF glucose, a __________ must be run for comparison
Blood glucose test
Specimen for blood glucose should be drawn ___ hours prior to spinal tap to allow time for equilibrium
2
Normal value for CSF lactate
10-22 mg/dL
Normal value for CSF protein in adults
15-45 mg/dL
2nd most abundant CSF protein
Prealbumin
Most routinely used techniques for measuring total CSF protein
Turbidimetry and dye-binding
Concentration of TCA (&SSA) for CSF total protein determination
3%
IgG index indicative of immunoglobulin production within the CNS
> 0.70 (or >0.77)
Analyte used to identify unknown body fluid as CSF
Prealbumin / “tau” transferrin
In CSF electrophoresis by immunofixation or isoelectric focusing, what stain is used?
Silver stain
Used to monitor the course of multiple sclerosis
Myelin basic protein
Indirect test for ammonia in the CSF
CSF glutamine
Limulus lysate test detects
Gram-negative endotoxin
Increased NEUTROPHILS; high CSF protein; LOW CSF glucose; high CSF lactate
Bacterial meningitis
Increased LYMPHOCYTES; high CSF protein; NORMAL CSF glucose and CSF lactate
Viral meningitis
Marker used to differentiate bacterial from non-bacterial (viral) meningitis
Procalcitonin
Pellicle or WEB-LIKE clot formation is seen in what time of meningitis?
Tubercular meningitis
Specimen (s) used in latex agglutination test for detection of Cryptococcus neoformans
Serum and CSF
Site of specimen maturation
Epididymis
Part of male reproductive system responsible for coagulation and LIQUEFACTION
Prostate gland
ACP, citric acid, zinc and other proteolytic enzymes are produced by what gland?
Prostate gland
Period of abstinence prior to semen collection
2-7 days
What part of the ejaculate should the patient collect for semen analysis?
Entire ejaculate
Failure to document time a semen is collected primarily affects interpretation of
Viscosity
Normal semen liquefaction time
30-60 minutes after collection
Cause of BROWN or red seminal fluid
Blood
Primary purpose of diluting specimens before performing sperm concentration
To immobilize sperms
Alternative diluent for semen dilution
Cold tap water
When doing sperm concentration, the counts on both sides of hemocytometer should agree within
10%
Normal % sperm motility within 1 hour
> 50%
The nucleus (genetic material) of a sperm is located at the
Head
Part of a sperm cell responsible for egg penetration
Acrosomal cap / acrosome
Abnormalities in the sperm HEAD morphology are associated with
Poor ovum penetration
Abnormalities in the sperm TAIL are associated with
Poor motility
Part of sperm cell that produces energy needed for motility
Neck / midpiece
Hardening of veins that drain the testes; tapered head sperm
Varicocele
Stain of choice for sperm morphology determination
Papanicolaou stain
Reagent used for assessment of sperm viability
Eosin-Nigrosin stain
Color of living sperm cells on Eosin-Nigrosin stain
Bluish-white / unstained
Color of dead sperms on Eosin-Nigrosin stain
Red against a purple background
Determines sperm velocity, trajectory, morphology, and concentration
CASA (computer-assisted semen analysis)
Measurement of neutral a-glucosidase is performed to detect a disorder of the
Epididymis
Test for fructose in seminal fluid
Resorcinol test (Seliwanoff ‘s)
Positive color in the Resorcinol test
Orange-red
If fructose cannot be tested within 2 hours, the semen should be kept
Frozen
These are termed round cells found in semen
Spermatids and leukocytes
Immature sperm cells; mistaken as WBC
Spermatids
Sperm maturation
Spermatogonium > primary spermatocyte > secondary spermatocyte > spermatid > spermatozoon
Reagents used on the Florence test
Potassium iodide and iodine crystals
Reagents used in the Barbiero’s test
Saturated picric acid and TCA
After vasectomy, when should the patient submit semen for analysis?
2 months
Normal volume of synovial fluid
<3.5 mL
Test (s) to determine an unknown body fluid as synovial
Ropes test
Toluidine blue test
A normal synovial fluid forms a string that is _____ long
4-6 cm long
Synovial fluid forms a SOLID OR COMPACT CLOT using mucin clot test, this is graded as
Good
Synovial fluid WBC diluents
- NSS with methylene blue
- Hypotonic saline
- Saline with saponin
Synovial fluid WBC diluents should not contain
Acetic acid (forms mucin clot)
Methylene blue is added to the normal saline diluent for what purpose?
To stain WBC nuclei
Normal value for synovial fluid RBC count
None (0)
Normal value for synovial fluid WBC count
<200/uL
Neutrophil with DARK cytoplasmic granules containing immune complexes
Ragocyte (RA cell)
Neutrophils with INGESTED round body
LE cell
Macrophage with ingested neutrophils
Reitter cell
Macroscopically resembles POLISHED RICE; microscopically collagen and fibrin
Rice bodies
Debris or pieces of pigmented cartilage with GROUND PEPPER appearance
Ochronotic shards
Birefringence of CPPD (calcium pyrophosphate dihydrate crystal)
Blue (positive BR)
Birefringence of MSU (monosodium urate) crystal
Yellow (negative BR)
Birefringence of apatite crystal in synovial fluid
None
A control slide for the polarization properties of MSU can be prepared using
Betamethasone acetate corticosteroid
MSU crystals are seen in
Gout
CPPD crystals are seen in
Pseudogout
Normal synovial fluid glucose should be _____ than the blood urine
<10 mg/dL lower
Normal synovial protein level
<3 g/dL
Anticoagulant for SEROUS FLUIDS submitted for chemistry tests
None / heparin
Specimen requirement for pH measurement on serous fluids
Heparinized syringe; anaerobic
Normal appearance of serous fluids
Clear, pale yellow
Effusion due to hypoproteinemia, congestive heart failure, and nephrotic syndrome
Transudate
Effusion caused by infection, inflammation, and malignancies
Exudate
Most reliable tests to distinguish transudate from exudate
Fluid : serum protein and LD ratios
Total protein level that differentiates transudate (T) and exudates (E)
<3.0 g/dL (transudate)
>3.0 g/dL (exudate)
Method of collection for pleural fluid
Thoracentesis
Method of collection for pericardial fluid
Pericardiocentesis
Method of collection for ascites and peritoneal fluid
Paracentesis
Also increased in pleural effusions resulting from pancreatitis and pulmonary infarction
Neutrophils
How to differentiate hemothorax from hemorrhagic exudate
Run a hematocrit on the fluid
Type of effusion in empyema
Pleural exudate
Adenosine deaminase level highly indicative of tuberculosis
> 40 U/L
WBC count in peritoneal fluid is 775/uL. This indicates
Bacterial peritonitis, cirrhosis
Significance of green peritoneal fluid
Gall bladder / pancreatic disorder
Significance of milky peritoneal fluid
Lymphatic trauma and blockage
Significance of black pleural fluid
Aspergillosis
A product of fetal metabolism; its constituents provide information about the metabolic processes taking place
Amniotic fluid
Major contributor to amniotic fluid volume DURING 1st trimester of pregnancy
Maternal plasma
Major contributor to amniotic fluid AFTER 1st trimester of pregnancy
Fetal urine
Ultimate source of amniotic fluid water and solutes
Placenta
Normal volume of amniotic fluid during the 3rd trimester of pregnancy
800-1200 mL
Amniotic fluid storage condition for FETAL LUNG MATURITY (FLM) tests
Refrigerated or frozen
Amniotic fluid storage condition for CYTOGENETIC STUDIES
Room temperature or 37C
Amniotic fluid storage condition for HDN testing
Protected from light
Significance of dark green amniotic fluid
Meconium
First fetal bowel movement
Meconium
Significance of dark red-brown amniotic fluid
Fetal death
Instrument used in the O.D 450 test
Spectrophotometer
A significant rise in the OD of amniotic fluid at 450 nm indicates the presence of
Bilirubin
A significant rise in the OD of amniotic fluid at 410 nm indicates the presence of
Oxyhemoglobin
LILEY GRAPH ZONE: not affected / mildly affected fetus
Zone 1 (no/mild HDN)
LILEY GRAPH ZONE: moderately affected fetus and requires careful monitoring
Zone 2 (moderate HDN)
LILEY GRAPH ZONE: severely affected fetus and requires intervention
Zone 3 (severe HDN)
Alpha-fetoprotein in amniotic fluid is produced by
Fetal liver
Maternal serum AFP is usually measured around
15th to 18th week of pregnancy
When should assessment of Down Syndrome be performed?
18th week (15th to 18th week of pregnancy)
Tests for FLM, fetal distress, HDN, and infection should be done around
20th to 42nd week of pregnancy
Down syndrome is also known as
Trisomy 21
Reagent used in the FOAM STABILITY TEST in amniotic fluid
95% ethanol
Lung surfactant produced by Type 2 pneumocytes
Lamellar bodies
Specimen requirement prior to Lamellar Bodies testing
Centrifuge at 2,000g for 10 minutes
Lamellar body count uses platelet channel of hematology analyzers that are based on
Electrical impedance / optical light scatter
Human chorionic gonadotropin (HCG) is produced by _____ cells of the placenta
Syncytiotrophoblast
How many days will hCG disappear after ectopic pregnancy
3-7 days
Source of anti-hCG in home-based pregnancy test kits
Rabbit
The anti-hCG in the POCT PT kits is directed against what subunit
Beta-subunit of the amino acid
Positive cut-off point for pregnancy
25 mIU/mL
NEGATIVE reaction in POCT pregnancy test
1 colored band
POSITIVE reaction in POCT pregnancy test
2 colored bands
Protein that functions as BIOLOGICAL GLUE, attaching fetal sac to uterine lining
Fetal fibronectin (fFN)
Marker used as an indicator of pre-term delivery
Fetal fibronectin (fFN)
Normal volume of gastric fluid (fasting state)
20-50 mL
Normal appearance of gastric fluid
Pale gray, slightly mucoid
Gastric tube inserted through the nose
Levin tube
Gastric tube inserted through the mouth
Rehfuss tube
Duration of gastric fluid collection
1 hour with 15-min interval (fasting)
Tubeless gastric fluid analysis
Diagnex
Specimen used in Diagnex blue (tubeless test)
Urine
Produced by parietal cells that breaks down pepsinogen
HCl
Hormone that stimulates parietal cells to produce HCl
Gastrin
Enzyme that degrades proteins into smaller amino acids
Pepsin
Purpose of histamine on the stomach
Gastric stimulant
BAO stands for
Basal acid output
MAO stands for
Maximum acid output
Basal acid output in pernicious anemia
Zero (0)
Specimen used for quantitative fecal fat determination
3 day (72 hour) stool
An acid steatocrit of <10% in children is indicative of
Steatorrhea
Undigested muscle fibers in the feces appearance
Has 2 dimensional striations
Lactoferrin latex agglutination is used to detect
Fecal leukocytes
How many neutrophils are indicative of an invasive diarrhea
3 neutrophils per HPF
Diarrhea with WBCs (+) Lactoferrin latex test, what bacteria?
Salmonella
Shigella
Yersinia
Enteroinvasive E. coli
Campylobacter
Diarrhea without WBCs, what microorganism (s)?
Toxin producing (Staphylococcus aureus, Vibrio cholerae)
Virus
Parasite
Seen in stool of a patient with allergic reactions
Charcot-Leyden crystal
Excessive fat excretion in stool is termed of
Steatorrhea
Specimen (s) used in the D-xylose test
2 hour postprandial blood and 5-hour urine
Fecal occult blood testing is used to screen
Colorectal cancer
Positive color for Guaiac test
Blue
Why is Guaiac reagent preferred in the Fecal Occult Blood testing?
Less sensitive (avoids false-positive)
Vitamin contraindicated for fecal occult blood testing
Vitamin C (ascorbic acid)
Stain used for muscle fiber determination in the feces
10% eosin
Reagent used in the APT test
1% sodium hydroxide
Pink solution in the APT test indicates the presence of
Fetal blood
Yellow-brown supernatant in the APT test indicates the presence of
Maternal blood
Pancreatic enzyme that breaks down gelatin
Trypsin
Normal stool pH
7.0 - 8.0
Reject SMALL body fluid specimen (few drops) in a syringe received more than ___ minutes after collection
10
Reject LARGER body fluid specimen (>1mL) in a syringe received more than ___ hour after collection
1 hour
Quality control for urinalysis laboratory must be done
Every beginning of the shift / daily
Checking the pH and purity meter resistance of deionized water is done every
Week
Performing bacterial count on deionized water is done every
Month
It is the time from the test order through analysis to the charting of report
TAT (turnaround time)
PDCA stands for
Plan-Do-Check-Act
PDSA stands for
Plan-Do-Study-Act
PDMAI stands for
Plan, Design, Measure, Assess, Improve
Refers to the time from ordering a test through the analysis in the lab to the charting of the report
Turnaround time
