Urinalysis- MAcrocoscopic

Question 1

Red blood cells within the urine can come from any point along
the urinary tract.________________ red blood cells are often a sign of
glomerular disease.

Answer 1

Dysmorphic

Question 2

The __________________, because it is the most concentrated,
is often the best specimen for analysis. Some procedures may require
a 12- or 24-hour urine sample.

Answer 2

first voided morning urine

Question 3

Specific gravity and osmolality measurements reflect the
_________________. After a period of dehydration,
the osmolality should be three to four times that of plasma.

Answer 3

concentrating ability of the kidneys

Question 4

**Proteinuria greater than_______________ **is seen in the nephrotic syndrome.
Although nephrotic syndrome is usually seen in primary renal disease,
it is occasionally seen in a systemic disease that affects the kidneys.

Answer 4

** 4 g/day**

Question 5

Ketonuria can be seen in diabetic individuals. It can also be seen in
other states, such as____________________________

Answer 5

** febrile illness and cachexia.**

Question 6

The dipstick nitrite and leukocyte esterase tests are used to help
___________________. Positive results should be confirmed
by microscopic analysis of the urine.

Answer 6

diagnose urinary tract infection

Question 7

Urinary calculi are most commonly formed from _______________ Workup of
habitual stone formers should include analysis of both the urine and
the stone.

Answer 7

calcium.

Question 8

The recommended capacity for the container is_______________-, which allow collection of the 12 mL specimen for microscopic analysis.

Answer 8

50mL

Question 9

The specimen should be delivered within________________if not use refrigeration or chemical preservatives……

Answer 9

2 hours

Question 10

Pediatric specimens are collected using clear__________________ to attach to the genital area.

Answer 10

plastic bags with adhesive

Question 11

Odor: Ammonia-like
________________

Answer 11

(Urea-splitting bacteria)

Question 12

Odor: offensive
________________

Answer 12

Old specimen, pus or inflammation

Question 13

_______________
Glucose\

Answer 13

-Sweet

Question 14

Fruity
__________

Answer 14

Ketones

Question 15

Maple syrup-like
______________________

Answer 15

Maple Syrup Urine Disease

Question 16

Colorless

Answer 16

Diluted urine

Question 17

Deep Yellow
______

Answer 17

Concentrated Urine, Riboflavin

Question 18

Yellow-Green

Answer 18

Bilirubin / Biliverdin

Question 19

Red

Answer 19

Blood / Hemoglobin

Question 20

Brownish-red
\

Answer 20

Acidified Blood (Acute GN)

Question 21

Brownish-black

Answer 21

Homogentisic acid (Melanin)

Question 22

The yellow color of urine is due to______________

. It is a product of endogenous metabolism.
 Additional pigments are uroerythryn urobilin which are present in small amount.

Answer 22

urochrome

Question 23

:
− Typically cells or crystals.
− Cellular elements and bacteria will clear by centrifugation.
− Crystals dissolved by a variety of methods.
− Microscopic examination will determine which is present.

Answer 23

Turbidity

Question 24

Use to measure specific gravity in urine manually?

Answer 24

1. Urinometer
2. Refractometer

Question 25

– Consists of a **weighted float** attached to a scale that has been calibrated in terms of urine specific gravity. – **Displaces a volume of liquid equal to its weight**and has been designed to sink to a level of **1.000 in distilled water.** – **Less accurate t**han other methods **– Not recommended** – Uses large amounts of urine  READ 1st  The container must also be wide enough to allow it to float without touching the sides and from resting at the bottom.

Answer 25

Urinometer:

Question 26

– **Determines the concentration** of dissolved particles – Does by **measuring the refractive index** o It is a **comparison of the velocity of light** in air with the **velocity of light in a solution.** – The specific gravity scale is calibrated in terms of the angles at which the light passes through the specimen. – It uses a small amount of urine **(1-2 drops).**

Answer 26

Refractometer:

Question 27

The blood level at which tubular re-absorption stops(renal threshold) for glucose is approximately\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Answer 27

160-180 mg/dL

Question 28

Uses and Limitations of Urine Glucose Detection Significance \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Answer 28

– Diabetes mellitus. – Renal glycosuria.

Question 29

What are the limitations of glucose reagent strip method?

Answer 29

Limitations – Interference: reducing agents, ketones. – Only measures glucose and not other sugars. – Renal threshold must be passed in order for glucose to spill into the urine.

Question 30

Other Tests –\_\_\_\_\_\_\_\_\_\_\_\_\_ test for reducing sugars.

Answer 30

CuSO4

Question 31

Detection of Reducing Sugars\* by CuSO4 Sugar Disease(s) Galactose: Galactosemias Fructose :Fructosuria, Fructose Intolerance, etc. Lactose :Lactase Deficiency Pentoses :Essential Pentosuria Maltose: Non-pathogenic **\* NOT Sucrose because it is not a reducing sugar.**  It uses your\_\_\_\_\_\_\_\_\_\_\_\_\_ which was developed in 1908 (copper sulfate, sodium carbonate, sodium citrate buffer)  Blue to orange/red

Answer 31

Benedict’s solution

Question 32

Uses and Limitations of **Urine Bilirubin** Detection Significance

Answer 32

 Increased direct bilirubin (correlates with urobilinogen and serum bilirubin) Limitations  Interference: **prolonged exposure of sample to light**  Only measures **direct bilirub**in--will not pick up indirect bilirubin

Question 33

Other Tests – (more sensitive **tablet version of same assay**) – Serum test for total and direct bilirubin is more informative

Answer 33

Ictotest

Question 34

Significance of Test for Ketones

Answer 34

– Diabetic ketoacidosis – Prolonged fasting

Answer 35

Limitations – **Interference:** expired reagents (degradation with exposure to moisture in air) – **Only measures acetoacetate** not other ketone bodies (such as in rebound ketosis).

Question 36

Other Tests for Ketone (more sensitive tablet version of same assay)

Answer 36

– Ketostix (more sensitive tablet version of same assay)

Question 37

Other Tests for Ketone – Serum glucose measurement to confirm

Answer 37

DKA

Question 38

Specimens with a **pH of 6.5** or **higher** will have \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_readings cause by **interference** with the **Bromthymol blue indicato**r (the blue-green readings associated with an alkaline pH correspond to a low specific gravity reading). It is recommended to add 0.005 to specific gravity readings when the pH is 6.5 or higher.

Answer 38

decreased

Question 39

Chemical tests for blood uses the\_\_\_\_\_\_\_\_\_\_\_\_\_of hemoglobin to catalyze a reaction between **hydrogen peroxide and the chromogen tetramethylbenzidine** to produce an oxidized chromogen which has a green-blue color.

Answer 39

pseudoperoxidase activity

Question 40

Uses and Limitations of Urine Blood Detection Significance – Hematuria (nephritis, trauma, etc) – Hemoglobinuria (hemolysis, etc) – Myoglobinuria (rhabdomyolysis, etc) Limitations

Answer 40

– Interference: reducing agents, microbial peroxidases – Cannot distinguish between the above disease processes Other Tests – Urine microscopic examination – Urine cytology

Question 41

Uses and Limitations of Urine pH Detection Significance – Acidic (less than 4.5): metabolic acidosis, high-protein diet – Alkaline (greater than 8.0): **renal tubular acidosis (\>5.5**) Limitations \

Answer 41

– Interference: bacterial overgrowth (alkaline or acidic) – “run over effect” effect of protein pad on pH indicator pad