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7 UA > 2 > Flashcards

2 Flashcards

1
Q

What does the physical examination consist of?

A

1) Color and clarity
2) Clarity
3) Foam
4) Odor
5) Concentration

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2
Q

What is the definition of a “Random” type (timing of collection)?

A

Unspecified, can be collected at any time, most common screening purposes, can sometimes give an inaccurate view of a patient’s health

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3
Q

What is the definition of a “First Morning” type (timing of collection)?

A

First voided the urine is generally more concentrated, contains relatively higher levels of cellular elements, or protein

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4
Q

What is the definition of “fasting-second” type (timing of collection)?

A

Voided after 8 hours of fasting

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5
Q

What is the definition of “postprandial-first” type, (timing of collection)?

A

Voided is before a meal, and to collect a specimen 2 hours after eating

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6
Q

What are the types of “Timing of Collection”?

A

1) Random
2) First Morning
3) Fasting - second
4) Postprandial - first

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7
Q

What is the definition of the “Timed” aka 24 hour collection?

A

It is a collection of urine that measures creatinine **, urine urea nitrogen, glucose, sodium, and potassium

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8
Q

What is the definition of a “Midstream Clean Catch” (timing of collection)?

A

Urine is the preferred type of specimen for bacteria culture* and sensitivity testing because of the reduced incidence of cellular and microbial contamination

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9
Q

For a routine urinalysis, what is needed?

A

a fresh (less than 1-hour old clean-catch urine sample)

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10
Q

What happens when urine stands at room temperature for a long time?

A

Casts and red cells undergo lysis, and the urine becomes alkalinized with precipitation of salts

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11
Q

If you are testing urine specimens within a two hour window what do you need to do?

A

Refrigeration or Chemical preservation should be utilized

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12
Q

What is used for chemical preservation?

A
  • Boric Acid (MOST COMMON*)
  • Chloroform
  • Formalin
  • Thymole
  • Toluene
  • Preservation Tablet
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13
Q

Preserved urine specimens can be stored at room temperature until _____

A

time of testing

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14
Q

What are the steps of Routine Urinalysis?

A

1) Physical Exam
2) Chemical Exam
3) Microscopic Exam

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15
Q

What are you looking for during the physical exam of urine?

A
  • Color
  • Transparency (clarity)
  • Foam
  • Odor
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16
Q

What are the 3 things that are being assessed during the physical examination of urine?

A

Appearance, Specific gravity, and volume

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17
Q

What is the pigment that gives urine it’s characteristic yellow color?

A

Urochrome (urobilin)

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18
Q

What substance in urine may contribute to some pinkish or reddish color in urine?

A

Uroerythrin

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19
Q

What are the 4 colors that are “normal?”

A

Colorless, straw, yellow, amber/dark yellow

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20
Q

If urine is white and pathogenic, what will it contain?

A

Chyle, lipids, pyuria

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21
Q

If urine is white and NONpathogenic, what will it be the result of?

A

phosphates and vaginal creams

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22
Q

Define “Chyle”

A

A milky body fluid consisting of lymph and emulsified fats, or free fatty acids

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23
Q

Pyuria =

A

many WBC’s

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24
Q

If you have yellow to amber/orange urine and it’s pathologic, what would be the cause of this?

A

liver dysfunction (excessive urobilin or bilirubin), and also some Chemotherapy drugs**

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25
Q

If you have yellow to amber/orange urine and it’s NON pathologic, what would you expect the reason for this color change?

A
  • carrots
  • concentrated
  • urine dehydration
  • food color
  • vitamin B complex or C
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26
Q

What is the NON pathologic list of things associated with urine chasing to a yellow/amber/orange color?

A

nitrofurantoin, pygidium, quinacrine, rhubarb, senna, serotonin, sulfasalazine-acriflavine, azo ganstrisin

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27
Q

If you urine has changed to yellow/green, what would be the pathologic reason for this change?

A

Biliverdin and Bilirubin

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28
Q

If your urine is yellow/green and it is NON pathologic, what is the most likely cause?

A

Asparagus

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29
Q

If your urine is pink/red, what is the most likely pathologic reason for this?

A

RBCs, Hemoglobin, Myoglobin, and Porphyrin

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30
Q

If your urine is pink/red and it is NON pathologic, what is the most likely cause?

A

Beets (anthocyanin) and food colors: (long list)

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31
Q

If your urine is red to purple and it is pathologic what is the most likely cause?

A

Porphyrin

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32
Q

If your urine is red to purple, can this be non pathologic?

A

NO, there is definitely something wrong

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33
Q

If your urine is red to brown, what is the most likely Pathologic cause?

A

Methemoglobin and Myoglobin

34
Q

If your urine is red to brown, is there any way it can be non-pathologic?

A

NO, this is bad

35
Q

If your urine is brown to black, what is the most likely Pathologic cause?

A
  • Bilirubin **
  • Methemoglobin**
  • Myoglobin **
  • Homogentistic Acid (alkapton ***
36
Q

If your urine is brown to black, what is the most likely cause in NON pathologic cases?

A
  • Iron compounds*
  • Fava beans*
  • Aloe *
37
Q

If your urine is Blue to Green and it is pathologic, what is the most likely cause?

A
  • Biliverdin (green)*
  • Psudomonas infection*Indicans
38
Q

If your urine is blue to green and it is NON pathologic, what is the most likely cause?

A
  • Vitamin B12*
  • Thymole*
  • Diuretic Therapy* (blue urine color)
39
Q

Why would urine become cloudy?

A

Due to precipitation of amorphous crystals

40
Q

Amourphous phosphates precipitate =

A

WHITE

41
Q

Amorphous urate precipitate =

A

PINK (uroerythrin)

42
Q

Cloudy urine may contain ____

A

Salts/crystals**

43
Q

Hazy urine may contain _____

A

Mucus**

44
Q

Smoky urine may contain _____

A

RBCs ***

45
Q

Turbid urine may contain _____

A

leukocytes, bacteria, pus, proteins, and epithelial cells **

46
Q

Milky urine may contain ____

A

Fat or chyle **

47
Q

Various non-urinary substances can cause _____

A

urine specimens to appear hazy or cloudy

48
Q

If your urine is clear, what is the most likely cause it would be a Pathologic problem?

A

Very dilute or Polyuria (DM, or DI)

49
Q

If your urine is clear, what is the most likely cause it would be a NON pathologic problem?

A

Over hydrated

50
Q

If urine is cloudy to turbid, what is the most likely pathologic cause of this?

A

Varying degrees of:

  • Casts
  • Cells
  • Crystals and Calculi
  • Fat (lipid, chyle)
  • Microorganisms
  • Fecal Contamination
51
Q

If urine is cloudy to turbid, what is the most likely NON-pathologic cause of this?

A
  • Creams, lotions
  • Crystals
  • Mucus
  • Radiographic dyes
  • Powders
  • Fecal Contamination
52
Q

What is the tell all sign that foamy urine is pathologic?

A

It is PERSISTENTLY* foamy urine and becomes more noticeable over time

53
Q

What is the tell all sign that foamy urine is NON pathologic?

A

It SOMETIMES develops (the foam)

54
Q

What are the main causes of foamy urine in regards to Pathologic problems?

A
  • Significant amounts of protein (kidney disease)
  • UTI (pus)
  • Fistula from colon to bladder
55
Q

What are the main causes Urine would be foamy under Non-pathologic circumstances?

A
  • Rapid urination
  • Foam increased with urine concentration (dehydration)
  • Toilet cleaner
56
Q

Sweet or fruity urine is associated with:

A

Ketones (e.g. DM)

57
Q

Pungent urine is associated with:

A

Bacteria (ammonia) (e.g. UTI)

58
Q

Maple syrup smelling urine is associated with:

A

Amino acids (maple syrup urine disease)

59
Q

Musty or mousy urine odor of an infant is associated with:

A

Phenylketonuria

60
Q

Rancid butter or fishy urine odor is associated with:

A

Hypermethioninemia

61
Q

Stronger ammonia smelling urine is associated with:

A

Dehydration

62
Q

What does a urine concentration test actually test?

A

specific gravity, refractive index, pKa, osmolarity

63
Q

What is Urine Specific Gravity (USG)?

A

Ratio of the weight of a volume of urine to the weight of the same volume of distilled water at a constant temperature

64
Q

What is Urine Specific Gravity used to measure (USG)?

A

Measures the concentrating and diluting ability in the kidney

65
Q

What is one of the first functions to be lost as a result of tubular damage?**

A

Concentrating ability**

66
Q

What is the normal range in regards to Urine Specific Gravity (USG)?

A

1.003-1.035

67
Q

Urine Specific Gravity simple definition:

A

Simply the ratio of the density of a substance to the density of water. It is one of the few unites quantities in chemistry

68
Q

What is the definition of “Refractive Index?”

A

Ratio of the velocity of light in air to the velocity of light in solution, using a Total Solids (TS) Meter (refractometer)

69
Q

What is actually occurring when checking the Refractive Index?

A

The path of light is deviated when it enters a solution, and the degree of deviation or refraction is proportional to the density of the solution

70
Q

What does Refractive index vary with?

A

With temperature, but the TS meter is temperature-compensated for temperatures between 60-100 degrees, and requires no corrections in that range

71
Q

What are you testing with a refractometer?

A

Testing specific gravity of urine

72
Q

What is a schematic representation of the refractometer?

A

Schematic Refractometer TS scale

73
Q

What does Specific Gravity Reagent Strips (pka) measure?

A

Measures pKa change of polyelectrolytes in relation to ionic concentration; actually measures ionic concentration

74
Q

What does specific gravity reagent strips (pka) relate to?

A

Urine specific gravity

75
Q

When more ions are present during the specific gravity reagent test strips, what happens?

A

When more ions are present, more acid groups become disassociated, releasing hydrogen ions and causing pH to change

76
Q

What would we use to measure the change in pH of urine?

A

Specific Gravity Reagent Strips (pKa)

77
Q

In regards to Specific Gravity Reagent Strips (pKa), when urine has an increased specific gravity, what will the reagent pad become?

A

more Acidic

78
Q

What does urine osmolality measure?

A

It measures total solute concentration

79
Q

What does Urine osmolality depend on?

A

The number of particles in the solution**

80
Q

What does specific gravity depend on?

A

The number and weight of the solutes**

81
Q

What is a better indicator of the concentrating and diluting abilities of the kidney?

A

Osmolality because it is unaffected by the density of solutes

82
Q

What should be used in pathological urines?***

A

Direct measurement of urine osmolality should be used (uncontrolled diabetes mellitus, nephrotic syndrome and in assessing hydration status)

7 UA (4 decks)

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