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chapter 13 - urinalysis Flashcards

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1
Q

What is urinalysis (UA) used for?

A

To detect multiple diseases assess the effectiveness and side effects of medications

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2
Q

What historical method was used to test urine for abnormalities?

A

Pouring urine on the floor to check if it attracted insects indicating ‘honey urine’ associated with skin eruptions.

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3
Q

What are some conditions that urinalysis can help detect?

A

Extrinsic conditions like diabetes mellitus, intrinsic conditions like kidney stones or urinary tract infections, and medication effectiveness.

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4
Q

What does the presence of glucose in urine indicate?

A

It indicates hyperglycemia commonly associated with diabetes mellitus.

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5
Q

What is Clinitest used for in urinalysis?

A

To screen for glucose and detect other sugars such as galactose, pentose, and maltose.

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6
Q

What hormone do pregnancy tests detect in urine?

A

Human chorionic gonadotropin (hCG) produced by the placenta.

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7
Q

What does a positive result in ovulation testing indicate?

A

It indicates the presence of follicle stimulating hormone (FSH) in urine suggesting menopause.

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8
Q

What is urine toxicology?

A

The testing of urine to monitor therapeutic drugs and detect poisoning from various substances.

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9
Q

What types of drugs are commonly monitored in urine toxicology?

A

Antibiotics, anticonvulsants, antidepressants, barbiturates, and illegal drugs.

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10
Q

What is the typical specimen collection method for routine drug screening?

A

A random urine specimen is usually collected.

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11
Q

What is the purpose of rapid drug screening devices?

A

To quickly test urine samples for the presence of targeted drugs.

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12
Q

What do negative results from a rapid drug screening device indicate?

A

That none of the targeted drugs were detected in the urine sample at specified cutoff levels.

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13
Q

What do inconclusive results from a rapid drug screening device indicate?

A

That the device reacted with something in the urine requiring confirmation testing.

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14
Q

Why is urine the specimen of choice for many routine procedures?

A

Because it is easily collected and provides valuable diagnostic information.

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15
Q

What ancient belief was associated with urine abnormalities?

A

An abnormality in urine was considered a possible indicator of a disturbance in homeostasis.

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16
Q

How has the role of urinalysis changed over time?

A

It has evolved from ancient methods to a practical laboratory procedure widely used in clinical settings.

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17
Q

What is the significance of urine analysis in modern medicine?

A

It is the most frequently analyzed body fluid providing insights into various health conditions.

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18
Q

What is the common type of pregnancy test used today?

A

The lateral flow immunoassay test.

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19
Q

What does the absence of medication in urine indicate?

A

That the medication is completely absorbed by the body.

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20
Q

What are some toxic substances that urine testing can detect?

A

Herbicides, metals, animal toxins, and poisonous gases like carbon monoxide.

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21
Q

What is the importance of understanding urinalysis for a medical assistant?

A

To assist effectively in the processes of physical and chemical analysis of urine.

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22
Q

What is one of the primary uses of urinalysis in relation to medications?

A

To determine the effectiveness and possible side effects of prescribed drugs.

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23
Q

What does routine urine screening often reveal?

A

Usage of illegal drugs or alcohol often required for employment or legal purposes.

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24
Q

What is ‘honey urine’ and why was it significant in the past?

A

Urine that attracted insects was considered ‘honey urine’ indicating the presence of sugar.

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25
What is urinalysis (UA) and when did it become a practical laboratory procedure?
Urinalysis became a practical laboratory procedure in the 20th century.
26
What are extrinsic conditions detected by urinalysis?
Extrinsic conditions are those where kidneys function normally but abnormal end products of metabolism are excreted due to homeostasis imbalance.
27
What are intrinsic conditions that can be identified through urinalysis?
Intrinsic conditions involve the kidneys or urinary tract such as kidney stones or urinary tract infections.
28
How can urinalysis be used to assess medication effectiveness?
By measuring the amount of medication present in the patient's urine after drug metabolism.
29
List some routine procedures that use urine analysis
Clinitest, pregnancy testing, ovulation testing, and testing for toxic substances, illegal drugs, and therapeutic drugs.
30
What components are involved in the physical examination of urine?
Color, turbidity, volume, foam, odor, and specific gravity.
31
What does the color of urine indicate?
Urine color ranges from pale straw to amber depending on the concentration of urochrome and water content.
32
What does turbidity in urine indicate?
Cloudiness in urine can be due to cells, bacteria, yeast, vaginal contaminants, or crystals.
33
What is the normal volume of urine produced by adults in 24 hours?
750 to 2,000 mL, with an average of about 1,500 mL.
34
What is polyuria and what conditions is it associated with?
Polyuria is excessive urine production, commonly seen in diabetes mellitus, diabetes insipidus, and some kidney disorders.
35
Define oliguria and its causes.
decreased fluid Oliguria is insufficient urine production due to dehydration, decreased fluid intake, shock, renal disease, or urinary tract infections.
36
What does anuria indicate?
Anuria is the absence of urine production which can occur in renal obstruction and renal failure.
37
What does the presence of foam in urine indicate?
Foam in urine suggests an abnormality; white foam may indicate increased protein while greenish-yellow foam indicates bilirubinuria.
38
What is the normal odor of urine and what can changes in odor indicate?
Normal urine is odorless; changes can indicate metabolic disorders, infections, or dietary influences.
39
What does a fruity odor in urine suggest?
A fruity odor indicates uncontrolled diabetes.
40
What are some dietary causes of abnormal urine odor?
Asparagus and garlic can produce an abnormal odor in urine.
41
What is the significance of a mousy smell in urine?
A mousy smell is common in children with phenylketonuria (PKU).
42
What is an aliquot in the context of urine analysis?
An aliquot is a small part of a well-mixed urine specimen removed for testing.
43
What is the purpose of reagent strip testing in urinalysis?
Reagent strip testing is used to detect chemicals in urine using plastic strips with chemical pads.
44
What does pH measurement in urine indicate?
The pH measures the degree of acidity or alkalinity of the urine.
45
What does pH measure in urine?
The degree of acidity or alkalinity with a neutral pH of 7.
46
What indicates a positive glucose finding in urine?
Glycosuria which occurs when there is a high amount of filtered glucose affecting reabsorption into the blood.
47
What does the presence of ketones in urine indicate?
Ketonuria indicates starvation, low-carbohydrate diets, excessive vomiting, and diabetes mellitus.
48
What is proteinuria and what does it indicate?
The presence of protein in urine indicating the first signs of renal disease.
49
What does hematuria refer to?
The presence of intact red blood cells in urine, which may indicate irritation of the ureter, bladder, or urethra.
50
What conditions can cause hemoglobinuria?
Intravascular red blood cell destruction due to transfusion reactions, malaria, drug reactions, snakebites, and severe burns.
51
What is myoglobinuria and in which patients is it common?
The presence of myoglobin in urine due to muscle tissue damage common in patients with muscular dystrophy.
52
What does bilirubinuria indicate?
The first signs of liver disease or other diseases along with urobilinogen indicating increased red blood cell destruction.
53
What do leukocytes in urine indicate?
Infections of the urinary tract.
54
What are some common errors in reagent strip testing?
Over dilution of chemicals, not holding the strip horizontally, not reading at the correct time, and interference from ascorbic acid.
55
What does urinalysis include?
Both physical and chemical examination of a urine sample.
56
What are the components of the physical examination of urine?
Assessment of color, turbidity, volume, foam, and odor.
57
What factors can affect the color of urine?
Diet, medication, and disease.
58
What is the normal volume of urine produced in adults over 24 hours?
750 to 2,000 mL, with an average of about 1,500 mL.
59
What does a chemical test using reagent strips detect?
The presence of chemicals like glucose, ketones, protein, blood, and bilirubin.
60
What does a urine pH value of 7 indicate?
Normal acidity or alkalinity of urine.
61
What is the purpose of centrifugation in urine preparation?
To separate sediments from the liquid and obtain a well-mixed sediment and supernatant.
62
What is supernatant in urine testing?
The clear upper portion of the specimen after centrifugation.
63
Why is staining of sediment important in urine examination?
It provides greater contrast to the formed elements for better microscopic analysis.
64
What training should a medical assistant receive for centrifugation?
Training on the use of a centrifuge, periodic proficiency testing, and compliance with CLIA quality assurance protocols.
65
What is the KOVA System or UriSystem used for?
Preparation of urine specimens including graduated centrifuge tubes and slides for sediment analysis.
66
What is the significance of correlating physical and chemical analyses in urinalysis?
Most microscopic examinations require correlation with physical and chemical test results.
67
What is the purpose of microscopic examination of urine?
To categorize and count cells, casts, crystals, and miscellaneous constituents in the sediment after centrifugation.
68
What are casts in urine microscopy?
Casts are cylindric structures formed during protein accumulation and precipitation in the kidney tubules which wash into the urine.
69
What are hyaline casts and when do they occur?
Hyaline casts are pale, transparent, cylindrical structures that form when urine flow through nephrons diminishes, often found in patients with renal disorders.
70
What do white blood cell casts indicate?
White blood cell casts, which are hyaline casts containing leukocytes, occur with pyelonephritis.
71
What condition is indicated by red blood cell casts?
Red blood cell casts, which are hyaline casts with embedded red blood cells, occur in patients with glomerulonephritis.
72
What are renal tubular epithelial cell casts and their causes?
Renal tubular epithelial cell casts are embedded with renal tubular epithelial cells and occur due to shock, renal ischemia, heavy-metal poisoning, allergic reactions, and nephrotoxic drugs.
73
What are finely and coarsely granular casts?
These casts contain a hyaline matrix with granular inclusions due to protein aggregation or degeneration of cellular inclusions.
74
What are waxy casts?
Waxy casts are degenerated cellular casts and are considered rare.
75
What do a large number of squamous epithelial cells in urine indicate?
They indicate vaginal contamination.
76
What do transitional and renal tubular epithelial cells in urine suggest?
A large number indicates a pathological condition and tubular damage respectively.
77
What do red blood cells in urine signify?
They occur as a result of inflammation or injury.
78
What do yeast cells in urine indicate?
They indicate vaginal contamination or a yeast infection in the urine.
79
What does a high number of white blood cells in urine suggest?
It indicates a urinary tract infection or vaginal contamination during collection.
80
What is the clinical significance of crystals in urine?
Crystals are common but only have clinical significance when present in large numbers.
81
What are amorphous urates?
Amorphous urates are salts of uric acid that appear as shapeless granulation in acidic urine.
82
What do abnormal crystals in acidic urine indicate?
They may indicate metabolic activity, certain disease states, inherited metabolic conditions, or effects of medication.
83
What do oval fat bodies in urine indicate?
They indicate kidney distress.
84
What does heavy bacteria in a urine specimen suggest?
It may indicate a urinary tract infection.
85
What does the presence of spermatozoa in urine of female patients suggest?
It may indicate vaginal contamination.
86
What do a large number of mucous threads in urine indicate?
They indicate inflammation and vaginal contamination.
87
What do plant fibers in urine suggest?
They indicate fecal contamination.
88
What is the role of centrifugation in urine preparation for microscopic examination?
Centrifugation provides a well-mixed sediment and a supernatant which is the clear upper portion of the specimen.
89
What should medical assistants be trained in before performing urine centrifugation?
They should be trained on the centrifuge, periodic proficiency testing, and compliance with CLIA quality assurance protocols.
90
What is the primary purpose of urinalysis?
To analyze a person's health, determine the effectiveness of medications, and identify urinary system side effects from prescribed drugs.
91
What aspects are assessed in the physical examination of urine?
Color, turbidity, volume, foam, and odor.
92
What is the role of reagent strip testing in urinalysis?
To detect chemicals in the urine, measure pH, and assess specific gravity.
93
What does centrifugation do in the preparation of urine specimens?
It provides a well-mixed sediment and a supernatant for analysis.
94
What is included in the microscopic examination of urine?
casts
95
What are the types of urine examinations mentioned?
Casts, cells, and crystals examination.
96
What additional tests can be performed on urine?
97
How has the use of urine in health analysis evolved over time?
Urine has been used since ancient times with urinalysis becoming a practical laboratory procedure in the 20th century.
98
What are extrinsic conditions in relation to urinalysis?
Conditions where the kidneys function normally but abnormal end products of metabolism are excreted due to homeostasis imbalance.
99
What are intrinsic conditions in relation to urinalysis?
Conditions that involve the kidneys or urinary tract such as kidney stones or urinary tract infections.
100
How can urinalysis indicate the effectiveness of medication?
By measuring the amount of medication present in the patient's urine after drug metabolism.
101
What indicates the presence of diabetes in urine?
The presence of glucose.
102
What does protein in urine indicate?
It is indicative of kidney diseases.
103
What is the normal pH value of urine?
7 indicating neutrality.
104
What factors can change the color of urine?
Diet, medication, and disease.
105
What is the significance of urine odor?
Urine is normally odorless; infections and certain foods can alter its odor.
106
What is the supernatant in urine analysis?
The clear upper portion of the specimen after centrifugation.
107
What training is required for medical assistants before performing centrifugation?
periodic proficiency testingTraining on the centrifuge, periodic proficiency testing, and compliance with CLIA quality assurance protocols.
108
What can microscopic examination of urine reveal?
The presence of many pathological conditions.
109
What is the importance of assessing urine turbidity?
It helps in identifying potential abnormalities in the urine.
110
How does the intensity of urine color relate to its composition?
It depends on the concentration of the pigment urochrome and the amount of water in the specimen.
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