UNIT 2 Flashcards by FRANCHESCA MAUREEN CUISON

Most commonly received specimen

random specimen

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Useful for screening tests to detect obvious abnormalities

May show erroneous result resulting from dietary intake orphysical activity just before collection.

random

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Ideal screening specimen
Prevents false negative pregnancy tests
For evaluating orthostatic proteinuria

first morning specimen

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For quantitative testing

timed

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Collected under sterile conditions by passing a hollow tube
(catheter) through the urethra into the bladder

For bacterial culture

cathetherized specimen

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Ideal specimen
Safer, less traumatic method for obtaining urine for bacterial
culture and routine urinalysis.
Less contaminated by epithelial cells and bacteria

midstream clean-catch specimen

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Strong bacterial agents, such as hexachlorophene or
povidone-iodine, should not be used as cleansing agents.

TRUE

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External introduction of a needle through the abdomen

suprapubic specimen

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for bacterial culture that is completely free of extraneous
contamination, particularly in infants or children.
can be used for cytological examination.

suprapubic specimen

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Three-Glass Collection
○ 1st urine passed = collected in a sterile container
Midstream portion = collected in a separate container

Prostate is massaged so that prostate fluid will be
passed with the remaining urine

prostatitis specimen

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Quantitative cultures are performed on all specimens

prostatitis specimen

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1st and 3rd specimens are examined microscopically
Prostatic Infection: 3rd specimen will have WBC/hpf
and bacterial count 10x that of the first specimen
2nd specimen: control for kidney and bladder infection

prostatitis specimen

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will have WBC/hpf

3rd specimen

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control for kidney and bladder infection

2nd specimen

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clean-catch midstream urine specimen
○ A second urine sample is collected after the prostate
is massaged.
○ A positive result is significant bacteriuria in the
postmassage specimen of greater than 10 times the
premassage count

pre and post massage test

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The first urine specimen is voided bladder (VB1),
represents the urethral specimen.
■ Then the patient voids another 100 to 150 mL of
urine.

Stamey-Mares Test for Prostatitis (Four-glass urine
collection technique)

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represents the bladder
specimen

VB2

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is the expressed prostatic
specimen (EPS), which is the fluid collected during
prostatic massage.

3rd specimen EPS

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consists of urine collected
after EPS; it contains any EPS trapped in the prostatic
urethra.

VB3

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The three urine specimens are centrifuged, and the
sediment is examined for white blood
cells/aggregates, macrophages, oval fat bodies,
bacteria, and fungal hypha.

TRUE

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tested for by
the VB1

Urethral infection or inflammation

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urinary bladder
infection

VB2

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Having more than 10 to 20 white blood cells per
highpower field is considered

ABNORMAL

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Soft, clear plastic bags
Hypoallergenic skin adhesive to attach to the cleaned
genital area for boys and girls

pediatric specimen

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A urine pH of greater than _____ suggests adulteration of the urine

GREATER THAN 9

A specific gravity of less than ______ could indicate dilution of the urine specimen and requires re-collection

LESS THAN 1.005

Second voided urine after a period of fasting

FASTING SPECIMEN

Fasting urine, 1-hour, 2-hour, 3-hour and possibly 4-hour, 5-hour, and 6-hour specimens. tested for glucose and ketones, and the results were reported along with the blood test results

GLUCOSE TOLERANCE SPECIMEN

ODOR PH NITRITE BACTERIA

ALL INCREASED

Prevents bacterial growth and metabolism Interferes with analysis of drugs and hormones Keeps pH at about 6.0m; Can be used for transport of urine cultures

Acids (boric acid, HCL, acetic acid, tartaric acid)

Excellent sediment preservative Acts as a reducing agent, interfering with chemical tests for glucose, blood, leukocyte esterase, and copper reduction Rinse specimen container with formalin to preserve cells and casts

Formalin (formaldehyde)

Good preservative for drug analyses Inhibits reagent strip tests for glucose, blood, and leukocytes

sodium floride

Convenient when refrigeration not possible; Have controlled concentration to minimize interference

commercial preservative tablets

Contains collection cup, transfer straw, culture and sensitivity preservative tube, or UA tube

Urine Collection Kits (Becton, Dickinson, Rutherford, NJ)

Specimen stable at room temperature (RT) for 48 hours; prevents bacterial growth and metabolism Preservative is boric acid, sodium borate, and sodium formate; Keeps pH at about 6.0

Light gray and gray C&S tube 48 hrs

Use on automated instruments Must refrigerate within 2 hours Round or conical bottom, no preservative

Yellow UA Plus tube

Specimen stable for 72 hours at RT; instrument-compatible Must be filled to minimum fill line; Bilirubin and urobilinogen may be decreased if specimen is exposed to light and left at RT Preservative is sodium propionate, ethyl paraben, and chlorhexidine Round or conical bottoms

Cherry red/yellow Preservative Plus tube 72/hes

Oxidation or Reduction of metabolites

color modified/ darkened

Bacterial growth and of amorphous material

clarity

Bacterial multiplication or breakdown of urea to ammonia to ammonia

odor

Breakdown of urea to ammonia by urease-producing bacteria/ loss of CO2

Glycolysis and bacterial use

glucose

Volatilization and bacterial metabolism

ketones

Exposure to light/ photo-oxidation to biliverdin

bilirubin

Oxidation to urobilin

urobilinogen

Multiplication of nitrate-reducing bacteria

nitrite

Disintegration in dilute alkaline urine

RBC, WBC & Casts

Multiplication

bacteria increased

Loss of motility, death

trichomonas decreased

wrote a book on “uroscopy”

hippocrates

discovery of albuminuria by boiling urine

frederick dekkers

These charlatans, called “pisse prophets, ” became the subject of a book published by

thomas bryant

developed methods of quantitating microscopic sediments ○ The invention of the microscope in the 17th century led to the examination of urinary sediment and to the development by

thomas addis

introduced the concept of urinalysis as part of a doctor’s routine patient examination

richard bright

Ideal preservative is _______: inhibits urease and preserves formed elements in the sediment

bactericidal

Routine is ________; this is a must for culture specimens

refrigeration

Must return to room temperature for chemical testing

TRUE

More concentrated than a random specimen

first morning specimen

Actually is second specimen voided - collected after the first morning specimen Does not contain metabolites from evening meal Recommended for glucose monitoring

FASTING SPECIMEN second specimen voided

Monitors insulin therapy Results can be compared with fasting urine specimen and blood test result Patient voids before eating routine meal Eats meal Collects next specimen 2 hours after finishing meal

2 hour postprandial specimen

Specimens are collected at the same intervals as the blood samples Used to correlate renal threshold with patient’s ability to metabolize glucose

glucose tolerance specimen

Principle: collection must begin and end with an empty bladder

24 hour (timed) specimen

7 a.m. – patient voids and discards urine Patient begins collecting urine 7 a.m. second day – patient voids and adds this urine to the specimen container

24 HOUR TIMED SPECIMEN

Alternative to catheterized specimen Less contaminated than routine collection Provide patient with mild cleansing material and container and instructions:

midstream clean catch specimen

Positive culture in specimen 2 invalidates positive culture in specimen 3 (cannot differentiate urinary tract infection from prostate infection)

TRUE

________ on VB1 and VB2 and _________ on EPS and VB3 show prostatitis

VB1 and VB2 negative cultures EPS AND VB3 Positive

UNIT 2 Flashcards

(66 cards)