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Diagnostic Laboratory Medicine > Diagnostic Laboratory Medicine Exam 1 > Flashcards

Diagnostic Laboratory Medicine Exam 1 Flashcards

Urine Testing, Stool Testing, and Other Common Medical Tests

1
Q

What is a Urine Culture (C&S)? What is it used for?

A

Culture & Sensitivity, used to see what bacteria are growing

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2
Q

What test would you order to see if E. coli is in the urine?

A

Urine culture

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3
Q

What is a Routine UA?

A

Urinalysis that is a rapid tests to test for many different things = Macroscopic

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4
Q

How long does it take for a urine culture to come back? UA?

A

Culture = 24-48 hrs, UA = rapid, 2 mins

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5
Q

Why would you order a Microscopic UA?

A

gives rapid cell count

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6
Q

Urine Pregnancy tests are (quantitative/qualitative)

A

QUALitative (yes/no)

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7
Q

T/F - Random collections must be taken in the morning

A

False, they can be taken anytime of day

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8
Q

Random collections are (sterile/nonsterile)

A

Non-sterile

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9
Q

T/F - Pregnancy tests are most accurate during the (night/morning)

A

Morning

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9
Q

What test reflects the ability of the kidney to concentrate urine during dehydration?

A

Early morning collection

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10
Q

What is a timed urine test? Why would it be used? Should it be refrigerated?

A

24 hour urine collection that looks at renal and endocrine problems. Yes, refrigerate!!

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11
Q

T/F - A patient can touch the inside of the lid for a clean-catch midstream urine specimen

A

False, this provides contamination

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12
Q

What is the most sterile way to obtain urine through the urethra? Through a needle?

A

Catheterization, Suprapubic transabdominal needle aspiration

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13
Q

What is the most common microorganism in a UTI?

A

E. coli

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13
Q

If a urine specimen is left out, what should you do with it?

A

Refrigerate

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14
Q

What is the MIC?

A

Minimum Inhibitory Concentration (Least amount needed to kill bacteria)

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15
Q

A positive urine culture is at or above what number?

A

1 x 10^5 CFU/mL (100,000)

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16
Q

What are some positives of a Macroscopic UA? What is another name for it?

A

URINALYSIS, Inexpensive, readily available, useful indicator of body’s major metabolic functions, uses disposable strips

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17
Q

How long does the test for a Macroscopic UA take? Is it time sensitive?

A

2 minutes, yes!!

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18
Q

What is the first part of UA? What is normal?

A

Direct visual observation, normal, fresh urine is pale to dark yellow and clear (not cloudy or turbid)

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19
Q

What causes cloudiness or turbidity?

A

Excessive cellular material or protein in the urine, may develop if it sat too long

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20
Q

Give the reasons for a red or red-born color of urine

A

Beets, food dye, a drug or multivitamin, presence of hemoglobin or myoglobin, or possibly from menstrual drips
(If many RBC, will be red and cloudy)

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21
Q

What are some benefits to using an automated UA?

A

Accurate, easier

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22
Q

T/F - There’s a variety of dipstick types that test for different things

A

True

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23
Q

Name 10 things that the Urine Dipstick tests for

A

pH, ketones, glucose, protein, specific gravity, nitrites, bilirubin, urobilinogen, blood, and leukocytes

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24
Q

When something is bold on a UA result, what does that mean?

A

It is abnormal

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25
Q

Give the range for a urinary pH

A

4.5-8.0

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26
Q

Give reasons for a high urine pH or low urine pH. What is it important in managing?

A

High: -UTI
-Kidneys not properly removing acids from bloodstream

Low: -Diarrhea -Starvation

Important in management of bacteriuria, renal calculi, drug treatment

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27
Q

What does specific gravity measure?

A

urine density, or the ability of the kidney to concentrate or dilute the urine over that of plasma

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28
Q

Give a normal specific gravity range

A

1.002-1.035

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29
Q

Name some reasons for a high SG or a low SG

A

High: Dehydration, Diabetes Mellitus, CHF, nephrosis
Low: Severe renal damage, diabetes insipidus, over hydration

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30
Q

T/F - Healthy urine contains some protein

A

False, should contain none or trace amounts

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31
Q

Proteinuria is seen with what illnesses?

A

Glomerular damage or diminished tubular reabsorption

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32
Q

What does a large number of leukocytes + proteinuria indicate?

A

Infection at some level of urinary tract: UTI, pyelonephritis (bacterial infection), nephrolithiasis (kidney stones)

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33
Q

Glucose is primarily present in urine with which condition? What else could be the reason?

A

Diabetes mellitus, can also be present with endocrine, liver, or pancreas disease

34
Q

If you see POSITIVE ketones + POSITIVE glucose in urine, what should you suspect?

A

Diabetic ketoacidosis, BGL is VERY high if glucose is spilling into urine

35
Q

T/F - Ketones should be found in some amounts in the urine

A

False, they are completely metabolized, so normally only negligible amounts should be found in urine

36
Q

What organ makes ketones?

A

Liver

37
Q

Ketonuria (high levels of ketones) indicates that a person is in a (anabolic/catabolic) state and is breaking down (carbs/fat/protein)

A

Catabolic, fat

38
Q

What suspicions should you have for someone with ketonuria?

A

UNDIAGNOSED EATING DISORDER (altered carb. metabolism from starvation), acute illness, diabetes mellitus that is at risk for diabetic ketoacidosis

39
Q

What does a POSITIVE nitrite test indicate?

A

Bacteria may be present in significant numbers in the urine

40
Q

Positive Nitrite + Leukocytes should cause a suspicion of ?

A

UTI

41
Q

What are leukocytes?

A

White Blood Cells as a whole or as lysed cells

42
Q

What is the next step if someone tests positive for nitrites and leukocytes?

A

Order a culture for bacterial identification

43
Q

What would cause a false positive on a UA?

A

Leaving urine out at room temp. too long, causing bacteria to multiply

44
Q

What is pyuria?

A

When urine sample contains elevated WBCs and pus

45
Q

What is hematuria?

A

Blood in the urine

46
Q

T/F - Hematuria can only be macroscopic

A

False, can be MACRO and MICRO scopic

47
Q

The UA dipstick can detect hematuria with a sensitivity of 90% with more than _____ RBCs/HPF

A

3

48
Q

What causes hematuria?

A

Damage to the bladder, kidneys, or urinary tract. Can also be from menstruation. UTI, Kidney stones, Exercise, Trauma, Endometriosis.
IN ELDERLY PTS, BLADDER, KIDNEY, OR PROSTATE CANCER

49
Q

Bilirubin and urobilinogen will appear in the urine before other signs of which organ dysfunction?

A

Liver

50
Q

What does a elevated bilirubin and urobilinogen levels possibly indicate?

A

Early sign of possible hemolytic disorders (pernicious anemia)

51
Q

What is the term for abnormally shaped cells from kidney issues?

A

Casts

52
Q

Give examples of what a MICROscopic UA might contain

A

RBCs
WBCs
Bacteria
Yeast
Casts
Crystals
Sperm
Misc

53
Q

Name the 2 types of Serum pregnancy tests and their levels

A

Qualitative (5-10 IU/L), Quantitative (1-2 IU/L) to test how much hCG

54
Q

What hormone is a pregnancy test testing for?

A

hCG

55
Q

T/F - After abortion or miscarriage, hCG can still be positive for a period of time

A

True

56
Q

How soon can pregnancy be detected on a test?

A

6-12 days after conception

57
Q

Reason for false negative and false positive pregnancy tests?

A

False Neg: performed too soon
False Pos: Preg. lost after implantation

58
Q

Tool for catching clean stool specimen

A

Hat

59
Q

Name the items in a Macroscopic Stool Sample

A

Color
Amount
Consistency
Odor
Gross blood (Seen)
Mucus, Pus

60
Q

Name the items in a Microscopic Stool Sample

A

Occult Blood (Hidden)
Ova/Parasites
Bacteria
Viruses
Yeast
Leukocytes

61
Q

Fecal Occult Blood Test tests for what?

A

Blood in stool

62
Q

What is the replacement for FOBT tests?

A

FIT (Fecal Immunochemical Test)
-Unaffected by diet or meds, unlike FOBT
-First line rec. Uses a monoclonal or polyclonal antibody
-Superior Sensitivity

63
Q

Name for the cancer prescreening test at home

A

Cologuard

64
Q

T/F - C. diff is spore-forming and is infectious

A

True

65
Q

What would you use to assess a wound?

A

Wound Cultures, testing for MRSA, Staph, etc.

66
Q

Bacteria are responsible for how much of all pharyngitis cases?

A

5-10%

67
Q

What do throat cultures interpret?

A

Group A hemolytic Streptococci, Neisseria gonorrhoeae, and bordetella pertussis (whooping cough)

68
Q

What is the most common bacterial etiology of pharyngitis?

A

Streptococci, or strep throat

69
Q

The likelihood of a positive Influenza test happens when it is obtained how long from symptom onset?

A

24-72 hours

70
Q

When are Influenza results available after rapid antigen test?

A

10-30 minutes

71
Q

Mononucleosis, or ___ ___ Virus, is detected how?

A

Epstein Barr Virus, fingerstick blood test

72
Q

When is mono testing most accurate?

A

More than 80 percent sensitive in the SECOND WEEK, 1/3 of cases are missed in the first week

73
Q

T/F - CBC will show atypical lymphocytes with mono

A

True, indicative of disease

74
Q

Name some other onsite rapid tests

A

HIV, Hepatitis B or C, INR, Hemoglobin A1C

75
Q

Diabetic with proteinuria (with no other infection or related causes) means there is high risk of ?

A

Chronic kidney disease

76
Q

A pt presenting with edema and proteinuria is a symptom of what ? The pt also was later diagnosed with Hepatitis C

A

Nephrotic syndrome (damage to blood vessels in kidneys that filter waste)

77
Q

What is the cause associated with over 50% of bladder cancer?

A

Smoking

78
Q

Pt presents with lupus (an autoimmune disease that tends to develop kidney issues), fatigue, and peripheral edema. What would be positive in their urine?

A

Protein, blood - lupus is major clue of kidney issue

79
Q

T/F - A negative nitrite UA means there is no bacteria in the urine

A

False. There is still bacteria, but not significant amounts

80
Q

T/F - A negative leukocyte esterase test means that infx is unlikely and without additional symptoms, urine culture does NOT need to be done to rule out significant bacteriuria

A

True

81
Q

T/F - A positive Cologuard result is diagnostic for cancer

A

False. Could indicate cancer, but need further testing

82
Q

What is the sensitivity to the rapid strep tests?

A

70-90%

83
Q

What organism most commonly causes strep throat

A

Group A hemolytic streptococci

84
Q

What organism is responsible for STI gonorrhea? G - or G + ? Shape?

A

Neisseria Gonorrhoeae
Gram negative coffee bean shaped diplococci

85
Q

What organism is responsible for whooping cough? G- or G+? Aerobic or anaerobic? Shape?

A

Bordetella pertussis
Gram -, aerobic, pathogenic, encapsulated coccobacillus

Diagnostic Laboratory Medicine (4 decks)

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