1. Intro to Urinalysis Flashcards by Samantha Boyer

“Uroscopy” book

Hippocrates 5th century BC

How well did you know this?

Not at all

Perfectly

first urine color charts

1140 CE

How well did you know this?

Not at all

Perfectly

discovery of albuminuria

1694

How well did you know this?

Not at all

Perfectly

urinalysis introduced as part of routine patient exam

1827

How well did you know this?

Not at all

Perfectly

body converts —— mL of filtered plasma to ——- mL of urine each day

170,000
1,200

How well did you know this?

Not at all

Perfectly

primary components in normal urine (9)

urea
creatinine
uric acid
chloride
sodium
potassium
phosphate
ammonium
calcium

How well did you know this?

Not at all

Perfectly

define urea

primary organic component

product of amino acid metabolism

1/2 the total dissolved solids

How well did you know this?

Not at all

Perfectly

define creatinine

product of creatine metabolism in muscles

How well did you know this?

Not at all

Perfectly

ID a fluid as urine

urea + creatinine

How well did you know this?

Not at all

Perfectly

define uric acid

product of nucleic acid breakdown

How well did you know this?

Not at all

Perfectly

primary inorganic component

chloride

How well did you know this?

Not at all

Perfectly

formed elements found in urine

cells
casts
crystals
mucus
bacteria

How well did you know this?

Not at all

Perfectly

factors that influence urine volume (4)

Fluid intake
Fluid loss from nonrenal sources
Variations in the secretion of ADH
Need to excrete increased amounts of dissolved solids, such as glucose or salts

How well did you know this?

Not at all

Perfectly

average urine output range
normal urine output range

1200-1500 mL
800-2000 mL

How well did you know this?

Not at all

Perfectly

oliguria

decrease in urine output
dehydration
< 400 mL/day in adults

How well did you know this?

Not at all

Perfectly

cessation of urine flow

anuria

How well did you know this?

Not at all

Perfectly

increase in daily urine volume

polyuria
> 2500 mL/day in adults

How well did you know this?

Not at all

Perfectly

polyuria can indicate…

DM
DI

How well did you know this?

Not at all

Perfectly

increased body glucose concentration

How well did you know this?

Not at all

Perfectly

why does DM lead to polyuria?

increased amounts of water are needed to remove excess glucose from the body

How well did you know this?

Not at all

Perfectly

what is different about the urine of DM patients and DI patients?

specific gravity
DM: increased
DI: decreased

How well did you know this?

Not at all

Perfectly

decrease in production or function of ADH

How well did you know this?

Not at all

Perfectly

3 general types of urine containers

cups
individual collection devices
24-hour urine jugs

How well did you know this?

Not at all

Perfectly

cup capacity

50 mL

How well did you know this?

Not at all

Perfectly

individual urine tube capacity

10-12 mL

24 hour jug capacity

3000 mL

All specimens should be labelled with... (7)

- Patient's Name - Medical Record Number (MRN) - DOB/age - Patient Location - Date & Time of Collection - Collector’s Initials - Tests to be run

must accompany specimens delivered to the lab - must match info on label

requisition form

types of urine deterioration over time (5)

- microbial - oxidative - photolytic - thermal - autolytic

which metabolic processes to the bacteria continue to undergo over time?

- Decompose **ketone** bodies - Ferment **glucose** - Produce **NH3** (ammonia) from the breakdown of urea - Reduces **nitrates** to nitrites - Alters **pH** (NH3 production changes the pH to alkaline)

example of oxidative deterioration

urine color can change from brown to green due to **bilirubin** being oxidized to **biliverdin**

analyte that is unstable when exposed to light, collected in a brown bottle

porphyrins

examples of autolytic deterioration

RBCs and WBCs lyse casts deteriorate (↑ pH)

# Change to unpreserved urine after 2 hours color

darkened oxidation/reduction of metabolites

# Change to unpreserved urine after 2 hours clarity

decreased bacterial growth precipitation of amorphous material

# Change to unpreserved urine after 2 hours odor

increased bacterial multiplication, breakdown of urea to ammonia

# Change to unpreserved urine after 2 hours pH

increased breakdown of urea to ammonia loss of CO2

# Change to unpreserved urine after 2 hours glucose

decreased glycolysis bacterial use

# Change to unpreserved urine after 2 hours ketones

decreased volatilization bacterial metabolism

# Change to unpreserved urine after 2 hours bilirubin

decreased photooxidation to biliverdin

# Change to unpreserved urine after 2 hours urobilinogen

decreased oxidation to urobilin

# Change to unpreserved urine after 2 hours nitrite

increased bacteria

# Change to unpreserved urine after 2 hours RBC/WBC/casts

decreased deterioration in dilute alkaline urine

# Change to unpreserved urine after 2 hours bacteria

increased

# Change to unpreserved urine after 2 hours trichomonas

decreased death loss of motility

urine refrigeration temperature

2°-8°

the ideal preservative

- bactericidal - inhibit urease - preserve formed elements - not interfere with chemical tests

# refrigeration disadvantage

precipitates amorphous phosphates and urates

# boric acid advantage disadvantage keeps pH at ----, used for urine culture transport

prevents bacterial growth/metabolism interferes with drug and hormone analyses 6.0

# formalin advantage disadvantage

preserves cells and casts interferes with chemical tests (reducing agent)

# sodium fluoride advantage disadvantage

good preservative for drug analyses inhibits reagent test strips for glucose, blood, WBCs

# C&S tube function stability limitations

culture; prevents bacterial growth/metabolism stable at RT for 48 hr do not use if below fill line

# yellow UA plus tube function limitations preservative

used on automated instruments refrigerate within 2 hours no preservative

# tiger tops function stability limitations preservatives

urine-instrument compatible stable for 72 hr at RT not used for culture must be filled to minimum fill line sodium propionate, ethyl paraben, chlorhexidine

most commonly received specimen

random specimen

now-uncommon specimen that took the 2nd void of the day

fasting urine

ideal urine specimen

first morning

best specimen for pregnancy testing, detection of chemicals and formed elements, and for evaluation orthostatic proteinuria

first morning

used for quantitative measurement of analytes

24 hour urine

diurnal variation

Some analytes are excreted in varying concentrations during a 24-hour period catecholamines, 17-hydroxysteroids, and electrolytes lowest concentration is in the early morning and the highest concentration occurs in the afternoon

instructions for start and end times for 24 hour collection

Completely void the bladder of urine into the toilet and record this date and time as the START of the collection. Even if there is not a big urge to urinate at the exact END time, it is best to try and add it to the collection. The final collection should be recorded as the END date and time.

specimen of choice for cytologic exam

suprapubic aspiration

process that provides documentation of proper collection and identification from the time of collection to the receipt of lab results

chain of custody

# drug screen volume collected

30-45 mL

# drug screen temperature taken within...

4 minutes

# drug screen temp should fall between....

32.5° - 37.7°