Biological and Chemical Hazards

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Questions and Answers

What significance is associated with the presence of epithelial casts?

  • Normal cellular metabolism
  • Early signs of dehydration
  • Increased glomerular filtration rate
  • Advanced tubular destruction (correct)

Which type of calcium oxalate crystal is more commonly observed in urine?

  • Sulfate
  • Phosphate
  • Dihydrate (correct)
  • Monohydrate

What condition is suggested by the presence of bacterial casts in urine?

  • Pyelonephritis (correct)
  • Nephrotic syndrome
  • Chronic renal failure
  • Cystitis

What is the appearance of finely granular casts?

<p>Sandpaper appearance (B)</p> Signup and view all the answers

What effect do foods high in oxalic acid have on calcium oxalate levels?

<p>Increase calcium oxalate formation (D)</p> Signup and view all the answers

Which of the following has a 'cigarette-butt' appearance?

<p>Calcium sulfate (C)</p> Signup and view all the answers

What are granular casts primarily derived from?

<p>Lysosomes of RTE cells (C)</p> Signup and view all the answers

Which substance is soluble in acetic acid?

<p>Calcium sulfate (C)</p> Signup and view all the answers

What is the distinctive characteristic of hemosiderin crystals?

<p>Coarse, yellow-brown granules (A)</p> Signup and view all the answers

Which test indicates a positive result for tyrosyluria/tyrosinemia?

<p>FeCl3 tube test (C)</p> Signup and view all the answers

What type of urine odor is characteristic of tyrosyluria/tyrosinemia?

<p>Rancid butter (D)</p> Signup and view all the answers

Which substance can produce crystals mistaken for RBCs?

<p>Oil droplets (C)</p> Signup and view all the answers

What is the appearance of acyclovir crystals?

<p>Colorless slender needles (D)</p> Signup and view all the answers

Which type of tyrosinemia is associated with the enzyme fumarylacetoacetate hydrolase (FAH)?

<p>Type 1 (B)</p> Signup and view all the answers

What characteristic shape do pollen grains display when observed under a microscope?

<p>Spheres with a cell wall and concentric circles (B)</p> Signup and view all the answers

What is a false result of fecal contamination in urinary sediment analysis?

<p>Hair and fibers (B)</p> Signup and view all the answers

What does the presence of blood casts indicate?

<p>Glomerulonephritis (C)</p> Signup and view all the answers

How should you report the presence of budding yeast in a specimen?

<p>Quantitate and report with specific codes (B)</p> Signup and view all the answers

What do the orange-red colored casts likely contain?

<p>Hemoglobin from lysed RBCs (D)</p> Signup and view all the answers

What is the significance of WBC (leukocyte) casts?

<p>They suggest inflammation or infection in the nephron (B)</p> Signup and view all the answers

Which of the following is true about renal tubular epithelial cells?

<p>Their average number is reported per 10 HPFs (D)</p> Signup and view all the answers

What does a high level of bacteria per HPF signify?

<p>Possible urinary tract infection (B)</p> Signup and view all the answers

What does the presence of squamous epithelial cells in a urine sample indicate?

<p>Contamination from the external urethra (A)</p> Signup and view all the answers

What kind of significance do crystals in urine have?

<p>May indicate metabolic abnormalities (C)</p> Signup and view all the answers

What is a common laboratory finding in individuals with Lesch-Nyhan disease?

<p>Increased uric acid levels in blood (D)</p> Signup and view all the answers

Which test is indicated to show white turbidity in cases of antiglomerular basement membrane disorders?

<p>Cetyltrimethylammoniumbromide (CTAB) Test (A), Acid albumin test (D)</p> Signup and view all the answers

What is a distinguishing feature of Wegener's Granulomatosis?

<p>Presence of anti-neutrophilic cytoplasmic autoantibody (ANCA) (D)</p> Signup and view all the answers

Which condition is commonly associated with macroscopic hematuria following a viral infection in children?

<p>Henoch Schönlein Purpura (C)</p> Signup and view all the answers

What type of ANCAs are formed when neutrophils are fixed with ethanol?

<p>Perinuclear ANCA (p-ANCA) (B)</p> Signup and view all the answers

What is an expected clinical feature of Sanfilippo Syndrome?

<p>Only mental retardation as the abnormality (C)</p> Signup and view all the answers

Which of the following tests would show a positive blue color indicating the presence of mucopolysaccharides?

<p>Mucopolysaccharide (MPS) Paper Test (A)</p> Signup and view all the answers

What is a key laboratory finding in Henoch Schönlein Purpura?

<p>RBC casts in urine (D)</p> Signup and view all the answers

What does a lamellar body count (LBC) greater than 32,000/uL indicate?

<p>Adequate fetal lung maturity (B)</p> Signup and view all the answers

Which dye characteristic indicates the presence of surfactant when measured?

<p>Longer fluorescence and low polarization (D)</p> Signup and view all the answers

What is the primary composition of sputum?

<p>95% water and 5% solids (A)</p> Signup and view all the answers

Which method can be used to determine the lamellar body count (LBC)?

<p>Optical scatter method (C)</p> Signup and view all the answers

What is the significance of an O.D. (Absorbance) greater than 0.150?

<p>Correlates with a L/S ratio of greater than 2.0 (B)</p> Signup and view all the answers

What is NOT a characteristic of sputum?

<p>It is a sterile body fluid (A)</p> Signup and view all the answers

Which component is the most important for sputum viscosity?

<p>Sialic acid (A)</p> Signup and view all the answers

What is the acceptable white blood cell count in a sputum specimen?

<p>25 WBC/LPF (A)</p> Signup and view all the answers

What condition could lead to false-positive results in a pregnancy test?

<p>Molar pregnancy (A)</p> Signup and view all the answers

Which hormone is primarily produced by the syncytiotrophoblast cells of the placenta?

<p>Human chorionic gonadotropin (hCG) (D)</p> Signup and view all the answers

At what stage of pregnancy does hCG typically peak?

<p>First trimester (B)</p> Signup and view all the answers

What method is commonly used for the collection of specimens for genetic defect assessment during the 2nd trimester?

<p>Amniocentesis (C)</p> Signup and view all the answers

Which of the following is NOT a typical cause of false-negative pregnancy tests?

<p>Ectopic pregnancy (A)</p> Signup and view all the answers

What is the cut-off point for a positive result in home-based hCG pregnancy tests?

<p>25 mIU/mL (A)</p> Signup and view all the answers

Which of the following tests is performed to assess fetal lung maturity?

<p>Amniocentesis (C)</p> Signup and view all the answers

What should be done with specimens for cytogenetic studies immediately after collection?

<p>Keep at room temperature or 37°C (A)</p> Signup and view all the answers

Which condition can lead to urinary tract deformities in a fetus?

<p>Spina bifida (D)</p> Signup and view all the answers

Which of the following is not a component of the quadruple screening test?

<p>Fetal hemoglobin (C)</p> Signup and view all the answers

Flashcards

Epithelial Cells (urine)

Cells present in urine from lining of tubules or other parts of the urinary system. Their presence and quantity varied. It is quantitated by per LPF (low power field).

WBC Cast

Cylindrical structures in urine composed of white blood cells, indicating inflammation or infection in kidney's nephron region.

RBC Cast

Cylindrical structure in urine containing red blood cells., indicating bleeding within the nephron region.; Quantitated by quantity per HPF (high power field).

Significance of casts (urine)

Urine casts provide insight into potential kidney diseases or conditions.

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Blood Casts (urine)

Cylindrical structures in urine, containing hemoglobin from lysed red blood cells, having characteristic orange-red color.

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Bacteria in urine

Presence of bacteria in urine sample implies infection; quantitated by per HPF

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Renal Tubular Epithelial Cells

Cells from the kidney's tubules; Normal presence can vary and is usually assessed by number per 10 HPF, high power fields.

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Pseudoleukocyte Cast

Clump of leukocytes that resembles, but is not a true cast. Do not report as a cast.

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Epithelial Casts

Urinary casts composed of cells (small, round, oval).

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Calcium Oxalate Casts

Urinary crystals, frequently observed, formed from calcium oxalate.

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Bacterial Casts

Urinary casts visible using Gram stain; indicative of infection.

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Granular Casts

Urinary casts made of granules (from broken down cells).

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Calcium Oxalate Monohydrate

A specific type of calcium oxalate crystal (oval or dumbbell shape).

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Calcium Oxalate Dihydrate

A specific type of calcium oxalate crystal (envelope, bipyramidal, octahedron shape).

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Glomerulonephritis

Kidney disease associated with granular casts.

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Tubular Destruction

Damage to structures inside the kidney.

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Hemosiderin crystals

Coarse, yellow-brown granules resembling amorphous urates and detectable by Prussian blue stain.

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Acyclovir crystals

Colorless slender needles in alkaline urine, strongly birefringent under polarized light.

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Indinavir Sulfate crystals

Slender colorless needles or rectangular plates, often feather-like, forming bundles or sheaves.

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Starch granules in urine

Spherical shapes with dimpled centers, sometimes forming a Maltese cross pattern under polarized light.

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Oval fat bodies

Oval structures often seen in urine caused by damaged cells.

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Fatty casts

Tube-like structures in the urine filled with lipids.

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Oil droplets

Lipid droplets that can be mistaken for red blood cells.

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Tyrosyl/Tyrosinemia

Inherited metabolic disease causing tyrosine build-up in the body.

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Sanfilippo Syndrome

A genetic disorder causing mental retardation, characterized by the deposition of abnormal substances in the body.

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Lesch-Nyhan Disease

A genetic disorder causing excess uric acid in the body, leading to kidney and other problems.

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Acid Albumin Test

A test used to detect abnormalities in some genetic disorders by looking for white turbidity.

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CTAB Test

A screening test used to detect some genetic disorders that results in white turbidity.

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Mucopolysaccharide Paper Test

A test used to detect some genetic disorders, producing a blue color.

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Wegener's Granulomatosis

An autoimmune disease causing inflammation in blood vessels, resulting in hematuria and proteinuria.

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Henoch-Schönlein Purpura

A disease affecting children, often following viral infections, and characterized by blood in the urine and protein in the urine.

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ANCA

Antibodies that target neutrophils (immune cells) and cause damage to the blood vessels. There are two types.

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Sputum

Mucus coughed up from the respiratory tract, containing cells, bacteria, and other debris.

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Bronchoalveolar Lavage (BAL)

A procedure where fluid is flushed into the lungs and then collected, providing a sample of airway cells and fluid.

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Surfactant to Albumin Ratio (S/A)

A test that measures the amount of surfactant (a lung-lining substance) compared to albumin (a protein in blood).

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Lamellar Body Count (LBC)

A test that counts the number of lamellar bodies, which store surfactant in lung cells.

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What does a high LBC indicate?

A high LBC indicates adequate surfactant production, which is essential for healthy lung function.

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OD 650 nm

A measurement of absorbance at a specific wavelength (650 nm) that is associated with the presence of surfactant.

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What does a high OD 650 nm indicate?

A high OD 650 nm suggests adequate surfactant production and presence of phospholipids, crucial for lung health.

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Acceptable Sputum Specimen

A sputum sample suitable for analysis, typically containing a low number of white blood cells (WBCs) per low power field (LPF).

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hCG function

Produced by the placenta, peaking in the first trimester, and found in blood, urine, and amniotic fluid.

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hCG structure

Composed of alpha and beta subunits; alpha is shared with other hormones (LH, FSH, TSH), while beta confers hCG specificity.

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hCG pregnancy test

An enzyme-immunoassay using 1st morning urine, with a 25 mIU/mL cut-off.

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False-positive hCG

A positive test result when a woman isn't pregnant.

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False-negative hCG

A negative test result when a woman is pregnant.

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Amniocentesis

Procedure to collect amniotic fluid for testing fetal abnormalities.

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Amniotic fluid testing

Used to asses genetic defects, fetal lung maturity, and fetal hemolytic disease.

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Quadruple screening

Tests using alpha-fetoprotein, hCG, unconjugated estriol, and inhibin A for prenatal risk assessment.

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Fetal lung maturity (FLM)

Assessment of fetal lung development via amniotic fluid analysis, done usually in 3rd trimester.

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Specimen handling (amniotic fluid)

Proper handling of amniotic fluid is critical, with different handling requirements for different tests.

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Study Notes

Biological Hazards

  • Potentially harmful organisms can be transmitted through a cycle of infection
  • This cycle requires a source, mode of transmission, and susceptible host
  • Preventing infection requires breaking this chain, focusing on personal protective equipment (PPE) and proper hand hygiene
  • Components of the infection cycle: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host

Sharp Hazards

  • Sharp objects (needles, lancets, broken glass) should be disposed of in puncture-resistant containers
  • Workers should carry puncture-resistant containers
  • Accidental needle-stick incidents must be reported to supervisor

Chemical Hazards

  • Chemical spills should be flushed with large amounts of water for 15 minutes followed by seeking medical attention
  • Never neutralize chemicals on skin
  • Acid spills should be neutralized then soaked up with wet rags or spill pillows
  • Always add acid to water, not water to acid, to prevent splashing

Radioactive Hazards

  • Procedures involving radioisotopes require precautions against radiation exposure
  • Radioactive waste should be stored in a secure, marked room until its radioactivity decays to a safe level

Fire/Explosive Hazards

  • Flammable substances should be stored in safety cabinets or explosion-proof refrigerators
  • Laboratory personnel should participate in annual fire drills
  • Actions to take if a fire is discovered: rescue, alarm, contain, extinguish/evacuate

Electrical Hazards

  • Do not operate electrical equipment with wet hands
  • All electrical equipment should be grounded
  • If an electrical shock occurs, turn off the power, unplug the equipment and move the equipment using a nonconductive object

Miscellaneous Hazards

  • Ergonomic hazards are related to repetitive movements or positions
  • Cryogenic hazards are related to extremely low temperatures
  • Mechanical hazards related to equipment (centrifuges, refrigerators) and broken glassware
  • Aerosols can be formed from centrifuge accidents

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