Urinalysis final exam Flashcards
name 4 reasons amniotic fluid is collected during pregnancy.
- genetic disorders
- assess fetal pulmonary maturity
- pedicting hemolytic disease
- sex determination
If an amniotic fluid is collected early in pregnancy, it is most likely being collected to determine what?
genetic and congenital disorders
What is the definition of oligohydraminos?
abnormally decreased amounts of amniotic fluid
What would be the reason for protecting amniotic fluid from light?
to protect bili from light
When present in amniotic fluid, fetal cells are adversely affected by what?
refrigeration
Physical examination of amniotic fluid (i.e. color, turbidity)
- Normal-colorless *Early- little particulate matter
- bilirubin-yellow or amber *later stage more particulate
- meconium-green
- blood-pinkish
4 tests done to evaluate the surfactants present to the fetal pulmonary system.
- L/S
- phosphatidylglycerol (PG)
- Foam stability index (FSI)
- mircroviscocity
Fetal lung maturity comparing L/S and PG determiniation what would indicate lung maturity?
L/S >2 affected by blood and meconium
PG present- not affected by blood and meconium
3 biochemical tests used to evaluate the secretory function of the prostate?
Zinc, citric acid and acid phosphates
biochemical test that positively identifies seminal fluid and is useful in cases of sexual assult?
acid phosphate can positively identify a fluid as seminal fluid
4 reasons semen analysis is ordered?
- evaluate fertility
- follow-up vasectomy
- quality for donation
- forensic applications
which structures contribute secretions to seminal fluid?
- seminal fluid
- prostate gland
- testies
- epididimas
What is a normal seminal fluid concentration?
20-250 million/ml
Is normal seminal fluid concentration constant in an individual?
no
what factors might influence seminal fluid concentration?
abstinence, viral infections and stress
Is concentration of seminal fluid the most important factor in determining infertility?
actual # is not important for fertility purposes
What percentage of sperm with normal morphology is considered normal or acceptable?
50%
How is sperm morphology determined?
smears of fresh semen
What parameter of a semen analysis is directly related to and provides a check of the motility evaluation and how?
viability
*distinguishes between dead and non-motile
What is the normal pH of seminal fluid?
7.2-7.8
What might a pH of < 7.2 in seminal fluid indicate?
abnormality of the epididymis, vas defernes, or seminal vesicles
What might a pH of > 7.8 in seminal fluid indicate?
indication of infection in the male reproductive track
What is the primary function of seminal fluid?
transports spermatozoa
Requirements for the collection of a specimen for semen analysis.
- abstinence 2 days
- recieved within an hour
- collect through masterbation in a sterile cup
- 2 specimens in a 3 month period 7 days apart
What is the normal length (mins) for a semen to liquefy?
30 mins
After semen liquefies the viscosity closely resembles that of what other fluid?..
water
What would be considered abnormal liquefaction of semen?
*takes longer than 60 mins
motility should be evaluated within how many mins following collection?
60 mins
color, clarity, viscosity, and clot formation of normal synovial fluid.
color: pale yellow-colorless
clarity: clear
viscosity; very viscous due to protein
clot formation: no clots
Is fibrinogen a normal constituent of normal synovial fluid?
no, its due to damage to synovial membrane or blood from traumatic tap
Does hyaluronate affect the turbidity of a synovial fluid specimen?
no
Things that may cause synovial fluid to be turbid in appearance.
WBC’s
RBC’s
fat droplets
cellular debris
What should a synovial fluid be examined ASAP?
crystals can break down or WBCS can Phagocytize crystals
Which component of synovial fluid if present might be adversely affected by a delay in examination?
Crystals
For microscopic purposes synovial fluid should be placed in a tube containing what anticoagulant?
Sodium heparin
Why should other anticoagulants be avoided for synovial fluid microscopic examination?
to avoid artifacts
What should synovial fluid be diluted with should it need to be for microscopic examination?
0.85% saline
A joint disease process is indicated by what?
neutrophils > 25%
What type of microscopy differentiates synovial fluid crystals based on their birefringence? How?
- compensated polar microscopy
- differentiation of + and - birefringence substances based on different colors produced when crystals are parallel and perpendicular to its axis(yellow or blue)
Indicators of a synovial fluid being classified as septic?
- greater than 40 mg/dL plasma/ synovial glucose difference increases
- yellow-green
- low viscoscity
- high WBC count
- cloudy
Which crystal is usually seen in patient with gout?
monosodium urates (MSU)
Are monosodium urate, calcium pyrophosphate dihydrate, and cholesterol crystals all birefringent?
.yes
Which analytes are present in synovial fluid at concentrations equal to blood plasma levels?
glucose and uric acid
If a bloody CSF fluid is recieved in the lab, what are some steps to take to determine if it is a traumatic tap or the patient has actually had a hemorrhage?
clear after centrifuge=traumatic tap
xanthochromic supernatant after centrifuge (yellow)=hemorrhage
xanthochromia
yellow discoloration
subarachnoid or intracerebral hemorrahage
Does fibrinogen NORMALLY pass through the blood-brain barrier?
no
first tube collected in lumbar puncture procedure should be used for what type of testing?
chemical and immunologic testing
a predominance of lymphocytes within CSF indicates which type of meningitis?
viral
Normal ranges for glucose and protein in a normal CSF?
glucose: 50-80 mg/Dl
protein: 15-45 mg/Dl
CSF decreased glucose and incresed protein indicate what?
meningitis
the amount of glucose in CSF is approximately_______% or ________ of the plasma concentration.
60-70%
2/3
pleocytosis as related to CSF?
increase in # of cells
Does an increased number of leukocytes within CSF cause xanthochromia?
no
An uneven distribution of blood in the CSF collection tubes most likely indicates what?
traumatic tap
Normal CSF WBC cell counts for adults
0-5 cells/ microliter
Normal CSF WBC cell counts for children
0-10cells/ microliter
Normal CSF WBC cell counts for newborns
up to 30 cells/microliter
In adult CSF cell counts what 2 cell types are considered normal if seen in the fluid?
lymphs and monos
a predominance of neutrophils within CSF indicates what type of meningitis?
bacteral
What is normal range for lactate in CSF?
10-22 mg/Dl
Normal lactate levels are often found in patients with what type of meningitis?
viral
What procedure frequently provides a rapid presumptive diagnosis of bacterial meningitis?
microscopic exam
What do the 3 zones mean?
- normal hemolysis
- moderate hemolysis
- severe hemolysis
testing fructose in seminal fluid reflects the secretory function of the ______ ______ as well as the functional integrity of the ______ _______ and _______ _______.
- seminal vesicles
- ejaculatory ducts
- vas deferens
Transudates
- non-inflammatory
- decrease that causes either an increase in hydrostatic pressure or a decrease in the plasma oncotic pressure in the membrane capillaries
Transudates clarity, does it clot, luekocyte count and SG
- clear
- No clots
- < 1000 Leukocytes(pleural)
- <1.015
Exudates
- inflammatory
* increase capillary permeability in the membrane or decrease the absorption of the fluid by the lymphatic system.
Exudates clarity, does it clot, luekocyte count and SG
- cloudy
- > 1000 cells (pleural)
- > 500 cells (peritoneal)
- SG >1.015
