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Analysis of Urine and Body Fluids > Ch. 3 - Introduction to Urinalysis > Flashcards

Ch. 3 - Introduction to Urinalysis Flashcards

1
Q

Give the two unique characteristics of a urine specimen

A

Readily available and easily collected specimen
Contains information, which can be obtained by inexpensive laboratory tests, about many of the body’s major metabolic functions.

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2
Q

Clinical and Laboratory Standards Institute defines urinalysis as

A

“The testing of urine with procedures commonly performed in an expeditious, reliable, accurate, safe and cost-effective manner.”

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3
Q

Enumerate the reasons for performing a urinalysis identified by the CLSI

A

Aiding in the diagnosis of disease
Screening asymptomatic populations for undetected disorders
Monitoring the progress of disease and the effectiveness of therapy

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4
Q

The kidneys continuously form urine as an _____ of plasma.

A

Ultrafiltrate

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5
Q

What is the average daily urine output?

A

1,200 mL - 1,500 mL

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6
Q

Urine is ___% water and ___% solutes.

A

95; 5

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7
Q

Enumerate factors that influence the concentration of solutes in urine

A

Body metabolism
Endocrine functions
Body position

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8
Q

An organic component in urine that is a metabolic waste product produced in the liver from the breakdown of protein and amino acids; this accounts for nearly half of the total dissolved solids in urine

A

Urea

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9
Q

Aside from urea, what other organic substances can be found in urine?

A

Creatinine

Uric acid

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10
Q

This is the major inorganic solid dissolved in urine.

A

Chloride, followed by sodium and potassium

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11
Q

Enumerate formed elements that can be found in urine. These are not part of the original plasma filtrate and increased amounts are often indicative of disease.

A 
Cells
Casts
Crystals
Mucus
Bacteria
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12
Q

When determining whether a fluid is urine, the specimen can be tested for its _____ and _____ content. These substances are present in much higher concentrations in urine than in other body fluids.

A

Urea

Creatinine

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13
Q

Urine volume depends on the amount of _____ that the kidneys excrete.

A

Water

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14
Q

Enumerate factors that influence urine volume

A

Fluid intake
Fluid loss from non renal sources
Variations in the secretion of ADH
Need to excrete increased amounts of dissolved solids, such as glucose or salts

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15
Q

Although the normal daily output is usually 1200 to 1500 mL, a range of ___ to ___ mL is considered normal.

A

600 to 2000

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16
Q

The condition wherein there is decreased urine output

A

Oliguria

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17
Q

What is the level of urine for infants suffering from oliguria?

A

1 mL/kg/hr

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18
Q

What is the level of urine for children suffering from oliguria?

A

0.5 mL/kg/hr

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19
Q

What is the level of urine for adults suffering from oliguria?

A

400 mL/day

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20
Q

Oliguria is commonly seen when the body enters a state of dehydration as a result of excessive water loss from what conditions or instances?

A

Vomiting
Diarrhea
Perspiration
Severe burns

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21
Q

The condition where there is a cessation of urine flow; this may result from any serious damage to the kidneys or from a decrease in the flow of blood to the kidneys.

A

Anuria

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22
Q

The kidneys excrete two to three times (more/less) urine during the day than during the night.

A

More

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23
Q

The term used to describe increased nocturnal excretion of urine.

A

Nocturia

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24
Q

The term used to describe increase in daily urine volume.

A

Polyuria

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25
Q

What is the level of urine for children suffering from polyuria?

A

2.5 - 3 mL/kg/hr

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26
Q

What is the level of urine for adults suffering from polyuria?

A

2.5 L/day

27
Q

Polyuria is usually associated with what types of diabetes?

A

Diabetes mellitus

Diabetes insipidus

28
Q

Enumerate factors that can artificially induce polyuria

A

Diuretics
Caffeine
Alcohol
- suppress the secretion of ADH

29
Q

A type of diabetes producing polyuria that is caused by a defect either in the pancreatic production of insulin or in the function of insulin, which results in an increased body glucose concentration. Increased amounts of water must be excreted to remove the dissolved glucose from the body

A

Diabetes mellitus

30
Q

Although appearing to be dilute, a urine specimen from a patient with diabetes mellitus has a (high/low) specific gravity because of the increased glucose content.

A

High

31
Q

A type of diabetes producing polyuria that results from a decrease in the production or function of ADH; thus, the water necessary for adequate body hydration is not reabsorbed from the plasma filtrate.

A

Diabetes insipidus

32
Q

A urine specimen from a patient with diabetes insipidus, the urine is truly dilute and has a (high/low) specific gravity.

A

Low

33
Q

Fluid loss from diabetes mellitus and diabetes insipidus is compensated by increased ingestion of water called _____, producing an even greater urine volume.

A

Polydipsia

34
Q

Enumerate analytes that are decreased when a urine sample is allowed to remain unpreserved at room temperature for longer than 2 hrs.

A 
Clarity
Glucose
Ketones
Bilirubin
Urobilinogen
Red and white blood cells and casts
35
Q

Enumerate analytes that are increased when a urine sample is allowed to remain unpreserved at room temperature for longer than 2 hrs.

A

Odor
pH
Nitrite
Bacteria

36
Q

What happens to the color of urine when it is allowed to remain unpreserved at room temperature for longer than 2 hrs?

A

Modified/darkened due to oxidation or reduction of metabolites

37
Q

What is the most routinely used method of preserving a urine sample?

A

Refrigeration at 2 - 8 C

38
Q

Refrigeration can (increase/decrease) specific gravity when measured by a urinometer.

A

Increase

39
Q

Refrigeration can (increase/decrease) the precipitation of amorphous phosphates and urates, which may obscure the macroscopic sediment analysis.

A

Increase

40
Q

What must be done to counter the increase in specific gravity and precipitation of amorphous phosphates and urates due to the refrigeration of a urine sample?

A

The specimen must be allowed to return to room temperature before chemical testing

41
Q

What are the characteristics of the ideal preservative to be used when transporting a urine specimen over a long distance and refrigeration is inaccessible?

A 
The preservative must be:
Bactericidal
Inhibits urease
Preserve formed elements in the sediment
The preservative should not interfere with chemical tests
(does not exist)
42
Q

This is the most commonly received specimen because of its ease of collection and convenience for the patient. It may be collected at any time

A

Random specimen

43
Q

The ideal screening specimen; it is essential for preventing false-negative pregnancy tests and for evaluating orthostatic proteinuria.

A

First Morning specimen or 8-hour specimen

44
Q

It is a concentrated specimen, thereby assuring detection of chemicals and formed elements that may not be present in a dilute random specimen.

A

First Morning specimen or 8-hour specimen

45
Q

This specimen must be collected immediately upon arising and must be delivered to the laboratory within 2 hours.

A

First Morning specimen or 8-hour specimen

46
Q

This is the second voided specimen after a period of fasting. This will not contain any metabolites from food ingested before the beginning of the fasting period. It is recommended for glucose monitoring.

A

Fasting Specimen (Second Morning)

47
Q

The patient is instructed to void shortly before consuming a routine meal and to collect a specimen 2 hours after eating.

A

2-hour Postprandial Specimen

48
Q

This specimen is tested for glucose, and the results are used primarily for monitoring insulin therapy in persons with diabetes mellitus.

A

2-hour Postprandial Specimen

49
Q

This type of specimen is sometimes collected to correspond with the blood samples drawn during a glucose tolerance test (GTT). Collection of this specimen is an institutional option.

A

Glucose tolerance specimen

50
Q

This type of urine sample is tested for glucose and ketones, and the results are reported along with the blood tests results as an aid to interpreting the patients ability to metabolize a measured amount of glucose and are correlated with the renal threshold for glucose.

A

Glucose tolerance specimen

51
Q

It is a type of urine specimen required when the concentration of the substance to be measured changes with diurnal variations and with daily activities such as exercise, meals, and body metabolism.

A

24-Hour (Timed) Specimen

52
Q

Give solutes that exhibit diurnal variations (Low concentration in the morning; high concentration in the afternoon)

A

Catecholamines
17-hydroxysteroids
Electrolytes

53
Q

This specimen is collected under sterile conditions by passing a hollow tube (catheter) through the urethra into the bladder.

A

Catheterized specimen

54
Q

What is the most commonly requested test on a catheterized specimen?

A

Bacterial culture

55
Q

An alternative specimen for catheterized specimens, provides a safer, less traumatic method for obtaining urine for bacterial culture and routine urinalysis.

A

Midstream clean-catch specimen

56
Q

It provides a specimen that is less contaminated by epithelial cells and bacteria and, therefore, is more representative of the actual urine than the routinely voided specimen. Patients must be provided with appropriate cleansing materials, a sterile container, and instructions for cleansing and voiding

A

Midstream clean-catch specimen

57
Q

This is a type of urine sample that is collected by external introduction of a needle through the abdomen into the bladder, which is sterile under normal conditions and, therefore, provides a sample for bacterial culture that is completely free of extraneous contamination. This can also be used for cytologic examination.

A

Suprapubic aspiration

58
Q

Similar to midstream clean-catch collection, this procedure is used to determine prostatic infection.
First and midstream urine are collected in different sterile containers. Then, the prostate will be massaged so that the prostate fluid will be passed with the remaining urine into a third sterile container.

A

Prostatitis specimen

59
Q

Soft. clear plastic bags with hypoallergenic skin adhesive to attach to the genital area of both boys and girls are available for collecting this type of specimen

A

Pediatric specimen

60
Q

It is the most vulnerable part of a drug-testing procedure.

A

Urine specimen collection

61
Q

The process that provides correct collection procedures and documentation of proper sample identification from the time of collection to the receipt of the laboratory results.

A

Chain of Custody (COC)

62
Q

It is a standardized form that must document and accompany every step of drug testing, from collector to courier to laboratory to medical review officer to employer.

A

Chain of Custody (COC)

63
Q

For urine drug specimen, the temperature of the urine must be taken within ___ minutes from the time of collection to confirm the specimen has not be adulterated.

A

4

64
Q

For urine drug specimen, the temperature of the urine must be within the range of ___. Temperature outside this range may indicate specimen contamination.

A

32.5 C to 37.7 C

Analysis of Urine and Body Fluids (6 decks)

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