Urinalysis Flashcards
(97 cards)
1
Q
wrote a book on uroscopy in 5th BCE
A
Hippocrates
2
Q
physicians concentrated their efforts very intensively on
the art of uroscopy, receiving instruction in urine examination as part of their training
A
Middle ages
3
Q
color charts had been developed that described the significance of 20 different colors
A
1140 CE
4
Q
discovered albuminuria by boiling urine (1964)
A
Frederick Dekkers
5
Q
wrote a book on “pisse prophets” (1627)
A
Thomas Bryant
6
Q
17th century: invention of the microscope led to the examination of urine sediment and development by _ of methods for quantitating
urine sediments (cells in the urine)
A
Thomas Addis; Addis count
7
Q
primary organic component; product of protein and amino acid metabolism
A
Urea
8
Q
primary inorganic component; found in combination with sodium and many inorganic substances
A
chloride
9
Q
product of creatine metabolism by muscles
A
creatinine
10
Q
product of nucleic acid breakdown in food and cells
A
uric acid
11
Q
primarily from salt, varies by intake
A
sodium
12
Q
combined with chloride and other salts
A
potassium
13
Q
combines with sodium to buffer and the blood
A
phosphate
14
Q
regulates blood and tissue fluid acidity
A
ammonium
15
Q
combines with chloride, sulfate
A
calcium
16
Q
normal daily urine output
A
1200-1500 ml
17
Q
increase in daily urine volume
A
polyuria
18
Q
decrease in urine output
A
oliguria
19
Q
cessation of urine flow
A
anuria
20
Q
painful urination
A
Dysuria
21
Q
increase volume of urine during night
A
Nocturia
22
Q
Increased ingestion of water
A
Polydipsia
23
Q
container of urine from infants
A
pliable polyethylene bags w/ adhesive
24
Q
24-hour urine collection container
A
large, wide-mouthed plastic containers
25
container of urine for bacterial culture
sterile plastic container
26
Urine collection within?
2 hours
27
Most routinely used method preservation of urine
Refrigeration at 2-8℃
28
Urine preservation: prevents bacterial growth and metabolism
Boric acid
29
Urine preservation: excellent sediment preservative
Formaline
30
Urine preservation: for drug analysis
Sodium flouride
31
Increased urine change
pBACON = Bacteria, Color, Odor, Nitrite
32
most commonly received specimen for convenience of patient; routine screening test
Random specimen
33
ideal screening specimen; preventing false-negative pregnancy and evaluating orthostatic proteinuria
*concentrated specimen
*best for cast and crystal retrieval
First morning specimen
34
+/- orthostatic and clinical proteinuria (1st morning, random urine)
1st morning urine : - , +
random urine: +, +
35
*include fasting, half-hour, 1-hour, 2-hour...
*urine is tested for glucose and ketones along with blood test result correlated with renal threshold
Glucose Tolerance Specimens
36
*measuring exact amount of urine after 1st morning specimen
*diurnal variations (catecholamines) w/ daily activities such as exercise
*all urine is thoroughly mixed and volume is measured and recorded
*refrigerated, chemical preservative may be added
24-hour/Timed Specimen
37
Timed specimen for 24-hour specimen:
4 hour?
Afternoon (2-4pm)?
12 hour?
24 hour?
- nitrite determination
- alkaline tide determination (urobilinogen) = after meal
- ADDIS count
- for creatinine
38
collected under sterile conditions passing a catheter through urethra into bladder; for bacterial culture
Catheterized Specimen
39
alternative to catheterized specimen; provides safer, less traumatic method for bacterial culture and routine urinalysis
Antiseptic: mild antiseptic towelletes
*contains least amount of normal floral contaminant from distal urethra
Midstream clean-catch specimen
40
collected by external introduction of needle through abdomen into bladder; provides sample for bacterial culture that is completely free of extraneous contamination
*for cytologic examination
Suprapubic aspiration
41
Prostatitis specimen: Three-Glass Specimen procedure
*cleaned using male midstream clean-catch procedure
*quantitative cell count in all 3 specimen; 1st and 3rd urine examined microscopically
Prostatic infection: 3rd specimen will have WBC/HPO and bacterial count 10x of 1st specimen; Macrophages containing lipids may also present
*first urine in sterile container
*midstream portion in sterile container
*prostate massaged that prostate fluid passed in urine in sterile container
42
Prostatitis Specimen: Pre- and Post- Massage test procedure
positive result is significant bacteruria in post massage specimen of greater than 10x pre massage count
*1st clean-catch midstream urine specimen is collected
*2nd urine is collected after prostate is massaged
43
Prostatitis Specimen: Stamey-Mears Test (four-glass method)
*urethral infection for VB1
*urinary bladder infection for VB2
*prostatic secretions/infections examined for WBC for VB3
*confirmatory prostate infection for VB4
VB1: initial voided urine
VB2: midstream urine
EPS: expressed prostatic secretions
VB3: post-prostatic massage urine specimen
44
obtained by catheterization/suprapubic aspiration
*attach soft and clear bag firmly over genital area avoiding anus
Pediatric specimens
45
Chain of custody form collection
*witness specimen a same-gender collection
*30-45 ml urine
*tempt within 4 mins
*tempt range: 32.5℃-37.7℃ and urine color
Drug specimen collection
46
2nd voided urine after 1st morning urine; for glucose determination
Fasting urine/Second morning urine
47
Diabetic monitoring (insulin therapy), specimen collection after a routine meal and 1 hours after comprehensive result
2 hours post prandial urine specimen
48
frequently ordered urine test screens and not limited to physical analysis but also covers chemical and microscopic analysis
Routine analysis
49
patient have symptoms of UTI used midstream clean-catch collection
*measured for 18-25 hours
Culture & sensitivity
50
requested to detect cancer, cytomegalovirus and other viral diseases in urinary system; midstream clean-catch specimen
*Papanicolaou (PAP) method for smear from cells of lining urinary tract
Urine cytology studies
51
for recreational drugs, anabolic steroids used in sports, unwarranted prescription of drugs and therapeutic drug
Urine drug testing
52
performed to screen diabetes and glucose level for px who are already diabetics
Urine glucose and ketone testing
53
determine if px is suffering from diabetic ketoacidosis
Urine ketone level test
54
used to confirm pregnancy can be detected 8-10 days; first morning urine specimen = highest concentration of human gonadotropin
urine pregnancy testing
55
Physical examination of urine
clarity, color, specific gravity
56
a yellow pigment responsible for the normal yellow color of urine; named by Thudichum
*product of endogenous metabolism and dependent in body's metabolic state
Urochrome
57
concentrated specimen
dark yellow
58
dehydration from fever and burns
amber
59
yellow foam appears when specimen is shaken
bilirubin - yellow orange
60
due to photo-oxidation of urobilinogen to urobilin
yellow orange
61
drug use for UTI
yellow orange/thick orange; phenazopyridine (Pyridium)
62
due to photo-oxidation of bilirubin to biliverdin
yellow green
63
due to oxidation of hemoglobin to methemoglobin
RBC/acid urine; brown/black
64
oxidation of product of colorless pigment melanogen, produced in excess when malignant melanoma is present
melanin; black/brown
65
metabolite of phenylalanine
Homogentisic acid
66
Black color in alkaline urine from person with IEM
Alkaptonuria (alkaline urine)
67
pink pigment, indicator that specimen is refrigerated (binds to amorphous urates leading to its perception)
Uroerythrin
68
medications like methocarbamol, methylene blue, amitriptyline
Blue
69
clorets, phenol derivatives; found in IV medications
Green
70
bacterial infection caused by klebsiella/providencia species
Indicanuria - purple
71
clear urine w/ positive chem test, intravascular hemolysis
hemoglobin
72
clear urine w/ positive cehem test, muscle damage
myoglobin
73
red in alkaline urine and red in acidic urine
beets and blackberries
74
cause of white cloudiness in urine clarity
precipitation of amorphous phosphates and carbonates
75
white precipitate in alkaline pH
amorphous phosphate and carbonate
76
uroerythrin in acidic pH
amorphous urates
77
1.010 SG of plasma filtrate entering the glomerulus
Isothenuric
78
Normal specific gravity
1.003-1.035 (1.015-1.030)
79
Consist of a weighted float that displaces a volume of liquid equal to its weigh
Urinometer
80
Calibration tempt of Urinometer?
Below/ Cold tempt?
Above calibration tempt?
Every 1g/dl Protein?
Every 1g/dl Glucose?
20℃
Subtract 0.001 every 3 degrees
Add 0.001 every 3 degrees
Subtract 0.003
Subtract 0.004
81
determines the concentration of dissolved particles in a specimen by measuring refractive index
Refractometer
82
Specimen containing 1 g/dL protein and 1 g/dL glucose has a specific gravity of 1.030
1.023
83
The urine specific gravity is determined using urinometer at 26C and read 1.025. what is the corrected value?
1.0027
*26-20 = 6/3 = 2 (0.002) = 1.0025 +0.002
84
based on the principle that the
frequency of sound wave entering a
solution changes in proportion to the density of the solution
Harmonic Oscillation Densitometry
85
based on the change in pKa (dissociation constant) of a
polyelectrolyte in an alkaline medium
Reagent strip reaction (specific gravity)
86
Normal urine odor (breakdown of urea to ammonia)
Aromatic
87
Reaction strips time of glucose and bilirubin
30 sec (Double sequential enzymatic reaction, Diazo reaction)
88
Reaction strips time of ketones
40 sec (Legal's test)
89
Reaction strips time of specific gravity
45 sec (pKa change of polyelectrolytes)
90
Reaction strips time of proteins, pH, urobilinogen, nitrites
1 min (Sorensen's error, Double indicator sys, Ehrlich's reaction, Greiss's reaction)
91
Reaction strips time of leukocytes
2 mins (Leukocyte esterase)
92
Protein test in reagent strips
SSA (Sulfosalicylic acid precipitation test), Micral test
93
Glucose test in reagent strips
clinitest
94
Ketones test in reagent strips
acetest
95
Bilirubin test in reagent strips
Ictotest
96
Include urinalysis as part of doctors routine
Richard Bright
97
