Collection, Handling, & Physical Examinations Flashcards
Most common type of specimen type?
Easiest to collect
Useful for routine screening tests
Random Specimen
First voided specimen upon waking
IDEAL screening specimen (most concentrated)
First morning specimen
Avoids external contamination - may introduce infection
Catheterization
Clean external genital area
First and last stream of urine voided: midstream collected
Midstream clean catch specimen
Specimen of CHOICE for BACTERIAL CULTURE in routine circumstances
Midstream clean catch specimen
Insertion of CATHETER directly into bladder via URETHRA
Catheterization
Sterile, plastic collection bag placed over genital area with adhesive
Pediatric specimen
Pediatric specimen bag should be checked every?
Every 15 minutes
Many sources of contamination
Pediatric specimen
Insert NEEDLE through suprapubic abdominal area directly into bladder
Suprapubic aspiration
FAVOURABLE specimen for bacterial culture: INVASIVE procedure
Suprapubic aspiration
Collected over 24-hour period
24 Hour urine
Urine should be analyzed for:
within 1 hour
Used for quantitative urine studies
24 Hour urine
First specimen discarded while all others collected
24 hour urine
What increases when prolonged sitting of specimens at room temperature?
↑ INCREASED ↑
▪ Nitirite
▪ pH
▪ Turbidity
T-P-N
Completeness of collection of 24 hour urine is monitored by
Creatinine levels
> 1.0 mg/dL
Changes in urine color is due to?
▪ Oxidation
▪ Reduction of metabolites
What decreases when prolonged sitting of specimens at room temperature?
↓ DECREASED ↓
▪ Glucose
▪ Ketones
▪ Bilirubin
▪ Urobilinogen
▪ Cells and casts
B-U-C-K-G
Prolonged sitting of urine in RT increases this chemical and GROWS BACTERIA
Nitrite
Prolonged sitting of urine in RT increases this chemical and bacterial growth, red or white cells, or AMORPHOUS MATERIAL
Turbidity
Prolonged sitting of urine in RT increases this chemical and UREA CONVERTED TO AMMONIA
pH
Prolonged sitting of urine in RT decreases this chemical and VOLLATILIZATION - exposure to air
Ketones
Prolonged sitting of urine in RT decreases this chemical and GLYCOLYSIS due to BACTERIA AND YEAST
Glucose
Prolonged sitting of urine in RT decreases this chemical and exposure to LIGHT
Bilirubin
Prolonged sitting of urine in RT decreases this chemical and lysis
Cells and casts
Preservation method of choice
Refrigeration
Prolonged sitting of urine in RT decreases this chemical and OXIDIZED TO UROBILIN
Urobilinogen
This could result in precipitation of AMORPHOUS CRYSTALS
Refrigeration
How many hours for refrigeration?
24 hours
What to do after removing the specimen from the ref?
Let it return to ROOM TEMPERATURE BEFORE testing
How long to let it sit in ROOM TEMP after removing it in the ref?
approx. 15 minutes
Not evaluated, but may provide clue to constituents
Odor
What is associated when urine smells MOUSY?
Phenylketonuria (PKU)
What is associated when urine smells FRUITY?
Ketones
What is associated when urine smells AMMONIA?
Old urine
What is associated when urine smells MAPPLE SYRUP?
Maple syrup disease
What is the COLOR of normal urine?
Pale yellow (STRAW) to Yellow
What makes the urine cloudy?
Cells
Casts
Crystals
Bacteria
What is the CLARITY of normal urine?
Clear
pH of normal urine
slightly acid
pH 6.0
It gives the urine its normal color
Urochrome
Sample that is 2 hours after eating
Postprandial sample
pH of random urine
4.5 - 8.0
This sample may be alkaline
Postprandial sample
Abnormal colors of Urine:
▪ Red
▪ Red- Brown
▪ Yellow - Brown
▪ Amber-Yellow-Green
▪ Yellow Orange
▪ Bright Yellow
▪ Dark Yellow
▪ Brown-Black
▪ Blue
▪ Green/Blue-Green
▪ Port Wine
What color with a substance of:
▪ Hemoglobin
▪ Red blood cells
▪ Myoglobin
▪ Porphyrin
▪ Uroerythrin
Red
What color with a substance of:
▪ Hemoglobin
▪ RBC’s
▪ Myoglobin
Red-Brown
What color with a substance of:
▪ Bilirubin
▪ Biliverdin
Yellow-Brown
Amber-Yellow-Green
What color with a substance of:
▪ Bilirubin
▪ Urobilin
▪ PYRIDIUM (drug)
Yellow-Orange
What color with a substance of:
▪ Vitamin C
Bright Yellow
What color with a substance of:
▪ Concentrated specimen
▪ Bilirubin
▪ Urobilin
Dark-Yellow
What color with a substance of:
▪ Methemoglobin
▪ Homogentisic acid
▪ Melanin
Brown-Black
What color with a substance of:
▪ Indican (Tryptophane metabolic disorder)
Blue
What color with a substance of:
▪ Old urine
▪ Pseudomonas
Green
Blue-Green
What color with a substance of:
▪ Porphyrin
Port wine
What happens when urine stands at room temperature for some time?
Becomes ALKALINE
What happens to urine when it becomes metabolic or respiratory acidosis, high protein diet, or cranberry juice
Acidic
Vegetarian
Alkaline
Offers the simplest way to check the concentration and dilution function of the kidney tubules
Specific Gravity (SG)
Normal SG of urine:
1.002 - 1.035
SG of urine which is the highest in kidney that can concentrate
1.040
TRUE OR FALSE
The higher the SG, the deeper the color
TRUE
A pale colored urine with high SG is probably due to?
Glucose
Defect: ↓ Insulin
Polyuria: +
Polydipsia: +
SG: ↑
Glu: ↑
Ketones: ↑
Diabete Mellitus
Defect: ↓ ADH/AVP
Polyuria: +
Polydipsia: +
SG: ↓
Glu: Normal
Ket: Normal
Diabetes Insipidus
pKa change of electrolytes
Reagent strip
Reagent strip is measured?
Indirect - Colorimetric
No temperature corrections
Correct for large amount of PROTEIN ( - 0.003 for each gram) and GLUCOSE (- 0.004 for each gram)
Refractometer -TS
Refractometer is measured?
Refractive index