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Clinical Microscopy > (3) Urine Specimen Types, Collection, and Preservation > Flashcards

(3) Urine Specimen Types, Collection, and Preservation Flashcards

1
Q

Types of Urine specimen

A 
Random Urine
First Morning 
Second Morning 
2 hours Post Prandial
OGTT (Oral Glucose Tolerance Test)
24 hour / Timed 
Catheterized
Midstream Clean-Catch
SPA (Suprapubic Aspiration)
Three-glass collection
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2
Q

Factors that can become falsely increased

A 
Sp. Gravity
pH
Urobilin
Nitrite
Bacteria
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3
Q

How to physically preserve sample?

A

Refrigeration (to prevent bacterial growth/bacteriostatic)

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4
Q

Significant level of bacteria for Midstream Clean-Catch collection

A

100 cfu/ml

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5
Q

Physical parameters in routine urinalysis

A

Volume
Color
Transparency
Sp. gravity

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6
Q

STAT acronym meaning

A

Short Term Around Time!!

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7
Q

Least accepted urine specimen collection

A

Catheterized Urine Sampling

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8
Q

No. of times blood collection is done for 2 hours Post Prandial Test

A

2 times (before - to get baseline, and after - to measure abnormality if present)

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9
Q

Three-glass collection sampling is done to…?

A

To differentiate Prostatic infection from UTI

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10
Q

Normal urine output per day

A

600-2000ml/day

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11
Q

Most ideal urine specimen

A

First morning urine

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12
Q

Factors seen in Diabetes Mellitus

A 
Polyuria
Polydipsia
Polyphagia
High specific gravity
Low Insulin/ No Insulin
Hyperglycemia
Glucosuria
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13
Q

24 hour urine/ Timed collection is done because..?

A

for creatinine CLEARANCE purposes

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14
Q

Average volume of urine excreted per day

A

1200-1500 ml/day

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15
Q

Condition wherein urine output is increased (about 2500ml a day)

A

Polyuria

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16
Q

2 Poly’s are seen in what type of Diabetes

A

Diabetes Insipidus

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17
Q

Why is First Morning Urine the most ideal specimen?

A

Concentrated (high sp. gravity, high osmolarity)
Uniform pH (acidic)
Uniform volume
least likely to be contaminated with bacteria
to rule out orthostatic proteinuria

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18
Q

Absence of urine output

A

Anuria

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19
Q

Significant level of bacteria in SPA

A

<10 000 cfu/ml

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20
Q

Factors falsely decreased when the 2hr time period is exceeded

A 
Glucose 
Clarity
Urobilinogen
Bilirubin
Ketone bodies
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21
Q

Color range of urine

A

straw (colorless to amber)

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22
Q

Pigments found in urine

A

Urochrome (!)
Uroeythrin
Urobilin

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23
Q

Conditions seen in Diabetes Insipidus

A 
Polydipsia
Polyuria
Low sp. gravity
Decreased functionn ADH
No hyperglycemia
No glucosuria
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24
Q

Decreased urine output (about <400ml)

A

Oliguria

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25
Q

Diabetes caused by a lack of ADH

A

Diabetes Insipidus

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26
Q

Most convenient type of urine specimen

A

Random urine

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27
Q

Chemical regarded as enzyme poison

A

NaF

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28
Q

Enumerate examples of chemicals to preserve specimen

A

Boric acid - to retain acidity and to prevent bacterial growth
NaF
Chlorhexidine
10% formalin

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29
Q

Pigment that binds to amorphous crystals

A

Uroerythrin

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30
Q

Urine sampling done in males only

A

Three-glass collection

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31
Q

measured in Addis count

A

WBC
Casts
Epithelial cells

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32
Q

Urine Collection types used to monitor diabetes

A

Second Morning
2 hours Post Prandial
OGTT

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33
Q

A disorder in which blood sugar (glucose) levels are abnormally high because the body does not produce enough insulin to meet its needs.

A

Diabetes Mellitus

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34
Q

Explain Three-glass collection results.

A

1st tube- contains urine
2nd tube - contains urine, but if positive with bacteria, UTI is present and Prostatic Infection is ruled out, and the test is finished
3rd tube- if positive with prostatic fluid, then prostatic infection is apparent

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35
Q

Parameter that reflects body’s state of hydration

A

Volume of Urine

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36
Q

A technique for the quantitative determination of cells, casts, and protein in a 12-hour urine sample used in the diagnosis and treatment of kidney disease

A

Addis Count

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37
Q

Urine color when uroerythrin is present/elevated

A

light pink/reddish

Urine is often termed as having a “brick dust” color.

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38
Q

Causes of decreased ADH

A

Medication (diuretics)
Caffeine
Alcohol

39
Q

Urine specimen for quantitative tests

A

24 hour / Timed

40
Q

Elevated factors seen in urine during infection

A

WBC
Proteins
Bacteria

41
Q

If NaF is the preservative used in urine, what method would you use for glucose determination?

A

O-toluidine Method

42
Q

Blood collection is done how many times when performing OGTT?

A

4x (initial, 5mins, 30mins, 1hr)

43
Q

Conditions of urine output

A

Oliguria
Anuria
Polyuria
Nocturia

44
Q

2 chemical used to preserve the glucose in urine

A
  • chlorhexidine

- mannitol

45
Q

Chemical used to preserve urine pH

A

Boric acid

46
Q

Reasons for urine specimen rejection

A

Unlabeled urine specimen container
Mislabeled urine specimen
Inappropriate urine collection technique or specimen type for test requested
Specimen not properly preserved during a time delay or inappropriate urine preservative used
Visibly contaminated urine
Insufficient volume of urine for test requested

47
Q

Urine collection for routine screening and quantitative assays

A

Pediatric collection bag

48
Q

Urine specimen collection for differentiation of kidney infections

A

Catheterized, ureteral

49
Q

Use of routine void collection

A

Routine screning
Bacterial and fungal cultures
Cytology

50
Q

Collection procedure used with patients that are unable to urinate voluntarily

A

Pediatric collection bag

51
Q

Collecting urine directly from the bladder by puncturing the abdominal wall and the distended bladder using a syringe and needle

A

Suprapubic aspiration

52
Q

A urine specimen collected at any time, day or night, without prior patient preparation

A

Random urine specimen

53
Q

A urine specimen collected throughout a specific time interval

A

Timed collection

54
Q

A urine specimen obtained using a sterile flexible tube inserted through the urethra and into the bladder

A

Catheterized specimen

55
Q

The first urine specimen voided after rising from sleep

A

First morning specimen

56
Q

Ideal urine specimen to test for substances that may require concentration

A

First morning urine

57
Q

A urine specimen collected throughout a specific time interval

A

Timed collection

58
Q

A urine specimen obtained after thorough cleansing of the glans PENIS in the male or the urethral meatus in the female

A

Midstream “clean catch” specimen

59
Q

A chemical substance or process used to prevent composition changes in a urine specimen

A

Urine preservative

60
Q

Purposes of routine urinalysis

A

To aid in the diagnosis of disease
To screen for asymptomatic, congenital, or hereditary disease
To monitor therapy effectiveness or complications

61
Q

A fluid biopsy of the kidney

A

Urine

62
Q

The only organ with noninvasive means to directly evaluate its status

A

Kidney

63
Q

Three basic types of urine

A

First morning
Random
Timed

64
Q

How long is the urine approx. retained in the bladder for first morning specimen collection?

A

8 hours

65
Q

Ultrafiltrate of plasma

A

Urine

66
Q

Most cytologic protocols require collection of random urine specimen daily for up to how many days?

A

3-5 consecutive days

67
Q

Formed elements that are more stable in first morning specimen

A

WBC
RBC
Casts
Epith. Cells

68
Q

The most concentrated and frequently specimen of choice for urinalysis

A

First morning urine

69
Q

Specimen used for evaluation of fistula, clearance tests, cytology studies, and quantitative chemical analysis

A

Timed

70
Q

Factors that may affect quantitative urine assays

A

Circadian rhythms
Excretion of many substances (eg. Hormones, proteins, glomerular filtration rate)
Effects of exercise, hydration, body metab on excretion rates

71
Q

Two types of timed urine specimens

A

Those collected for a predetermined amount of time (eg. 2hrs, 12 hrs, 24 hrs)
Those collected for a specific time of the day (eg. From 2pm to 4pm)

72
Q

UrineSpecimen type for routine screening, cytology studies with prior hydration, and fluid deprivation tests

A

Random

73
Q

Uses of first morning urine

A

Routine screening; good recovery of cells and casts
To confirm postural or orthostatic proteinuria
Cytology studies

74
Q

Specimen to use if the possibility of contamination exists or if a bacterial culture is desired

A

Midstream “clean catch” specimen

75
Q

Collection type that most often leads to UTI

A

Catheterized

76
Q

Procedure for bacterial cultures, esp. for anaerobic microbes and in infants, in whom specimen contamination is often unavoidable

A

Suprapubic aspiration

77
Q

Volume usually required for Routine urinalysis

A

10-15ml

78
Q

Physical changes in unpreserved urine

A

Color (darkens or changes)
Clarity (decreases)
Odor (ammoniacal, foul smelling)

79
Q

Microscopic changes in unpreserved urine

A

Blood cells (decrease)
Casts (“)
Trichomonads (“)
Bacteria (increase)

80
Q

Chemical changes in unpreserved urine

A 
pH (increase) 
Nitrite (") 
Glucose (decrease) 
Ketones (")
Bilirubin (")
Urobilinogen (")
81
Q

Causes of changes in physical examination of unpreserved urine

A

Alteration of the urine solutes to a different form
Bacterial growth causing an increased odor bec. Of metab or proliferation of bacteria
Solute precipitation in the form of amorphous material which decreases urine clarity

82
Q

The easiest and most common form of preservation

A

Refrigeration at 4degrees C to 6degrees C -suitable for up to 24 hours

83
Q

Factors to help you identify if the fluid passed is urine

A

Specific gravity (1.002-1.035)
Temperature (32.5 C-37.5C)
pH (4.0 - 8.0)
High creatinine concentration (approx. 50x that of plasma)—most useful substance!!!!!!!!

84
Q

Examples of urine specimen preservatives

A 
Refrigeration
Commercial transport tubes
Thymol
Formalin
Saccomanno's fixative
Acids (HCl,glacial acetic acid)
Sodium carbonate
85
Q

Preservatives used for cytology purposes

A

Formalin

Saccomanno’s fixative

86
Q

Urine preservatives that are unacceptable for urinalysis testing

A

Acids (HCl, glacial acetic acid)

Sodium carbonate

87
Q

Preservative for sediment preservation

A

Thymol

88
Q

Preservative used for storage before and after testing of the urine specimen

A

Refrigeration

89
Q

Urine preservative used for quantitative analysis of urine solutes such as steroids, hormones, etc.

A

Acids (HCl, glacial acetic acid)

90
Q

Urine preservative for quantitative analysis of porphyrins, porphobilinogen, etc.

A

Sodium carbonate

91
Q

Urine preservative to preserve specimen at room temp for longer time period that varies with tube used

A

Commercial transport tubes

92
Q

Preservative of urine to transport it from off-site to laboratory

A

Commercial transport tubes

93
Q

Examples of commercial transport tubes

A

BD Vacutainer; plus plastic conical UA preservative tube
InTac UA System, Therapak corporation product
BD Vacutainer; C & S preservative tube

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