Clinical Microscopy Flashcards
Potentially harmful microorganism
Biological hazards
Transmission of microorganisms
Chain of infection
Essential in preventing the spread of infection
Chain of infection
Chain of infection requires a continuous link between:
- Source
- Mode (means) of transmission
- Susceptible host
6 components of the chain of infection
“IREMES”
- Infectious agent
- Reservoir
- Exit portal
- Mode of transmission
- Entry portal
- Susceptible host
3 routes of infection
- Inhalation
- Ingestion
- Direct inoculation or skin contact
Personal Protective Equipment
- Gloves
- Fluid-resistant gowns
- Eye and face shields
- Countertop shields
______ is the primary method of infection transmission
Hand contact
The best way to break the chain of infection
Handwashing
When hands are visibly soiled, wash hands with ___
soap and water
When hands are not visibly soiled, apply ___
alcohol based hand-rub (sanitizer)
Handwashing procedure
1. Wash hands with ___
2. Apply antimicrobial soap.
3. Rub to form a lather, create _____, and loosen debris
4. Thoroughly clean between fingers, and up to the wrist for at least ____
5. Rinse hands in a ____ position
6. Dry with a paper towel
7. Turn off faucets with a clean paper towel to prevent recontamination .
- warm water
- friction
- 15 (or 20) seconds
- Downward
Handwashing song
Happy Birthday 2x
All biological wastes, except urine, must be placed in appropriate containers labeled with the_____ symbol
Biohazard
The accepted BIOHAZARD label is _____
Fluorescent orange
Discard urine by pouring it into a _____
Avoid splashing, and then flush with water
laboratory sink
Empty urine containers can be discarded as ____
nonbiologically hazardous waste
Disinfection of the sink using a ________ should be performed ______
1:5 or 1:10 dilution of sodium hypochlorite; daily
Disinfection eliminates many or all pathogenic microorganisms, except _____
bacterial spores
A 1:10 dilution of sodium hypochlorite is prepared by adding _______
effective for 1 month; used for disinfecting countertops and spills
1 part of sodium hypochlorite to 9 parts of water
The basic outline of the biohazard symbol is a plain trefoil, which is _____ equally like in a triple Venn diagram with the overlapping parts erased. The diameter of the overlapping part is equal to half the radius of the three circles.
three circles overlapping each other
Sharp objects are disposed of in ___
puncture resistant containers
Color of puncture-resistant containers
red
Type of hazard where procedures using radioisotopes are performed
Radioactive hazards
True or false.
The best method of radioactive waste disposal is to store the used radioactive material in a locked, marked room until the background count is down to 10 half-lives for radioiodine,
True
Best first aid for chemical spills
Flush the are with amounts of water for at least 15 minutes then seek medical attention
For alkali or acid burns in the eye, wash out eye thoroughly with ____ for ____
running water for 15 minutes.
DO not neutralize chemicals that come in contact with the skin.
Acid spills on floors can be neutralized and the soaked up with wet rages or spill pillows
Both statements are True
Proper handling of chemicals “AW!”
Acid to water
What will happen when water is added to acid
explosion
The National Fire Protection Association (NFPA) Hazardous Materials Classification uses numbers from ____ to classify hazard severity, with 4 representing extremely hazardous.
0 to 4
Yellow Quadrant
Reactivity or Stability Hazard
“SUVSM”
0 = Stable
1 = Unstable if heated
2 = Violent chemical change
3 = Shock and heat may deteriorate/detonate
4 = May deteriorate/detonate
White Quadrant
Specific Hazard
OXY = Oxidizer
ACID = Acid
ALK = Alkali
COR = Corrosive
W = Use no water
Radiation
Blue Quadrant
Health Hazard
“NSHED”
0 = Normal material
1 = Slightly hazardous
2 = Hazardous
3 = Extreme danger
4 = Deadly
Red Quadrant
Flammability hazard
0 = Will not burn
1 = Above 200 deg F
2 = Below 200 deg F
3 = Below 100 deg F
4 = Below 73 deg F
Degree of Hazards (Hazard Index)
“No SMS Ex’s”
0 = No/Minimal hazard
1 = Slight Hazard
2 = Moderate hazard
3 = Serious hazard
4 = Extreme / Severe Hazard
All electrical equipment is grounded in a ____ to avoid electric shock
3-pronged plug
If electrical shock occurs, never touch the person or the equipment involved. T/F
T
Flammable chemicals should be stored in safety cabinets and ____ away from heat sources
explosion-proof refrigerators
laboratory fire drills are held
Annually
When fire is discovered, RACE
Rescue anyone in immediate danger
Activate the institutional fire alarm system
Close all doors to potentially affected areas
attempt to Extinguish the fire, if possible; exit the area
To operate the fire extinguisher, PASS
Pull the pin
Aim at the base of the fire
Squeeze handles
Sweep nozzle side to side
Fire type and fire extinguisher for ordinary combustibles: paper, cloth, rubbish, plastic, wood
Fire Type A
Extinguisher: Water, dry chemical, loaded steam
Fire type and fire extinguisher for flammable liquids: alcohol, ether, grease, gasoline, paints, oil
Fire Type B
Extinguisher: Dry chemical, carbon dioxide, halon foam
Fire type and fire extinguisher for electrical equipment and motor switches
Fire Type C
Extinguisher: Dry chemical, carbon dioxide, halon - best
Fire type and fire extinguisher for flammable metals: mercury, magnesium, sodium, lithium
Fire Type D
Extinguisher: Metal X, sand; dry powder; fought by firefighters only
Fire type and fire extinguisher for detonation (Arsenal fire)
E for Explosives
Fire Type E
Extinguisher: Allowed to burn out and nearby materials protected
Fire Type and fire extinguisher for cooking media: grease, oils, fats
Fire Type K
Extinguisher: Liquid designed to prevent splashing and cool the fire
Key Notes:
Water (A)
Dry chemicals (ABC)
Carbon dioxide (BC)
Halon (BC)
Dry chemical extinguishers (ABC) are the most common all-purpose extinguishers
Class D and E fires should be handled only by trained personnel
General precautions - Physical hazards
- Avoid running in rooms and hallways
- Watch for wet floors
- Bend knees when lifting heavy objects
- Keep long hair pulled back
- Avoid dangling jewelry
- maintain clean, organized work area
- Wear closed-toe shoes
Miscellaneous Hazard Information
- Ergonomic work hazards are work-related and include strain due to repeated positions
- Cryogenic hazards are hazards due to extremely low temperatures
- Mechanical hazards include centrifuges, refrigerators, autoclaves, homogenizers, and glasswares
- Centrifuge accidents or improper removal of rubber stopper from test tubes may produce aerosols
Weighs approximately 150 g and measures 12.5 cm x 6 cm x 2.5 cm (length, width, depth)
Kidney
How long is the ureter?
25 cm
Site when approximately 150 ml urine accumulates; a nerve reflex is initiated
Bladder
4 cm long in women and 24 cm long in men`
Urethra
About every ______, small amounts of urine are emptied into the bladder from the ureters
10-15 seconds
___ is actually a fluid biopsy of the kidney
Urine
Basic structural and functional unit of the kidney
Nephron
How many nephrons are there in each kidney?
1 to 1.5 Million nephrons
2 Types pf nephron
Cortical and Juxtamedullary Nephrons
Consists of glomerulus and renal tubules
Nephrons
Order of Urine formation
- Glomerulus
- PCT
- LH
- DCT
- CD
- Calyx
- Renal Pelvis –> Ureter –> Bladder –> Urethra
Renal Blood Flow:
The kidneys receive ___ of the total cardiac input
25%
Total Renal Blood FLow
1,200 mL/min
Total Renal Plasma Flow
600 - 700 mL/min
Order of renal blood flow
- Renal artery (blood in)
- Afferent arteriole
- Glomerulus
- Efferent arteriole
- Peritubular capillaries
- Vasa recta
- Renal vein (blood out)
In the order of renal blood flow, where is reabsorption and secretion takes place
Peritubular capillaries
What part of the renal blood flow does the countercurrent mechanism takes place
Vasa recta
The working portion of the kidney
Glomerulus
Coil of approx. 8 capillary lobes (capillary tuft) located within the Bowman’s capsule
Glomerulus
Attached to the glomerular basement membrane are the ____
Podocytes (epithelial cells)
Glomerulus resembles a _____
Sieve
Glomerulus serves as a non-selective filter of plasma substances with a MW of _____
< 70,000 Da
Approximately ______ of the filtered plasma volume is actually excreted as urine
1%
3 parts of the glomerular filtration barrier
- Capillary endothelium
- Trilayer basement membrane
- Filtration diaphragm
GFM with large open pores
Capillary endothelium
GFM: lamina rara, lamina densa, lamina rara externa
Trilayer basement membrane
Found between the podocytes of Bowman’s space
Filtration diaphragm
SG of Glomerular filtrate
1.010
Substances that are filtered out in the glomerulus
“SWAGU”
Salt
Water
Amino acids
Glucose
Urea
pH of albumin
<4.9
Why is albumin not excreted in the urine?
It is not filtered by the glomerulus (has a shield of negativity because they repel each other (albumin is negatively charged, tho it is only 69kda)
First function to be affected in renal disease
Tubular reabsorption
When the plasma concentration of a substance that is normally completely reabsorbed reaches an abnormally high level, the filtrate concentration exceed the ______ of the tubules, and the substance begins appearing in the urine
Maximal reabsorptive capacity (Tm)
_____ is the plasma concentration at which active transport stops
Renal threshold
Renal threshold for glucose
160 - 180 mg/dL
Alter urine concentration
PCT, LH, DCT, CD
Major site (65%) of reabsorption of plasma substances
PCT
Renal concentration begins in the _______
Descending and ascending LH
Solute concentration is highest in the _____
LH (renal medulla)
_____ is a selective urine concentration process in the ascending and descending loops of Henle
Countercurrent mechanism
The ____ is highly impermeable to water
Ascending LH
“DAM” collects water, so does the
Descending LH
“ASIN” - ding loop reabsorbs
ASIN (salt), but NOT water
Substances that are reabsorbed via active transport
Glucose, amino acids, salts
Sodium
Chloride
Substance Location
Glucose, amino acids, salts
Sodium
Chloride
GAS - PCT
Sodium - PCT and DCT
Chloride - Ascending LH
Substances that are reabsorbed via passive transport
Water
Urea
Sodium
Substance and their location
Water
Urea
Sodium
Water - PCT, descending LH, CD
Urea - PCT, ascending LH
Sodium - Ascending LH
The movement of substance across cell membranes into the bloodstream by electrochemical energy
Active transport
The movement of molecules across a membrane by diffusion because of a physical gradient
Passive transport
Regulates water reabsorption in the DCT and CD
Antidiuretic hormone (ADH/ Vasopressin)
Regulates sodium reabsorption in the DCT
Aldosterone
Increased body hydration = Decreased ADH = ____ Urine volume
Increased
Decreased body hydration = Increased ADH = ____ Urine volume
Decreased
Diabetes insipidus = ____ Deficiency
“DI = Daming Ihi”
ADH
SIADH = ___ Excess
ADH
T or F
Effects of Angiotensin II
Release of Aldosterone and ADH (Increase water and sodium reabsorption
Vasoconstriction (Increased blood pressure)
Corrects renal blood flow
T
T or F
The juxtaglomerular apparatus consists of the JG cells (which produce renin) in the afferent arteriole, and the macula densa (which detects decrease in BP) of the DCT
T
Action of RAAS:
Dilates the ___ and constricts the ___
afferent arteriole; efferent arteriole
Action of RAAS:
Stimulates __ reabsorption in the PCT
Sodium
Action of RAAS:
Triggers the adrenal cortex to release ____ to cause sodium reabsorption and potassium excretion in the DCT and CD
aldosterone
Action of RAAS:
Triggers release of ____ by the hypothalamus to stimulate water reabsorption in the CD
anti-diuretic hormone
One of the functions of tubular secretion is the regulation of the ____ in the body through secretion of hydrogen ions (in the form of NH4 and H2PO4)
Acid-base balance
Blood pH
7.4
Another function of the tubular secretion is the elimination of waste products not filtered by the glomerulus.
T or F
T
Major site for removal of nonfiltered substances
Proximal convoluted tubule
It is in the PCT where H ions are secreted in exchange for Na ions, which are reabsorbed with HcO3 into the plasma.
T or F
T
Failure to produce an acid urine due to inability to secrete hydrogen ions
Renal Tubular Acidosis
Acidic blood pH
Alkaline urine
Renal Tubular Acidosis
An example of test for glomerular filtration is the clearance tests
T
used to evaluate glomerular filtration
Clearance tests
Measure the rate at which the kidneys are able to remove a filterable substance from the blood
Glomerular Filtration Test
Examples of glomerular filtration tests
- Urea
- Creatinine
- Inulin
- Beta microglobulin
- Radioisotopes
- Cystatin C
Obsolete clearance test
Urea clearance test
Most common clearance test
Creatinine
Gold standard or reference method clearance test
Inulin (MW: 5,200 Da)
Better marker for renal tubular function than of GFR
Beta2-microglobulin (MW 11,800 Da)
Alternative for creatinine clearance
Cystatin C (MW: 13, 359 Da)
Formula of creatinine clearance
(UV / P) x (1.73 m2/ A)
U = Urine creatinine (mg/dL)
P = Plasma creatinine
V = Urine volume
A = Body Surface area
Reference ranges for creatinine clearance
Males = 107 - 139 mL/min
Females = 87 - 107 mL/min
Measure of the completeness of a 24-hour urine collection
Creatinine clearance
What is the greatest source of error in any clearance procedure utilizing urine?
The use of improperly timed urine specimens
Around ___ of creatinine is secreted by the renal tubules
7 - 10%
Detect and monitor kidney disease (recent studies)
Estimated GFR
Estimated GFR formula developed by Cockgroft and Gault
Ccr = [(140 - age) (body weight in kg) / 72 x serum creatinine in mg/dl] x 0.85 (if female)
What are the variables included in the estimated GFR formula by Cockgroft and Gault
Age
Body wt in kg
Sex
“ABS”
Modification of Diet in Renal Disease (MDRD) System Formula
See notes for reference
What are the variable included in the MDRD system formula?
Ethnicitiy
BUN
Serum albumin
“EBS”
MDRD- IDMS (Isotope Dilution Mass Spectrometry) Traceable formula
See notes for reference
Formula for GFR recommended by the National Kidney Disease Education Program (NKDEP)
MDRD- IDMS (Isotope Dilution Mass Spectrometry) Traceable formula
Tests for Tubular Reabsorption
Concentration Tests
- Obsolete tests (Fishberg, Mosenthal test)
- Recently used tests (Specific gravity, Osmolality)
OFM
RSO
Used to evaluate tubular reabsorption
Concentration test
A tubular reabsorption test wherein the patient is deprived of fluid for up to 24 hours
Fishberg test
Urine SG after 12-hr restricted fluid diet is about ___ or more (Fishberg test)
1.022 or more
Urine SG after 24-hr restricted fluid diet is about ___ or more (Fishberg test)
1.026 or more
A tubular reabsorption test wherein the patient maintains normal diet and fluid intake.
Mosenthal test
Compares day and night urine in terms of volume and SG
Mosenthal test
Tubular reabsorption test influenced by the number and density of particles in a solution
Specific Gravity
Influenced by the number of particles in a solution (Tubular reabsorption test)
More preferred than SG determination
More precise than osmolarity because it does not vary with temperature
Osmolality
Osmolality include the methods of
Freezing point osmometry and Vapor pressure osmometry
NV for urine osmolality
1-3x (275 to 900 mOsm/kg) than of serum (275 to 300 mOsm/kg)
Tests for tubular secretion and renal blood flow
P-aminohippuric acid (PAH) test
Phenolsulfonphthalein (PSP) test
Other measurements used (urine pH, titratable acidity, urinary ammonia)
Most commonly used (reference method) test for tubular secretion and renal blood flow
P-aminohippuric acid (PAH) test
First illustrated medical book printed.
Fasciculus Medicinae
During the Middle Ages, disease was thought to result from the imbalance of ____, reflected by one of the urine colors
Humours
4 temperaments/ humours
Sanguineous (blood)
Choleric (yellow bile)
Phlegmatic (phlegm)
Melancholic (black bile)
The ____ of urine was used by the Babylonians and Egyptians to detect diabetes
Taste test
Hindu physicians noticed that ____ attracted ants
honey urine
Uroscopy; first documented the importance of sputum examination
Hippocrates
Albuminuria by boiling urine
Frederik Dekkers
Wrote a book about “pisse prophets” (charlatans)
Thomas Bryant
Examination of urine sediment
Thomas Addis
Introduced urinalysis as part of doctor’s routine patient examination
Richard Bright
Urochrome (history)
Ludwig Thudichum
CSF (history)
Domenico Cotugno
Phenylketonuria (history)
Ivan Folling
Alkaptonuria (history)
Archibald Garrod
Orthostatic or cyclic proteinuria
Frederick William Pavy
Cystine calculi (history)
William Wollaston
Benedict’s reagent (history)
Stanley Benedict
Urine composition
95 - 97% water
3 - 5% solids (60 grams = Total Solids in 24 hours)
Total solids
35 grams organic
25 grams inorganic
Urine component - Total solids (organic component)
Urea (major)
Creatinine (2nd)
Hippurate
Uric acid
CHO
Pigments
fatty acids
mucins
enzymes
hormones
Urine component - total solids (inorganic components
Chloride (major) > sodium > potassium
Sodium chloride (principal salt)
sulfate
phosphate
ammonium
magnesium
calcium
Urine specimen for routine and qualitative urinalysis
Ideal for cytology studies (ONLY IF with prior hydration and exercise 5 mins before collection!)
Random/ Occasional / Single
Ideal specimen for routine urinalysis and pregnancy testing (hCG)
Often preferred for cytology studies / cytodiagnostic urine testing
First morning
Most concentrated and most acidic urine specimen - allows well preservation of cells and casts
First morning
Urine specimen for the evaluation of orthostatic proteinuria
First morning
Patient voids before going to bed, and immediately on rising from sleep collects urine specimen
First morning
2nd voided urine after a period of fasting
Second morning/Fasting
Urine specimen for glucose determination
Second morning/Fasting
Urine specimen for diabetic screening or monitoring
Preferred for testing glucose
2-hr post-prandial
Optimal with blood samples in glucose tolerance test
Glucose tolerance
At least 2 voided collection
Series of blood and urine samples are collected at a specific time intervals to compare concentration of a substance in urine with its concentration in the blood
Used in the diagnosis of diabetes
Fractional specimen
For routine screening and bacterial culture
Midstream clean catch
Patient should thoroughly cleanse his glans penis or her urethral meatus before collection
Midstream clean catch
May be urethral or ureteral urine specimen
For bacterial culture
Catheterized
Abdominal wall is punctured, and urine is directly aspirated from the bladder
Bladder urine for anaerobic bacterial culture and urine cytology
Suprapubic
Use of soft, clear plastic bag with adhesive
Sterile specimen obtained by catheterization or suprapubic aspiration
Urine collected from diaper is NOT recommended for testing
Pediatric specimen
Urine specimen for prostatic infection
1. First portion of voided urine
2. Middle portion of voided urine
3. Urine after prostatic massage
Three-glass technique
tube number that serves as the control for bladder and kidney infection for the three-glass technique
2
Prostatitis (infected prostate) how many WBC and bacteria are seen
Number of WBC and bacteria in the 3rd specimen is 10x greater than that of the 1st
T or F
If control is positive for WBC and bacteria, the results from the 3rd specimen are considered invalid
T
Four glass method of urine collection method which consists of bacterial cultures of the initial voided urine (VB1), midstream urine (VB2), expressed prostatic secretions (EPS), and a post-prostatic massage urine specimen (VB3)
Stamey-Meares Test for Prostatitis
In the Stamey-Meares test for prostatitis, urethral infection or inflammation is tested for by the ___
initial voided urine
In the Stamey-Meares test for prostatitis, urinary bladder infection is tested for by the ___
Midstream urine
The ______ are cultured and examined for white blood cells in the Stamey-Mears prostatitis test
Prostatic secretions
Having more than ____ WBCs per high power field is considered abnormal in the Stamey-Mears test
10 to 20
4 types of timed urine specimen
- 24-hour
- 12-hour
- 4-hour
- Afternoon (2-4PM)
In the 24-hour urine, at the start time, the patient empties bladder into toilet, then all subsequent urine is collected.
At end time, patient empties bladder into collection container
Requires preservative - it depends on the test performed
24-hour
Type of urine specimen for Addis Count
12-hour
Type of urine specimen for nitrite determination
Urine remains in bladder for at least 4 hours before voiding
4-hour
Type of urine specimen for urobilinogen determination
Afternoon (2-4pm)
Process providing documentation of proper sample ID from the time of collection to the receipt of laboratory results
Chain of Custody
Required urine volume for drug specimen collection
30 - 45 ml
Container capacity for drug specimen collection
60 ml
Temperature for drug specimen. Checked within 4 minutes; if out of range, record temperature and contact supervisor immediately
32.5 deg C - 37.7 deg C
Added to the toilet water reservoir to prevent specimen adulteration
Blueing agent (dye)
pH of a possibly adulterated urine specimen for drug testing
> 9
Specific gravity of a possibly adulterated urine specimen for drug testing
SG <1.005
Urine containers should have a wide base, and has an opening of at least ___. The wide base prevents spillage, and a _____ opening is an adequate target for urine collection.
4 cm
24-hr urine containers should hold up to ___ and may be colored to protect light sensitive analytes.
3L
Addition of urine before the start of 24-hour collection period causes ____ results
False increased
Failure to include urine at the end of 24-hour collection period causes ___ results
False decreased
When both routine UA and culture are requested, the ____ should be performed first
culture
Following collection, urine specimens should be delivered to the laboratory promptly and tested within ____.; ideally within ___
2 hours; 30 minutes
Physical, chemical, and microscopic characteristics of a urine specimen begin to change ___
As soon as possible
Changes in unpreserved urine (increased)
pH
Bacteria
Odor
Nitrite
“pBaON”
Darkened / modified in unpreserved urine
Color
Decreased in unpreserved urine
Clarity
Glucose
Ketones
Bilirubin
Urobilinogen
RBC/WBC/Cast
Trichomonas
Proteins
Urea –Urease—> Ammonia ; loss of CO2
pH
Increased due to multiplication in unpreserved urine
Bacteria, Nitrite
Urea –Urease—> Ammonia
Odor
Oxidation or reduction of metabolites happen leading to darkened or modified changes in unpreserved urine
Color
Bacterial multiplication; precipitation of amorphous material –> decreased
Clarity
Decreases due to glycolysis
glucose
Volatilization and bacterial metabolism –> decreased
Ketones
Light exposure/photo oxidation to biliverdin
Bilirubin (CB)
Disintegrate in dilute alkaline urine
RBC, WBC, Casts
Loss of motility; death; possible misidentification as WBCs
Trichomonas
Least affected parameter in unpreserved urine
Protein
What are the ideal characteristics of a urine specimen
Bactericidal, inhibit urease, preserve elements, no interference
Urine preservative
Adv: Does not interfere with chemical tests
Disadvantage: Raises SG by hydrometer; Precipitates amorphous phosphates and urates
Refrigeration
Preservative of choice for routine UA and urine culture (up to 24 hours0
Prevents bacterial growth for 24 hours
Refrigeration
Urine preservative
Preserves glucose and sediments well
Disadvantage: Interferes with acid precipitation test for protein
Thymol
Preserves protein and formed elements well
Does not interfere with routine analyses other than pH
Disadvantage: May precipitate crystals when used in large amounts
Boric acid
Keeps pH about 6.0
Bacteriostatic at 18 g/L;
For culture transport, C&S
Interfere with drug and hormone analyses
Boric acid
Excellent sediment preservative
Disadvantage: Reducing agent;
interferes with chemical tests for glucose, blood, leukocytes & copper reduction
Formalin (Formaldehyde)
Preservative that does not interfere with routine tests
-Floats on urine surface and clings to pipettes and testing materials
-Best all round preservative
Toluene
Preservative that prevents glycolysis
-Good preservative for drug analysis
-May use sodium benzoate instead of fluoride for reagent strip testing
Sodium fluoride
Preservative that does not interfere with routine tests
-Causes an odor change
-use 1 drop/ounce of specimen
Phenol
Preservative that is convenient when refrigeration not possible
-May contain one of more of the preservatives including sodium fluoride
Commercial preservative tablets
Preservative that contains collection cup, C & S preservative tube or UA tube
Urine Collection Kits
Preservative wherein the sample is stable at room temperature for 48 hours; preserves bacteria
-Preservative is boric acid and may not be used for UA
Gray C & S tube
Preservative that is stable for 72 hours at room temperature
-Instrument compatible
-Bilirubin and urobilinogen may be decreased if specimen is exposed to light and left at RT
-Preservative is sodium propionate
Cherry red/Yellow top tube
Preservative that preserves cellular elements
-Used for cytology studies (50 mL urine)
Saccamano fixative
(50% ethanol + 2% carbowax)
Normal urine (24 hours) volume
600 to 2000 mL
Average volume of urine (24 hours)
1200 to 1500 mL
Night urine output
< 400 mL
Urine day:night ratio
2-3:1
Container capacity (UA)
50 mL
required volume of urine for routine UA
10 to 15 mL (ave: 12 mL)
Polyuria
> 2000 mL/24 hours
Causes of polyuria
Increased fluid intake
Diuretics, nervousness
Diabetes mellitus
Diabetes insipidus
Oliguria
< 500 mL/24 hrs
< 400 mL/day
Causes of oliguria
Dehydration
Renal diseases
Renal calculi or tumor
Anuria
< 100 ml/ 24 hours
Causes of anuria
Complete obstruction
Toxic agent
Decreased renal blood flow
Excretion of more than 500 mL of urine at night
Nocturia
SG of nocturia
< 1.018
Any increase in urine excretion
Diuresis
Rough indicator of the degree of hydration
Urine color
Correlates with urine SG
Urine color
Normal urine color
Colorless to deep yellow
Abnormal urine color
Red or red brown
Urine color determination
Look down through the container against a white background
-Major pigment of urine
-lipid soluble pigment that is a product of endogenous metabolism
Urochrome
