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AMT MT Exam > Review Cards - Urinalysis & Body Fluids > Flashcards

Review Cards - Urinalysis & Body Fluids Flashcards

1
Q

Urine specimens - random - use

A

routine urinalysis

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2
Q

Urine specimens - random - collection

A

Any time

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3
Q

Urine specimens - random - not ideal?

A

Because urine may be dilute & contaminated

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4
Q

Urine specimens - first morning - use

A

Routine urinalysis

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5
Q

Urine specimens - first morning - collection

A

Upon waking

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6
Q

Urine specimens - 2-hour postprandial - use

A

Diabetes mellitus monitoring

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7
Q

Urine specimens - 2-hour postprandial - collection

A

2 hours after eating

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8
Q

Urine specimens - 2-hour postprandial - best for detecting?

A

glycosuria

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9
Q

Urine specimens - 24-hour - use

A

quantitative chemical tests

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10
Q

Urine specimens - 24-hour - collection

A

-discard 1st void on day 1 & note time
-collect all urine for next 24 hours, including 1st void at same time on day 2

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11
Q

Urine specimens - 24-hour - common source of error

A

improper collection

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12
Q

Urine specimens - clean catch - use

A

routine, culture

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13
Q

Urine specimens - clean catch - collection

A

cleanse external genitalia & collect midstream in sterile container

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14
Q

Urine specimens - catheterized - use

A

culture

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15
Q

Urine specimens - catheterized - collection

A

catheter inserted into urethra

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16
Q

Urine specimens - suprapubic aspiration - use

A

culture

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17
Q

Urine specimens - suprapubic aspiration - collection

A

needle inserted through abdomen into bladder

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18
Q

Urine volume - normal daily volume

A

600-2,000 mL (average 1,200-1,500 mL)

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19
Q

Urine volume - normal day-to-night ratio

A

2:1 - 3:1

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20
Q

Urine volume - diuresis

A

increased urine production

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21
Q

Urine volume - polyuria

A

Marked increase in urine flow
-adult: >2,500 mL/day
-children: 2.5-3 mL/kg/day

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22
Q

Urine volume - oliguria

A

Marked decrease in urine flow
-adult: <400 mL/day
-children: <0.5 mL/kg/hour
-infants: <1 mL/kg/hour

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23
Q

Urine volume - anuria

A

no urine production

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24
Q

Urine color - normal

A

yellow due to urochrome

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25
Urine color - diluted urine
colorless, pale yellow
26
Urine color - concentrated urine
dark yellow, amber
27
Urine color - bilirubin
amber, orange, yellow-green; yellow foam on shaking
28
Urine color - urobilin
amber, orange; NO yellow foam in shaking
29
Urine color - homogentisic acid
normal on voiding; brown or black on standing
30
Urine color - melanin
brown or black on standing
31
Urine color - methemoglobin
brown or black
32
Urine color - myoglobin
red; brown on standing
33
Urine color - blood/hemoglobin
pink or red when fresh; brown on standing
34
Urine color - porphyrin
port-wine
35
Urine color - drugs, medications, food
green, blue, red, orange
36
Urine color - *Pseudomonas* infection
green, blue-green
37
Changes in unpreserved urine at room temperature >2 hours - turbidity
increased -cause: —multiplication of bacteria —precipitation of amorphous crystals
38
Changes in unpreserved urine at room temperature >2 hours - pH
increased -cause: conversion of urea to ammonia by bacteria
39
Changes in unpreserved urine at room temperature >2 hours - glucose
decreased -cause: metabolism by bacteria
40
Changes in unpreserved urine at room temperature >2 hours - ketones
decreased -cause: —volatilization of acetone —breakdown of acetoacetate by bacteria
41
Changes in unpreserved urine at room temperature >2 hours - urobilinogen
decreased -cause: oxidation to urobilin
42
Changes in unpreserved urine at room temperature >2 hours - bilirubin
decreased -cause: oxidation to biliverdin
43
Changes in unpreserved urine at room temperature >2 hours - WBCs, RBCs, casts
decreased -cause: lysis in dilute or alkaline urine
44
Chemical urinalysis by reagent strip - pH - normal
First AM: 5-6 Random: 4.5-8
45
Chemical urinalysis by reagent strip - pH - principle
double indicator system
46
Chemical urinalysis by reagent strip - pH - significance
-acid-base balance -management of UTI/renal calculi
47
Chemical urinalysis by reagent strip - pH - acid
protein/meat diet
48
Chemical urinalysis by reagent strip - pH - alkaline
vegetarian diet
49
Chemical urinalysis by reagent strip - pH - pH 9
Improperly preserved specimen
50
Chemical urinalysis by reagent strip - protein - normal
negative - trace
51
Chemical urinalysis by reagent strip - protein - principle
protein error of indicators
52
Chemical urinalysis by reagent strip - protein - significance
possible renal disease
53
Chemical urinalysis by reagent strip - protein - buffered to a pH of?
3
54
Chemical urinalysis by reagent strip - protein - most sensitive to?
albumin
55
Chemical urinalysis by reagent strip - protein - orthostatic proteinuria
-benign condition -protein is negative in 1st AM specimen -protein is positive after standing
56
Chemical urinalysis by reagent strip - glucose - normal
Negative
57
Chemical urinalysis by reagent strip - glucose - principle
glucose oxidase/peroxidase
58
Chemical urinalysis by reagent strip - glucose - significance
possible diabetes mellitus
59
Chemical urinalysis by reagent strip - glucose - specific for?
glucose
60
Chemical urinalysis by reagent strip - glucose - normal renal threshold
160-180 mg/dL
61
Chemical urinalysis by reagent strip - ketones - normal
negative
62
Chemical urinalysis by reagent strip - ketones - principle
sodium nitroprusside reaction
63
Chemical urinalysis by reagent strip - ketones - significance
Increased fat metabolism: -uncontrolled diabetes mellitus -vomiting -starvation -low carb diet -strenuous exercise
64
Chemical urinalysis by reagent strip - ketones - most sensitive to?
Acetoacetic acid
65
Chemical urinalysis by reagent strip - ketones - less sensitive to?
acetone
66
Chemical urinalysis by reagent strip - ketones - doesn’t react with?
beta-hydroxybutyric acid
67
Chemical urinalysis by reagent strip - blood - normal
negative
68
Chemical urinalysis by reagent strip - blood - principle
pseudoperoxidase activity of hemoglobin
69
Chemical urinalysis by reagent strip - blood - significance
-hematuria -hemoglobinuria -myoglobinuria
70
Chemical urinalysis by reagent strip - blood - uniform color vs. speckled
-uniform color: HGB or myoglobin -speckled: RBCs
71
Chemical urinalysis by reagent strip - blood - bilirubin - normal
negative
72
Chemical urinalysis by reagent strip - blood - bilirubin - principle
Diazo reaction
73
Chemical urinalysis by reagent strip - blood - bilirubin - significance
-liver disease -biliary obstruction
74
Chemical urinalysis by reagent strip - blood - bilirubin - what type excreted in urine?
conjugated bilirubin
75
Chemical urinalysis by reagent strip - blood - urobilinogen - normal
1 Ehrlich Unit or 1 mg/dL
76
Chemical urinalysis by reagent strip - blood - urobilinogen - principle
Ehrlich aldehyde reaction or diazo reaction
77
Chemical urinalysis by reagent strip - blood - urobilinogen - significance
-liver disease -hemolytic disorders
78
Chemical urinalysis by reagent strip - blood - urobilinogen - reagent strips DO NOT detect?
they do not detect ABSENCE of urobilinogen, only increased
79
Chemical urinalysis by reagent strip - blood - nitrite - normal
negative
80
Chemical urinalysis by reagent strip - blood - nitrite - principle
Greiss reaction
81
Chemical urinalysis by reagent strip - blood - nitrite - significance
UTI
82
Chemical urinalysis by reagent strip - blood - nitrite - bacteria
some bacteria reduce nitrates to nitrites
83
Chemical urinalysis by reagent strip - blood - nitrite - increased sensitivity when?
Urine in bladder at least 4 hours
84
Chemical urinalysis by reagent strip - blood - leukocyte esterase - normal
negative
85
Chemical urinalysis by reagent strip - blood - leukocyte esterase - principle
LE reaction
86
Chemical urinalysis by reagent strip - blood - leukocyte esterase - significance
UTI
87
Chemical urinalysis by reagent strip - blood - leukocyte esterase - longest reaction time
2 minutes
88
Chemical urinalysis by reagent strip - blood - leukocyte esterase - detects
intact & lysed granulocytes and monocytes
89
Chemical urinalysis by reagent strip - blood - leukocyte esterase - does NOT detect?
lymphocytes
90
Chemical urinalysis by reagent strip - blood - specific gravity - normal
Random specimen: 1.003-1.030
91
Chemical urinalysis by reagent strip - blood - specific gravity - principle
pKa change of polyelectrolyte
92
Chemical urinalysis by reagent strip - blood - specific gravity - significance
Indication of kidney’s concentrating ability & state of hydration -increased: DM due to glucose -decreased: diabetes insipidus due to decreased ADH
93
Chemical urinalysis by reagent strip - blood - specific gravity - only measures?
ionic solute
94
Chemical urinalysis by reagent strip - blood - specific gravity - not affected by?
-urea -glucose -radiographic contrast media -plasma expanders
95
General sources of error with reagent strip testing: failure to test within 2 hours of collection or to preserve correctly - possible effect?
changes in chemical composition
96
General sources of error with reagent strip testing: failure to bring refrigerated specimens to room temperature before testing - possible effect?
False negative enzymatic reactions
97
General sources of error with reagent strip testing: failure to mix specimen well- possible effect?
False negative leukocyte/blood -WBCs, RBCs settle out
98
General sources of error with reagent strip testing: failure to perform quality control - possible effect?
Erroneous results -perform pos & neg control every 24 hours & when opening new container
99
General sources of error with reagent strip testing: failure to dip all test pads in urine - possible effect?
False negative reactions
100
General sources of error with reagent strip testing: prolonged dipping - possible effect?
False negative reactions -reagents may leach from pads
101
General sources of error with reagent strip testing: failure to remove excess urine from strip - possible effect?
run over of chemicals to adjacent pads, distortion of colors
102
General sources of error with reagent strip testing: highly pigmented urine - possible effect?
atypical colors, false positive reactions -pigment masks true reactions -test by alternate method
103
General sources of error with reagent strip testing: failure to read at recommended time - possible effect?
erroneous results
104
General sources of error with reagent strip testing: failure to store strips properly - possible effect?
erroneous results -store in capped original container at RT
105
Specific sources of error with reagent strip testing - pH - increased or false positive
improperly preserved specimen
106
Specific sources of error with reagent strip testing - pH - decreased or false negative
acid run over from protein square
107
Specific sources of error with reagent strip testing - protein - increased or false positive
-highly buffered alkaline urine -prolonged dipping -contaminated container -increased specific gravity
108
Specific sources of error with reagent strip testing - protein - decreased or false negative
proteins other than albumin
109
Specific sources of error with reagent strip testing - glucose - increased or false positive
contamination with peroxide or bleach
110
Specific sources of error with reagent strip testing - glucose - decreased or false negative
-unpreserved specimen -increased ascorbic acid -increased specific gravity -decreased temperature
111
Specific sources of error with reagent strip testing - ketones - increased or false positive
-red pigments -dyes -some meds
112
Specific sources of error with reagent strip testing - ketones - decreased or false negative
-improper storage: —acetone is volatile —bacteria break down acetoacetic acid
113
Specific sources of error with reagent strip testing - blood - increased or false positive
-menstruation -oxidizing agents -bacterial peroxidase
114
Specific sources of error with reagent strip testing - blood - decreased or false negative
-increased ascorbic acid -increased nitrite -increased specific gravity (crenated RBCs) -unmixed specimen
115
Specific sources of error with reagent strip testing - bilirubin - increased or false positive
highly pigmented urine
116
Specific sources of error with reagent strip testing - bilirubin - decreased or false negative
-exposure to light -increased ascorbic acid -increased nitrite
117
Specific sources of error with reagent strip testing - urobilinogen - increased or false positive
highly pigmented urine
118
Specific sources of error with reagent strip testing - urobilinogen - decreased or false negative
-improperly preserved specimen (oxidation to urobilin) -formalin
119
Specific sources of error with reagent strip testing - nitrite - increased or false positive
-highly pigmented urine -improperly preserved specimen (contaminating bacteria produce nitrites)
120
Specific sources of error with reagent strip testing - nitrite - decreased or false negative
-non-nitrate-reducing bacteria -inadequate time in bladder -reduction of nitrites to N2 -decreased dietary nitrate -antibiotics -increased ascorbic acid -increased specific gravity
121
Specific sources of error with reagent strip testing - LE - increased or false positive
-highly pigmented urine -oxidizing agents -formalin -nitrofurantoin -vaginal discharge
122
Specific sources of error with reagent strip testing - LE - decreased or false negative
-increased glucose -increased protein -increased ascorbic acid -increased specific gravity -antibiotics -reading too soon
123
Specific sources of error with reagent strip testing - SG - increased or false positive
increased protein
124
Specific sources of error with reagent strip testing - SG - decreased or false negative
-alkaline urine (add 0.005 if pH is 6.5 or higher; correction is made by automated readers)
125
Other urine chemistry tests - microalbumin - detects
albumin in low/moderate concentrations
126
Other urine chemistry tests - microalbumin - method(s)
-immunoassay on 24-hour urine -albumin-to-creatinine ratio (ACR) on random sample -dipsticks available for ACR
127
Other urine chemistry tests - microalbumin - not detected by?
most urine dipsticks
128
Other urine chemistry tests - microalbumin - concentration predictive of diabetic nephropathy
Males: 50-200 mg/24 hour OR ACR >=2.8 Females: 50-200 mg/24 hour OR ACR >=2.0
129
Other urine chemistry tests - Ictotest - detects
bilirubin
130
Other urine chemistry tests - Ictotest - method(s)
Diazo reagent
131
Other urine chemistry tests - Ictotest - sources of error - false positives
urine pigments
132
Other urine chemistry tests - Ictotest - sources of error - false negatives
-exposure to light -improperly stored specimen -increased ascorbic acid -increased nitrite
133
Other urine chemistry tests - Ictotest - less affected by?
interfering substances
134
Sediment stains - Sternheimer-Malbin - action
delineates cell structure and contrasting colors of nucleus vs. cytoplasm
135
Sediment stains - Sternheimer-Malbin - function
identify WBCs, epithelial cells, and casts
136
Sediment stains - Oil Red O and Sudan III - action
stains triglycerides and neutral fats, cholesterol will not stain
137
Sediment stains - Oil Red O and Sudan III - function
ID free fat droplets and lipid-containing cells or casts
138
Sediment stains - Hansel stain - action
methylene blue and eosin Y stain eosinophilic granules
139
Sediment stains - Hansel stain - function
ID eosinophils in the urine
140
Epithelial cells in the urine sediment - squamous epithelial cell - description
-40-50 um -flat -prominent round nucleus
141
Epithelial cells in the urine sediment - squamous epithelial cell - origin
-lower urethra -vagina
142
Epithelial cells in the urine sediment - squamous epithelial cell - clinical significance
usually none
143
Epithelial cells in the urine sediment - squamous epithelial cell - increased numbers usually seen from?
females
144
Epithelial cells in the urine sediment - squamous epithelial cell - may obscure?
RBCs & WBCs
145
Epithelial cells in the urine sediment - squamous epithelial cell - reduced by?
collecting midstream clean-catch specimen
146
Epithelial cells in the urine sediment - transitional epithelial cell - description
-20-30 um -spherical, pear-shaped, or polyhedral -round central nucleus
147
Epithelial cells in the urine sediment - transitional epithelial cell - origin
-renal pelvis -ureters -bladder -upper urethra
148
Epithelial cells in the urine sediment - transitional epithelial cell - clinical significance
seldom significant
149
Epithelial cells in the urine sediment - transitional epithelial cell - may form?
syncytia (clumps)
150
Epithelial cells in the urine sediment - renal tubular epithelial cell - description
-slightly larger than a WBC (12 um) -round -eccentric round nucleus
151
Epithelial cells in the urine sediment - renal tubular epithelial cell - origin
renal tubules
152
Epithelial cells in the urine sediment - renal tubular epithelial cell - clinical significance
-tubular necrosis -toxins -viral infections -renal rejection
153
Epithelial cells in the urine sediment - renal tubular epithelial cell - must differentiate from?
WBCs
154
Epithelial cells in the urine sediment - oval fat body - description
renal tubular epithelial cell containing fat droplets
155
Epithelial cells in the urine sediment - oval fat body - origin
renal tubules
156
Epithelial cells in the urine sediment - oval fat body - clinical significance
-tubular necrosis -toxins -viral infections -renal rejection
157
Epithelial cells in the urine sediment - oval fat body - polarized light
Maltese crosses
158
Blood cells in the urine sediment - WBCs - description
-usually polys -about 12 um -granular appearance
159
Blood cells in the urine sediment - WBCs - origin
kidney, bladder, or urethra
160
Blood cells in the urine sediment - WBCs - clinical significance
-cystitis -pyelonephritis -tumors -renal calculi
161
Blood cells in the urine sediment - WBCs - normal
0-8/HPF
162
Blood cells in the urine sediment - WBCs - clumps
associated with acute infection
163
Blood cells in the urine sediment - glitter cell - description
-WBC with Brownian movement of granules -stain faintly or not at all
164
Blood cells in the urine sediment - glitter cell - description
-WBC with Brownian movement of granules -stain faintly or not at all
165
Blood cells in the urine sediment - glitter cell - origin
kidney, bladder, or urethra
166
Blood cells in the urine sediment - glitter cell - clinical significance
-cystitis -pyelonephritis -tumors -renal calculi
167
Blood cells in the urine sediment - glitter cell - observed in?
hypotonic urine
168
Blood cells in the urine sediment - RBC - description
-biconcave disk -about 7 um -smooth -non-nucleated
169
Blood cells in the urine sediment - RBC - origin
kidney, bladder, or urethra
170
Blood cells in the urine sediment - RBC - clinical significance
-infection -trauma -tumors -renal calculi -dysmorphic RBCs indicate glomerular bleeding
171
Blood cells in the urine sediment - RBC - normal
0-3/HPF
172
Blood cells in the urine sediment - RBC - hypertonic urine
crenated RBCs
173
Blood cells in the urine sediment - RBC - hypotonic urine
RBCs lyse
174
Blood cells in the urine sediment - RBC - 2% acetic acid
RBCs lyse
175
Normal crystals found in acid or neutral urine - amorphous urates - description
irregular granules
176
Normal crystals found in acid or neutral urine - amorphous urates - precipitate
pink
177
Normal crystals found in acid or neutral urine - amorphous urates - may obscure?
significant sediment
178
Normal crystals found in acid or neutral urine - amorphous urates - dissolve by?
warming to 60*C
179
Normal crystals found in acid or neutral urine - uric acid - description
-pleomorphic -4-sided, 6-sided, star-shaped, rosettes, spears, plates -colorless, red-brown, or yellow
180
Normal crystals found in acid or neutral urine - uric acid - birefringent?
yes
181
Normal crystals found in acid or neutral urine - uric acid - polarizes light?
yes
182
Normal crystals found in acid or neutral urine - calcium oxalate - description
-octahedral (8-sided) envelope form is most common -dumbbell & ovoid forms
183
Normal crystals found in acid or neutral urine - calcium oxalate - form that may be mistaken for RBCs
monohydrate form
184
What is the most common constituent of renal calculi?
calcium oxalate
185
Normal crystals found in acid or neutral urine - calcium oxalate - caused by?
oxalate-rich foods
186
Normal crystals found in alkaline urine - amorphous phosphates - description
irregular granules
187
Normal crystals found in alkaline urine - amorphous phosphates - precipitate
white
188
Normal crystals found in alkaline urine - amorphous phosphates - dissolves with?
2% acetic acid
189
Normal crystals found in alkaline urine - triple phosphate - description
"coffin-lid" crystal
190
Normal crystals found in alkaline urine - ammonium biurate - description
yellow-brown "thorn apples" & spheres
191
Normal crystals found in alkaline urine - ammonium biurate - seen in what type of urine specimens?
old specimens
192
Normal crystals found in alkaline urine - calcium phosphate - description
-needles -rosettes -"pointing finger"
193
Normal crystals found in alkaline urine - calcium phosphate - what form is the only form seen in alkaline urine?
needle form
194
Normal crystals found in alkaline urine - calcium carbonate - description
colorless dumbbells or aggregates
195
Abnormal crystals (acid or neutral urine) - leucine - description
-yellow, oily-looking spheres -radial & concentric striations
196
Abnormal crystals (acid or neutral urine) - leucine - significance
severe liver disease
197
Abnormal crystals (acid or neutral urine) - leucine - often seen with what other crystal?
tyrosine
198
Abnormal crystals (acid or neutral urine) - tyrosine - description
fine yellow needles in sheaves or rosettes
199
Abnormal crystals (acid or neutral urine) - tyrosine - significance
severe liver disease
200
Abnormal crystals (acid or neutral urine) - tyrosine - often seen with what other crystal?
leucine
201
Abnormal crystals (acid or neutral urine) - cystine - description
hexagonal (6-sided)
202
Abnormal crystals (acid or neutral urine) - cystine - significance
cystinuria
203
Abnormal crystals (acid or neutral urine) - cystine - must differentiate from?
uric acid
204
Abnormal crystals (acid or neutral urine) - cystine - polarizes light?
no
205
Abnormal crystals (acid or neutral urine) - cholesterol - description
-flat plates -notched out corners -"stair steps"
206
Abnormal crystals (acid or neutral urine) - cholesterol - significance
nephrotic syndrome
207
Abnormal crystals (acid or neutral urine) - cholesterol - birefringent?
yes
208
Abnormal crystals (acid or neutral urine) - bilirubin - description
yellowish brown needles, plates, granules
209
Abnormal crystals (acid or neutral urine) - bilirubin - significance
liver disease
210
Abnormal crystals (acid or neutral urine) - bilirubin - chemical tests should be?
positive
211
Casts - hyaline - description
homogeneous with parallel sides, rounded ends
212
Casts - hyaline - normal
0-2/LPF
213
Casts - hyaline - significance
increased: -stress -fever -trauma -exercise -renal disease
214
Casts - hyaline - type of protein?
Tamm-Horsfall
215
Casts - hyaline - dissolve in?
alkaline urine
216
Casts - hyaline - why might they be overlooked with bright light?
because they have the same refractive index as urine
217
Casts - granular - description
-homogeneous with parallel sides, rounded ends -granules
218
Casts - granular - normal
0-1/LPF
219
Casts - granular - significance
increased: -stress -exercise -glomerulonephritis -pyelonephritis
220
Casts - granular - from disintegration of?
cellular casts
221
Casts - RBC - description
-RBCs in cast matrix -yellowish to orange color
222
Casts - RBC - significance
-acute glomerulonephritis -strenuous exercise
223
Casts - RBC - source of bleeding?
kidneys
224
Which urinary cast is the most fragile and often found in fragments?
RBC casts
225
Casts - blood - description
-contain hemoglobin -yellowish to orange color
226
Casts - blood - significance
-acute glomerulonephritis -strenuous exercise
227
Casts - blood - from disintegration of?
RBC casts
228
Casts - WBC - description
-WBCs in cast matrix -irregular in shape
229
Casts - WBC - significance
pyelonephritis
230
Casts - WBC - IDs what as the site of infection?
kidneys
231
Casts - epithelial cell - description
renal tubular epithelial cells in cast matrix
232
Casts - epithelial cell - significance
renal tubular damage
233
Where are casts formed?
renal tubules & collecting ducts
234
Are transitional & squamous epithelial cells seen in casts?
no
235
Casts - waxy - description
-homogeneous -opaque -notched edges -broken ends
236
Casts - waxy - significance
urinary stasis
237
Casts - waxy - from degeneration of?
cellular & granular casts
238
The presence of what type of urinary casts is considered an unfavorable sign?
waxy cast
239
Casts - fatty - description
casts containing lipid droplets
240
Casts - fatty - significance
nephrotic syndrome
241
Casts - fatty - what is seen with polarized light if the lipid inside the cast is cholesterol?
Maltese crosses
242
Casts - broad - description
-wide -may be cellular, granular, or waxy
243
Casts - broad - significance
advanced renal disease
244
Casts - broad - formed in?
dilated distal tubules & collecting ducts
245
What type of urinary casts are considered "renal failure casts"?
broad casts
246
Miscellaneous urine sediment - bacteria - description
rods, cocci
247
Miscellaneous urine sediment - bacteria - significance
UTI or contaminants
248
Miscellaneous urine sediment - bacteria - what is also present if bacteria are clinically significant?
WBCS - unless patient is neutropenic
249
Miscellaneous urine sediment - yeast - description
-5-7 um -ovoid -colorless -smooth -refractile -may bud & form pseudohyphae
250
Miscellaneous urine sediment - yeast - significance
-usually due to vaginal or fecal contamination -may be due to kidney infection -often in urine in diabetics
251
Miscellaneous urine sediment - yeast - how to differentiate from RBCs?
add 2% acetic acid - RBCs lyse; yeast do not
252
Miscellaneous urine sediment - yeast - pseudohyphae indicate?
severe infection
253
Miscellaneous urine sediment - yeast - what are also present in true yeast infections?
WBCs
254
Miscellaneous urine sediment - sperm - description
-4-6 um head -40-60 um tall
255
Miscellaneous urine sediment - sperm - significance
-usually not significant in adults -may be sign of sexual abuse in child
256
Miscellaneous urine sediment - *Trichomonas* - description
-resembles WBC -flagella & undulating membrane -rapid, jerky, non-directional motility
257
Miscellaneous urine sediment - *Trichomonas* - significance
parasitic infection of genital tract
258
Miscellaneous urine sediment - *Trichomonas* - reporting
don't report unless motile
259
Miscellaneous urine sediment - Mucus - description
transparent, long, thin, ribbon-like structure with tapering ends
260
Miscellaneous urine sediment - Mucus - significance
none
261
Miscellaneous urine sediment - Mucus - may be mistaken for?
hyaline casts
262
Renal disorders - acute glomerulonephritis - cause
inflammation & damage to glomeruli
263
Renal disorders - acute glomerulonephritis - reagent strip
protein, blood
264
Renal disorders - acute glomerulonephritis - sediment
-RBCs (some dysmorphic) -WBCs -hemoglobin casts
265
Renal disorders - acute glomerulonephritis - frequently follows what type of infection?
group A strep infection
266
Renal disorders - nephrotic syndrome - cause
increased glomerular permeability
267
Renal disorders - nephrotic syndrome - reagent strip
protein (large amount)
268
Renal disorders - nephrotic syndrome - sediment
-casts (all kinds) -free fat & oval fat bodies
269
Renal disorders - nephrotic syndrome - blood
-hypoproteinemia -hyperlipidemia
270
Renal disorders - pyelonephritis - cause
kidney infection
271
Renal disorders - pyelonephritis - reagent strip
-protein -LE -nitrite
272
Renal disorders - pyelonephritis - sediment
-WBCs -WBC casts -bacteria
273
Renal disorders - cystitis - cause
bladder infection
274
Renal disorders - cystitis - reagent strip
-LE -nitrite
275
Renal disorders - cystitis - sediment
-WBCs -bacteria -possibly RBCs -NO casts
276
Renal disorders - acute interstitial nephritis - cause
allergic reaction to medication
277
Renal disorders - acute interstitial nephritis - reagent strip
-LE -blood -protein
278
Renal disorders - acute interstitial nephritis - sediment
-WBCs -WBC casts -RBC casts -NO bacteria
279
Renal disorders - acute interstitial nephritis - frequently presents with?
rash
280
Renal disorders - Fanconi syndrome - cause
Failure of tubule reabsorption: -hereditary -exposure to drugs -multiple myeloma
281
Renal disorders - Fanconi syndrome - reagent strip
-glucose -protein -low pH
282
Renal disorders - Fanconi syndrome - plasma glucose
normal
283
Urinalysis correlations - pH/microscopic
-check pH when identifying crystals -RBCs, WBCs, & casts lyse at alkaline pH
284
Urinalysis correlations - pH/nitrite/LE/microscopic
Bacterial UTI: -pos nitrite -pos LE -check for bacteria & WBCs -bacteria convert urea to ammonia, increased pH
285
Urinalysis correlations - protein/microscopic
-protein may indicate renal disease -check for casts
286
Urinalysis correlations - protein/blood/microscopic
-large amounts of blood or myoglobin can cause positive protein -check for RBCs -present with hematuria, NOT with hemoglobinuria or myoglobinuria
287
Urinalysis correlations - protein/SG
-increased SG may cause false positive trace protein -trace protein is more significant in dilute urine
288
Urinalysis correlations - glucose/ketones
ketones present in uncontrolled DM
289
Urinalysis correlations - glucose/microscopic
-yeast thrives in increased glucose -WBCs should be present if true yeast infection
290
Urinalysis correlations - glucose/protein/microscopic
-renal disease is common complication of DM -check for casts
291
Urinalysis correlations - blood/microscopic
Pos blood, no RBCs: -blood reaction could be due to hemoglobin or myoglobin OR -false pos due to bacterial peroxidase -check for bacteria Neg blood, RBCs seen: -could be false negative blood due to increased ascorbic acid -yeast or monohydrate calcium oxalate crystals could be misidentified as RBCs
292
Urinalysis correlations - bilirubin/urobilinogen
Liver disease: -bili pos or neg -urobili increased Biliary obstruction: -bili pos -urobili negative Hemolytic disorder: -bili neg -urobili increased
293
Urinalysis correlations - LE/microscopic
-can have pos LE without WBCs (WBCs lysed) -can have pos LE & WBCs without bacteria (*Trichomonas*)
294
Urinalysis correlations - Nitrite/LE/microscopic
-with Pos nitrite, usually have pos LE, WBCs, & bacteria -can have pos LE, WBCs, bacteria, & NEG nitrite (non-nitrate-reducing bacteria)
295
Urinalysis correlations - SG/microscopic
-RBCs & WBCs lyse in dilute urine -with increased SG, RBCs & RBCs may crenate, cause false-negative blood & LE
296
CSF - color - normal
colorless
297
CSF - color - abnormalities - xanthochromia
-slight pink, orange, or yellow due to oxyhemoglobin or bilirubin -seen in subarachnoid hemorrhage
298
CSF - color - abnormalities - traumatic tap
red or pink, decreasing from tube 1-3
299
CSF - color - examine within?
1 hour of collection to avoid false positive from lysis of RBCs
300
CSF - clarity - normal
clear
301
CSF - clarity - abnormalities
cloudy with infection or bleeding
302
CSF - WBC - normal
Adult: 0-5/uL Newborn: 0-30/uL (mononuclear)
303
CSF - WBC - abnormalities
increased in meningitis
304
CSF - WBC - perform cell count within?
30 minutes of collection - cells begin to lyse within 1 hour
305
CSF - WBC - count done in?
hemacytometer, following lysis of RBCs with 3% glacial acetic acid
306
CSF - WBC - differential on stained smear following?
concentration (cytocentrifugation)
307
CSF - RBC - normal
0
308
CSF - RBC - abnormalities
increased with subarachnoid hemorrhage, traumatic tap
309
CSF - RBC - diagnostic value
limited
310
CSF - Glucose - normal
60-70% of blood glucose
311
CSF - Glucose - abnormalities
decreased in bacterial meningitis
312
CSF - Glucose - method
blood glucose method
313
CSF - Protein - normal
15-45 mg/dL
314
CSF - Protein - abnormalities
increased in meningitis & with traumatic tap
315
CSF - Protein - method
biuret method is not sensitive enough, use alternative method
316
CSF - cells - normal
-lymphocytes -monocytes -ependymal cells -choroid plexus cells
317
CSF - cells - abnormalities
-siderophages with subarachnoid hemorrhage -blasts with leukemia
318
CSF - cells - nucleated RBCs seen?
due to bone marrow contamination
319
Differential diagnosis of meningitis: WBC: increased Differential: neutrophils Protein: increased Glucose: decreased Lactate: increased Other: pos gram stain, bacterial antigen
bacterial meningitis
320
Differential diagnosis of meningitis: WBC: increased Differential: lymphocytes Protein: increased Glucose: normal Lactate: normal
viral meningitis
321
Differential diagnosis of meningitis: WBC: increased Differential: lymphs, monos Protein: increased Glucose: decreased Lactate: increased Other: weblike clot or pellicle
mycobacterial meningitis
322
Differential diagnosis of meningitis: WBC: increased Differential: neutrophils Protein: increased Glucose: normal or decreased Lactate: increased Other: pos India ink and/or *Cryptococcus neoformans* antigen test
fungal meningitis
323
abnormal accumulation of fluid in body cavity; classified as transudate or exudate
effusion
324
fluid contained in pericardial, peritoneal, & pleural cavities
serous fluid
325
fluid surrounding heart
pericardial fluid (pericardiocentesis fluid)
326
fluid in abdominal cavity
peritoneal fluid (abdominal fluid, ascitic fluid)
327
fluid surrounding lungs
pleural fluid (chest fluid, thoracentesis fluid, empyema fluid)
328
fluid in joints
synovial fluid (joint fluid)
329
Differentiation of transudates and exudates - Transudate - etiology
-systemic disorder affecting fluid filtration & reabsorption (CHF, hypoalbuminemia, cirrhosis) -problem originating outside body cavity
330
Differentiation of transudates and exudates - Transudate - type of process
non-inflammatory
331
Differentiation of transudates and exudates - Transudate - color
colorless
332
Differentiation of transudates and exudates - Transudate - clarity
clear
333
Differentiation of transudates and exudates - Transudate - SG
<1.015
334
Differentiation of transudates and exudates - Transudate - protein
<3 g/dL
335
Differentiation of transudates and exudates - Transudate - fluid-to-serum protein ratio
<0.5
336
Differentiation of transudates and exudates - Transudate - glucose
equal to serum level
337
Differentiation of transudates and exudates - Transudate - spontaneous clotting
no
338
Differentiation of transudates and exudates - Transudate - lactate dehydrogenase
<60% of serum
339
Differentiation of transudates and exudates - Transudate - WBC
<1,000/uL
340
Differentiation of transudates and exudates - Transudate - differential
predominantly mononuclears
341
Differentiation of transudates and exudates - Exudate - etiology
condition involving membranes within body cavity (infection, malignancy, inflammation, hemorrhage)
342
Differentiation of transudates and exudates - Exudate - type of process
inflammatory
343
Differentiation of transudates and exudates - Exudate - color
yellow, brown, red, green
344
Differentiation of transudates and exudates - Exudate - clarity
cloudy
345
Differentiation of transudates and exudates - Exudate - SG
>1.015
346
Differentiation of transudates and exudates - Exudate - protein
>3 g/dL
347
Differentiation of transudates and exudates - Exudate - fluid-to-serum protein ratio
>0.5
348
Differentiation of transudates and exudates - Exudate - glucose
30 mg or more < than serum level
349
Differentiation of transudates and exudates - Exudate - spontaneous clotting
yes
350
Differentiation of transudates and exudates - Exudate - lactate dehydrogenase
>60% of serum
351
Differentiation of transudates and exudates - Exudate - WBC
>1,000/uL
352
Differentiation of transudates and exudates - Exudate - differential
predominantly neutrophils
353
Synovial fluid - normal - color
pale yellow to colorless
354
Synovial fluid - normal - clarity
clear
355
Synovial fluid - normal - viscosity
good
356
Synovial fluid - normal - WBcs/uL
<200
357
Synovial fluid - normal - Polys
<25%
358
Synovial fluid - non-inflammatory - etiology
degenerative joint disease
359
Synovial fluid - non-inflammatory - color
yellow
360
Synovial fluid - non-inflammatory - clarity
clear
361
Synovial fluid - non-inflammatory - viscosity
good
362
Synovial fluid - non-inflammatory - WBCs/uL
<2,000
363
Synovial fluid - non-inflammatory - Polys
<30%
364
Synovial fluid - inflammatory - etiology
-rheumatoid arthritis -lupus erythematosus -gout -pseudogout
365
Synovial fluid - inflammatory - color
yellow
366
Synovial fluid - inflammatory - clarity
cloudy, turbid
367
Synovial fluid - inflammatory - viscosity
poor
368
Synovial fluid - inflammatory - WBCs/uL
2,00-100,000
369
Synovial fluid - inflammatory - Polys
>50%
370
Synovial fluid - infectious - etiology
bacterial infection
371
Synovial fluid - infectious - color
yellow-green
372
Synovial fluid - infectious - clarity
cloudy, turbid
373
Synovial fluid - infectious - viscosity
poor
374
Synovial fluid - infectious - WBCs/uL
50,000-200,000
375
Synovial fluid - infectious - Polys
>90%
376
Synovial fluid - infectious - other
positive culture (*S. aureus*, *N. gonorrhoeae*, most common)
377
Synovial fluid - crystal induced - etiology
gout, pseudogout
378
Synovial fluid - crystal induced - color
yellow, white
379
Synovial fluid - crystal induced - clarity
cloudy, milky
380
Synovial fluid - crystal induced - viscosity
poor
381
Synovial fluid - crystal induced - WBCs/uL
500-200,000
382
Synovial fluid - crystal induced - Polys
<90%
383
Synovial fluid - hemorrhagic - etiology
trauma, coagulation abnormality
384
Synovial fluid - hemorrhagic - etiology
trauma, coagulation abnormality
385
Synovial fluid - hemorrhagic - color
pink, red, red-brown
386
Synovial fluid - hemorrhagic - clarity
cloudy
387
Synovial fluid - hemorrhagic - viscosity
poor
388
Synovial fluid - hemorrhagic - WBCs/uL
50-10,000
389
Synovial fluid - hemorrhagic - Polys
<50%
390
Synovial fluid crystals - monosodium urate - description
-1-30 um long needles -intra- or extracellular -strongly birefringent -yellow when long axis of crystal is parallel to slow wave of red compensator; blue when perpendicular
391
Synovial fluid crystals - monosodium urate - significance
gout
392
Synovial fluid crystals - calcium pyrophosphate - description
-1-20 um long, 4 um wide -rod-shaped, rectangular, or rhomboid -intracellular -weakly birefringent -blue when long axis of crystal is parallel to slow wave of red compensator; yellow when perpendicular
393
Synovial fluid crystals - calcium pyrophosphate - significance
pseudogout
394
Synovial fluid crystals - cholesterol - description
-large rectangle with notched-out corner -extracellular
395
Synovial fluid crystals - cholesterol - significance
extracellular
396
Semen analysis - fertility testing - specimen collection
-collect in sterile container, without condom, after 3-day abstinence -keep at RT -deliver to lab within 1 hour of collection
397
Semen analysis - fertility testing - liquefaction
don't analyze until specimen is liquefied (normally within 30 minutes of collection)
398
Semen analysis - fertility testing - volume
Normal: 2-5 mL
399
Semen analysis - fertility testing - motility
-observe within 3 hours of collection -50-60% of sperm should show at least fair motility
400
Semen analysis - fertility testing - cell count
-dilute & count in Neubauer hemacytometer -Normal: >20 million per mL
401
Semen analysis - fertility testing - morphology
-stain & examine at least 200 cells -Normal: oval head (3 x 5 um) with long tapering tail -Abnormalities: double heads, giant heads, amorphous heads, pinheads, tapering heads, constricted heads, double tails, coiled tails, large numbers of spermatids (immature forms) -NORMAL: <=30% abnormal forms
402
Semen analysis - fertility testing - pH
7.3-8.3
403
Semen analysis - post-vasectomy - specimen collection
-condom can be used -time & temp not critical -test monthly beginning 2 months after vasectomy -continue until 2 consecutive specimens are without sperm
404
Semen analysis - post-vasectomy - liquefaction
don't analyze until specimen is liquefied
405
Semen analysis - post-vasectomy - cell count
-examine undiluted & following centrifugation -even 1 sperm is significant
406
Amniotic fluid tests - Lecithin-to-sphingomyelin (L/S) ratio - assessment/diagnosis of
fetal lung maturity
407
Amniotic fluid tests - Lecithin-to-sphingomyelin (L/S) ratio - method
thin-layer chromatography
408
Amniotic fluid tests - Lecithin-to-sphingomyelin (L/S) ratio - ratio that signal maturity
>=2.0
409
Amniotic fluid tests - Lecithin-to-sphingomyelin (L/S) ratio - false increases
blood or meconium contamination
410
Amniotic fluid tests - Phosphatidylglycerol (PG) - assessment/diagnosis of
fetal lung maturity
411
Amniotic fluid tests - Phosphatidylglycerol (PG) - assessment/diagnosis of
fetal lung maturity
412
Amniotic fluid tests - Phosphatidylglycerol (PG) - method
immunologic agglutination
413
Amniotic fluid tests - Phosphatidylglycerol (PG) - affected by presence of blood or meconium?
no
414
What is the last surfactant to rise (fetal lung maturity)?
phosphatidylglycerol
415
Amniotic fluid tests - Foam stability index (shake test) - assessment/diagnosis of
fetal lung maturity
416
Amniotic fluid tests - Foam stability index (shake test) - method
shake with increasing amounts of 95% ethanol
417
Amniotic fluid tests - Foam stability index (shake test) - index is?
highest concentration of ethanol that supports ring of foam after shaking
418
Amniotic fluid tests - Foam stability index (shake test) - what index is comparable to L/S ratio of 2.0?
0.48
419
Amniotic fluid tests - Foam stability index (shake test) - does blood and meconium interfere?
yes
420
Amniotic fluid tests - lamellar body count - assessment/diagnosis of
fetal lung maturity
421
Amniotic fluid tests - lamellar body count - method
count in platelet channel of hematology analyzers
422
Amniotic fluid tests - lamellar body count - number correlates with?
amount of phospholipid present in fetal lungs
423
Amniotic fluid tests - lamellar body count - sample must be free of?
blood or meconium
424
Amniotic fluid tests - amniotic fluid bilirubin - assessment/diagnosis of
hemolytic disease of the newborn/fetus
425
Amniotic fluid tests - amniotic fluid bilirubin - method
direct spectrophotometric scan from 365-550 nm
426
Amniotic fluid tests - amniotic fluid bilirubin - peak absorbance
450 nm
427
Amniotic fluid tests - amniotic fluid bilirubin - determine severity of disease by?
deltaA450 compared to gestational age
428
Amniotic fluid tests - amniotic fluid bilirubin - specimen must be protected from?
light
429
Amniotic fluid tests - amniotic fluid bilirubin - do blood and meconium interfere?
yes
430
Amniotic fluid tests - alpha-fetoprotein (AFP) - assessment/diagnosis of
neural tube defects
431
Amniotic fluid tests - alpha-fetoprotein (AFP) - method
immunologic method
432
Amniotic fluid tests - alpha-fetoprotein (AFP) - high levels with?
-anencephaly -spina bifida
433
Amniotic fluid tests - alpha-fetoprotein (AFP) - confirm with?
ultrasound
434
A first morning urine specimen is best for screening and for routine urinalysis because it: A. Is produced when the body is in a resting state B. Is more concentrated C. Is not affected by diurnal variation D. Will be the most acidic
B. Is more concentrated
435
Which of the following "color of urine: cause" is a correct match? A. Red: concentrated specimen B. Black: bilirubin C. Green: *Pseudomonas* infection D. Pink or red: homogentisic acid
C. Green: *Pseudomonas* infection
436
Which of the following cells found in the urine sediment is indicative of tubular damage or necrosis? A. WBC B. Epithelial cell C. Renal tubular epithelial cell D. Transitional epithelial cell
C. Renal tubular epithelial cell
437
In a patient with severe liver disease, which of the following crystals would be anticipated upon examination of their urine sediment? A. leucine B. tyrosine C. bilirubin D. all of the above
D. all of the above
438
Large amounts of protein (proteinuria) are most frequently found associated with which of the following renal diseases? A. Nephrotic syndrome B. Acute glomerulonephritis C. Acute interstitial nephritis D. Cystitis
A. Nephrotic syndrome
439
In which of the following conditions would a positive leukocyte esterase reagent strip in the absence of bacteria is most likely? A. Acute pyelonephritis B. *Trichomonas* infection C. Cystitis D. All of the above
B. *Trichomonas* infection
440
Which of the following characterizes a subarachnoid hemorrhage rather than a traumatic spinal tap? A. Increase in protein B. Clear supernatant after centrifugation C. Xanthochromia D. Presence of bacteria
C. Xanthochromia
441
Which of the following laboratory results is characteristic of an exudate fluid? A. Clear and colorless B. Total protein = 2.5 g/dL C. Fluid/serum protein ratio = 0.3 D. Specific gravity = 1.021
D. Specific gravity = 1.021
442
In which form of meningitis is a normal CSF glucose value most often observed? A. Bacteria B. Fungal C. Viral D. Mycobacterial
C. Viral
443
Which of the following amniotic fluid tests is utilized for the diagnosis of open neural tube defect? A. Lamellar body count B. AFP C. Bilirubin D. Phosphatidylglycerol
B. AFP

AMT MT Exam (12 decks)

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