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Lab Procedures 1 > Chapter 3: Urinalysis Exam 2 > Flashcards

Chapter 3: Urinalysis Exam 2 Flashcards

1
Q

Confirmatory test for Bilirubin

A

Ictotest

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2
Q

Clinitest

A
  • Detects all reducing substances (other sugars)
  • Multistix detects only glucose
  • Can be used to correlate with Multistix test for possible detection of Galactosemia, a congenital deficiency in the body’s ability to metabolize galactose to glucose; when seen in infants, can result in failure to thrive
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3
Q

Hematuria

A

Red blood cells in the urine

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4
Q

What results could be positive on a reagent strip to indicate a UTI?

A
  • Protein
  • Leukocytes
  • Blood
  • Nitrites
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5
Q

What results could be positive if a patient has diabetes mellitus?

A
  • Glucose

- Ketones

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6
Q

Acetest

A

Confirmatory test for Ketones

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7
Q

What does the presence of nitrites indicate in fresh urine?

A

Bacteria

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8
Q

Positive erythrocytes in urine could be an indication of?

A

Kidney Stones

Sometimes tumors/lesions

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9
Q

Reagent strips are defined as this….

A

Qualitative & Semiquantitative urine tests

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10
Q

Qualitative

A

Indicates whether a particular analyte is present

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11
Q

Quantitative

A

measures the exact amount of a substance

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12
Q

Semiquantitative

A

determines the approximate quantity of an analyte

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13
Q

Amorphous

A

Shapeless clumps/without shape or definite shape

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14
Q

What objectives are used to view microscopic urines?

A

Lower Power Field-10x

High Power Field- 40x

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15
Q

Supernatant

A

Liquid portion of urine on top of the spun sediment

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16
Q

Sediment

A

Material at the bottom of the centrifuge tube of urine

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17
Q

Crystals

A

Are formed by the precipitation of urine salts when changes in pH, temperature, or concentration occur

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18
Q

the most important aid in the identification of urine crystals

A

pH

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19
Q

Crystals are counted on ____ and identified under ______ and reported as few, moderate, and many

A
  • counted on LPF

- identified under HPF

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20
Q

Abnormal crystals may represent disorders such as

A
  • liver disease
  • inborn errors of metabolism
  • or renal damage caused by the crystallization of iatrogenic compounds (caused by treatment or diagnostic procedures).
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21
Q

Procedure for preparing urine for microscopic examination

A
  • put 12 mL in centrifuge tube
  • 5 mins in centrifuge
  • Take it out after 5 mins and pour off supernatant
  • Mix up sediment
  • Put into 10 slides
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22
Q

Casts

A
  • formed primarily within the lumen of the distal convoluted tubules and collecting ducts
  • Provide a microscopic view of conditions within the nephron
  • Shapes usually contain parallel sides and rounded ends
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23
Q

Four factors can lead to cast formation…..

A
  • decreased urine flow
  • increased acidity (low pH)
  • increased solute concentration (high specific gravity)
  • increased plasma protein
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24
Q

Types of casts

A
  • Hyaline Casts
  • Red Blood Cell Casts
  • White Blood Cell Casts
  • Renal Epithelial Cell Casts
  • Granular Casts
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25
Q

Positive bilirubin test strips could be caused by what liver diseases?

A

Jaundice and Hepatitis

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26
Q

Pyuria

A

White Blood Cells in the urine

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27
Q

squamous epithelial cells

A

not clinically significant usually

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28
Q

what are examples of artifacts/contaminants?

A
  • Hair
  • Fecal matter
  • Diaper fibers/clothing fibers
  • Pollen Grains
  • Air bubbles
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29
Q

what is is the most frequently seen parasite in urine specimens?

A

Trichomonas vaginalis

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30
Q

What is trichomonas vaginalis?

A

a sexually transmitted parasite that causes vaginal inflammation in women and infection of the urethra and prostate in men

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31
Q

What is yeast?

A

Are small, oval organisms that may bud and form hyphae (branches)

32
Q

What word is associated with yeast that distinguishes it from red blood cells?

A

Budding

33
Q

To know about bacteria

A
  • Quality of collection of specimen (midstream clean catch)
  • Are very tiny and must be viewed on high power
  • Appear as either rod shaped (bacilli) or round (cocci) or amorphous (without definite shape)
  • Are reported as few, moderate, or many or as 1+, 2+, 3+, or 4+
34
Q

What will show up when bacteria is detected?

A

Elevated nitrite will show up (patient has infection)

35
Q

erythrocyte

A

red blood cells

36
Q

WBC description

A

WBCs have a visible nucleus, and their cytoplasm may appear granular and coarse. They are reported as cells per HPF

37
Q

Presence of WBCs can be a factor in ….

A

pyelonephritis, cystitis, prostatitis, and urethritis

38
Q

what is the most common WBC found in the urine?

A

neutrophils

39
Q

Renal Tubular epithelial cells can indicate……

A

pyelonephritis, toxic reaction, viral infection, allograft rejection, and secondary effects of glomerulonephritis

40
Q

RBCs definition

A

RBCs are round, biconcave, no nucleus, colorless disks.

Counted and reported as cells per HPF.

41
Q

Guidelines when using reagent test strips…

A
  • Reagent strip bottle must be kept tightly closed.
  • Pads on strip should not be touched.
  • Do not refrigerate strips; keep in cool, dry place.
  • Don’t use expired strips.
  • Do not combine strips from different bottles.
  • Follow all directions from the manufacturer.
  • Make sure all pads are covered with urine
42
Q

Specific Gravity

A

The weight of urine as compared to an equal volume of water

43
Q

What does SG measure in urine?

A

measures the the amount of particles that are dissolved in the urine, which indicates the ability of the kidneys to concentrate the urine

44
Q

which specimen is specimen is usually the most concentrated?

A

First morning

45
Q

The normal range for urine S/G is…

A

1.003 to 1.030, but the range is usually between 1.010 and 1.025.

46
Q

what is pH?

A

Scale from 0-14, measures the level of acidity or alkalinity in the urine

47
Q

pH of 7 is?

A

neutral

48
Q

pH of 0 to 6 is….

A

acid

49
Q

pH of 8 to 14 is…

A

alkaline

50
Q

Normal urine has a pH of….

A

5.0-8.0

51
Q

why should you use freshly voided urine to measure pH?

A

because bacteria in the urine will convert urea to ammonia causing the urine to become alkaline.

52
Q

If freshly voided urine is alkaline what may it indicate?

A

UTI

53
Q

Glucose is…

A

The most common sugar

54
Q

Glycosuria occurs when…

A

blood glucose levels are so high that renal tubule glucose cannot be reabsorbed back into the blood and the renal threshold is reached

55
Q

The presence of glucose in the urine may be an indication of

A

diabetes mellitus
vigorous exercise
emotional stress

56
Q

Ketones

A

Products of fat metabolism that are then oxidized by the muscles

57
Q

ketonuria

A

The excess ketones accumulate in tissues and blood and subsequently in the urine

58
Q

Ketones and glucose in the urine may be associated with

A

uncontrolled diabetes mellitus

59
Q

Other conditions producing ketones in urine without the presence of glucose

A
  • Anorexia and starvation
  • Diets high in fat and low in carbohydrates
  • Prolonged vomiting
  • Fever
60
Q

What is bilirubin produced from?

A

the breakdown of hemoglobin

61
Q

what color is bilirubin?

A

yellow pigment

62
Q

where does bilirubin become urobilinogen?

A

small intestine

63
Q

where does bilirubin become water soluble?

A

the liver

64
Q

Conditions that cause excessive blood levels of bilirubin are

A 
Excessive hemolysis
Hepatitis
Liver damage, Liver sclerosis
Obstructive jaundice
Obstruction of the bile duct
65
Q

Bilirubin gives a _______ color (jaundice) to the urine, plasma, skin, mucous membranes, and whites of the eye (sclera).

A

yellow-orange

66
Q

what does urobilinogen result from?

A

results from a breakdown of bilirubin in the colon by bacteria.

67
Q

what does urobilinogen give color?

A

feces

68
Q

Conditions that can cause increased levels of urobilinogen in the urine are

A

Excessive hemolysis of RBCs
Cirrhosis
Infectious mononucleosis
Congestive heart failure

69
Q

Three substances can cause pad to be positive for blood

A
  • Intact red blood cells
  • Hemoglobin from lysed red blood cells
  • Myoglobin (Oxygen-storing pigment of muscle tissue, can be found in urine after massive muscle injury, physical trauma, or electrical injury.)
70
Q

Hemoglobinuria can be caused by

A

transfusion, reactions, malaria, drug reactions, snake bites, and severe burns.

71
Q

Blood in urine usually occurs from…

A
  • UTIs associated with bleeding, such as cystitis and urethritis.
  • Kidney stones, tumors, and lesions may cause bleeding.
72
Q

Protein

A

Small amounts are normal in urine

73
Q

proteinuria

A

A large amount of protein in the urine

74
Q

what is one of the the first signs of renal disease?

A

proteinuria

75
Q

What specimen is best for testing for nitrites?

A

First morning specimen is best because urine must remain in the bladder a minimum of 4-6 hours for nitrates to be changed to nitrites

76
Q

What is usually indicated by the presence of leukocytes in the urine?

A

UTI

Lab Procedures 1 (7 decks)

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