CM RECALLS

URINOMETRY STEPS:

1. Fill the glass cylinder with 15mL of urine

2. Place the urinometer in twisting motion

3. Read at lower meniscus

How will erythrocytes appear in hypertonic urine?

a. biconcave discs

b. crenated

c. lysed

d. swollen

CRENATED

Casts are classified on the basis of their:

a. color

b. contents

c. length

d. site of formation

CONTENTS

Stain that best differentiates small cells and monocytic cells?

A. PAPS*

B. Gram stain

C. Giemsa

D. NMB

Same patient voided urine thrice. Which has the highest specific gravity?

A. All have the same SG

B. 100mL

C. 80mL

D. 30mL

30mL

High renin CORRESPONDS to?

A. Low sodium and low plasma volume*

B. High potassium and low plasma volume

C. Low aldosterone

LOW SODIUM AND LOW PLASMA VOLUME

Low EPO is due to?

A. Renal Disease*

B. Cardiomegaly

RENAL DISEASE

Diluent for WBC CSF count:

3% acetic acid with methylene blue

NOTE: (CSF)

1. Normal saline = TOTAL CELL COUNT

2. RBC count = Total cell count - WBC count

Dilute urine effect on RBC:

SWELL (HYPOTONIC SOLN); Appears like a halo

Curshmann spirals:

Elongated crystal with Charcot Leyden

NOTE:

1. @Notes: whitish or yellow wavy threads frequently coiled into little balls

2. BRONCHIAL ASTHMA (3C): Curshmann's, Charcot-Leyden, Creola bodies, Dttrich plugs

How much can the glomeruls filter Less than:

A. <50kDa

B. <60kDa

C. <70kDa

D. 7000

<70kDa

Note:

1. MW < 70, 000

2. Capillaries RETAIN BLOOD CELLS & SERUM PROTEINS

2. Smaller molec, AA, glucose, urea, creatinine, uric acid, ammonia or dissolved solutes and water FILTER INTO BOWMAN'S SPACE

Temperature for Total WBC CSF COUNT?

(when cannot be processed immediately)

REFRIGERATED TEMP

CaOx MONOHYDRATE SHAPE:

Elongated hourglass shape

NOTE:

1. Whewellite

2. PEG poisoning

3. Oval, Dumbell shape

True about sputum:

A. Normal body fluid

B. Usually green color

C. From tracheo-bronchial

D. AOTA

FROM-TRACHEO BRONCHIAL

NOTE:

1. Healthy individual DOES NOT NORMALLY produce sputum

First stage in spermatogenesis:

A. Spermatogonia

B. Spermatocytes

C. Spermatids

D. Spermatozoa

SPERMATOGONIA

For newborn screening specimen collection

A. Capillary

B. Blood spot

Blood spot

Bilirubin conjugated with albumin to be processed in the liver?

A. Unconjugated

B. Conjugated

C. Direct

D. None

UNCONJUGATED

NOTE:

1. B1 (Unconjugated) attaches to bilirubin and then goes to the liver where it is conjugated with UDPGT

Bilirubin measurement in amniotic fluid:

SPECTROPHOTOMETRIC

Note:

1. OD: 450nm (Bilirubin)

2. Interference: If specimen is contaminated with blood, OXYHEMOGLOBIN interferes at 410nm

Biohazard symbol:

Three circles arrange in a triangle connected by a circle in the middle

NOTE:

1. Labels must be predominantly fluorescent orange or orange-red, containing a biohazard symbol and the word "biohazard."

Sharp symbol:

Syringe enclosed in a circle to make it look like an X

Oligoclonal band in CSF but not in serum:

Multiple sclerosis

Note: Other Oligoclonal band:

1. Neurosyphilis

2. Enchephalitis

3. Guillain-Barre Syndrome

4. Neoplastic disorders

Occult blood in stool principle:

Pseudoperoxidase activity of hemoglobin

Principle of protein reagent strip:

Albumin ACCEPTS hydrogen ions which changes the pH

Stool WBC differential count:

A. PMN and Monocytes*

B. Phagocytic and non-phagocytic

C. Segmenters, Monocytic, Eosinophils

NOTE:

1. 3 neutrophils/HPF can be indicative of invasive condition

2. Lactoferrin Latex Aggln Test: available for detecting fecal leukocytes & remains SENSITIVE in refrigerated and frozen specimens.

Best indicator for urinary bladder infection:

NEUTROPHILS*

Indicator for Acute Tubular Necrosis?

A. Brown Cast*

B. >1000 WBC

C. Renal cell- RTE cells*

D. Hemoglobinuria

NOTE: ACUTE TUBULAR NECROSIS

1. Shower of casts

2. Granular, dirty, brown casts representing hemoglobin degradation products such as methemoglobin may also be present.

3. These dirty, brown casts must be present in conjunction with other pathologic findings such as RTE cells and a positive reagent strip test for blood.

ACUTE TUBULAR NECROSIS:

1. Mild proteinuria, microscopic hematuria

2. RTE CELLS and RTE CELL CASTS

3. Hyaline, granular, waxy, and broad casts

ACUTE INTERSTITIAL NEPHRITIS:

1. Hematuria, possibly macroscopic

2. Mild to moderate proteinuria

3. Numerous WBCs, and WBC casts WITHOUT bacteria.

4. INCREASED URINARY EOSINOPHILS

NEPHROTIC SYNDROME:

1. Massive proteinuria ( >3.5 g/d)

2. Low levels of serum albumin, high levels of serum lipids, and edema

3. Marked proteinuria

4. Urinary fat droplets; oval fat bodies; renal tubular epithelial (RTE) cells; epithelial, fatty, and waxy casts; and microscopic hematuria

5. Oval fat bodies

Blood in peritoneal fluid:

A. Malignancy

B. TB peritonitis

MALIGNANCY

NOTE:

1. Blood-streaked: Trauma, infection, malignancy

2. Green: Gallbladder, pancreatic disorders

LEAST SIGNIFICANT TO MOST SIGNIFICANT CAST:

Hyaline, RBC, Granular, WBC, Waxy

Note: (FORMATION)

1. Hyaline

2. Cellular

3. Granular (coarse, fine)

4. Waxy

The order of cast degradation is:

a. cellular granular waxy

b. cellular hyaline waxy

c. hyaline cellular waxy

d. hyaline granular waxy

CELLULAR, GRANULAR, WAXY

In what part of the nephron does cast formation NOT

take place?

a. collecting tubules

b. distal convoluted tubule

c. distal portion in loop of Henle

d. proximal convoluted tubule

PCT

NOTE:

1. Formed at the DCT and collecting ducts

Granular cast derived from:

Cells (Apollon)

Associated with melanuria:

Albinism*

Seminal fluid fructose:

Tested within 2 hours of collection or FROZEN to prevent fructolysis

PPE:

1. Gloves

2. Fluid-resistant gowns

3. Eye and face shields

4. Plexiglas countertop shields

(2015)

Degree of Hazard: 3

a. Slight Hazard

b. Moderate Hazard

c. Extreme Hazard

d. Serious Hazard

SERIOUS

3. For chemical spills, flush the area with large amounts of water for at least ________ minutes then seek medical attention.

a. 15*

b. 20

c. 25

d. 30

15

The clarity of a urine sample should be determined:

a. Using glass tubes only, never plastic

b. Following thorough mixing of the specimen

c. After addition of salicylic acid

d. After the specimen cools to room temperature

FOLLOWING THOROUGH MIXING OF SPECIMEN

Which method for the determination of urine specific gravity is based on refractive index?

a. Total solids meter

b. Hydrometer

c. Reagent strip

d. Harmonic oscillation densitometry

TOTAL SOLIDS METER

Urine clarity grading: "Few particulates, print easily seen through urine"

a. Clear

b. Hazy

c. Cloudy

d. Turbid

HAZY

Reading time: 30 seconds

a. Bilirubin

b. Ketones

c. Specific gravity

d. pH

BILIRUBIN

SSA turbidity: "Turbidity with granulation, no flocculation"

a. 1+

b. 2+

c. 3+

d. 4+

2+

Convert 0.4 mg/dL urobilinogen to Ehrlich units.

a. 0.4

b. 4

c. 40

d. 400

0.4

Reagent strip result for hemoglobinuria:

a. speckled green

c. uniform brown

b. uniform blue

d. uniform green*

UNIFORM GREEN

Soluble in ether, except:

a. Red blood cells

b. Lipids

c. Chyle

d. Lymphatic fluid

RBC

Ascending sequence of casts:

a. Waxy - hyaline - coarsely granular - finely granular - cellular

b. Coarsely granular - finely granular - hyaline - waxy - cellular

c. Hyaline - cellular - coarsely granular - finely granular - waxy

d. Cellular - hyaline - finely granular - coarsely granular - waxy

Hyaline - cellular - coarsely granular - finely granular - waxy

Major inorganic substance in urine:

a. Chloride

c. Sodium

b. Calcium

d. Phosphate

CHLORIDE

Normal urinary crystal which is colorless, resembling flat plates or thin prisms often in rosette form:

a. Amorphous phosphates

b. Struvite

c. Apatite

d. Calcium carbonate

APATITE

If alcohol is added to urine with tyrosine crystals, this other abnormal crystal may be precipitated:

a. Bilirubin

b. Sulfonamide

c. Leucine

d. Cystine

LEUCINE

Transitional epithelial cells seen in urine may be reported using rare/few/moderate/many by using the:

a. Scanner field

b. Low power field

c. High power field

d. Oil immersion field

HPF

In a urine specimen, nine bacteria were seen per HPF. How do you report the finding?

a. Rare

b. Few

c. Moderate

d. Many

RARE

A renal calculi described as very hard, dark in color with rough surface:

a. Calcium oxalate

b. Uric acid

c. Cystine

d. Phosphate

CaOx

Renal disease whose etiology is the deposition of anti-glomerular basement membrane antibody to glomerular and alveolar basement membranes:

a. Berger's disease

c. Wegener's granulomatosis

b. Goodpasture syndrome

d. Membranous glomerulonephritis

Goodpasture syndrome

The sperm acrosomal cap should encompass approx. ____ of the head and covers _____ of the nucleus.

a. One half, two-thirds

b. One third, one half

c. Two-thirds, one fourth

d. One fourth, one third

One half, two-thirds`

Reagent/s used for the assessment of sperm viability:

a. Papanicolau

b. Wright's

c. Giemsa

d. Eosin-Nigrosin

EOSIN-NIGROSIN

Oligoclonal banding in cerebrospinal fluid but not in serum, except:

a. Multiple myeloma

b. Encephalitis

c. Neurosyphilis

d. Guillain-Barre disease

MULTIPLE MYELOMA

Normal synovial fluid glucose should not be more than ________ mg/dL lower than the blood value.

a. 5

b. 10

c. 15

d. 20

10

The normal color of gastric fluid is

a. Colorless

b. Green

c. White

d. Gray

GRAY

What reagent is used for the APT Test?

a. Hydrochloric acid

c. Sodium hydroxide

b. Sulfuric acid

d. Potassium hydroxide

10% NaOH

Lacks phenylalanine hydroxylase:

a. PKU

c. Tyrosinemia

b. MSUD

d. Alkaptonuria

PKU

Characterized by increase retention of water and solutes in large intestine?

A. Osmotic Diarrhea

B. Bloody Diarrhea

C. Secretory Diarrhea

OSMOTIC DIARRHEA

NOTE:

1. Secretory Diarrhea: caused by INCREASED SECRETION OF WATER & ELECTROLYTES

2. Osmotic Diarrhea: Incomplete breakdown or reabsorption of food resulting in WATER & ELECTROLYTE RETENTION in the large intestine

The normal brown color of the feces is produced by:

A. urobilinogen

B. stercobilin

C. Urobilin

UROBILIN