exam aubf

these organisms are frequently present in the specimens received in the clinical laboratory. Understanding how microorganisms are transmitted (chain of infection) is essential to preventing infection.

biological hazard

The chain of infection requires a continuous link among six elements

pathological agent reservoir portal of exit mot portal of entry susceptible host

the location of potentially harmful microorganisms, such as a contaminated clinical specimen or an infected patient

reservoir

when inanimate object are an reservoir what are they called

fomites

what do fomites contain

bodily fluids

UNIVERSAL PRECAUTIONS was a response to the concern of

hep b hep c and hiv

what does up reccomend to health care worker

wear gloves when handling blood or other bodily fluids, wear face shield when there are chances of blood splashing, dispose needles or sharps in puncture resistant trash can

what was not included in up

possibility of blood appearing urine or bodily fluid that is not visible to naked eye

to alleviate the concern on up what was created to solve this

bodily substance isolation

bodily substance isolation considers

all bodily fluids to be infectious

major disadvantage of bsi

not using hand sanitizer after removing gloves if there is no visual contamination

combined the major features of UP and BSI guidelines and called the new guidelines Standard Precautions

Healthacare infection control practices advisory commitee

when handling a specimen of mycobacteria what should be worn

n95 respirator

When skin or eye contact occurs, the best first aid is to flush

the area with large amounts of water for at least

15 minutes and seek medical attention

chemical spill kits contain a substance called _____ and

sodium bicarbonate, sand and ground clay

what were the observed from the primitive style of urinalysis

color, turbidity, odor, volume, viscosity, and even sweetness

who,in the 5th century BCE, wrote a book on “uroscopy.”

hipporcrates

boiling discovered

albuminuria

who discovered albuminuria

frederik dekkers

what were the charlatans who tanked the credibility of urinalysis called

pisse prophets

The invention of the microscope in the 17th century led to

development by Thomas Addis of methods for quantitating the microscopic sediment.

introduced the concept of urinalysis as part of a doctor’s routine patient examination in 1827

richard bright

Two unique characteristics of a urine specimen account for this continued popularity

A urine specimen is readily available and easily collected and Urine contains information about the body’s metabolic function

continuously form urine as an ultrafiltrate of plasma.

kidney

In general, urine consists of

urea and organic and inorganic substances

a metabolic waste product produced in the liver from the breakdown of protein and amino acids,

urea

Other organic substances include primarily

uric acid and creatinine

Product of metabolism of creatine by muscles

creatinine

Product of breakdown of nucleic acid in food and cells

uric acid

The major inorganic solid dissolved in urine is

chloride, sodium, potassium

Factors that influence urine volume

fluid intake, fluid loss from non renal sources, variation of secretion of adh

the normal daily urine output is usually

1200 to 1500 ml daily

a decrease in urine output (less than 1 mL/kg/hr in infants, less than 0.5 mL/kg/hr in children, and less than 400 mL/day in adults),

oliguria

oliguria is typically seen in patients that are

dehyrdated due to vomiting, diarrhea, perspiration

oluguria can lead to

anuria

cessation of urine flow, may result from any serious damage to the kidneys or from a decrease in the flow of blood to the kidneys.

anuria

The kidneys excrete two to three times more urine during the ___ than during the ___

day, night

An increase in the nocturnal excretion of urine is termed

nocturia

an increase in daily urine volume (greater than 2.5 L/day in adults and 2.5 to 3 mL/kg/day in children),

polyuria

polyuria is related to

diabetes mellitius and diabetes insipidus

The recommended capacity of the container is

50 ml

needed volume of urine for microscopic analysis

12 ml

time duration of urine sample

2 hours

the method of preservation used most routinely is

refrigeration at 2 to 8 c up to 24 hours

Prevents bacterial growth and metabolism but Interferes with analysis of drugs and hormones

boric acid

Excellent sediment preservative but Acts as a reducing agent, interfering with chemical tests for glucose, blood, leukocyte esterase, and copper reduction

formalin

Good preservative for drug analyses but Inhibits reagent strip tests

sodium fluoride

Convenient when refrigeration not possible

commercial preservative tablets

This is the specimen received most commonly because of

its ease of collection and convenience for the patient.

random specimen

this is the ideal screening specimen. It is also essential for preventing false-negative pregnancy tests

first morning specimen

This specimen is collected under sterile conditions by passing

a hollow tube through the urethra into the bladder.

catheterized specimen

catheterized specimen for

bacterial culture

a safer, less traumatic method for obtaining urine for bacterial culture and routine urinalysis

mid stream clean catch specimen

provides a specimen for bacterial culture that is completely free of extraneous contamination

suprapubic aspiration

Three-Glass Collection

first urine is put in container, then mid stream put into container, then prostate is massage then pee into container

Three-Glass Collection second speciment is for

control for uti if positve discard 3rd specimen since its contaminated

Three-Glass Collection if patient has prostate infection 3rd specimen will have

high wbc count and high bacterial count

Each kidney contains approximately 1 to 1.5 million functional

units called

nephrons

2 types of nephrons

Cortical nephrons, juxtamedullary nephrons

Cortical nephrons responsible for

removal of waste products and reabsorption of nutrients.

juxtamedullary responsible for

the concentration of urine

factors that affect The ability of the kidneys to clear waste

• Renal blood flow

• Glomerular filtration

• Tubular reabsorption

• Tubular secretion

The renal artery supplies blood to the kidney. The human kidneys receive approximately

25%

bloodflow of blood going to kidney

cappiliaries → afferent arteriole → glomerulus → efferent arteriole

The glomerulus is located within

bowmans capsule

Plasma filtrate must pass through three glomerular filtration

barrier cellular layers

capillliary wall membrane basal lamina visceral layer

glomerular filtration barrier that prohibits the filtration of large molecules, the barrier contains a

shield negativity

shield negativity is for

repels molecules with a negative charge even though they are small enough to pass through the three layers of the barrier.

maintains the glomerular blood pressure at a relatively constant rate, regardless of fluctuations in systemic blood pres- sure

juxtoglomerular apparatus

how does the glomerulus maintain the glomerular bp

dilating the efferent and afferent arteriole

raas system responds to

low bp and sodium content

what alerts raas

macula densa

raas process

low bp low sodium →renin → renin react angiotensinogen → angiotensin 1 → a1 reacts with ace → a2

The cellular mechanisms involved in tubular reabsorption are

active and passive transport

Active transport is responsible for the reabsorption of the following substances:

glucose amino acids sodium

passive transport is responsible for the reabsorption of the following substances:

water urea sodium

when substance reach ____ it will appear in urine

maximal reabsorptive capacity

The physical examination of urine includes the determination

of the

urine color clarity and specific gravity

The yellow color of urine is caused by the presence of a pigment, which Thudichum named

urochrome

attaches to the urates, giving a pink color to the sediment

uroerythin

an oxidation product of the normal urinary constituent urobilinogen,

imparts an orange-brown color to urine that is not fresh.

urobilin

Dark yellow or amber urine may not always signify a normal con-

centrated urine but can be caused by the presence of

bilirubin

Photo-oxidation of bilirubin imparts a yellow-green color to the urine caused by the

biliverdin

most common causes of abnormal red urine color is the presence of.

blood

when blood is intact urine is

red and cloudy

when blood is not intact urine is

red and clear

oxidation of porphobilinogen to porphyrins turn blood into

port wine color

Pathogenic causes of blue/green urine are limited to bacterial

infections, including urinary tract infection by

pseudomonas

is a general term that refers to the transparency or turbidity of a urine specimen

clarity

normal urine clarity is

clear

why does women urine sometime is hazy

epithelial cells

preservation that results in affecting clarity of specimen

refrigeration

refrigeration of urine has

amorphous phosphates, carbonates, and urates

amorphous phosphates, carbonates color in basic pee

white

amorphous urate color in acidic urine

pink

The pathological causes of turbidity in a fresh specimen that are

encountered most commonly are

rbc wbc and bacteria

why use refractometer

can identify specific gravity with only small amounts of volume