UA and Body Fluids Polansky Review Flashcards
First morning specimen
best for screening most concentrated
2hr post prandial
diabetes monitoring, 2hr after eating, glycosuria
24hr urine
quantititive chemistries, discard first void, fridge
diuresis
increased urine production
polyuria
increased urine flow
oliguria
decreased urine flow
anuria
no urine production
bilirubin urine color
amber orange, yellow foam with shaking
urobilin urine
amber orange, no yellow foam with shaking
homogentisic acid urine
normal on void, black/brown standing
melanin urine
black/brown standing
methemoglobin urine
brown/black
myoglobin urine
red/brown standing
blood/hgb urine
pink/red, brown standing
porphyrin urine
port wine
changes in unpreserved urine standing for 2 hr
increase turbidity
inc pH
dec glucose, ketones, bili, urobili, WBC/RBC
pH strip test
double indicator, acid base balance, pH =9 improperly preserved
protein urine strip
what error indicator
disease?
most senst to ?
protein error of indicator
renal disease
most sensitive to alb
glucose test strip
glucose oxidase/peroxidase
diabetes
spec for glucose
ketone strip test
increased?
most sensitive to?
sodium nitroprusside rxn
increased fat metabolism
acetoacitic acid
blood strip test
pseudo….
pseudoperoxidase activity of hgb
bilirubin strip test
significance?
diazo rxn
liver disease/biliary obst
only conjugated bili is excreted
urobilinogen strip test
ehrlichs aldehyde rxn
liver disease hemolysis
only detect increase, not absence
nitrite strip test
greiss rxn
UTI
inc specificty when urine in bladder is 4hr old
leukocyte esterase strip test
disease association?
doesnt detect?
UTI
longest rxn time, doesnt detect lymphs
SG strip test
pKa changes
kidney conc ability in hydration
inc in diabetes mellitus
dec in diabetes insip (ADH)
ionic solutes
protein erros strip test
highly alk urine, increased SG
proteins other than ALB
glucose errors strip test
contamination with peroxide or bleach, ascorbic acid, incr SG
ketone errors strip test
red pigments, dyes, acetone
SG errors strip test
increased proteins, alk urine
microalbumin
what kind of specimen
24hr urine ACR
females diab nephrop
SSA sulfsalicylic acid
proteins, bence jones
clintest
what reduction
watch to avoid?
reducing substances, coper reduction
watch to avoid pass through
Acetest
detects ketones
sodium nitroprusside
most senitive to acetoacitic acid
ictotest
detects bilirubin
diazo rgnt
more sensitive than reagent strip
gluc oxidase +
copper reduct (clintest) +
glucose
gluc oxidase +
clintest 0
glucose below sensitivity for clintest
gluc oxidase 0
clintest +
non glucose reducing substance
gluc oxidase 0
clintest 0
no gluc or other reducing subtance
squamous epithelial cells
located?
lower urethra, vagina,
no signif
increase in females sometimes, reduce with midstream
transitional epithelial cells
shape?
location?
may form?
renal eplvis, urteres, bladder
pherical pear shapped, polyherdral
seldom significant
may form syncytia (clumps)
RTE cells
tn/t/v/rr
round eccentric nucelpus
renal tubules
tubular necrosis, toxins, viral infection, renal rejection
oval fat body
RTE cell containing fat
renal tubes
maltese cross with polarized light
WBC in urine
cystitis, pyelonephritis, tumors, renal calculi
clumps with acute infection
glitter cell
wbc with brownian movement of granules
seen in hypotonic urine
RBC in urine
infection, trauma, tumors
dysmophic indicate glomerular bleeding
lyse in hypotonic urine and w acetic acid
amorphous urates
acid or neutral urine
normal
pink precipitate
dissolve by warming
uric acid crystals
acid/neutral urine
normal
birefirngent/polarizes
calcium oxalate
acid/neutral urine
normal
octahedral most common form
slight alk urine sometimes, most common consituent of renal calculi
amorphous phosphates
alk urine
normal
white precipitate
dissolve with acidic acid
triple phos crystals
alk urine
normal
coffin lids
ammonium biurate
alk urine
normal
old specimens
thorny apples
calcium phosphate
alk urine
normal
rosettes, pinting inger
only needle forms in alk urine
calcium carbonate
alk urine
normal
colorless dumbless/aggregates
Leucine
abnormal
radial concentric striations
severe liver disease
seen w tyrosine
tyrosine
abnromal
fine yellow needles in sheaves/rossettes
severe liver disease
seen with leucine
cystine
abn
hexagonal
cystinuria
must diff from uric acid
doesnt polarize light
confirm with sodium nitroprusside test
cholesterol
abnormal
flat plates notched corners
stair-steps
nephrotic syndrome
birefringent
bilirubin crystal
looks?
disease?
chem test?
abnormal
yellow brown needles, plates, granules
liver disease
chem test for bilirubin should be positive
Hyaline cast
incr w?
what protein?
normal
incr w stress, fever, excersice
most common least sign
tamms horsefall
granular cast
inc w s/e/g/p
disintigration?
inc w stress, excersise, glomnerph, pyloneph
from disintegration of cellular cast
rbc cast
rbc in cast matrix
acute glom nephr, strenous exersice
ID kidney as source of bleeding, most fragile cast
blood cast
contain hgb,
acute glomneph, strenous exercise
disitegration of rbc casts
WBC cast
irreg shape, wbc in matrix
pyelonephritis
ID kidney as site of infection
epithelial cast
damage?
where are they made
rte cells in matrix
renal tube damage
distal to renal tubes/collecting duct where casts are formed
waxy cast
caused by?
degeneration of?
homogenous, opawue, notched/broken edges
urinary stasis
degenertion of cellular/granular casts
unfavorable
fatty cast
lipid droplets
nephrotic syndrome
maltese cross w polarizer is cholesterol
sudan II oil Red O stain
broad cast
shape
significance?
formed in?
wide, cellular, waxy, granular
advanced renal disease
formed in distal/collecting ducts
renal failure casts
Yeast
vaginal/fecal contam
may be due to kidney infection
often in diabeteics
add 2% acetic acid to lyse rbcs,
wbc present with true yeast
trichomonas
flagella/undulating membrane
parasitic infection of genital tract, in females
dont report unless motile
acute glomerulonephritis
what type of infections?
inflamm and damage to glomeruli
protein and blood on strip
rbcs/wbc/hgb casts
group a strep infections
nephrotic syndrome
increased?
large
what kind of casts?
hypo/hyper
incr glom permeability
large protein
casts, free fat and oval fat bodies
hypoproteinemeia/hyperlipidemia
pyelonephritis
kidney infection
protein, leukocyte esterase, nitrite
wbc, wbc casts, bacteria
cystitis
doesnt have?
bladder infection
leukocyte esterase, nitrie
abc, bacteria, rbcs, no casts
liver disease
bili pos or neg
urobili increased
biliary obstruction
bili pos
urobili N
hemolytic disorders
bili neg
urobili increased
CSF exam
1hr post collection to avoid rbc lysis, centrifuge
wbc CSF
increased in meningitis, cell count within 30min
glucose CSF
inc in bacterial meningitis
protein CSF
increased in meningitis and tramatic tap
use trichloracetic acid
cells in CSF
siderophages with subarachnoid hemorrhage
blasts w leukemia
mycobacterium meningitis CSF
web…
inc wbc
lymphs monos
weblike clot or pellicle
inc protein/glucose
fungal meningitis CSF
inc wbc
lymphs monos
pos india ink or latex agglut
Effusion
abn accum of fluid in body cavity
serous effusion
fluid contained in pericardial, peritoneal and pleural cavities
pericardial fluid
fluid around heart
Transudate
systemic disorder afecting fluid filtration and reabs, problem originating outside body
noninflamm
colorless/clear
mononuclears
exudate
within
i/h
i
y
c
inc
clo
pol
membranes within bodycavity
infection/hemorrage
inflammation
yellow/brown/green
cloudy
inc glucose
inc protein
clotting
polys
noninflammatory synovial fluid
degenerative joint disease
yellow
inflammatory synovial fluid
RA, lupus, gout, pseudogout
yellow
cloudy/turbid
poor viscosity
inc wbcs polys
infectious synovial fluid
bacterial infection
yellow green
cloudy
inc wbcs
(s. aureus/gonorrhoeae common)
crystal induced synovial fluid
gout/pseudogout
yellow/white
milky
crystals
hemorrhagic synovial fluid
trauma, coag abnormality
pink/red/brown
clpudy
monosodium urate crystals synovial fluid
needles, briefringnet
yellow when long axis is parallel to slow wave
gout
calcium pyrophosphate synovial fluid
rod shaped, rhomboid
weakly birefingent
blue when parallel
pseudogout
cholesterol synovial fluid
extracellular
chronic effusions (RA)
semen collection fertility
3 days no sex
no conodms
deliver within 1 hr
dont examin until liquified
motility/morphology sperm
observe motility within 3hr 50-60% should be fair motility
200 cell count,
post vasc
condom can be used, time temp not critical
testing after 2 mos, continue until 2 samples are w/o sperm
1 sperm significant
L/S ratio
fetal lung maturity
TLC
>2 ideal
PG phosphatidylglycerol
not affected by
fetal lung maturity
immunologic agglut
last surfactant to rise
not affected by blood
foam stability index (shake test)
index is?
fetal lung maturity
shake w increase ammount of 95% ethanol
index is highest conc that supports ring
lamellar body count
fetal lung maturity
count in plt channel of hemocytometer
number correlates to phosph in fetal lungs
amniotic fluid bilirubin
HDFN
determine severity of disease, protect from light
AFP
neural tube defects
high levels with anecephaly/spina bifida