INTRODUCTION TO URINALYSIS Flashcards
(80 cards)
1
Q
Wrote the book of “uroscopy”
A
Hippocrates
2
Q
Discovered albuminuria by boiling urine
A
Frederik Dekker
3
Q
Published a book about “Pisse Prophets”
A
Thomas Bryant
4
Q
Addis Count
A
Thomas Addis
5
Q
Introduced the concept of urinalysis as part of a doctor’s routine patient examination
A
Richard Bright
6
Q
Urochrome - the pigment that causes yellow color or urine
A
Thudichum
7
Q
Reasons for performing urinalysis (CLSI): (4)
A
- Diagnosis of disease
- Screening asymptomatic populations for undetected disorder
- Monitoring the progress of disease
- Monitoring the effectiveness of therapy
8
Q
Primary organic component. Product of protein and amino acid metabolism
A
Urea
9
Q
Product of creatine metabolism by muscles
A
Creatinine
10
Q
Product of nucleic acid breakdown in food and cells
A
Uric acid
11
Q
Primary Inorganic component. round in combination with sodium and many other inorganic substances
A
Chloride
12
Q
Primarily from salt, varies by intake
A
Sodium
13
Q
Combined with chloride and other salts
A
Potassium
14
Q
Combines with sodium to buffer the blood
A
Phosphates
15
Q
Regulates blood and tissue acidity
A
Ammonium
16
Q
Combines with chloride, sulfate, and phosphate
A
Calcium
17
Q
A normal urine constituent
A
Nitrate
18
Q
The single most useful substance that identifies a fluid as urine
A
uniquely high creatinine concentration (approximately 50 times that of plasma)
19
Q
Factors that influence urine volume include: (4)
A
- Fluid intake
- Fluid loss from non-renal sources
- variations in the secretion of ADH
- need to excrete increased amounts dissolved solids such as glucose or salts
20
Q
DM or DI:
- Due to defect in the pancreatic production of insulin
- Increase Urine Specific gravity
- Increase urine Glucose (glucosuria)
A
Diabetes mellitus
21
Q
DM or DI:
- Due to decrease production or function of ADH
- Decreased Urine Specific gravity
A
Diabetes insipidus
22
Q
Urine specimens should be delivered to the laboratory promptly and tested within 1 hour. Never discard a specimen before checking with a supervisor.
A. First statement is true, second statement is true.
B. First statement is false, second statement is true.
C. First statement is true, second statement is false.
D. First statement is false, second statement is false.
A
B. First statement is false, second statement is true.
- Within 2 hours
23
Q
Characteristics of urine specimen container: (4)
A
- Clean, Dry, Leak-proof
- With Screw top lids - they are less likely to leak than snap-on lids
- Wide mouth, and wide flat bottom
- Made of sterile material
24
Q
- Recommended container capacity
- Required specimen volume for microscopic analysis
A
- 50 mL
- 15 mL
25
This must accompany specimens delivered to the laboratory
Requisition form
26
When to reject specimen? (6)
1. Specimen in unlabeled containers
2. Non matching labels and requisition forms
3. Specimens contaminated with feces or toilet papers
4. Containers with contaminated exteriors
5. Specimens of insufficient quantity
6. Specimens that have improperly transported
27
Collect urine after 2 hours of meal. Measures the amount of glucose and correlated with the renal threshold.
2 hour post prandial
28
For quantitative measurement of analytes that shows
diurnal variation. Urine specimen for clearance test. Urine specimen evaluation of fistulas
Timed specimen
29
This specimen is collected under sterile conditions by passing a hollow tube through the urethra into the bladder
Catheterized specimen
30
Ideal for screening microalbuminuria (brunzel). For determination of urine albumin, creatinine, and the albumin-to creatinine ratio.
12 hours urine specimen
31
Preferred for urobilinogen measurements
Afternoon urine (20m to 40m)
32
Easy to collect and convenient. For Routine screening.
Random specimen
33
Urine specimen that is ideal for cytology
Random urine “clean catch” with prior hydration
34
Specimen that is ideal to test for substances that require concentration or incubation for detection. These specimens are often preferred for cytology studies because the number epithelial cells present can be significant.
First morning or 8-hour specimen
35
Specimen for glucose or diabetic monitoring and screening
Second morning/fasting specimen
36
Specimen for glucose or diabetic monitoring and screening
Second morning/fasting specimen
37
For bacterial culture (especially for anaerobic microbes). It is used for cytological examination.
Suprapubic aspiration
38
This specimen is safer, less traumatic method for obtaining urine for bacterial culture and routine urinalysis
Midstream Clean catch
39
Urine specimen in soft, clear plastic bags with hypoallergenic skin adhesive to attach to the genital area of both boys and girls
Pediatric specimen
40
If both urinalysis and culture are requested on a midstream or catheterized collection, which should be performed first and why?
Culture. This is to prevent contamination of the specimen
41
blank
42
Process that provides documentation or proper sample identification from the time of collection to the receipt of laboratory results
Chain of custody
43
This is added to the toilet water reservoir to prevent an adulterated specimen
Bluing agent (dye)
44
Most common adulterant
Water
45
Container capacity for drug testing
60 mL
46
Urine volume required for drug testing
30-45 mL
47
Urine temperature for drug testing
Within 4 mins, the temp should be 32.5-37.7°C
48
This is inspected to identify any signs of contaminants during drug testing
Urine color
49
Explain each container in the three-glass collection for prostatitis test
1st sterile container - contains the first urine passed
2nd sterile container - contains the midstream portion of urine
3rd sterile container - contains the urine with prostate fluid after massaging the prostate
50
Which of the specimens in 3-glass collection is/are examined microscopically?
1st and 3rd specimen
51
In 3-glass collection, what is the 2nd specimen used for?
Serves as control or bladder and kidney infections and should not be positive for bacteria. can be used for routine UA if additional testing is required
52
This is performed in all specimens of 3-glass collection
Qualitative culture
53
In Stamey-Mears, what are the types of four glass specimen
a) VB1 Initial voided urine, For bacterial cultures, Urethral infection or inflammation testing
b) VB2 Midstream urine and is used to tests for urinary bladder infection.
c) EPS Expressed prostatic secretion
d) V63 Post prostatic massage urine
54
Changes in unpreserved urine:
Which of the analytes are increased?
pH
Bacteria
Odor
Nitrite
55
Changes in unpreserved urine:
Which of the analytes are decreased?
Clarity
Glucose
Ketones
Bilirubin
Urobilinogen
RBC, WBC, Casts
Trichomonas
56
Which of the analytes is the least or not affected by unpreserved urine?
Protein
57
Changes in unpreserved urine:
Cause of increase in Trichomonas
None.
Trichomonas is decreased in unpreserved urine due to loss of characteristic, motility and death.
58
Changes in unpreserved urine:
Cause decrease of RBC, WBC, and Cast
Disintegration in dilute alkaline urine
59
Changes in unpreserved urine:
Cause of decrease in Urobilinogen
Oxidation to urobilin
60
The decrease in bilirubin in unpreserved urine is due to photooxidation to urobilin.
A. True
B. False
B. False.
Bilirubin is photo oxidized to biliverdin.
61
This analyte is increased due to bacterial multiplication or breakdown of urea to ammonia
Odor
62
This analyte is affected due to oxidation or reduction of metabolites
Color (Modified/Darkened)
63
pH is _______ due to breakdown of urea to ammonia by urease-producing bacteria loss of CO2
A. Increased
B. Decreased
A. Increased
64
Why is Nitrite increased in an unpreserved specimen
Multiplication of nitrite reducing bacteria
65
Explain why clarity of unpreserved specimen decreases.
Due to bacterial growth and precipitation of amorphous material
66
This analyte is decreased due to glycolysis and bacterial consumption
Glucose
67
Urine preservative that can be used to preserve urine for catecholamines (e.g., epinephrine & norepinephrine) measurement
Concentrated HCl
68
Urine preservative that is Inexpensive, stabilizes porphyrins, porphobilinogen, etc. but unacceptable for urinalysis testing. Used for quantitative analysis of porphyrins, porphobilinogen, etc.
Sodium carbonate
69
Urine preservative that preserves cellular elements, and used for cytological examination.
Saccomanno fixative
70
Component of Saccomanno fixative
Ethanol + Carbowax
71
Urine preservative used for automated instrument with round or conical bottom. Must refrigerate within 2 hours.
Yellow plain UA
72
Urine preservative that is stable for 72 hours, which contains sodium propionate. This decreases bilirubin and urobilinogen when left exposed at room temperature and light.
Cherry red/Yellow top tube
73
Urine preservative that preserves bacteria using boric acid and is stable at room temperature for 48 hours. However, this decreases pH if urine is below minimum fill line.
Gray C and S tube
74
Urine preservative that does not interfere with routine test and uses 1 drop per ounce of specimen. This causes changes in odor.
Phenol
75
Urine preservative that is good for drug analysis and prevents glycolysis. It Inhibits reagent strip tests for glucose, blood, and leukocytes. May use sodium benzoate instead of fluoride for reagent strip testing.
Sodium fluoride
76
Urine preservative that does not interfere with routine test but floats on surface of specimens and clings to pipette and testing materials
Toluene
77
Excellent sediment preservative and can also be used for cytology (Brunzel). But act as reducing agent, interferes with chemical tests for glucose, blood, leukocyte esterase, and copper reduction, and gives false-negative reagent strip test for blood and urobilinogen
Formalin
78
Urine preservative that preserves protein and formed elements well, does not interfere with routine analysis other than pH, and prevents bacterial growth and metabolism. However, it may precipitate crystals when used in large amounts and interferes with drug and hormone analyses. Keeps pH at 6.0 and Bacteriostatic at 18 g/L
Boric Acid
79
Urine preservative that preserves glucose and sediments well but interferes with acid precipitation test for protein.
Thymol
80
Urine preservative that does not interfere with chemical test, but precipitates amorphous crystals and raises specific gravity by hydrometer. Prevents bacterial growth for 24 hours.
Refrigeration
