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Mercy CLS 3: Urinalysis > 1. Intro to Urinalysis > Flashcards

1. Intro to Urinalysis Flashcards

1
Q

“Uroscopy” book

A

Hippocrates 5th century BC

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2
Q

first urine color charts

A

1140 CE

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3
Q

discovery of albuminuria

A

1694

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4
Q

urinalysis introduced as part of routine patient exam

A

1827

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5
Q

body converts —— mL of filtered plasma to ——- mL of urine each day

A

170,000
1,200

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6
Q

primary components in normal urine (9)

A
  • urea
  • creatinine
  • uric acid
  • chloride
  • sodium
  • potassium
  • phosphate
  • ammonium
  • calcium
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7
Q

define urea

A

primary organic component

product of amino acid metabolism

1/2 the total dissolved solids

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8
Q

define creatinine

A

product of creatine metabolism in muscles

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9
Q

ID a fluid as urine

A

urea + creatinine

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10
Q

define uric acid

A

product of nucleic acid breakdown

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11
Q

primary inorganic component

A

chloride

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12
Q

formed elements found in urine

A

cells
casts
crystals
mucus
bacteria

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13
Q

factors that influence urine volume (4)

A
  • Fluid intake
  • Fluid loss from nonrenal sources
  • Variations in the secretion of ADH
  • Need to excrete increased amounts of dissolved solids, such as glucose or salts
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14
Q

average urine output range
normal urine output range

A

1200-1500 mL
800-2000 mL

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15
Q

oliguria

A

decrease in urine output
dehydration
< 400 mL/day in adults

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16
Q

cessation of urine flow

A

anuria

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17
Q

increase in daily urine volume

A

polyuria
> 2500 mL/day in adults

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18
Q

polyuria can indicate…

A

DM
DI

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19
Q

increased body glucose concentration

A

DM

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20
Q

why does DM lead to polyuria?

A

increased amounts of water are needed to remove excess glucose from the body

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21
Q

what is different about the urine of DM patients and DI patients?

A

specific gravity
DM: increased
DI: decreased

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22
Q

decrease in production or function of ADH

A

DI

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23
Q

3 general types of urine containers

A

cups
individual collection devices
24-hour urine jugs

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24
Q

cup capacity

A

50 mL

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25
Q

individual urine tube capacity

A

10-12 mL

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26
Q

24 hour jug capacity

A

3000 mL

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27
Q

All specimens should be labelled with… (7)

A
  • Patient’s Name
  • Medical Record Number (MRN)
  • DOB/age
  • Patient Location
  • Date & Time of Collection
  • Collector’s Initials
  • Tests to be run
28
Q

must accompany specimens delivered to the lab - must match info on label

A

requisition form

29
Q

types of urine deterioration over time (5)

A
  • microbial
  • oxidative
  • photolytic
  • thermal
  • autolytic
30
Q

which metabolic processes to the bacteria continue to undergo over time?

A
  • Decompose ketone bodies
  • Ferment glucose
  • Produce NH3 (ammonia) from the breakdown of urea
  • Reduces nitrates to nitrites
  • Alters pH (NH3 production changes the pH to alkaline)
31
Q

example of oxidative deterioration

A

urine color can change from brown to green due to bilirubin being oxidized to biliverdin

32
Q

analyte that is unstable when exposed to light, collected in a brown bottle

A

porphyrins

33
Q

examples of autolytic deterioration

A

RBCs and WBCs lyse
casts deteriorate (↑ pH)

34
Q

Change to unpreserved urine after 2 hours

color

A

darkened

oxidation/reduction of metabolites

35
Q

Change to unpreserved urine after 2 hours

clarity

A

decreased

bacterial growth
precipitation of amorphous material

36
Q

Change to unpreserved urine after 2 hours

odor

A

increased

bacterial multiplication, breakdown of urea to ammonia

37
Q

Change to unpreserved urine after 2 hours

pH

A

increased

breakdown of urea to ammonia
loss of CO2

38
Q

Change to unpreserved urine after 2 hours

glucose

A

decreased

glycolysis
bacterial use

39
Q

Change to unpreserved urine after 2 hours

ketones

A

decreased

volatilization
bacterial metabolism

40
Q

Change to unpreserved urine after 2 hours

bilirubin

A

decreased

photooxidation to biliverdin

41
Q

Change to unpreserved urine after 2 hours

urobilinogen

A

decreased

oxidation to urobilin

42
Q

Change to unpreserved urine after 2 hours

nitrite

A

increased

bacteria

43
Q

Change to unpreserved urine after 2 hours

RBC/WBC/casts

A

decreased

deterioration in dilute alkaline urine

44
Q

Change to unpreserved urine after 2 hours

bacteria

A

increased

45
Q

Change to unpreserved urine after 2 hours

trichomonas

A

decreased

death
loss of motility

46
Q

urine refrigeration temperature

A

2°-8°

47
Q

the ideal preservative

A
  • bactericidal
  • inhibit urease
  • preserve formed elements
  • not interfere with chemical tests
48
Q

refrigeration

disadvantage

A

precipitates amorphous phosphates and urates

49
Q

boric acid

advantage

disadvantage

keeps pH at —-, used for urine culture transport

A

prevents bacterial growth/metabolism

interferes with drug and hormone analyses

6.0

50
Q

formalin

advantage
disadvantage

A

preserves cells and casts
interferes with chemical tests (reducing agent)

51
Q

sodium fluoride

advantage
disadvantage

A

good preservative for drug analyses
inhibits reagent test strips for glucose, blood, WBCs

52
Q

C&S tube

function
stability
limitations

A

culture; prevents bacterial growth/metabolism
stable at RT for 48 hr
do not use if below fill line

53
Q

yellow UA plus tube

function
limitations
preservative

A

used on automated instruments
refrigerate within 2 hours
no preservative

54
Q

tiger tops

function
stability
limitations
preservatives

A

urine-instrument compatible
stable for 72 hr at RT
not used for culture
must be filled to minimum fill line
sodium propionate, ethyl paraben, chlorhexidine

55
Q

most commonly received specimen

A

random specimen

56
Q

now-uncommon specimen that took the 2nd void of the day

A

fasting urine

57
Q

ideal urine specimen

A

first morning

58
Q

best specimen for pregnancy testing, detection of chemicals and formed elements, and for evaluation orthostatic proteinuria

A

first morning

59
Q

used for quantitative measurement of analytes

A

24 hour urine

60
Q

diurnal variation

A

Some analytes are excreted in varying concentrations during a 24-hour period

catecholamines, 17-hydroxysteroids, and electrolytes

lowest concentration is in the early morning and the highest concentration occurs in the afternoon

61
Q

instructions for start and end times for 24 hour collection

A

Completely void the bladder of urine into the toilet and record this date and time as the START of the collection.

Even if there is not a big urge to urinate at the exact END time, it is best to try and add it to the collection. The final collection should be recorded as the END date and time.

62
Q

specimen of choice for cytologic exam

A

suprapubic aspiration

63
Q

process that provides documentation of proper collection and identification from the time of collection to the receipt of lab results

A

chain of custody

64
Q

drug screen

volume collected

A

30-45 mL

65
Q

drug screen

temperature taken within…

A

4 minutes

66
Q

drug screen

temp should fall between….

A

32.5° - 37.7°

Mercy CLS 3: Urinalysis (10 decks)

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