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MLT 111 Urinalysis > Exam II Study Guide > Flashcards

Exam II Study Guide Flashcards

1
Q

How does the pH of urine relate to its hydrogen ion concentration?

A

inverse relationship
increase H+, decrease pH
decrease H+, increase pH

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2
Q

Ketone bodies in the urine are suggestive of what?

A

elevated COH metabolism

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3
Q

What causes myoglobinuria?

A

rhabdomyolysis, muscle destruction

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4
Q

What color is positive nitrite on dipstick

A

pink

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5
Q

What substance is most likely to be present in urine that could cause a false negative reaction on dipstick for glucose?

A

ascorbic acid, vitamin D

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6
Q

What is SSA used for?

A

confirmatory test for proteins

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7
Q

What test is used for detecting reducing sugars in the urine? What would be expected in microscopic exam?

A

Clinitest

nothing

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8
Q

What two dipstick reactions are usually positive in pyelonephritis?

A

leukocytes and nitrite

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9
Q

Conditions that could be indicated by elevated urinary urobilinogen

A 
hepatitis
cirrhosis
liver disease
hemolytic anemia
PA
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10
Q

Conditions that can cause hemoglobinuria

A 
extensive burns
intravascular hemolysis
incompatible transfusions
PNH-paroxysmal nocturnal hemoglobinuria
infections; malaria, syphillis
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11
Q

What is specificity in relation to the dipstick?

A

each zone should react specifically to the substance being tested and no other

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12
Q

What does the test pad for ketones detect

A

acetoacetic acid

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13
Q

Principle of the dipstick method for protein

A

“protein error of indicators” tetrabromphenol blue buffered at a constant pH of 3 w/o proteins is yellow, but in the presence of proteins, H+ is released by indicator dye causing color to change ranging from ylw-gr to bl-gr

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14
Q

What unusual urinary protein is associated with Multiple Myeloma

A

Bence Jones protein

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15
Q

What sugar, especially in infants, is most likely indicated by a neg dipstick reaction for glucose but a pos Clinitest

A

galactose

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16
Q

WHat specimen is used to detect orthostatic proteinuria? When would you suspect this condition?

A

1st morning specimen (=) and specimen after patient has been erect for a few hours (+).

If protein is excreted sitting up but not laying down
seen in kids and adolescents

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17
Q

What is the active ingredient in Ehrlich’s reagent?

A

paramethylamino benzaldehyde

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18
Q

What reagent is used to detect bilirubin in the Ictotest?

A

2,4 - dichlorobenzene diazonium tetrachlorozincate

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19
Q

Hemoglobin pad on reagent strip detects

A

hemoglobin
myoglobin
intact rbcs

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20
Q

What is the action of the enzyme peroxidase?

A

to catalyze the oxidation of chromogen (3,3’,5,5’ - tetramethylbenzidine) by the O2 released from peroxidase on reagent pad to produce color change from yellow to green; sudoperoxidase acitivity

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21
Q

Why is there normally no glucose in urine?

A

usually reabsorbed back into the blood through the renal convoluted tubules

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22
Q

Advantage of using phase contrast microscopy in exam of urinary sedimentation? Relation to refractive index?

A

allows you to see unstained cellular components and casts

refractive index is similar to urine, enables you to see difficult to view formed elements

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23
Q

What is the use of polarizing microscope in urince microscopics?

A

detects sediment that is birefringent (anisotropic) and confirm presence of fat and cholesterol crystals

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24
Q

How are cells recorded

A

number per High (40x) power field

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25
Q

How many fields should be examined?

A

lpf/hpf 10 fields; dependent on what the examiner is looking for

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26
Q

What is the most common type of WBC found in urinary sediment?

A

neutrophils

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27
Q

Whats usually pos when casts are present?

A

protein

28
Q

Casts containing cells indicate problems in what part of the urinary tract

A

kidney

29
Q

Where are transitional epi cells found

A

lining of renal calyces, renal pelvis, ureters and and bladder. urethra in males

30
Q

Amorphous phosphates are found in what kind of urine?

A

alkaline

31
Q

What disease is indicated when tyrosine and leucine crystals are found in urine

A

severe liver disease; overflow of aminoaciduria

32
Q

What is characterized by lipiduria and proteinuria

A

Nephrotic syndrome

33
Q

Casts which have at least two distinct compnents

A

mixed casts

34
Q

How should casts be reported

A

lpf 10x

35
Q

Which WBC is most likely to be found in a transplant rejection

A

lymphocyte

36
Q

In what specific portion of the nephron are casts formed

A

distal convoluted tubule and collecting ducts

37
Q

Types of diseases RBC cast are found

A

intrinsic renal disease

basement membrane where glomerulous is damages

38
Q

Specific epi cells found in epi casts

A

renal tubular epi cells

39
Q

Glitter cells seen in urines with

A

low SG

40
Q

Epi cells indicative of vaginal contamination

A

squamous

41
Q

Calcium oxalate crystals are seen in

A

acidic urine

low pH

42
Q

Condition indicative by large numbers of uric acid crystals

A

gout

increase purine metabolism, such as treatment with cytotoxic drugs sued in leukemia

43
Q

Candida albicans often seen in urine of pts with

A

diabetes mellitus

44
Q

If flat, hexagonal, colorless crystals are found in urine, what constituent is suggested? What should be done prior to reporting?

A

Cystine

chemical confirmatory testing

45
Q

How can rbc and yest be differentiated

A

2% acetic acid; lyse rbcs

toludine blue; stain S-M color reveal nuclear details

46
Q

What is the appearance of waxy casts?

A

sharp, blunt uneven ends
cracks or fissures from lateral margins and along axes
high refractive index
homogenous

47
Q

Organisms that indicate contamination

A

parasites
Trich
sperm
yeast

48
Q

Order of aging process of casts

A

cellular, coarse granular, fine granular, waxy

49
Q

Presence of elevated numbers of casts in urine

A

cylinduria

50
Q

How can precipitate of amorphous phosphate (alkaline) crystals be removed

A

dissolve in diluted acetic acid

51
Q

How can precipitate or amorphous urate (acidic) crystals be removed

A

dissolve in alkali or heat to 60C using warm water

52
Q

What would the appearance of rbc in hypertonic urine be

A

crenated

53
Q

Can the multistix detect a neg urobilinogen

A

neg is there is none in urine, but cannot detect a complete absence

54
Q

How would you determine a neg nitrite but a pos bacteria

A

urine not in bladder long enough, nitrate to nitrite reductions hasnt occured
bacteria pop is too high and nitrite has been further reduced to nitrogen
no nitrite in diet
leeching or runover of reagents

55
Q

What type of casts may be found in the urine of normal pH

A

hyaline

56
Q

What are shadow cells

A

rbc with nohgb

57
Q

What is the significance of the shape and size of a cast

A

variable; helps in ID

cast type can distinguish kidney disease from lower urinary tract disease

58
Q

Urine for testing should always be

A

room temp

59
Q

Why use refractometer for SG instead of dipstick

A

dipstick detects ionic solutes only

refractometer detects ionic solutes and non ionic solutes

60
Q

How does Watson-Schwartz test differentiate between urobilinogen and porphobilinogen

A

red+chloroform = uronilinogen
soluble in chloroform and butanol

red+butanol = porphobilinogen
soluble in aqueous layer

61
Q

What is the principle of the automated instruments for dipstick reading

A

reflectence

62
Q

Glucose in urine is referred to as

A

glycosuria

glucosuria

63
Q

Two different forms of blood in the urine are known as

A

hematuria

hemoglobinuria

64
Q

What reagent is used to differentiate urinary hgb and myoglobin

A

ammonium sulfate

precipitates hgb

65
Q

What is the normal range for urinary urobilinogen

A

0.1-1 mg%

66
Q

Which test is most sensitive for bulirubin

A

Ictotest

67
Q

What is ketonuria

A

excessive amounts of ketone bodies in urine

MLT 111 Urinalysis (3 decks)

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