PRELIM LEC: INTRODUCTION TO URINALYSIS Flashcards
(95 cards)
1
Q
Wrote a book on “uroscopy”
A
Hippocrates
2
Q
– Urine Color charts had been developed
– Chemical testing progressed from “ant testing” and “taste testing” for glucose
A
1140 CE
3
Q
Discover Albuminuria by boiling the urine
A
Frederik Dekkers (1694)
4
Q
- Published the book “Pisse Prophets”
A
Thomas Bryant (1627)
5
Q
Thomas Bryant (1627)
* - Invention of the microscope
* - Led to the examination of urinary sediment
A
17 centuries
6
Q
Developed the method for quantitating the microscope sediment
A
Thomas Addis
7
Q
Introduced the concept of urinalysis as part of a doctor’s routine patient examination
A
Richard Bright (1827)
8
Q
Began to disappear from routine examination.
A
1930s
9
Q
2 unique characteristics of urine specimen
A
- Urine is a readily available and easy collected specimen
- Urine contains information, w/c can be obtained by inexpensive laboratory tests, about many of the body’s major metabolic functions.
10
Q
Defines urinalysis as “the testing of urine with procedures commonly performed in an expeditious, reliable, accurate, safe, and cost effective manner.”
A
Clinical and Laboratory Standards Institute (CLSI)
11
Q
Fountain of information
A
URINE
12
Q
Liquid tissue biopsy of the urinary tract
A
URINE
13
Q
Tests need to be carefully performed and properly controlled
A
URINE
13
Q
Painlessly obtained (EASY)
A
URINE
13
Q
Yields a great deal of information quickly and economically
A
URINE
14
Q
The _______ continuously form ______as an ultrafiltrate of plasma.
A
kidneys; urine
15
Q
Reabsorption of water and filtered substances essential to body function converts approximately ______of filtered plasma to the daily urine output of 1200 mL
A
170,000 mL
16
Q
Urine consist of ____and other organic and inorganic chemicals dissolved in water
A
urea
17
Q
Urine is normally _____ water and ______ solutes
A
95%; 5%
18
Q
These solutes can occur owing to the influence of factors such as:
A
dietary intake, physical activity, body metabolism and endocrine functions
19
Q
Other substances found in urine include:
A
hormones, vitamins and medications
20
Q
May contain formed elements, such as:
A
cells, casts, crystals, mucus and
bacteria (increase amount is often
indicative of disease)
21
Q
Diagnosis and management of renal or urinary tract diseases
A
EXAMINATION OF URINE
22
Q
Detection of metabolic or systemic diseases not directly related to the kidney
A
EXAMINATION OF URINE
23
MEDICAL INFORMATION-physiologic and structural disorders of the kidney and the urinary
tract
EXAMINATION OF URINE
24
Elevated formed elements in urine may indicate?
disease
25
The normal odor of freshly voided urine is_____ due to volatile acids
faintly aromatic
26
is a major body constituent
Water
27
Factors that influence urine volume
include:
fluid intake, fluid loss from nonrenal sources, variations in the secretion of antidiuretic hormone and need to excrete dissolved solids
28
Main determinant of urine volume is
water
29
Normal range (24h) daily urine output is usually
600-2000mL
30
Average volume (24hrs)
1200-1500 mL
31
Maintain fluid in the body
Anti-diuretic hormone (vasopressin)
32
acceptable urine containers:
disposable containers should be used
clean/sterile
dry
leak-proof
screw-top lids
wide mouth
clear
50ml capacity
33
Bacteriologic examination is done first if
requested
34
Normal night urine volume:
<400 mL
34
Urine less than the standard volume requirement is acceptable only for following cases:
acute renal failure
pediatric patient
gastric patient
35
OLIGURIA CAN CAUSE
DEHYDRATION
36
POLYURIA CAN CAUSE
DIABETES INSIPIDUS
DIABETES MELLITUS
DIURETIC
37
ANURIA CAN CAUSE
serious damage to the kidneys
38
DEFECY IN PRODUCTION OR FUNCTION OF INSULIN
DIABETES MELLITUS
39
DECREASED PRODUCTION OR FUNCTION OF ANTIDIURETIC HORMONE(ADH) / VASOPRESSIN
DIABETES INSIPIDUS
40
SYNOVIAL FLUID NEEDLE ASPIRATION
arthrocentesis
41
MOST COMMON USED METHOD OF PRESERVATION
REFRIGERATION AT 2C TO 8C
42
DOES NOT INTERFERE WITH CHEMICAL TESTS AND PREVENTS BACTERIAL GROWTH FOR 24 HOURS
REFRIGERATION AT 2C TO 8C
43
SPECIMEN MUST BE RETURNED TO ROOM TEMPERATURE BEFORE CHEMICAL TESTING BY REAGENT STRIPS
REFRIGERATION AT 2C TO 8C
44
INTERFERES WITH DRUG AND HORMONE ANALYSES
BORIC ACID
45
PREVENTS BACTERIAL GROWTH AND METABOLISM
BORIC ACID
46
MAY BE USED FOR URINE TRANSPORT
BORIC ACID
47
EXCELLENT SEDIMENT PRESERVATIVE
FORMALIN/FORMALDEHYDE
48
REDUCING AGENT; INTERFERES WITH TESTS FOR GLUCOSE, BLOOD, LE AND COPPER REDUCTION
FORMALIN/FORMALDEHYDE
49
GOOD PRESRVATIVE FOR DRUG ANALYSES
SODIUM FLUORIDE
50
CHANGES IN UNPRESERVED URINE:
INCREASED ANALYTES (pBaON)
ph
bacteria
odor
nitrite
51
breakdowns of urea to ammonia by urease, producing bacterial/loss of CO2
pH
52
multiplication
BACTERIA
53
bacterial multiplication causing breakdown of urea to ammonia
ODOR
54
multiplication of nitrate, reducing bacteris
Nitrate
55
CHANGES IN UNPRESERVED URINE:
DECREASED ANALYTES (BGC KURT)
Bilirubin (conjugated bilirubin)
Glucose
Clarity
Ketones
Urobilinogen
RBCs and WBCs
Trichomonas
56
photo-oxidation
Bilirubin (conjugated bilirubin)
57
glycolysis and bacterial use
Glucose
58
bacterial growth and precipitation of amorphous materials
Clarity
59
volatilization and bacterial metabolism
Ketones
60
oxidation or urobilin
Urobilinogen
61
disintegration to dilute alkaline
RBCs and WBCs
62
loss of motility, death
Trichomonas
63
pink precipitate (microscope)
amorphous urates
64
white precipitate (microscope)
amorphous phosphate
65
Normal day:night ration of urine output
2 to 3:1
66
Container capacity of urinalysis
50 ml
67
Required volume for urinalysis
10 to 15 ml
68
Average volume of urinalysis
12 ml
69
Increased specific gravity (due to increased glucose excretion)
DIABETES MELLITUS
70
Decreased specific gravity (truly dilute urine)
DIABETES INSIPIDUS
71
TYPES OF URINE SPECIMEN
1. RANDOM SPECIMEN
2. FIRST MORNING SPECIMEN
3. FASTING SPECIMEN
4. 2-HOUR POST PRANDIAL
5. GLUCOSE TOLERANCE SPECIMENS
6. 24- hour (or Timed) Specimen
7. EARLY AFTERNOON SPECIMEN
8. 12-HOUR URINE
9. CATHETERIZED SPECIMEN
10. MIDSTREAM-CLEAN CATCH SPECIMEN
11. SUPRAPUBIC ASPIRATION
12. PROSTATIS SPECIMEN
13. PEDIATRIC SPECIMEN
14. THREE-GLASS COLLECTION
15. DRUG SPECIMEN COLLECTION
16. FOUR-GLASS METHOD (STAMEY-MEARS TEST)
72
* This is the most commonly received specimen
* It may be collected anytime but the actual time of voiding should be recorded on the container
* It is use for ROUTINE SCREENING TEST
- ease of collection and convenience patients
RANDOM SPECIMEN (occasional/single)
73
- also called as 8 hour specimen
- prevents false-negative pregnancy test results
* IDEAL SPECIMEN FOR ROUTINE URINALYSIS and Pregnancy Test
* Most concentrated and acidic specimen
* It is use for evaluation of orthostatic proteinuria
FIRST MORNING SPECIMEN
74
- second voided specimen after period of fasting
- does not contain any metabolities
- recommended for glucose monitoring
FASTING SPECIMEN
75
- collected shortly after consuming a routine meal and collecting again 2 hours after eating
- for monitoring of insulin therapy
2-HOUR POST PRANDIAL
76
- collected to correspond with the blood samples drawn during an OGTT (Oral glucose tolerance tests)
* The urine is tested for glucose and ketones
* The results reported along with the blood test results
* Correlated with renal threshold for glucose
* FASTING URINE, 2-HOUR POSTPRANDIAL, GLUCOSE TELERANCE, FRACTIONAL SPECIMEN
* These specimens is an INSTITUTIONAL OPTION
GLUCOSE TOLERANCE SPECIMENS
77
- for analytes that exhibit diurnal variation
- patients must be instructed on the procedure
* Begin and end the collection period with an EMPTY BLADDER
* It should be refrigerated or keep on ice during the collection
* It must be thoroughly mixed, and the volume accurately measured and recorded
* 12-HOUR SPECIMEN, 4-HOUR SPECIMEN, AFTERNOON SPECIMEN (2PM-4PM)
* Measuring the exact amount of a urine chemical (Quantitative Chemical Tests)
24- hour (or Timed) Specimen
78
- for urobilinogen determination
- collected between 2pm to 4pm
- this collection correlates with the ''alkaline tide''
EARLY AFTERNOON SPECIMEN
79
- for ADDIS count
- quantitates formed elements using hemocytometer
12-HOUR URINE
80
ADDIS NORMAL VALUE:
RBC: 0-500,000
WBC AND EPITHELIAL CELLS: 0-1,800,000
HYALINE CAST: 0-5000
81
* FOR BACTERIAL CULTURE
* It is collected under sterile conditions by passing a hollow tube(catheter) through the urethra into the bladder.
- also used to measure function of individual kidney
CATHETERIZED SPECIMEN
82
* FOR ROUTINE SCREENING AND BACTERIAL CULTURE
* Alternative to the catheterized specimen
* Provides a safer, less traumatic method
* Provides a safer, less traumatic method
MIDSTREAM CLEAN-CATCH SPECIMEN
83
- collected by external introduction of needle through abdomen into bladder
* FOR BACTERIAL CULTURE AND URINE CYTOLOGY
* Provides a sample that is free of extraneous contamination
SUPRAPUBIC ASPIRATION
84
- aka THREE-GLASS COLLECTION
- for prostatic infection determination
- quantitative
PROSTATIS SPECIMEN
85
- should be collected in soft, clear plastic bags with hypoallergic skin adhesive to attach to the genital area
PEDIATRIC SPECIMEN
86
- for drug testing
DRUG SPECIMEN COLLECTION
87
Process that provides documentation of proper sample identification from time of collection to the receipt of the laboratory
CHAIN OF CUSTODY (COC)
88
Required urine volume for DRUG SPECIMEN COLLECTION
30-45 ml
89
urine container capacity for DRUG SPECIMEN COLLECTION
60 ml
90
Temperature (with in 4 min) for DRUG SPECIMEN COLLECTION
32.5- 37.7 °C
91
is added to the toilet water
reservoir to prevent specimen adulteration
Bluing Agent (dye)
92
- also used for testing for prostatitis
- same procedure as the three-glass method, with the addition of expressed prostatic secretions (EPS) prior container 3
FOUR-GLASS METHOD (STAMLEY-MEARS TEST)
