Unit 2 Flashcards
(89 cards)
1
Q
What is a random urine collection?
A
Collected at anytime
- not ideal source because urine may be diluted or contaminated.
2
Q
What is a first AM urine collection?
A
Collected at first awakening
- best for screening because it is most concentrated
3
Q
What is a 2 hour postprandial urine collection
A
- used for diabetes mellitus monitoring
- collected 2 hours after you eat
- best for detecting glycosuria
4
Q
What is a 24 hour urine collection?
A
- used for quantitative chemical tests
- discard first morning urine on day 1 and note time. Then collect urine for 24 hours including first void on day 2
- improper collection is common source of error
- needs to be kept refrigerated or on ice
Preservatives are required for some of the chemical tests
5
Q
What is a clean catch urine collection?
A
- used for routine urinalysis and culture
- cleanse genitals and collect mid stream in sterile container
- culture must be done first, so it is not contaminated during routine urinalysis
6
Q
What is a catheterized urine collection?
A
- used for culture
- catheter is inserted into urethra
- avoids contamination
7
Q
What is suprapubic aspirations?
A
- used for culture
- needle inserted into abdomen and into the bladder
- avoid contamination but it’s pretty invasive
8
Q
Normal daily urine output?
A
600-2,000 mL
- average is 1,200 - 1,500 mL
9
Q
What is the normal urine day to night ratio?
A
2:1 - 3:1
10
Q
What is diuresis?
A
Increased urine production
11
Q
What is polyuria?
A
- marked increased urine flow
- adult >2,500 mL per day
12
Q
What is oliguria?
A
- marked decrease in urine flow
- adult < 400 mL per day
13
Q
What’s anuria?
A
No urine production
14
Q
Describe color of normal urine
A
Yellow due to urochrome
15
Q
Describe color of concentrated urine
A
- dark yellow or amber
16
Q
Describe color of urine with bilirubin
A
- amber/orange
- yellow or green
- if shaken, yellow foam will appear at top
17
Q
Describe color of urine with urobilin
A
- amber/orange
- no yellow foam when shaken
18
Q
Describe color of homogentisic acid urine
A
- look normal while voiding
- will turn black or brown upon standing
19
Q
Describe the color of urine with melanin
A
Black or brown upon standing
20
Q
Describe the color of urine with methemoglobin
A
Brown or black upon standing
21
Q
Describe color of urine with myoglobin
A
Red and turns brown upon standing
22
Q
Describe the color of urine with blood/hemoglobin
A
Red or pink, turns brown upon standing
23
Q
Describe the color of urine with porphyrins
A
Port wine
24
Q
Describe the color of urine with a pseudomonas infection
A
Green or blue/green (from bacteria)
25
What happens to turbidity if urine is unreserved for > 2 hours?
- increase
- multiplication of Bacteria
- precipitation of amorphous crystals
26
What happens to urine pH if it is in preserved for > 2 hours?
- increase
- conversion of urea to ammonia by bacteria
27
What happens to glucose in urine when it is unpreserved for > 2 hours?
- decrease
- metabolism by bacteria
28
What happens to ketones in urine when it is unpreserved for > 2 hours?
- decrease
- volatilization of acetone
- breakdown by acetoacetate by bacteria
29
What happens to bilirubin in urine when it is unpreserved for > 2 hours?
- decrease
- oxidation to biliverdin
30
What happens to urobilinogen in urine when it is unpreserved for > 2 hours?
- decrease
- oxidation to urobilin
31
What happens to WBCs, RBCs, and Cast in urine when it is unpreserved for > 2 hours?
- decrease
- lysis in dilute or alkaline urine
32
What is the normal range for pH?
- first AM: 5-6
- random: 4.5 - 8
- perfectly preserved: 9
33
What is the principal for pH?
Double indicator system
34
What is the significance of pH?
Can be seen in acid base balance disorder
35
How is the urine of a meat eater?
Acidic
36
How is the urine for vegetarians?
Alkaline
37
What is the normal range for protein?
Neg. - trace
38
What is the principal of protein?
Protein error of a decayed indicator
39
What is significant of protein in urine?
Possible renal disease
40
What is protein most sensitive to?
Albumin
41
Describe your proteins result with a first am and a random (after standing)
- first am: neg. For protein
- random while standing: Positive for protein
42
What is the normal range for glucose?
Negative
43
What is the principal for glucose?
Glucose oxidase peroxidase
44
What is the significance of glucose in urine?
Possible indicator of diabetes mellitus
45
What is the normal threshold for glucose in urine?
160 -200 mg/dL
- higher values will spill over into urine
46
What is the normal range of ketones in urine?
Negative
47
What is the principal of ketones?
Sodium nitroprusside reaction
48
What is the significance of ketones in the urine?
- fat metabolism such as uncontrolled diabetes, vomiting, starvation, low carb diet, or strenuous workout
49
What is ketones most sensitive to? Least sensitive?
- most: acetoacetate acid
- least: acetone
50
What is the normal range for blood in the urine?
Negative
51
What is the principal of blood?
Pseudo peroxidase activity of hemoglobin
52
What is significant about blood in the urine?
- hematuria
- hemoglobinuria
- myoglobinuria
53
What does it mean when there is a uniform color on the blood reagent pad?
It’s either hemoglobin and myoglobin
54
What does it mean when the blood reagent pad it speckled?
RBCs present
55
What is the normal range for bilirubin?
Negative
56
What is the principle of bilirubin?
Diazo reaction
57
Why is it significant when bilirubin is detected in urine?
- liver disease and biliary obstruction
58
What type of bilirubin is only excreted through urine?
Conjugated
59
What is the normal range for urobilinogen?
1 Ehrlich unit or 1 mg/dL
60
What is the principal of urobilinogen?
Ehrlich aldehyde reaction or diazo reaction
61
Why is it significant when urobilinogen is found in urine?
- liver disease
- hemolytic disorders
62
What can the urobilinogen reagent pad detect?
Only increase. Does not detect when absence
63
What is the normal range of nitrate?
Negative
64
What is the principal of nitrate?
Griese reaction
65
What is significant about nitrates in the urine?
- UTIs
66
What does some bacteria do to nitrates?
Reduce them to nitrites
67
What is the best type of urine collection for testing nitrates?
- first A.M
- increased sensitivity when urine is in bladder for atleast 4 hours
68
What is the normal range for leukocyte esterase?
Negative
69
What is the principal of leukocyte esterase?
Leukocyte esterase reaction
70
What is significant about finding leukocyte esterase in urine?
UTIs
71
Which reagent pad takes the longest to complete reaction?
Leukocyte esterase
72
What for does the leukocyte esterase reagent pad detect?
Intact and like granule sites and monocytes
- not lymphocytes
73
What is the normal range for specific gravity of urine?
1.003 - 1.030
74
What is the principle of specific gravity?
Pka change of the poly electrolytes
75
What is a the significance of increased specific gravity?
Diabetes mellitus due to glucose
76
What is the significance of decreased specific gravity in urine?
Diabetes insipidus due to decreased ADH
77
What error can occur if the urine specimen was not tested within 2 hours or improperly stored?
Changes in chemical composition
78
What error can occur if specimen is not brought to room temperature before testing?
False negative enzymatic reaction
79
What error can occur if the specimen isn’t mixed well?
False negative for WBC or RBC because they settled to bottom
80
What error can occur when the manufacturers instructions are not followed?
False negative reaction or erroneous results
81
What error can occur if all the test pads were dipped into the urine?
False negative reaction
82
What error can occur if the reagent pads are dipped to long in the urine?
False negative reaction and reagents can leak from pads
83
What error can occur if the specimen is not collected at the correct time?
Run over of chemicals to adjacent pads and distort colors
84
What error can occur if the results are not compared to color chart or read in good light?
Erroneous results
85
What error occurs if the test strips are not stored properly?
Erroneous results
86
What error occurs if a QC is not performed?
Erroneous results
87
What error can occur from using expired test stripes?
Erroneous results
88
What error can occur with highly pigmented urine?
- atypical colors on reagent pad
- can cause/look like false positive
- pigment can mask true reaction
89
What can cause a false positive/negative in pH?
Yyyyyyyyyyyyy
