Urine and Body Fluid Examination

Flashcards covering key concepts from the examination of urine, cerebrospinal fluid, fecal analysis, and synovial fluid.

What pigment makes urine yellow?

Urochrome

What is urochrome?

Pigment responsible for the yellow color of urine.

What causes dark yellow urine color?

Dehydration/Concentrated urine.

Red urine caused by intact RBCs

Hematuria

Red/Brown urine due to RBC destruction

Hemoglobinuria

What causes brown/black urine after standing?

Melanin due to melanoma.

What causes cloudy urine after standing?

Amorphous phosphate/amorphous urates.

What bacteria causes foul smelling urine?

Bacteria, particularly Escherichia coli.

What does milky (white) urine indicate?

Presence of lipids (chyluria).

What happens to urine color after standing due to oxidation of urobilinogen?

It darkens (becomes more yellow/brown).

What parasite is commonly seen in urine?

Trichomonas vaginalis.

What appearance of bacteria under the microscope indicates?

Small, refractile rods or cocci.

What is the screening test for UTI?

Positive nitrite and leukocyte esterase.

Which organism reduces nitrate to nitrite in urine?

Enterobacteriaceae.

What disease is associated with positive nitrite and leukocyte esterase?

Urinary Tract Infection.

What is the normal urine pH range?

4.5-8.0.

What causes a color change of the bilirubin pad?

Diazo reaction.

What do positive ketones indicate?

Diabetic ketoacidosis.

What does positive leukocyte esterase indicate?

Bacterial Infection/presence of WBCs.

What does a positive nitrite test indicate?

Presence of nitrate-reducing bacteria, usually Gram-negative bacteria (e.g., Escherichia coli).

What is the substance detected in a protein test?

ALBUMIN.

What is the most common cast found in urine?

Hyaline cast.

What cast is associated with chronic renal failure?

Waxy cast.

What cast is associated with acute tubular necrosis?

Granular cast.

What cast is associated with glomerulonephritis?

RBC cast.

What cast is associated with pyelonephritis?

WBC cast.

What is the most common bacterium seen in urine?

Escherichia coli.

What is the most common epithelial cell found in urine?

Squamous Epithelial Cell.

What yeast resembles RBCs in urine?

Candida Albicans.

What crystal is found in antifreeze poisoning?

Calcium oxalate monohydrate.

What is the microscopic finding in glomerular bleeding?

RBC cast + dysmorphic RBCs.

What cast is present in kidney disease?

RBC and WBC casts

What is the normal adult CSF opening pressure?

90-180 mm H2O.

Is 250 mm H2O normal for CSF pressure?

No, it is elevated.

What is the normal adult CSF volume?

90-150 mL.

Where is the needle inserted during a lumbar puncture?

Between L3, L4, L5

Why shouldn't the needle be inserted at L3 in adults?

Risk of injury to the spinal cord.

What position should the patient be in during a lumbar puncture?

Left lateral decubitus position.

What tube is used for Gram stain and culture in CSF?

Tube 2

What tube is used for cell count in CSF?

Tube 3

What tube is used for glucose in CSF?

Tube 3

What tube is used for other tests in CSF?

Tube 4

What should you do before using Neubauer for cell count?

Dilution.

What is the order of CSF tube collection?

1-Chemistry/Serology 2-Microbiology 3-Hematology.

How does CSF appear in viral meningitis?

Clear.

How does CSF appear in bacterial meningitis?

Turbid.

What are the predominant cells in viral meningitis?

Lymphocytes.

What is the predominant cell in bacterial meningitis?

Neutrophils.

What does xanthochromia indicate?

Hemoglobin degradation products.

What is the CSF glucose level in bacterial meningitis?

Decreased.

What does CSF lactate >35 mg/dL indicate?

Bacterial meningitis.

What is a weblike pellicle in CSF called?

Cobweb clot (seen in tuberculous meningitis).

What defines diarrhea?

Increased stool water content, volume, or frequency.

What is steatorrhea?

Excess fat in stool/increased fecal fat >6g.

What does steatorrhea look like?

Pale, bulky, greasy, foul-smelling, fatty due to fat malabsorption.

What is sudden onset watery diarrhea called?

Secretory diarrhea.

What is the gold standard method for fecal fat analysis?

Van de Kamer titration.

What is a characteristic of foul odor in stool?

Associated with steatorrhea.

How does normal synovial fluid appear?

Clear and pale yellow.

What causes increased viscosity of synovial fluid?

Hyaluronic acid.

What should be done if a synovial fluid specimen is super viscous before centrifugation?

Add hyaluronidase.

When is decreased synovial fluid viscosity seen?

In inflammation.

What indicates gout in synovial fluid?

Presence of monosodium urate crystals.

What indicates pseudogout in synovial fluid?

Calcium pyrophosphate dihydrate crystals.

What does clot formation in synovial fluid indicate?

Fibrinogen present.

What happens to urine pH after it stands?

Increases.

What happens to urine nitrite after it stands?

Increases.

What happens to urine glucose after it stands?

Decreases.

What happens to urine urobilinogen after it stands?

Decreases.

What happens to urine bilirubin after it stands?

Decreases.

What happens to urine ketones after it stands?

Decreases.

What happens to urine clarity after it stands?

Decreases.