Clinical Microscopy Flashcards

Flashcards from Clinical Microscopy: Analysis of Urine and Other Body Fluids

What are the 6 components of the Chain of Infection?

Infectious Agent, Reservoir, Portal of Exit, Mode of Transmission, Portal of Entry, Susceptible Host

What are the 3 routes of infection transmission?

Inhalation, Ingestion, Direct inoculation or skin contact

What is the primary method of infection transmission?

Hand Contact

What is the best way to break the chain of infection?

Handwashing

How long should you thoroughly clean between your fingers and under your fingernails during handwashing?

At least 20 seconds

What position should your hands be in when rinsing during handwashing?

Downward position

What should you use to turn off faucets after handwashing?

Clean paper towel

According to the notes, what song can be used to ensure proper handwashing time?

Happy Birthday (2x)

What acronym is used to remember when a fire is discovered?

RACE: Rescue, Alarm, Contain, Extinguish/Evacuate

What acronym is used to remember how to use a fire extinguisher?

PASS: Pull pin, Aim at the base of the fire, Squeeze handles, Sweep nozzle side to side

What dilution of sodium hypochlorite (bleach) should be performed daily for disinfection?

1:5 or 1:10 dilution

How long does sodium hypochlorite in plastic bottles protected from light remain effective?

1 month

What dilution of sodium hypochlorite should be used for routine disinfecting of countertops and accidental spills?

1:10 dilution

If paper towels are used to absorb a liquid spill, what should you pour over the towels?

Bleach

If skin or eye contact with chemicals occurs, what is the best first aid?

Flush the area with large amounts of water for at least 15 minutes

When combining acid and water, what is the correct order?

MUST BE Acid to Water!

What is the best method of radioactive waste disposal?

Store the used radioactive material in a locked, marked room until the background count is down to 10 half-lives for radioiodine.

What must all wet electrical equipment do before reusing?

Should be unplugged and allowed to dry completely before reusing.

What must all electrical equipment have?

MUST BE grounded with three-pronged plugs.

What should people with burning clothes be wrapped in to smother the flame?

Blanket

How often must all laboratory personnel be involved in laboratory fire drills?

At least annually

What do ergonomic hazards include?

Strain due to repeated work positions

What do mechanical hazards include?

Centrifuges, refrigerators, autoclaves, homogenizers and glassware.

What are the minimum labeling requirements for specimen collection?

Patient’s name, date, and time of collection

Within what time frame should routine Urinalysis be tested?

Within 2 hours

What are the Microscopy guidelines for Volume of Urine Examined?

10, 12, or 15mL

What are the Microscopy guidelines for Speed of Centrifugation?

400 g

What are the Microscopy guidelines for Length of Centrifugation?

5 minutes

What are the Microscopy guidelines for Sediment Preparation?

0.5 or 1mL left after decantation

What are the Microscopy guidelines for Volume of Sediment Examined?

20mL or 0.02mL

What are the Microscopy guidelines for Sediment Examination?

At least 10 LPFs and 10 HPFs

How many functional units called Nephrons does each kidney contain?

Approximately 1 to 1.5 million

What percentage of nephrons do cortical nephrons make up?

Approximately 85%

What is the primary function of juxtamedullary nephrons?

Concentration of the urine

Each kidney weighs approximately how much?

150 g

The human kidneys receive approximately what percentage of blood pumped through the heart at all times?

Approximately 25%

What is the Total Renal Blood Flow?

Approximately 1200 mL / min

What is the Total Renal Plasma Flow?

Ranges from 600 to 700 ml / min

What functions as a sieve of filter?

Glomerulus

What molecular weight does the Glomerulus nonselectively filter?

<70, 000

When does albumin become positive?

When Albumin expose in pH4.9

What percentage of filtrate is reabsorbed in the proximal tubule?

More than 80%

What is the renal threshold for Glucose?

160 - 18- mg/ dL

What is highly permeable to water but no resorption of substances?

Descending Loof of HENLE

What is highly impermeable to water but there’s resorption of substances?

Ascending Loop

What does Anti-Diuretic Hormone (ADH)/Vasopressin regulate?

Regulates water reabsorption in the DCT and Collecting Ducts

What does Aldosterone regulate?

Regulates sodium reabsorption

What is an enzyme produced by the juxtaglomerular cells?

Renin

What are the 2 major functions of Tubular Secretion?

1. Regulating the acid–base balance in the body through the secretion of hydrogen ions. 2. Eliminating waste products not filtered by the glomerulus.

In acidotic blood conditions, what ions are secreted in exchange for?

H+ ions are secreted in exchange for sodium and bicarbonate ions.

What are clearance tests used for?

The standard tests used to measure the filtering capacity of the glomeruli.

What must the substance being analyzed to ensure that glomerular filtration is being measured accurately?

Must be one that is neither reabsorbed nor secreted by the tubules

What is the most commonly used clearance test for routine assessment of GFR

Creatinine Clearance

What is the specimen of choice for measuring Creatinine Clearance?

24-hour urine collection

What variables are used in the Estimated GFR Formula developed by Cockgroft & Gault?

Variables: Age, Sex and Body Weight in Kilograms

What variables are used in the Modification of Diet in Renal Disease (MDRD) System Formula?

Variables: Ethnicity, BUN, Serum Albumin

What are Concentration tests used to determine?

The ability of the tubules to reabsorb the essential salts and water that have been non- selectively filtered by the glomerulus.

Why study urine

Urine is actually a “fluid biopsy” of the kidneys and can provide a fountain of information about the health of an individual

Urine is actually a __ of the kidneys and can provide a fountain of information about the health of an individual

Fluid biopsy

Who wrote a book on "uroscopy" in the 5th century BCE?

Hippocrates

Who wrote a book about charlatans (pisse prophets) which inspired the passing of the first medical licensure law in England?

Thomas Bryant

Who discovered albuminuria by boiling urine?

Frederik Dekkers

Who introduced the concept of urinalysis as part of a doctor's routine patient examination?

Richard Bright

Who discovered PKU?

Ivan Foling

Who discovered Alkaptonuria?

Archibald Garrod

Who discovered Cystine calculi?

William Wollaston

Who discovered Benedict’s reagent?

Stanley Benedict

Urine is actually a __ of the kidneys and can provide a fountain of information about the health of an individual

Fluid biopsy

What are the 4 temperaments/humors?

Sanguineous (Blood), Choleric (Yellow bile), Phlegmatic (Phlegm), Melancholic (Black bile)

What is the average daily urine output?

1200 - 1500 mL

What is the clinical significance of Polyuria?

DI and DM

What is the clinical significance of Nocturia?

Defective Hormonal Regulation of Volume Homeostasis

Oliguria- definition and Clinical Significance

Decrease in urine output (<400 mL/day) Clinical Significance: Shock, acute nephritis, dehydration, renal insufficiency, poorly compensated heart disease, calculi formation, kidney tumors

Anuria- definition and Clinical Significance

Complete suppression/cessation of urine flow (sometimes <100 mL/24 h during 2–3 consecutive days, in spite of a high fluid intake) Clinical Significance: Severe acute nephritis, Hg poisoning, obstructive uropathy, kidney failure

What should a specimen be delivered to the laboratory promptly and tested within?

2 hours

What should a urine specimen be put in if it cannot be delivered and tested within 2 hours?

Refrigerated or added to an appropriate chemical preservative

What advantages does Refrigeration have as a Urine Preservation method?

Acceptable for routine urinalysis for 24 hours
Acceptable for urine culture (Inhibits bacterial growth for 24 hours)
Inexpensive
Does not interfere with chemical tests

What advantages does Thymol have as a Urine Preservation method?

Preserves sediment elements (i.e casts, cells)
Inhibits bacterial and yeast growth
Glucose and Sediment preservation

What advantages does Toluene have as a Urine Preservation method?

Preserves ketones, proteins, and reducing substances

What advantages does Phenol have as a Urine Preservation method?

Does not interfere with routine tests

What advantages does Formalin have as a Urine Preservation method?

Excellent sediment preservative

What advantages does Sodium Fluoride have as a Urine Preservation method?

Good preservative for drug analyses

What advantages do Acids (boric acid, HCL, acetic acid, tartaric acid) have as a Urine Preservation method?

Prevents bacterial growth and metabolism
Keeps pH at about 6.0 and can be used for transport of urine cultures

What advantages does Saccomanno’s fixative have as a Urine Preservation method?

Excellent cellular preservative
Commercially available and inexpensive
Good for cytology

What advantages does Sodium carbonate have as a Urine Preservation method?

Inexpensive
Stabilizes porphyrins, porphobilinogen, etc. (Quantitative analysis)

What advantages does Chloroform have as a Urine Preservation method?

Inhibits bacterial growth

What advantages does Chlorhexidine have as a Urine Preservation method?

Prevents bacterial growth and is useful as a glucose preservative.

What 4 types of specimens is Cytology studies often collected with?

Random, First Morning, Midstrem Clean-Catch, Catheterized

What specimens are collected for Bacterial and fungal cultures?

Midstrem Clean-Catch, Catheterized, Suprapubic aspiration

What specimens are collected for 3-glass Collection?

Prostatic infection

What specimens are collected for 4-glass Collection?

Prostatic infection

What specimens are collected for Quantitative chemical analysis?

Timed collection (24-hour)

What specimens are collected for Urine albumin, creatinine, and the albumin-to-creatinine ratio determination?

Timed collection (24-hour)

What specimens are collected for Ideal screening specimen for microalbuminuria?

Timed collection (24-hour)

What specimens are collected for Determination of urinary urobilinogen?

Fasting/ Second morning/ 2-hour postprandial

What specimen is collected for Diabetic screening/monitoring?

Fasting/ Second morning/ 2-hour postprandial

What is normal urine?

May vary from a pale yellow, yellow, dark yellow, and amber, depending on the concentration of the pigments urochrome (Yellow pigment) and, to a lesser extent, urobilin (Orange-brown pigment) and uroerythrin (Pink pigment).

What may recent fluid consumption or diabetes insipidus cause urine to appear?

Colorless to Pale yellow

What may concentrated urine, dehydration, or B complex vitamins cause urine to appear?

Dark Yellow to Amber

What may Phenazopyridine (Pyridium) or Sulfasalazine (Azulfidine) cause urine to appear?

Orange to Yellow