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3J 2ND SEM - AUBF LEC > CHAPTER 2 - Urine Specimen Types, Collection, and Preservation > Flashcards

CHAPTER 2 - Urine Specimen Types, Collection, and Preservation Flashcards

1
Q

purposes of performing a routine urinalysis

A

(1) to aid in
the diagnosis of disease;
(2) to screen for asymptomatic, congenital, or hereditary disease;
(3) to monitor disease progression;
and
(4) to monitor therapy effectiveness or complication

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2
Q

urine is “?” of the kidneys and can provide a fountain of information about the health of an individual

A

fluid biopsy

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3
Q

only organs that can have their functional status evaluated by nonivasive means

A

kidneys

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4
Q

urine is ? = used to evaluate and monitor body homeostasis and
many metabolic disease processes

A

ultrafiltrate of the plasma

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5
Q

3 basic types of urine collection

A

first morning
random
timed collection

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6
Q

ideal urine specimen must be

A

adequately concentrated

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7
Q

detection of chemical components and formed elements fo intrest depend on ? and ?

A
  • patient’s state of hydration
  • the length
    of time the urine is held in the bladder
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8
Q

first morning specimen: urine has been retained in the bladder for approx ? hours

A

8 hours

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9
Q

specimen is ideal to test for substances that require CONCENTRATION or INCUBATION for detection (nitrates, proteins)

A

First morning specimen

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10
Q

first morning specimen is used to confirm ? and ?

A

postural and orthostatic proteinuria

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11
Q

morphology of cellular components and casts is enhanced by the ? of FMS

A

high osmolality

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12
Q

formed elements that more stable in these conc. acidic urine spx

A

WBC, RBC, casts

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13
Q

ex. of spx that can crystallize on cooling to room temp

A

amorphous urates

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14
Q

spx must be preserved if it is not going to be analyzed within 2 hours of collection.

A

frst morning spx

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15
Q

type of spx: routine screening is most often
performed

A

random urine spx

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16
Q

random urine spx: ? and ? can directly affect urine composition

A

excessive fluid intake
strenuous exercise

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17
Q

w prior hydration - ? is ideal for cytology studies

A

random “clean catch” urine spx

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18
Q

prior hydration for random urine spx: drink ? to ? oz of water each hour for - hours before urine collection

A

24-32 oz; 2 hours

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19
Q

Most cytology
protocols require collection of these specimens (random urine spx) daily for ? to
? consecutive days

A

3-5

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20
Q

One method that can be used to increase the cellularity of a
urine specimen (random urine)

A

patient exercises for 5 min

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21
Q

spx for quantitiave urine assays

A

timed collection

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22
Q

two types of timed urine spx

A

(1) urine colletected for a predetermined length of time
(2) collected during a specific time of day

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23
Q

4-hour or 12-hour for determination of ?,?, ?

A

urine
albumin, creatinine, and the albumin-to-creatinine ratio

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24
Q

timed collection (4/12-hour) is ideal spx to screen for ?

A

microalbuminaria

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25
Q

2-hour collection for determination of - is s preferably collected
from 2 PM to 4 PM

A

urinary urobilinogen

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26
Q

time when maximal excretion of urobilinogen is known to occur

A

2-4pm

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27
Q

most common errors encountered in quantitative urine tests are related
directly to - or -

A

specimen collection or to handling problems

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28
Q

errors related to specimen collection or to handling problems

A

LIIIT
- loss of spx
- inclusion of first two morning spx
- innacurate total volume measurement
- inadequate preservation
- transcription error

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29
Q

uses of random spx

A
  • Routine screening
  • Cytology studies (with
    prior hydration)
  • Fluid deprivation tests
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30
Q

uses for first morning spx

A
  • Routine
    screening; good
    recovery of cells
    and casts
  • To confirm
    postural or
    orthostatic
    proteinuria
  • Cytology
    studies
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31
Q

uses of timed collection

A

QCCE

  • quantitative chemical analysis
  • chemical tests
  • cytology studies
  • evaluation of fistula
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32
Q

sufficient volume for timed urine collection protocol ?

A

50 ml

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33
Q

50 ml is removed from timed urin collection for ? and ?

A

routine testing
repeat or addtl testing

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34
Q

types of collection technique

A
  • routine void
  • catheterized, urethral
  • catheterized, ureteral
  • suprapubic aspirate
  • pediatric collection bag
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35
Q

collection technique that requires no patient prep, no assistance other than clear instructions

A

routine void

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36
Q

spx collection technique done if there is possibility of contamination or bacterial culture is desired

A

midtsream clean catch spx

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37
Q
  • of male and - of female is throoughly cleansed and rinsed before collection of a midtsream clean catch xpc
A

glans penis
urethral meatus

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38
Q

midstream technique allows collection of spx that represents elements and analytes from the -, -, and -

A

bladder
ureter
kidneys

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39
Q

this technique eliminates sources of contamination and provides excellent spx for routine urinalysis and urine culture

A

midstream “clean catch”

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40
Q

urine spx can be collected at any time from this reservoir

A

catheterized spx

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41
Q

type of infx common in catheterized patients

A

Urinary tract infextions

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42
Q

collection technique involves collecting uine directly from the bladder by puncturing the abdominal wall and the distended bladder using a needle and syringe.

A

suprapubic aspiration

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43
Q

suprapubic aspiration is used principally for -

A

bacterial cultures

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44
Q

suprapubic aspiration is used principally for bacterial cultires, esp for - and in -

A

anaerobic microbes and in infants

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45
Q

patients that are unable to urinate voluntarily

A

newborns
infants
pediatric patients

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46
Q

area that is cleansed and dried before spx bag is placed onto the skin of the pediatric patient

A

perineal area

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47
Q

pediatric patient is checked every - min to see if adeq spx has veen collected

A

15 min

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48
Q

urine for bacterial culture is obtained by - or -

A

catheterization
suprpubic aspiration

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49
Q

uses for routine void

A

routine screening

50
Q

uses for midstream clean catch

A
  • Bacterial and
    fungal cultures
    (sterile container required)
  • Routine screening
  • Cytology
51
Q

A catheter is
inserted into the
bladder via the
urethra
* Urine flows
directly from
bladder through
catheter into
plastic bag

A

catheterized, urethral

52
Q

collection technique done To determine
and differentiate
kidney infections

A

catheterized, ureteral

53
Q
  • A catheter is
    inserted through
    the urethra and
    bladder and into the
    left and right ureter;
    urine is collected
    from each ureter
    before it reaches
    the bladder
A

Catheterized,
ureteral

54
Q

use of suprapubic aspiration

A

bacterial and fungal cultures

55
Q

collection technique Used with patients
unable to urinate
voluntarily

A

pediatric collection bag

56
Q

use for pediatric collection bag

A
  • routine screening
  • quantitiave assays
57
Q

most common reasons for spx rejection

A

unlabeled and improperly labeled urine spx

58
Q

reasons for urine spx rejection (6)

A

UMISIV

  • unlabeled
  • mislabaled
  • inappropriate urine collection technique or spx type for test
  • specimen not properly preserved; inappropriate preservative used
  • insufficient volume of urine for test req
  • visibly contaminated urine
59
Q

routine urinalysis require ? vol of urine when urinalysis is performed manually

A

10-15 ml of urine

60
Q

? vol hinder performance of the microscopic examination when the urinalysis is performed manually and can limit the chemical tests performed

A

<12 ml

61
Q

fully automated urinalysis system such as the iQ200 system, complete urinalysis can be perfromed w -ml of urine

A

4 ml

62
Q

urine vol needed for 24-hour urine collection (quantitative urine tests)

A

1 ml

63
Q
  • to - ml is usually retained to ensure sufficient specimen in case repeat or additional testing is required later
A

20-50 ml

64
Q

container have an opening of - to - cm and have a capacity of - to - ml

A

opening: 4-5 cm
capacity: 50-100 ml

65
Q

type of container used if urine spx is stored for a longer han 2 hrs before testing

A

sterile container

66
Q

urine container capacity for the collection of 12-hour and 24-hour urine specimens for quantitative analyses

A

3000 ml

67
Q

12-hour and 24-hour urine specimens is usually made of -, that protect spx from - and -

A

brown opaque plastic; ultraviolet and white light

68
Q

preseravtices added to large containers for the collection of 12/24 hr urine spx

A

acid preservatices

69
Q

collection bag used for collection spx from pediatric patient

A

clear, plaible, polyethylene urine collection bag

70
Q
  • enables transfer of the urine that has accumulated to another collection container, thereby eliminating the need for multiple collection bags.
A

exit port or tubing

71
Q

info provided on all lables

A

patients fill name
unique identification number
room number
date and time of collection
preservative used

72
Q

change due to Oxidation or reduction of solute

A

color = darkens

73
Q

physical change due to Crystal precipitation; bacterial proliferation

A

decreased clarity

74
Q

ammoniacal odor is due to -

A

bacterial conversion of urea to ammonia + bacterial proliferation

75
Q

chemical changes due ro removal of chemical entity by various mechanisms may lead o - results

A

false-negative

76
Q
  • and - increase in unpreserved
    urine as bacteria proliferate, converting nitrate to nitrite and
    metabolizing urea to ammonia
A

urine nitrite
pH

77
Q

microscopic change is due to

A

disintegration of formed elements (hypotonic and alkaline urine or from unchecked bacterial growth)

78
Q

chemical change mechanism: Consumed by cells and/or bacteria

A

decreased glucose

79
Q

chemical change mechanism: Volatilization and bacterial conversion

A

decreased ketones

80
Q

chemical change mechanism: Photo-oxidation to biliverdin by light exposure

A

decreased bilirubin

81
Q

chemical change mechanism: oxidation to urobilin

A

decreased urobilinogen

82
Q

chemical change mechanism: Bacterial conversion of dietary nitrates

A

increased nitrite

83
Q

chemical mechanism: bacterial conversion of urea to ammonia; loss of CO2

A

increased pH

84
Q

microscopic changes in unpreserved urine

A

decreased: blood cells and casts, trichomonads
increased: bacteria

85
Q

microscopic changes: disintegration, especially in dilute and alkaline urine

A

decreased blood cells and casts

86
Q

decreased trichomonads in unpreserved urine is due to

A

loss of characteristic MOTILITY AND DEATH

87
Q

type of preservative used depends on

A
  • type of collection
  • tests to be performed
  • time delay before testing
88
Q

easiest and most common form of preservation,

A

refrigeration at 4°C to 6 °C

89
Q
  • prevents bacterial proliferation, and the specimen remains suitable for culture for up to 24 hours
A

refrigeration

90
Q

urine preservative that is not recommended for routine urinalysis spx

A

refrigeration

91
Q

induce precipitation of amorphous urate and phosphate crystals that can interfere substantially with the microscopic examination

A

refrigeration

92
Q

routine urinalysis spx that must be transported long distances

A

commercial transport tubes w a preservative

93
Q

Acceptable for routine urinalysis;
preserves chemical and formed
elements in urine at room temperature

A

commerical transport tubes

94
Q
  • pH and SG may be altered;
    varies with tube used
  • Can interfere with chemistry
    tests
A

commercial transport tube

95
Q

Preserves sediment elements (e.g.,
casts, cells)
* Inhibits bacterial and yeast growth

A

thymol

96
Q
  • Interferes with protein
    precipitation tests
  • In high concentration, can
    precipitate crystals
A

thymol

97
Q

Excellent cellular preservative; False-negative reagent strip
tests for blood and
urobilinogen

A

formalin

98
Q

Unacceptable for urinalysis
testing
* Potential chemical hazard

A

acids (HCl,
glacial acetic
acid)

99
Q

For quantitative analysis of
urine solutes, such as
steroids, hormones, etc

A

acids

100
Q

For quantitative analysis of
porphyrins, porphobilinogen,

A

sodium carbonate

101
Q
  • Unacceptable for urinalysis
    testing; Stabilizes porphyrins, porphobilinogen,
A

sodium carbonate

102
Q

Stabilizes calcium, phosphorus,
steroids, hormones

A

Acids (HCl,
glacial acetic
acid)

103
Q

Excellent cellular preservative
* Commercially available and inexpensive; Potential chemical hazard

A

saccomanno’s fixative

104
Q

preservatives and additives of BD VACUTAINER; Plus Plastic
Conical UA Preservative Tube

A

chlorhexidine
ethyl paraben
sodium propionate

105
Q

D VACUTAINER; Plus Plastic Conical UA Preservative Tube: tube draw and stabilizes urine for up to

A

8ml; 72 hrs

106
Q

InTac UA System, Therapak Corporation: tube draw and stabilizes urine for up to

A

5-8ml; 96 hrs

107
Q

preservatives and additives of InTac UA System, Therapak
Corporation

A

Dowicil 200
Mannitol
Polyethylene glycol

108
Q

BD VACUTAINER; C & S
Preservative Tube: tube draw and stabilizes urine for up tp

A

4 ml draw; 48 hrs

109
Q

D VACUTAINER; C & S
Preservative Tube additives and preservatives

A

boric acid
d-sorbitol
sodium formate
sodium acetate

110
Q

Commercial Urine Transport Tubes With Preservative

Urinalysis
* Urine culture
and sensitivity
* Can be used for
urinalysis
* Bacteriostatic

A

BD vacutainer C and S preservative Tube

111
Q

BD vacutainer C and S preservative Tube adjusts ph and SG to

A

Ph: 6-7
SG increase: 0.006-0.007

112
Q

collection preservative needed for a particular analyte can differ among laboratories. these variations stem from:

A
  1. diff test methods
  2. how often the test is performed
  3. time delay and transportation conditions
113
Q

helpful in identifying urine spx to which addtl liquid has been added

A

ph
specific gravity
temperature

114
Q

urime pH in fresh urine spx

A

4-8 pH

115
Q

urine pH in fresh urine spx specific gravity

A

1.002 to 1.035

116
Q

normal temo of urine spx

A

32.5 and 37.5

117
Q

when - is performed, , concern may be raised regarding whether the fluid collected is
amniotic fluid or urine aspirated from the bladder.

A

amniocentesis

118
Q

single most useful substance that identifies a fluid as urine

A

high creatine conc (50 times higher that of plasma)

119
Q

conc of ??? are higher in urine than in any other body fluid

A

sodium
urea
chloride

120
Q

? and ? is not present in urine from healthy individuals

A

protein and glucose

121
Q

body fluids that contain glucose and high protein

A

amniotic fluid
plasma exudates

3J 2ND SEM - AUBF LEC (2 decks)

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