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Urinalysis > Chapter 5 > Flashcards

Chapter 5 Flashcards

1
Q

Physical examination of urine includes- (3)

A

-color
-clarity
-specific gravity

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2
Q

Physical examination of urine results provide- (2)

A

-preliminary info
-correlation with other chemicals & microscopic results

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3
Q

Urine color analysis provides preliminary info concerning disorders such as- (5)

A

-glomerular bleeding
-liver disease
-inborn errors of metabolism
-UTI
-renal tubular function

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4
Q

Urine color ranges from-

A

Colorless to black

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5
Q

Normal variations of urine color are caused by- (4)

A

-normal metabolic functions
-physical activity
-ingested materials
-pathological conditions

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6
Q

Normal urine color common terminology- (3)

A

-pale yellow
-yellow
-dark yellow

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7
Q

Normal urine color should be consistent within-

A

Lab

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8
Q

Urochrome is pigment causing-

A

Yellow color

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9
Q

Urochrome is normally excreted-

A

At a constant rate

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10
Q

Urochrome is increased in- (2)

A

-thyroid disorders
-fasting

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11
Q

Urochrome increases when-

A

Specimen sits at room temp

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12
Q

Urochrome provides estimate of-

A

Body hydration

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13
Q

Normal urochrome colors can be-

A

Pale yellow to dark yellow

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14
Q

Additional pigments of normal urine color- (2)

A

-uroerythrin
-urobilin

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15
Q

Color changes of urine occur in-

A

Older specimens

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16
Q

Pigment in uroerythrin-

A

Pink

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17
Q

Pink pigment in uroerythrin is caused when-

A

Attaches to amorphous urates formed in refrigerated specimens

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18
Q

Urobilin color in older specimens-

A

Orange-brown

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19
Q

Urobilin oxidation of normal constituent-

A

Urobilinogen

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20
Q

Common abnormal urine colors- (4)

A

-dark yellow/amber/orange
-red/pink/brown
-brown/black
-blue/green

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21
Q

Normal dark yellow & amber urine indicates-

A

Concentrated urine

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22
Q

Abnormal dark yellow & amber urine indicates-

A

Bilirubin

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23
Q

In dark yellow & amber urine, bilirubin produces-

A

Yellow foam when shaken

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24
Q

In dark yellow & amber urine, normal urine produces-

A

Small amount of white foam caused by protein

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25
Q

In dark yellow & amber urine, bilirubin indicates-

A

Possible hep virus present

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26
Q

In dark yellow & amber urine, photooxidation of large amounts of urobilinogen produces-

A

Yellow-orange urine (no foam when shaken)

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27
Q

In dark yellow & amber urine, Photooxidation of bilirubin to biliverdin produces-

A

Yellow-green urine

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28
Q

Common cause of red urine-

A

Blood

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29
Q

Blood in urine color can range from-

A

Pink to brown

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30
Q

Pink color in the urine indicates-

A

Small amount of blood

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31
Q

Brown color in the urine indicates-

A

Oxidation of hemoglobin to methemoglobin

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32
Q

Methemoglobin RBCs remain in-

A

Acid urine

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33
Q

Fresh brown urine specimen can indicate-

A

Glomerular bleeding

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34
Q

Cloudy red urine indicates-

A

RBCs

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35
Q

Clear red urine indicates-

A

Hemoglobin/myoglobin

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36
Q

Hemoglobin in urine- (3)

A

-in vivo lysis of RBCs
-patient’s plasma will also be red
-consider in vitro lysis

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37
Q

Myoglobin in urine- (3)

A

-breakdown of skeletal muscle
-fresh urine is often more reddish/brown
-patient’s plasma is clear

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38
Q

Port wine colored urine indicates-

A

Oxidation of porphobilinogen to porphyrias

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39
Q

Nonpathic red urine indicates- (3)

A

-Menstrual contamination
-Pigmented foods
-Medications (rifampin, pheno-compounds)

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40
Q

Generally susceptible people in alkaline urine-

A

Fresh beets

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41
Q

Found in acid urine-

A

Black raspberries

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42
Q

Additional testing for brown/black urine specimens that- (2)

A

-turn black after standing at room temp
-test negative for blood

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43
Q

Melanin in brown/black urine- (2)

A

-Excess in malignant melanoma
-Oxidation of melanogen to melanin

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44
Q

Homogentisic acid in brown/black urine- (2)

A

-Black color in alkaline urine
-Alkaptonuria

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45
Q

Clorets for brown/black urine- (5)

A

-Medications
-levodopa
-methyldopa
-phenol derivatives
-flagyl & furadantin

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46
Q

Pathogenic cause of blue/green urine-

A

Urinary & intestinal bacterial infections

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47
Q

Urinary bacterial infections-

A

Pseudomonas infection

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48
Q

Intestinal bacterial infection causes-

A

increased urinary indican oxidizing to indigo blue

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49
Q

Clorets for green urine- (2)

A

-B vitamin
-asparagus

50
Q

Clorets for blue urine- (5)

A

-medications
-Robaxin
-Indocin
-Tivorbex
-Elavil & Diprivan

51
Q

Catheter bags in blue/green urine-

A

Purple color from Klebsiella & Providencia

52
Q

Can cause green urine-

A

IV phenol medications

53
Q

Clarity refers to-

A

Transparency or turbidity of a specimen

54
Q

Visual examination for clarity of urine- (2)

A

-Gently swirl specimen in a clear container in front of a good light source
-Specimen should be in a clear container

55
Q

Color & clarity are routinely done at-

A

The same time

56
Q

Terminology used to report clarity of urine- (5)

A

-clear
-hazy
-cloudy
-turbid
-milky

57
Q

Clear urine clarity-

A

No visible particulates, transparent

58
Q

Hazy urine clarity-

A

Few particulates, print easily seen through urine

59
Q

Cloudy urine clarity-

A

Many particulates, print blurred through urine

60
Q

Turbid urine clarity-

A

Print cannot be seen through urine

61
Q

Milky urine clarity-

A

May precipitate or be clotted

62
Q

Freshly voided urine is usually-

A

Clear, particularly if it is a midstream specimen

63
Q

may cause a white cloudiness in an alkaline urine specimen- (2)

A

-amorphous phosphates
-carbohydrates

64
Q

Nonpathogenic turbidity in hazy female specimens-

A

With squamous epithelial cells & mucus

65
Q

Nonpathogenic turbidity in bacterial growth-

A

In nonpreserved specimens

66
Q

Nonpathogenic turbidity in refrigerated specimens with- (3)

A

-precipitated amorphous phosphates (white)
-carbonates (white)
-urates (pink)

67
Q

Nonpathogenic Turbidity contamination- (5)

A

-fecal
-talc
-semen
-vaginal creams
-IV contrast media

68
Q

Most common Pathological Turbidity- (3)

A

-RBCs
-WBCs
-bacteria

69
Q

Pathological Turbidity also include- (5)

A

-nonsquamous epithelial cells
-yeast
-trichomonads
-abnormal crystals
-lymph fluid
-lipids

70
Q

The extent of turbidity should correspond to-

A

the amount of material observed in the microscopic examination

71
Q

In pathological turbidity, clarity is on of the criteria considered in determining-

A

the necessity of performing a microscopic examination

72
Q

Specific gravity evaluates-

A

Urine concentration

73
Q

Specific gravity determines-

A

if specimen is concentrated enough to provide reliable chemistry results

74
Q

Specific gravity definition-

A

the density of a solution compared with the density of an equal volume of distilled water at the same temperature

75
Q

Isosthenuric SG-

A

1.010

76
Q

Isosthenuric is the standard gravity of-

A

Plasma ultrafiltrate

77
Q

Hyposthenuric SG-

A

Lower than 1.010

78
Q

Hypersthenuric SG-

A

Higher than 1.010

79
Q

Normal random specimen range SG-

A

1.002 - 1.035

80
Q

Most common specimen range SG-

A

1.015 - 1.025

81
Q

SG that may not be considered urine-

A

Below 1.002

82
Q

Refractometer measures-

A

velocity of light in air versus velocity of light in a solution

83
Q

Refractometer concentration changes-

A

the velocity and angle at which the light passes through the solution

84
Q

Prism in the Refractometer determines-

A

the angle that light is passing through the urine and converts angle to calibrated viewing scale

85
Q

Refractometer advantages- (3)

A

-Temperature compensation not needed
‒Light passes through temperature-compensating liquid
‒Compensated between 15°C and 38°C

86
Q

Refractometer specimen size-

A

One drop

87
Q

Corrections for glucose & protein in Refractometer- (2)

A

-Subtract 0.003 for each gram of protein present
-Subtract 0.004 for each gram of glucose present

88
Q

Refractometer process- (3)

A

-Drop of urine placed on prism
-Focus on light source, and read scale
-Wipe off prism between specimens

89
Q

Calibration of a Refractometer- (3)

A

-Distilled water should read 1.000; adjust set screw if necessary
-5% NaCl should read 1.022 ± 0.001
-9% sucrose should read 1.034 ± 0.001

90
Q

Osmolality is a more representative measure of-

A

renal concentrating ability can be obtained

91
Q

Osmolality SG depends on-

A

the number of particles present in a solution and the density of these particles

92
Q

Osmolality is affected only by-

A

The number of particles present

93
Q

Osmolality substances of interest are small molecules- (3)

A

-Sodium
‒Chloride
‒Urea

94
Q

Unit of measure of Osmolality-

A

mOsm (milliosmole)

95
Q

Osmolality Glu-

A

180 g/osm (C + H + O)

96
Q

Osmolality NaCl-

A

58.5 g/osm (Na + Cl)

97
Q

In Osmolality, 1 g molecular weight of a substance divided by-

A

the number of particles into which it dissociates (= to MW of substance)

98
Q

Osmolality of a solution can be determined by-

A

measuring a property that is mathematically related to the number of particles in the solution (colligative property)

99
Q

Changes in colligative properties- (4)

A

-Lower freezing point
-Higher boiling point
-Increased osmotic pressure
-Lower vapor pressure

100
Q

Measuring osmolality in the urinalysis laboratory requires an

A

Osmometer

101
Q

Osmometer is an additional step in-

A

the routine urinalysis procedure

102
Q

Automated Osmometer utilizes-

A

freezing point depression to measure osmolality

103
Q

The reagent strip reaction is based on the change in-

A

pKa (dissociation constant) of a polyelectrolyte in an alkaline medium

104
Q

Reagent strips release H ions in direct proportion to-

A

number of ions in the solution

105
Q

The more hydrogen ions released in reagent strip SG-

A

the lower is the pH

106
Q

Indicator bromothymol-LS blue on the reagent pad measures-

A

Changes in pH

107
Q

Reagent strip SG Indicator changes from-

A

blue (1.000 [alkaline]), through shades of green, to yellow (1.030 [acid])

108
Q

Reagent strip SG isn’t affected by-

A

Nonionizing substances

109
Q

Odor in fresh urine-

A

Faintly aromatic

110
Q

Odor in older urine-

A

Ammonia

111
Q

Odor in metabolic disorders- (3)

A

-urine disease (maple syrup)
-ketosis (fruity)
-infection (ammonia/unpleasant)

112
Q

Food odor in urine- (3)

A

-garlic
-onions
-asparagus (genetic: only certain people can smell asparagus, but all produce odor)

113
Q

Aromatic urine odor cause-

A

Normal

114
Q

Foul, ammonia-like urine odor cause- (2)

A

-bacterial decomposition
-UTI

115
Q

Fruity, sweet urine odor cause-

A

Ketones (diabetes mellitus, starvation, vomiting)

116
Q

Maple syrup urine odor cause-

A

Maple syrup urine increase

117
Q

Mousy urine odor cause-

A

Phenylketonuria

118
Q

Rancid urine odor cause-

A

Tryosinemia

119
Q

Sweaty feet urine odor cause-

A

Isovaleric acidemia

120
Q

Cabbage urine odor cause-

A

Methionine malabsorption

121
Q

Bleach urine odor cause-

A

Contamination

Urinalysis (7 decks)

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