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CLINMICRO_INTRODUCTION (STRASINGER) > CHAPTER 2: INTRODUCTION TO URINALYSIS > Flashcards

CHAPTER 2: INTRODUCTION TO URINALYSIS Flashcards

1
Q

He wrote the book on “uroscopy” in the 5th century BCE

A

Hippocrates

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2
Q

He discovered protein in urine by boiling urine (1694)

A

Frederick Dekkers

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3
Q

Term used to pertain to charlatans without medical credentials who offer predictions to the public in exchange for a healthy fee who became the subject of a book published by Thomas Bryant in 1627

A

Pisse prophets

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4
Q

He developed methods for quantitating microscopic sediments.

A

Thomas Addis

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5
Q

He introduced the concept of urinalysis as part of a doctor’s routine patient examination in 1827.

A

Richard Bright

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6
Q

TRUE or FALSE:

The kidneys continuously form urine as an ultrafiltrate of plasma.

A

TRUE

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7
Q

Average daily urine output

A

1200 mL – 1500 mL

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8
Q

Primary organic component of urine

A

Urea

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9
Q

Urine is normally composed of __% water and __% solutes.

A

95%; 5%

Note:
Concentrations may vary depending on dietary intake, physical activity, body metabolism, and endocrine functions.

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10
Q

This substance is a product of protein and amino acid metabolism

A

Urea

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11
Q

TRUE or FALSE:
Urea comprises majority (near half) of total dissolved solids in urine.

A

TRUE

Note:
Urea is the primary organic component of urine.

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12
Q

Aside from urea, what other primary organic substance/s is/are present in urine?

A

Creatinine
Uric acid

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13
Q

Major inorganic component of urine

A

Chloride

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14
Q

This is a product of creatine metabolism by muscles.

A

Creatinine

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15
Q

This substance is a product of nucleic acid breakdown in food and cells.

A

Uric acid

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16
Q

Aside from chloride, what are other primary inorganic components found in urine?

A

Sodium
Potassium

Note:
Chloride > Sodium > Potassium

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17
Q

This inorganic component combines with sodium to buffer the blood

A

Phosphate

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18
Q

This inorganic component regulates blood and tissue fluid acidity

A

Ammonium

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19
Q

This is used to determine whether a particular fluid is urine.

A

Testing urea and creatinine content.

Note:
Since urea and creatinine are present in high concentrations in urine as compared to other body fluids, these two substances may help identify fluid as urine.

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20
Q

Inorganic components present in urine

A

Chloride
Sodium
Potassium
Phosphate
Ammonium
Calcium

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21
Q

Normal daily urine output (range)

A

600 – 2000 mL

Average: 1200 – 1500 mL

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22
Q

This term is used to describe a decrease in urine output

A

Oliguria

Note:
Infants: <1 mL/kg/hr
Children: <0.5 mL/kg/hr
Adults: <400 mL/day

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23
Q

This term is used to describe cessation of urine flow

A

Anuria

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24
Q

An increase in excretion of urine at night

A

Nocturia

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25
Q

This term is used to describe an increase in daily urine volume

A

Polyuria

Note:
Children: 2.5-3 mL/kg/day
Adults: >2.5 L/day

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26
Q

TRUE or FALSE:
Polyuria may be encountered in both diabetes mellitus and diabetes insipidus.

A

TRUE

While polyuria may be encountered in both diabetes mellitus and diabetes insipidus, the two may differ in terms of specific gravity.

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27
Q

This condition is caused by a defect either in the pancreatic production of insulin or in the function of insulin leading to increased glucose.

A

Diabetes mellitus

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28
Q

A patient with diabetes mellitus has a urine with (increased/decreased) specific gravity.

A

Increased

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29
Q

This condition results from a decrease in production or function of the antidiuretic hormone (ADH).

A

Diabetes insipidus

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30
Q

TRUE or FALSE:

Urine is considered a biohazardous substance.

A

TRUE

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31
Q

Which of the following is NOT recommended for containers for urine collection?

A. Screw-top lids
B. Flat bottom
C. Has wide mouth
D. Snap-on lids

A

D. Snap-on lids

NOTE:
Snap-on lids are prone to leakage.

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32
Q

The recommended capacity of a urine container.

A

50 mL

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33
Q

Sterile containers are suggested if more than ______ hour/s elapse between specimen collection and analysis.

A

2 hours

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34
Q

Generally, when attaching labels to specimens, labels must be on the (container/lid).

A

Container

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35
Q

This is a document that must accompany the specimens delivered to the laboratory for confirmation. It must match the information attached on the specimen label.

A

Requisition form

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36
Q

REJECT OR ACCEPT SPECIMEN?

Specimens in unlabeled containers

A

REJECT

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37
Q

REJECT OR ACCEPT SPECIMEN?

Specimens in dry and clean containers

A

ACCEPT

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38
Q

REJECT OR ACCEPT SPECIMEN?

Specimens contaminated with toilet paper

A

REJECT

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39
Q

REJECT OR ACCEPT SPECIMEN?

Labels on specimens matched the information on the accompanying requisition form

A

ACCEPT

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40
Q

REJECT OR ACCEPT SPECIMEN?

Specimens of insufficient quantity

A

REJECT

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41
Q

REJECT OR ACCEPT SPECIMEN?

Specimens that have been improperly transported but came from a long way

A

REJECT

42
Q

REJECT OR ACCEPT SPECIMEN?

Specimens with contaminated exteriors

A

REJECT

43
Q

TRUE or FALSE:

There is only one and a standard protocol that must be followed by all laboratories in terms of specimen rejection.

A

FALSE

Note: Laboratories may have their own conditions for specimen rejection provided it is included in their own written policy.

44
Q

Following collection, urine specimen should be delivered to the laboratory promptly and tested within _____ hour/s.

A

2

45
Q

Identify whether the following are INCREASED or DECREASED in unpreserved urine:

Clarity

A

DECREASED

Note:
Due to bacterial growth and precipitation of amorphous material

46
Q

Identify whether the following analytes are INCREASED or DECREASED in unpreserved urine:

Odor

A

INCREASED

Note:
Due to bacterial multiplication causing breakdown of urea to ammonia

47
Q

Identify where the following analytes are INCREASED or DECREASED in unpreserved urine:

pH

A

INCREASED

Note:
Breakdown of urea to ammonia by urease-producing bacteria/loss
of CO2

48
Q

Identify whether the following analytes are INCREASED or DECREASED in unpreserved urine:

Glucose

A

DECREASED

Note:
Glycolysis and bacterial use

49
Q

Identify whether the following analytes are INCREASED or DECREASED in unpreserved urine:

Ketones

A

DECREASED

Note:
Volatilization and bacterial metabolism

50
Q

Identify whether the following analytes are INCREASED or DECREASED in unpreserved urine:

Bilirubin

A

DECREASED

Note:
Exposure to light/photo oxidation to biliverdin

51
Q

Identify whether the following analytes are INCREASED or DECREASED in unpreserved urine:

Urobilinogen

A

DECREASED

Note:
Oxidation to urobilin

52
Q

Identify whether the following analytes are INCREASED or DECREASED in unpreserved urine:

Nitrite

A

INCREASED

Note:
Multiplication of nitrate-reducing bacteria

53
Q

Identify whether the following analytes are INCREASED or DECREASED in unpreserved urine:

Red and white blood cells and casts

A

DECREASED

Note:
Disintegration in dilute alkaline urine

54
Q

Identify where the following analytes are INCREASED or DECREASED in unpreserved urine:

Bacteria

A

INCREASED

Note:
Multiplication

55
Q

Identify where the following analytes are INCREASED or DECREASED in unpreserved urine:

Trichomonas

A

DECREASED

Note:
Loss of motility, death

56
Q

Identify where the following analytes are INCREASED or DECREASED in unpreserved urine:

Color

A

INCREASED (DARKENED)

Note:
Oxidation or reduction of metabolites

57
Q

The most routinely used method of preservation is refrigeration at what temperature?

A

2°C to 8°C

Note:
This decreases bacterial growth and metabolism

58
Q

TRUE or FALSE.

If the urine is to be cultured, it should be refrigerated during transit and kept refrigerated until cultured up to 24 hours.

A

TRUE

59
Q

TRUE or FALSE.

Urine samples which are preserved via refrigeration may immediately be chemically tested (use of reagent strips).

A

FALSE

Note: The specimen must first return to room temperature before chemical testing by reagent strips because enzyme reactions on the strips perform best at RT.

60
Q

Identify the URINE PRESERVATIVE described:

This does not interfere with chemical tests but precipitates amorphous phosphates and urates.

This prevents bacterial growth for 24 hours.

A

Refrigeration

61
Q

Identify the URINE PRESERVATIVE described:

This prevents bacterial growth and metabolism but interferes with drug and hormone analyses.

This keeps pH at about 6.0 and can be used for urine culture transport.

A

Boric acid

62
Q

Identify the URINE PRESERVATIVE described:

This is an excellent sediment preservative but acts as a reducing agent and therefore interferes with chemical tests for glucose blood, leukocyte esterase, and copper reduction

A

Formalin (Formaldehyde)

63
Q

Identify the URINE PRESERVATIVE described:

This is a good preservative for drug analyses but it can inhibit reagent strip tests for glucose, blood, and leucocytes

A

Sodium fluoride

64
Q

Identify the URINE PRESERVATIVE described:

This is convenient when refrigeration is not possible. It also has controlled concentration to minimize interference.

A

Commercial preservative tablets

65
Q

Identify the URINE PRESERVATIVE described:

Contains collection cup, transfer straw, culture and sensitivity (C&S) preservative tube, or UA tube

A

Urine Collection Kits (Becton, Dickinson, Rutherford, NJ)

66
Q

Identify the URINE PRESERVATIVE described:

Sample stable at room temperature (RT) for 48 hours; prevents bacterial growth and metabolism; keeps pH at 6.0

This is not recommended if urine is below minimum fill line.

A

Light gray and gray C&S tube

67
Q

What are the preservatives present in the light gray and gray C&S tube?

A

Boric acid
Sodium borate
Sodium formate

68
Q

Identify the URINE PRESERVATIVE described:

This can be used on automated instruments, require refrigeration within 2 hours, has round or conical bottom, and has no preservatives

A

Yellow UA Plus tube

69
Q

Identify the URINE PRESERVATIVE described:

Stable for 72 hours at RT; instrument-compatible.

Urine must reach minimum fill line; preservatives include sodium propionate, ethyl paraben, and chlorhexidine

A

Cherry red/yellow Preservative Plus tube

70
Q

Preservatives included in a Cherry red/yellow Preservative Plus tube

A

Sodium propionate
Ethyl paraben
Chlorhexidine

71
Q

The most commonly received type of urine specimen because of its ease of collection and convenience for the patient.

A

Random Specimen

72
Q

The ideal type of urine specimen for screening.

A

First Morning Specimen

73
Q

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

A

First Morning Specimen

74
Q

Type of urine specimen used for quantitative tests

A

24-hour (Timed) Specimen

75
Q

TRUE or FALSE.

In collecting accurate timed specimen, the patient must begin and end the collection period with an empty bladder.

A

TRUE

76
Q

In collection of timed specimens, why must be the first collected urine voided?

A

Addition of urine formed before the start of collection period will falsely elevate results.

77
Q

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

A

Catheterized specimen

78
Q

This is considered an alternative to catheterized specimen and provides a safer, less traumatic method for obtaining urine for bacterial culture and urine analysis.

A

Midstream Clean-Catch

79
Q

This type of urine specimen is collected by external introduction of a needle through the abdomen into the bladder.

A

Suprapubic Aspiration

80
Q

Urine specimen that is easiest to collect and is used for routine screening.

A

Random Specimen

81
Q

Urine specimen used for routine screening, pregnancy tests, and for evaluation of orthostatic proteinuria

A

First morning specimen

82
Q

Type of urine specimen/s that may be used for bacterial culture

A

Catheterized
Midstream clean-catch
Suprapubic aspiration

83
Q

Type of urine specimen which may be used for cytologic examination

A

Suprapubic aspiration

84
Q

Type of urine specimen collected to determine presence of prostatic infection

A

Three-glass collection

85
Q

TRUE or FALSE

Similar to the midstream clean-catch specimen, the first urine passed is also discarded in three glass collection.

A

FALSE.

The first urine passed is collected in a sterile container and is examined microscopically.

86
Q

In three glass collection, what is the use of the second container?

A

This contains the midstream portion and is used as control for bladder and kidney infection.

Note:
If this turns out to be positive, the results from the third specimen are invalid because infected urine has contaminated the specimen.

87
Q

In three-glass collection, if the third specimen has white blood cell/high power field count and a bacterial count _____ times that of the first specimen, prostatic infection is diagnosed.

A

10

88
Q

The Stamey-Mears Test for Prostatitis involves the four-glass method. What are collected in each of the four containers?

A

1: Initial voided urine
2: Midstream urine
3: Expressed prostatic secretions (EPS)
4: post-prostatic massage urine specimen

89
Q

In testing for prostatitis via four-glass method, which part/container tests urethral infection or inflammation.

A

First container (Initial voided urine)

90
Q

In testing for prostatitis via four-glass method, which part/container tests for urinary bladder infection

A

Second container (Midstream)

91
Q

In Stamey-Mears test for prostatitis, how many white blood cells per high-power field present in cultured prostatic secretions are considered abnormal?

A

> 10-20

92
Q

This is used for collection of pediatric urine specimens.

A

Soft, clear plastic bags (hypoallergenic)/Wee bags

93
Q

In collecting pediatric urine specimens, applied bags must be checked every ______ minutes until the needed amount of sample has been collected.

A

15 minutes

94
Q

This is the most vulnerable part of drug testing program

A

Urine specimen collection

Note:
This requires correct collection procedures and documentations

95
Q

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

A

Chain of Custody (COC)

96
Q

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)

97
Q

TRUE or FALSE.

In drug testing, urine specimen collections may be “witnessed” or “unwitnessed.”

A

TRUE

98
Q

In urine collection for drug testing, the urine temperature must be taken within _____ minutes from the time of collection.

A

4 minutes

99
Q

In urine collection for drug testing, the specimen temperature must be within the range of ____________.

A

32.5°C to 37.7°C

100
Q

Identify whether the Timed Specimen Collection is CORRECT or INCORRECT:

Day 1: At 9 AM, the patient voids and discards this specimen; collects all urine for the next 24 hours.

Day 2: At 9 AM, the patient voids and adds this specimen to the previously collected urine.

A

CORRECT

CLINMICRO_INTRODUCTION (STRASINGER) (2 decks)

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