3 MIDTERMS - CLINICAL MICRO Flashcards
- For overall evaluation of renal function
- Permits a detailed, in-depth assessment of
renal status with an easily obtained specimen. - Serves as a quick indicator of an individual’s
glucose status and hepatic or biliary function.
URINALYSIS
- A test used to check how well the kidneys are
working. Specifically, it estimates how much
blood passes through the glomeruli each
minute.
GLOMERULAR FILTRATION RATE (GFR)
Tests Performed in Routine Urinalysis:
- Specimen collection
- Physical examination
- Chemical examination
- Microscopic examination
TYPE OF SPECIMEN
– Most preferred sample
particularly for protein analysis; more
concentrated from overnight retention in the
bladder.
- Early morning urine
TYPE OF SPECIMEN
Collected any time of the day;
for routine analysis.
- Random urine
TYPE OF SPECIMEN
– For glucose
determination.
- Fasting/Post-prandial urine
TYPE OF SPECIMEN
– For clearance test.
- Timed urine
– Relates to eating of food
Prandial
measures the glucose
level after having a meal or eating. 2 hours after eating,
urine sample for testing postprandial glucose level is
taken. At least 75 grams of carbohydrates.
Postprandial urine glucose test
– From 24 hr urine
Creatinine clearance test
measures the glucose
level after having a meal or eating. 2 hours after eating,
urine sample for testing postprandial glucose level is
taken. At least 75 grams of carbohydrates.
METHOD OF COLLECTION OF URINE
- Clean midstream catch
- Catheterization
Keeping your labia spread open, urinate a small
amount into the toilet bowl, then stop the flow of
urine. Hold the urine cup a few inches (or a few
centimeters) from the urethra and urinate until the cup
is about half full.
SPECIMEN HANDLING
* Must be analyzed within ___ of collection
(room temperature).
* If delayed: Ref at ___°C for not more than 8
hour
1 hour
2-8
EFFECTS OF UNPRESERVED URINE
* Bacterial multiplication will cause ____
false positive
(+) nitrite test.
- pH alkalinization: leads to cast degeneration
and red cell lysis
: leads to cast degeneration
and red cell lysis
- pH alkalinization
PHYSICAL EXAMINATION
- A rough indication of the state of hydration of
an individual. - The ___ of the urine, the more
concentrated it will be. This signals that one
has to drink plenty of water because he/she
may already be dehydrated.
- COLOR
darker the color
PHYSICAL EXAMINATION
- Has little diagnostic significance and is not
included in the routine laboratory result. - Urine is ___
- Suggestive of the freshness of the urine sample
ODOR
aromatic
PHYSICAL EXAMINATION
- Also known as clarity or transparency
- Refers to the degree of cloudiness in a urine
- Depends on the pH and the presence of
dissolved solids
TURBIDITY
PHYSICAL EXAMINATION
- Indicates balance between fluid ingestion and
water lost from lungs, sweat and intestines
VOLUME
Optimal volume for accurate ru
10-12 mL aliquot
Absence of urine output
Anuria
Scanty urine excretion
Oliguria
Excessive urine excretion
Polyuria
Normal adult volume
750-2000 mL/24 hr
Normal adult volume
750-2000 mL/24 hr
SPECIFIC GRAVITY
* Normal values:
1.005 – 1.030
- Indication of the density of a fluid depending
on the concentration of dissolved total solids. - Marker of the amount of
hydration/dehydration of an individual. - The darker the urine, the ___
- Urinometer and refractometer
SPECIFIC GRAVITY
higher its specific gravity.
___ SG = Diabetes mellitus, congestive heart
failure, dehydration, adrenal
insufficiency, liver disease, and nephrosis
___ SG = Diabetes insipidus, pyelonephritis, and
glomerulonephritis
High
Low
- Refers to the logarithm of the hydrogen ion
concentration. - A quantity representing the power to which a
fixed number (the base) must be raised to
produce a given number.
pH
- Chemical test:
Ø Acidity – Ph
less than 7
Ø Alkalinity– Ph
greater than 7
- Contains test pads impregnated with reagents
that specifically react with a test analyte and
register a specified color change. - Change in color in the pad is then compared to
a comparator chart to determine the result.
REAGENT STRIP METHOD
- Average of at least 10 microscopic fields
CELLULAR ELEMENTS
- Average count per high power field
- Glomerulonephritis, severe exercise, menstrual
blood contamination, and renal calculi
obstruction
RBC: “HEMATURIA”
- Average count per high power field
- Pyelonephritis, UTI, and inflammation
WBC : “PYURIA”
- Cells sloughed off the lining of the nephrons
and urinary tract.
EPITHELIAL CELLS
- Formed by the precipitation of urine salts
subjected to changes in pH, temperature or
concentration - May collect and aggregate together to form
renal stone or “calculus”
Ø Crystine
Ø Calcium oxalate
Ø Uric acid
Ø Triple-Phosphate (Struvite)
CRYSTALS: “CRYSTALLURIA”
- Formed within distal convoluted tubule and
collecting duct. - Hyaline, granular, and cellular
CASTS
MISCELLANEOUS ELEMENTS
Often encountered in urine of both
male and female but are usually not
reported (sexual intercourse or
nocturnal emissions).
Spermatozoa
Protein material produced by
glands and epithelial cells in the
genitourinary tract.
Thread-like structures with low
refractive index requiring
observation under subdued light
Mucus threads
Gram (-) coliforms Escherichia coli
and Proteus sp.
Bacteria
Enterobius vermicularis,
Trichomonas vaginalis, Schistosoma
haematobium
Parasites
Budding RBC-like cells (diabetes
mellitus and vaginal moniliasis).
Yeast cells
(Candida
albicans)
