Laboratory PT2 Flashcards by Spencer Martin

What are the clinical reasons to perform urinalysis testing?

Indication of health
Screening test
Cost effective
Non-invasive
Simple to perform

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What disorders can a screening UA test detect?

Renal disorder
Endocrine/Metabolic disorder
UTI
Systemic disease

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What are the two methods of urine collection?

Non-instrumented

Instrumented

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What are the non-instrumented collection methods?

First-morning void
Random
Clean catch
24-hour

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What are the instrumented collection methods?

Urethral cath
Suprapubic Needle Aspiration
Catherization and Bladder Irrigation

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Urine should be analyzed while fresh within how many hours?

1-2 hours

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If urine can’t be analyzed in the first 2 hours, it must be refrigerated by what time frame?

3-6 hrs after collection

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What decomposes urine?

Urea-splitting Bacteria

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urea splittling bacteria produces ammonia that combines with hydrogen ions which increases what in urine?

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What does bacteria use as an energy source?

Glucose

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What are the urine preservatives methods and chemicals?

Freezing
Toluene
Thymol
CHloroform
Formaldehyde
Hydrogen Chloride
Boric Acid
Preservative tablet

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What are the advantages and disadvantages of the freezing preservative?

A-for transpo/store, no cost, simple

D-May destroy formed elements

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What are the advantages and disadvantages of the toluene preservative?

A-Preserves acetone, diacetic acid and proteins by floating on top making seal
D-Flammable, difficult to separate from specimen

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What are the advantages and disadvantages of the thymol preservative?

A-inhibits bacteria/fungi

D-False positive for protein

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What are the advantages and disadvantages of the Chloroform preservative?

A-Preserves urine aldosterone levels

D-Settles to bottom of containers

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What are the advantages and disadvantages of the formaldehyde preservative?

A-Preserves urine sediment/cells

D-Interferes with gluclose evaluation

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What are the advantages and disadvantages of the Hydrogen Chloride preservative?

A-Stabilize steriods

D- Hazardous liquid and fumes. Formed elements are destroyed

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What are the advantages and disadvantages of the boric acid preservative?

A-preserves chemical and formed elements

D-Uric acid may precipitate

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What are the advantages and disadvantages of the preservation tablet preservative?

A- Preserves urine for dipstick chemical analysis and sediment eval for transport
D-unsuitable for sodium, potassium and hormone analysis

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What is the most concentrated UA method that shows an increase of abnormal elements, decreases deterioration of formed elements and is recommended for chemical and microscopic examination?

First-morning void

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What UA collection method is collected anytime, most convenient and common?

Random

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Which UA collection method is choice for bacterial cultures?

Clean catch

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How is the clean catch method performed?

Genitalia cleaned with mild antiseptic solution

Collect urine midstream in a sterile container

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Which UA collection method gives quantitative results and may require preservatives?

24-hour urine specimen

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What type of urine collection method is used for marked obese patients and is used when there is no other way to get urine?

Urethral catheterization

Which urine collection method inserts a needle directly into a distended bladder for a single sample and is choice for infants and young children?

Suprapubic needle aspiration

What urine collection method includes vigorous transcatheter agitation of the bladder with 50-72ml of saline?

catheterization and bladder irrigation

Which urine collection yields optimum cellular sample of bladder epithelium?

Cath and bladder irrigation

What are the three urine sample analysis methods?

Physical Chemical Microscopic

What is included in the physical analysis of urine?

``` Volume Color Turbidity Odor Specific gravity ```

What is the normal and average volume of urine in 24 hrs?

600-2000ml | avg 1500ml

Urine output is directly related to what factors?

Intake Temperature and climate Amount of perspiration that occurs

What is the pigment concentration of urine that determines color called?

urochrome

Blue green urine has what diagnostic significance?

Methylene blue used as dye for diagnostic procedure

Dark orange urine has what diagnostic significance?

Use of Pyridium for UTI infection

Milky white urine has what diagnostic significance?

caused by chyle (fats and lymphs)

Olive green to brown black urine has what diagnostic significance?

Phenols

Yellow to brown, turns green w/ foam when shaken, urine has what diagnostic significance?

Bile

Red or red-brown urine has what diagnostic significance?

Blood

Normal urine has what turbidity?

Clear

What would sweet or fruity smell in urine indicate?

Ketones

What would a pungent smell in urine indicate?

ammonia produced by bacteria

What would a maple syrup smell in urine indicate?

maple syrup urine disease (congenital metabolic disorder)

What would a musty or mousy smell in urine indicate?

Infant with phenylketonuria

What would a smelly feet smell in urine indicate?

isovaleric acidemia, presence of butyric or hexanoic acid in urine

What is the specific gravity of a random urine collection?

1.003-1.035

What is the specific gravity of a 24-hour urine collection?

1.015-1.025

What chemical analysis chemicals or elements are normally present in urine?

Urobilinogen, 1 EU or less concentration

What is the threshold for glucosuria?

Will appear in urine when 160-180 mg/dL in blood is exceeded

What is the threshold for glucosuria?

Will appear in urine when 160-180 mg/dL in blood is exceeded

Glucose in urine could indicate what condition?

DM or conditions that cause hyperglycemia

Ketones in the urine are from what?

Incomplete fatty acid utilization

Ketosis, ketones in blood and urine, could indicate what condition(s)?

``` DM Starvation KETO diet Eclampsia Prolonged vomiting Diarrhea ```

Blood in urine is termed what?

Hematuria

Intact RBCs in urine may indicate what condition(s)?

``` Damage to kidney or urinary tract Renal disease -Glomerulonephritis -Malignant hypertension -PKD Menstrual contamination or exercise ```

What condition would result in appearance of bilirubin in urine?

Jaundice

Bilirubinuria indicates what condition(s)?

Hepatocellular disease | Intra or extra-hepatic biliary obstruction

Urobilinogen may be up to 1mg/dL in urine and could indicate what condition(s)?

liver disease | hemolytic disease

What is the normal and average pH range for urine?

4.6 - 8.0 6.0 Slightly acidic

What conditions may cause acidic urine?

``` Resp or metabolic acidosis UTI by E. coli Uremia Severe diarrhea Starvation ```

What conditions could cause alkaline urine?

UTI caused by Proteus or Pseudomonas species | Respiratory or metabolic akalosis

What is an important indication in the chemical analysis of urine to indicate renal disease?

Protein

Proteinuria mainly occurs by what two mechanisms?

Glomerular damage | Defect in the reabsorption process of tubules

What are the levels and their values of proteinuria?

minimal - <0.5g/day moderate - 0.5-3.5 g/day significant >3.5g/day

Nitrites are breakdowns of nitrates in urine caused by what?

E. coli that causes UTIs

Bacteriuria indicates what?

UTI

What is the chemical in urine that is an enzyme, and is released by neutrophils?

Leukocyte esterase (LE)

What is the most common clinical tool used for renal and nonrenal problems?

UAs consists of what analysis?

Macro (apperance or physical) Chemical (dip stick) Micro (formed elements)

How much protein is usually excreted by adults per day?

10-100mg

What is the condition that is defined as excretion of >500mg/day of protein in urine?

Proteinuria

Persistant pH greater than 7 is assocatied with what?

calcium carbonate, calcium phosphate and magnesium ammonium phosphate stones

Persistent pH below 5.5 is associated with what?

Cystine and uric acid stones

What is a non-treponemal test for serologic detection of the antibody reagin?

Rapid Plasma Reagin

Reagin is produced in response to what?

Syphilis infection

Syphilis infections are caused by what?

Treponema pallidum

Reagin is found where?

in the serum/plasma

What is the carbon charcoal particle used to see results macroscopically on an RPR test called?

Vehicle or "antigen"

RPR is a ____________ test.

Screening

If flocculation is present on an RPR test it is what?

Reactive (positive)