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Laboratory > Ch 5 Urinalysis > Flashcards

Ch 5 Urinalysis Flashcards

1
Q

Clinical reasons for performing urinalysis testing

A
  1. An important indicator of health
  2. A screening test for various functions
  3. Cost effective
  4. Non-invasive procedure
  5. Simple to perform
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2
Q

A screening test to detect and assess:

A

Renal function/disorder

Endocrine or Metabolic function/disorder

Urinary tract infection

Systemic diseases

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3
Q

Methods of Urine Collection

A

Non-instrumented

Instrumented

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4
Q

Non-instrumented Collection

A

First-morning void

Random urine specimen

Clean catch urine specimen

24-hour urine specimen

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5
Q

Instrumented collection

A

Urethral catheterization

Suprapubic Needle Aspiration

Catheterization and Bladder Irrigation

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6
Q

UA’s should be analyzed while:

A

Fresh, within 1-2 hours

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7
Q

If unable to test the urine specimen at time of delivery, you should:

A

Refrigerate the specimen within 3-6 hours

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8
Q

What will happen to the UA if left at room temperature?

A

Decompose due to bacteria and deliver inaccurate results

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9
Q

Produces ammonia

A

Urea splitting bacteria

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10
Q

Ammonia combined with hydrogen irons will:

A

Increase pH

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11
Q

Glucose in the urine that is used by bacteria for energy will result in:

A

False negative for glycosuria

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12
Q

Will deteriorate if left without any preservative

A

Urinary elements, like blood cells and casts

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13
Q

Most concentrated

Increase number of abnormal elements

Decreased deterioration of formed elements

Recommended specimen for chemical and microscopic examination

A

First morning void

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14
Q

Collected anytime

Most convenient and most common

Can detect abnormalities but not as sensitive as first morning void

A

Random UA

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15
Q

Specimen of choice for bacterial cultures

  • Perform cultures within 12 hours after collection, only if refrigerated
  • Genitalia must be cleaned with mild antiseptic solution
  • Collect midstream in a sterile container
A

Clean catch UA

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16
Q

Gives quantitative results

Preservatives may be needed

A

24-hour UA

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17
Q

Not recommended for bacteriologic examination

Use only if no other way to collect urine

Commonly used on obese patients with difficulty in urine collection

A

Urethral Catheterization

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18
Q

Used in place of catheter for obtaining a single UA

Avoids vaginal and urethral contamination

Performed for bladder outlet obstruction (urinary retention)

A

Suprapubic Needle Aspiration

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19
Q

Vigorous transcatheter agitation

Yields optimum cellular sample of bladder epithelium for cytologic study

50-72 mL saline inserted into bladder

A

Catheterization and Bladder irrigation

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20
Q

Urine sample analysis:

A
  1. Physical
  2. Chemical
  3. Microscopic
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21
Q

Physical analysis includes:

A

Volume

Color

Turbidity

Odor

Specific Gravity

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22
Q

Normal volume in a 24-hour period ranges from:

A

600-2000 mL

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23
Q

Average 24-hour volume

A

1500 mL

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24
Q

Amount of volume of urine is directly related to:

A

Fluid intake

Temperature and climate

Amount of perspiration

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25
Q

Gives color to urine

A

Pigment (urochrome) concentration

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26
Q

Normal color

A

Straw (light yellow) to dark amber

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27
Q

Color can vary because of:

A

Foods or medications

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28
Q

Blue green

A

Methylene blue

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29
Q

Dark orange

A

Pyridium

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30
Q

Milky white

A

Chyle

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31
Q

Olive green to brown black

A

Phenols (poisonous compound, antimicrobial agent)

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32
Q

Yellow to brown (green foam when shaken)

A

Bile

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33
Q

Red or red-brown (smokey)

A

Blood

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34
Q

Turbid alkaline is due to:

A

Amorphous phosphate

Amorphous carbonate

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35
Q

Turbid Acidic urine is due to:

A

Amorphous urates

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36
Q

Pinkish turbidity frequently indicates the presence of:

A

Urates

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37
Q

Normal urine has a characteristic odor due to:

A

Volatile acids

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38
Q

Ammonia odor is due to:

A

breakdown of urea by bacteria

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39
Q

Not considered to be of special diagnostic importance

A

Odor

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40
Q

Sweet or fruity smell

A

Ketones

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41
Q

Pungent smell

A

Ammonia produced by bacteria

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42
Q

Maple syrup smell

A

Congenital metabolic disease

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43
Q

Musty or mousy smell

A

Infant with phenylketonuria

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44
Q

Specific gravity of random urine

A

1.003-1.035

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45
Q

Specific Gravity of 24-hour urine

A

1.015-1.025

46
Q

Chemical Analysis includes:

A

1) Glucose
2) Ketones
3) Occult blood
4) Bilirubin
5) Urobilinogen
6) pH
7) Protein
8) Nitrite
9) Leukocyte esterase (LE)

47
Q

Normal glucose

48
Q

Urine glucose is dependent on

A

Blood glucose

Glomerular filtration

Degree of tubular reabsorption

49
Q

Glucosuria will appear in urine once _____ in blood is exceeded

A

160-180 mg/dL

50
Q

Glucose may indicate

A

Diabetes mellitus

Hyperglycemia condition

51
Q

Normal ketones

52
Q

Ketonuria is a result of:

A

incomplete fatty acid utilization

53
Q

Ketones may indicate:

A

Diabetes mellitus

54
Q

Increase ketone in the blood or urine

55
Q

Ketosis is found in conditions like:

A

Decreased carbohydrates

Diabetes

Dietary imbalance (High fat/low carb)

Eclampsia

Prolonged vomiting

Diarrhea

56
Q

Intact RBCs present in the urine may indicate:

A

Damage/trauma to kidney or urinary tract

Renal Diseases

  • Glomerulonephritis
  • Malignant HTN
  • Polycystic kidney disease

Menstrual contamination or exercise

57
Q

Normal bilirubin

58
Q

Any condition that causes ______ will cause bilirubin in urine

59
Q

Yellow to brown (greenish foam when shaken)

60
Q

Bilirubinuria indicates

A

Hepatocellular disease

Intra or extra-hepatic biliary obstruction

61
Q

Normal Urobilinogen

A

<1 EU or <1 mg/dL

62
Q

Any increase indicates liver disease and hemolytic disease

A

Urobilinogen

63
Q

Range for pH

A

4.6 to 8.0

64
Q

Average pH

65
Q

Pathologic conditions that may cause acidic urine

A

Respiratory and metabolic acidosis

UTI (E. Coli)

Uremia

Severe diarrhea

Starvation

66
Q

Pathologic conditions that cause alkaline urine:

A

UTIs (Proteus and Pseudomonas species)

Respiratory and metabolic alkalosis

67
Q

Normal protein

68
Q

Important indicator for renal disease

69
Q

Two mechanisms that cause proteinuria:

A

Glomerular damage

Defect in the reabsorption process of the tubules

70
Q

Minimal proteinuria

A

(<0.5 g/day)

71
Q

Moderate proteinuria

A

0.5-3.5 g/day

72
Q

Severe proteinuria

A

> 3.5 g/day

73
Q

Polycystic kidneys

Chronic pyelonephritis

Inactive chronic glomerulonephritis

Benign orthostatic proteinuria

A

Minimal proteinuria

74
Q

Nephrosclerosis

Tubular interstitial disease

Preeclampsia

Diabetes nephropathy

Malignant HTN

Pyelonephritis with HTN

Toxic nephropathies

A

Moderate Proteinuria

75
Q

Glomerulonephritis

Lupus nephritis

Amyloid disease

Lipoid nephrosis

Intercapillary glomerulosclerosis

Severe venous congestion of the kidney

A

Severe proteinuria

76
Q

Normal nitrate

77
Q

Nitrite is formed by:

A

Breakdown of nitrates (E. coli)

78
Q

Enzyme

Released by neutrophils in urine

Indirect test for bacteriuria

A

Leukocyte esterase (LE)

79
Q

Associated with an inflammatory process in or around the urinary tract

A

Leukocyturia

80
Q

Macroscopic analysis

A

Appearance

81
Q

Chemical analysis

82
Q

Microscopic analysis

A

Looking for Formed elements

83
Q

Most UA consist of:

A

Macroscopic analysis

Chemical analysis

Microscopic analysis

84
Q

Normal RBC Range (high power field)

85
Q

Normal WBC range (high power field)

86
Q

Normal epithelial cell range (HPF)

87
Q

Normal bacterial range

A

Negative to trace

88
Q

Critical values:

A

Strong positive for glucose and ketones

Glucose >1000 mg/dL, with small, medium, or large ketones

Urine Colony Count >50,000 colonies/mL

89
Q

Normal secretion range of proteins

90
Q

Clinical proteinuria is defined as the loss of

A

> 500mg/day

91
Q

Mild proteinuria may be the result of:

A

HTN

Lower UTI

Fever

Exercise

92
Q

Moderate proteinuria may be the result of:

A

CHF

Chronic glomerulonephritis

Acute glomerulonephritis

Diabetic nephropathy

Pyelonephritis

93
Q

Significant (Severe) Proteinuria may be the result of:

A

Amyloid

Chronic glomerulonephritis (severe)

Diabetic nephropathy

Lupus nephritis

94
Q

Persistent pH >7.0 is associated with what kind of stones?

A

Calcium carbonate

Calcium phosphate

Magnesium-ammonium phosphate

95
Q

Persistent pH’s below 5.5 are associated with what kind of stones?

A

Crystine

Uric acid

96
Q

Increase in urobilinogen is usually from:

A

Hemolytic anemia

Cirrhosis

Viral Hepatitis

97
Q

Absent in total biliary obstructions

A

Urobilinogen

98
Q

Obstructions in the bile duct

A

Bilirubin (dark yellow to greenish brown)

99
Q

Dipsticks for blood are dependent on the presence of:

A

Hemoglobin

RBCs

Myoglobin

100
Q

Dipstick can detect as few as ____ RBCs (HPF)

101
Q

Presence of how many RBCs is abnormal

102
Q

A normal healthy person may have RBCs from:

103
Q

Persistent RBCs may indicate:

A

Glomerulonephritis

Kidney stones

Cancer

Infection

104
Q

May lead to a false positive of RBCs and is highly suggestive of rhabdomyolysis

105
Q

Significant pyuria is defined by

106
Q

Indirect indicators for UTI

A

Leukocyte esterase and WBCs

Nitrite

107
Q

Ketones and ketonuria along with glucose is suggestive of uncontrolled:

A

Type 1 diabetes

108
Q

Microorganisms found is urine is most likely from:

A

Contamination

109
Q

Number of epithelial cells found that is normal

110
Q

Increased epithelial cells may indicate

A

Acute necrosis or inflammation (Glomerulonephritis)

Laboratory (9 decks)

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