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post tav i idc school > LAB Part 2 > Flashcards

LAB Part 2 Flashcards

1
Q

Clinical reasons for performing urinalysis testing

A

An important indicator of health

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2
Q

What is urinalysis testing used to detect and assess

A
  1. Renal function/disorder
  2. Endocrine or Metabolic function/disorder
  3. Urinary Tract Infection (UTI)
  4. Systemic diseases
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3
Q

What is cost-effective in urinalysis testing

A

In-Vitro diagnostic testing

in-vitro = out of the body

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4
Q

What are the methods of urine collection

A

Non-instrumented Collection & Instrumented Collection

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5
Q

Name all methods of non-instrumented collection

A
  1. First-morning void
  2. Random urine specimen
  3. Clean catch urine specimen
  4. 24-hour urine specimen
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6
Q

Name all methods of instrumented collection

A
  1. Urethral catheterization
  2. Suprapubic needle aspiration
  3. Catheterization and Bladder irrigation
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7
Q

How soon should urine specimens be analyzed

A

While fresh, preferably within 1-2 hours

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8
Q

What should be done if the urine specimen is unable to be tested at time of delivery

A

Refrigerate the specimen 3-6 hours after collection

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9
Q

What happens if urine specimen is left at room temperature

A

It will begin to decompose and deliver inaccurate results

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10
Q

Explain the mechanism of urine decomposition

A
  1. Room temperature urine will decompose due to presence of BACTERIA in the sample.
  2. Urea splitting bacteria produces ammonia that combines with hydrogen ions to increase pH of urine (changes in pH will dissolve any casts present).
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11
Q

Significance of First-morning void

A
  1. Most concentrated (good for HCg)
  2. Increased abnormal elements
  3. Decreased deterioration of formed elements
  4. Recommended specimen for chemical and microscopic examination
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12
Q

Significance of Random urine specimen

A
  1. Can be collected anytime*
  2. Most convenient and most common
  3. Can detect abnormalities but not as sensitive as FMV
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13
Q

Significance of Clean catch urine specimen

A

Specimen of choice for bacterial cultures

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14
Q

Significance of 24-hour urine specimen

A

Gives quantitative results (values)

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15
Q

Who does Instrumented (urine) collection

A

Providers

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16
Q

Significance of Uretheral Catheterization

A
  1. NOT recommended for bacteriological examination
  2. Commonly used on marked obese patient with difficulty in urine collection or if there is no other way to collect urine
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17
Q

Significance of Suprapubic needle aspiration

A
  1. Avoids vaginal/urethral contamination
  2. Performed for Bladder outlet obstruction (urinary retraction)
  3. Collection of choice on infants and young children
  4. Performed to confirm positive cultures from disposable bag AND prior to institution of specific therapy
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18
Q

Significance Catheterization and Bladder Irrigation

A
  1. 50-72 mL saline inserted into bladder
  2. Content removed for cytologies study
    Yields optimum cellular sample of bladder epithelium (skin cells)
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19
Q

Urine Sample Analysis is

A

Physical, Chemical, Microscopic

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20
Q

What are the physical analyses of a urine sample

A
  1. Volume
  2. Color
  3. Turbidity (clarity)
  4. Odor
  5. Specific gravity
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21
Q

What is the normal volume in a 24-hour period range

A

600-2000 mL

Average is 1500 mL

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22
Q

What is the urine amount directly related to

A

Fluid intake, temperature and climate, amount of perspiration that occurs

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23
Q

What is the normal color of urine

A

Straw (light yellow) to dark amber

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24
Q

Meaning of urine being Blue green

A

Methylene blue (used as a dye or stain in diagnostics procedures)

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25
Q

Meaning of urine being Dark orange

A

Pyridium (used in UTI)

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26
Q

Meaning of urine being Milky white

A

Caused by chyle (fat)

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27
Q

Meaning of urine being Olive green to brown black

A

Phenols (poisonous compound used for anti microbial agents)

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28
Q

Meaning of urine being Yellow to brown (turning greenish with foam when shaken)

A

Presence of bile (located in the liver)

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29
Q

Meaning of urine being red or red-brown (Smokey appearance)

A

Presence of blood

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30
Q

What is turbid ALKALINE urine due to

A

Amorphous phosphate and Amorphous carbonate

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31
Q

What is turbid ACIDIC urine due to

A

Amorphous urates (pinkish turbidity indicates presence of urates)

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32
Q

Why does normal urine have a characteristic odor

A

Due to volatile acids

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33
Q

Meaning of urine smelling sweet and/or fruity

A

Presence of ketones

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34
Q

Pungent smell of urine indicates what

A

Ammonia produced by bacteria

35
Q

Meaning of urine smelling like maple syrup

A

A congenital metabolic disorder (maple syrup urine disease)

usually in infants

36
Q

Meaning of urine smelling musty and/or mousy

A

Infant with phenylketonuria

37
Q

Meaning of urine smelling like sweaty feet

A

Isovaleric acidemia, presence of buytric or hexanoic acid in urine

38
Q

What are the specific gravity values

A
  1. Random urine: 1.003 - 1.035
  2. 24-hour urine: 1.015 - 1.025
39
Q

For chemical analysis, normal urine is negative for what

A

Negative for:

  1. Glucose
  2. Ketones
  3. Occult blood
  4. Bilirubin
  5. Protein
  6. Nitrite
  7. Leukocyte esterase (LE)
40
Q

What is Glucosuria and what is the threshold level

A

Appears in the urine once the threshold of 160-180 mg/dL in the blood is exceeded

May indicate diabetes Melkite’s or any condition that causes hyperglycemia

41
Q

What is Ketonuria

A

Presence of ketones in the urine as a result of incomplete fatty acid utilization

42
Q

What is Ketosis

A

An increase of ketones in the blood and urine

43
Q

What conditions are associated with Ketosis

A

Starvation (decreased intake of carbs)
Diabetes mellitus (decreased utilization of carbs)
High fat, low carb diets (digestive disturbances or dietary imbalance)
Eclampsia (HTN during pregnancy)
Prolonged vomiting
Diarrhea

44
Q

Intact RBC’s present in the urine may indicate what

A
  1. Damage/trauma to the kidney or urinary tract
  2. Renal diseases such as: *glomerulonephritis, malignant hypertension, poly cystic kidney disease
  3. May also be due to menstrual contamination or excercise

*sample may appear red and smokey (blood in urine is hematuria)

45
Q

What does bilirubin indicate in the urine

A

Any condition that causes jaundice

Bilirubinuria indicates: Hepatocellular disease, Intra or extra-hepatic biliary obstruction

46
Q

How does Urobilinogen normally present in the urine

A

In concentration of 1EU or less

Any increase indicates liver disease and hemolytic disease

47
Q

What is the range for pH in the urine

A

4.6 - 8.0

*usually averages around 6.0 (slightly acidic)

48
Q

What are the pathological conditions that may cause acidic urine

A

Respiratory and metabolic acidosis
UTI by E. Coli
Uremia
Severe diarrhea
Starvation

49
Q

What are the pathological conditions that cause alkaline urine

A

UTIs caused by Proteus and Pseudomonas species
Respiratory and metabolic alkalosis

50
Q

What does protein in the urine indicate

A

Renal disease

51
Q

Proteinuria mainly occurs by what mechanisms

A

Glomerular damage
Defect in the reabsorption process of the tubules

52
Q

Associated disease due to minimal proteinuria

A

<0.5 g/day
Polycystic kidneys
Chronic pyelonephritis
Inactive chronic glomerulonephritis
Benign orthostatic proteinuria

53
Q

Associated disease due to Moderate proteinuria

A

0.5-3.5 g/day
Malignant hypertension
Pyelonephritis with hypertension

…. A lot of other ones but not enough to narrow down

54
Q

Associated disease due to severe proteinuria

A

> 3.5 g/day
Glomerulonephritis (side note: common thing that keeps popping up)
Lupus nephritis

55
Q

How is nitrite formed

A

Formed by breakdown of nitrates by organisms that cause UTIs - E. Coli

56
Q

What is bacteriuria and what chemical analysis is it a part of

A

Presence of bacteria in urine, indicative of UTI and is associated with Nitrites

57
Q

What is esterase

A

An enzyme

58
Q

What is leukocyturia

A

associated with an inflammatory process in or around the urinary tract

59
Q

UA is a clinical tool for the evaluation of what

A

Various renal and nonrenal problems

60
Q

Most UA consist of what

A

Macroscopic analysis (appearance)
Chemical analysis (dip stick)
Microscopic analysis looking for formed elements

61
Q

What is the purpose of Rapid Plasma Reagin (RPR)

A

It is a non-treponemal test for serologic detections of the antibody Reagin

62
Q

Why is Reagin produced

A

It is produced in response to an infection of syphilis caused by T. Pallidum (Treponema)

63
Q

What kind of test is the RPR and what is it mixed with

A

Screening test/ antigen is mixed with a serum/plasma sample

64
Q

What does it mean if flocculation is present in the screening test

A

The test is reactive

65
Q

What does it mean if there is no flocculation present in the screening test

A

The test is non-reactive

66
Q

What is the confirmatory test for RPR testing

A

Fluorescent treponemal antibody-absorbed test (FTA-ABS)

67
Q

How are serum sample or plasma sample collected

A

Collect VENOUS blood in tubes without anticoagulant (Red/SST) for serum and with anticoagulant (Purple top) for plasma

68
Q

How should serum appear after centrifugation

A

Serum should be clear and non-hemolyzed to be an acceptable sample

69
Q

How should RPR be mixed prior to opening the sample

A

By shaking vigorously for 10-15 seconds

70
Q

For RPR, test card and controls should be placed on the rotator for how long

A

8 minutes at 100 revolutions per minute (rpm)

71
Q

How can you differentiate non-reactive from weakly reactive results

A

Rotate and tilt card briefly, by hand (3 or 4 to-and fro-motion)

72
Q

How is RPR exam test card read

A

MACROSCOPICALLY (seen visually)

73
Q

How are RPR results read

A

Reactive or non-reactive

74
Q

Reactive test results shows flocculation ranging from what

A
  1. Slight but definite
  2. Minimum to moderate
  3. Marked and Intense
75
Q

Quality control for RPR is divided into what two sections

A

Equipment quality control and Reagent quality control

76
Q

The mechanical rotator is calibrated to what

A

100 rpm

77
Q

What is the antigen needle calibrated to

A

60 drops per 1 mL

78
Q

What test is used to detect infectious mononucleosis

A

The Monospot test

79
Q

What is infectious mononucleosis

A

A self-limiting disease caused by the Epstein-Barr virus (EBV)

80
Q

The age group seen with mononucleosis

A

Seen in young adults and children less than 5 years of age

81
Q

What is a heterophile antibody

A

An antibody that is structurally similar to the antibody that is specifically produced as a response to antigen stimulation

82
Q

For mono, serum samples should be collected how

A

Collect venous blood in tubes with or without anticoagulant/ after centrifugation, serum or plasma should be clear and non-hemolyzed

83
Q

The testing procedures for mono

A

Allow the Latex Reagent and controls to reach room temperature (20 - 30 degrees C)

GENTLY SHAKE (Vigorous shaking should be avoided) vial to disperse and suspend the latex particles in the buffer solution

GENTLY rotate the slide for 3 minutes manually or on a rotator shaker set at 60-100 rpm

84
Q

How do Monospot test results present

A

Positive and Negative

Positive results show agglutinations
Negative results demonstrate a smooth, homogenous solution. NO AGGLUTINATION.

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