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Analysis of Urine and Body Fluids > ENHANCEMENT CLASS LAB: ROUTINE URINE ANALYSIS > Flashcards

ENHANCEMENT CLASS LAB: ROUTINE URINE ANALYSIS Flashcards

1
Q

PHYSICAL EXAMINATION OF URINE

A

COLOR
CLARITY
ODOR (not performed)
SPECIFIC GRAVITY

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2
Q

Varies from almost colorless to black

A

COLOR

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3
Q

COLOR Variations may be due to:

A

○ Normal metabolic functions
○ Physical activity
○ Ingested materials
○ Pathologic conditions

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4
Q

More solutes, less water

A

darker urine

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5
Q

MAJOR PIGMENT OF URINE

A

UROCHROME

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6
Q

Pigment which causes the urine to become yellow

A

UROCHROME

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7
Q

UROCHROME WAS NAMED BY?

A

Thudichum in 1864

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8
Q

Proportional to the metabolic rate

A

UROCHROME

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9
Q

UROCHROME Increased during:

A

○ Fever
○ Thyroid condition (thyrotoxicosis)
○ Fasting states and starvation
○ Urine stands at room temperature

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10
Q

Pink pigment

A

UROERYTHRIN

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11
Q

Present in urines that have been refrigerated (precipitation of amorphous urates)

A

UROERYTHRIN

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12
Q

Attaches to the urates producing a pink-color to the sediment

A

UROERYTHRIN

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13
Q

From melanin metabolism

A

UROERYTHRIN

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14
Q

From the oxidation of urobilinogen

A

UROBILIN

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15
Q

Gives an orange-brown color to a urine that is not fresh

A

UROBILIN

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16
Q

Recent fluid consumption

A

COLORLESS/STRAW

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17
Q

Polyuria or diabetes insipidus, diabetes mellitus, diluted random specimen

A

PALE YELLOW

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18
Q

Concentrated urine

A

DARK YELLOW

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19
Q

Dehydrated

A

AMBER

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20
Q

Bilirubin, acriflavine, pyridium, nitrofurantoin, phenindione

A

ORANGE

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21
Q

white foam

A

Bilirubin

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22
Q

yellow/orange foam

A

Pyridium

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23
Q

Bilirubin oxidized to biliverdin

A

YELLOW-GREEN/
YELLOW-BROWN

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24
Q

Pseudomonas infection

A

GREEN

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25
Q

Clorets, indicant, phenol, methylene blue, robaxin

A

BLUE-GREEN

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26
Q

RBCs, hemoglobin, myoglobin, porphyrin, rifampin, menstruation

A

PINK-RED

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27
Q

pink supernatant

A

Myoglobin

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28
Q

port wine color of urine

A

Porphyrin

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29
Q

red supernatant

A

RBC

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30
Q

Methemoglobin, homogentisic acid, melanin, argyrols, levodopa, flagyl

A

BROWN/BLACK

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31
Q

No visible particulates, transparent

A

CLEAR

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32
Q

Few particulates, print easily seen through urine

A

HAZY

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33
Q

Many particulates, print blurred through urine

A

CLOUDY

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34
Q

Print cannot be seen through urine

A

TURBID

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35
Q

May precipitate or be clotted

A

MILKY

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36
Q

Mix the urine sample 3 times using a _______

A

figure of eight motion

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37
Q

Place a sample at least ____on a test tube

A

¾

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38
Q

Check the COLOR of the urine sample ______ with a good light source

A

ON A PLAIN WHITE BACKGROUND

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39
Q

Check the CLARITY of the urine sample on a ___________

A

PRINTED WHITE BACKGROUND

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40
Q

CHEMICAL EXAMINATION OF URINE

A

● Glucose
● Bilirubin
● Ketones
● Specific Gravity
● Protein
● pH
● Blood
● Urobilinogen
● Nitrite leukocytes

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41
Q

MNEMONICS FOR PARAMETERS REACTION TIME:

Good Boy (30 sec) Kill (40 sec) Sharks (45 sec) para papa BUN (60 sec) leukocytes (120 sec)

A

● (Good boy) Glucose and Bilirubin: 30 seconds
● (kill) Ketones: 40 seconds
● (sharks) Specific Gravity: 45 seconds
● (para papa BUN) pH, protein, blood, urobilinogen,
nitrite: 60 seconds
● (leukocyte esterase) Leukocytes: 120 seconds

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42
Q

DOUBLE-INDICATOR SYSTEM

A

ph

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43
Q

PROTEIN ERROR OF INDICATOR

A

Protein

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44
Q

SODIUM NITROPRUSSIDE
REACTION

A

Ketones

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44
Q

PSEUDOPEROXIDASE REACTION
OF HEMOGLOBIN

A

Blood

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45
Q

DOUBLE SEQUENTIAL ENZYMATIC REACTION

A

Glucose

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46
Q

DIAZO REACTION

47
Q

EHRLICH’S REACTION

A

Urobilinogen

48
Q

GREISS REACTION

49
Q

GRANULOCYTES ESTERASES
REACTION

A

Leukocyte Esterase

50
Q

pKa CHANGE OF
POLYELECTROLYTE

A

Specific Gravity

51
Q
  1. Dip the reagent strip completely in the urine
  2. Remove excess urine from the strip by running the edge of the strip on the container when withdrawing it from the specimen
  3. Blot the strip horizontally on an absorbent medium pad
  4. Wait for the specified length of time for reactions totake place
  5. Compare the colored reactions against the
    manufacturer’s chart using a good light source
    NOTE: Read HORIZONTALLY
A

CHEMICAL EXAMINATION PROCEDURES

52
Q

● Multistix
● Chemstrip

A

REAGENT STRIP

53
Q

The darker the color of the test pad, the less light will be reflected to the sample

A

REFLECTANCE PHOTOMETRY

54
Q

APPEARANCE: smooth, non-nucleated, biconcave disks measuring approximately 7 mm in diameter

55
Q

MOST DIFFICULT FOR STUDENTS TO
RECOGNIZE due to lack of characteristic
structures, variations in size, and close resemblance to other urine sediment constituents

56
Q

RBC Clinical Significance:

A

○ Hematuria
○ Glomerular Membrane Damage
○ Malignancy of the urinary tract
○ Vascular injury within genitourinary tract

57
Q

APPEARANCE: larger than RBCs, measuring an average of about 12 mm in diameter
○ Dirty center because of the nucleus

58
Q

brownian movement;
swells and sparkles (GLITTER CELLS)

A

Hypotonic Urine

59
Q

WBC Clinical Significance:

A

○ Pyuria

60
Q

Eosinophils >1%

A

CONSIDERED SIGNIFICANT

61
Q

increased eosinophil but no bacteria

A

Acute Interstitial Nephritis

62
Q

increased neutrophils with bacteria

63
Q

increased lymphocytes (T-cells)

A

Renal Transplant Rejection

64
Q

SEC infected with Gardnerella
vaginalis

A

CLUE CELLS

64
Q

FIRST STRUCTURES OBSERVED and good
reference for focusing of the microscope

A

POINT OF REFERENCE IN MICROSCOPY

65
Q

APPEARANCE:
Largest cells in the sediment with abundant,
irregular cytoplasm and prominent nuclei
○ Usually has a centric nucleus

A

SQUAMOUS EPITHELIAL CELLS

65
Q

POINT OF REFERENCE IN MICROSCOPY
Found in linings of urthra and vagina

A

SQUAMOUS EPITHELIAL CELLS

66
Q

APPEARANCE:
Smaller than squamous cells and appear in
several forms, including spherical, polyhedral,
and caudate with centrally located nucleus
○ Comes in many shapes and forms

A

TRANSITIONAL EPITHELIAL CELL (UROTHELIAL)

67
Q

Increased in number following catheterization

A

TRANSITIONAL EPITHELIAL CELL (UROTHELIAL)

68
Q

Clumps of urothelial cells
○ Normally present in urine

69
Q

Seen in deformed state in malignancy/viral infection
of the urinary tract

A

TRANSITIONAL EPITHELIAL CELL (UROTHELIAL)

70
Q

APPEARANCE: Rectangular (convoluted or columnar cell), round, oval, or cuboidal with an eccentric nucleus

A

TRANSITIONAL EPITHELIAL CELL (UROTHELIAL)

71
Q

MOST CLINICALLY
SIGNIFICANT EPITHELIAL
CELL

A

TRANSITIONAL EPITHELIAL CELL (UROTHELIAL)

72
Q

RTE with lipids/fats

A

OVAL FAT BODIES

73
Q

Not very common in high
amount
○ >2=indication of renal
tubular injuries

A

TRANSITIONAL EPITHELIAL CELL (UROTHELIAL)

74
Q

RTE with no lipid vacuoles and is
often associated with injured cells

A

BUBBLE CELLS

75
Q

TRANSITIONAL EPITHELIAL CELL (UROTHELIAL) Clinical Significance:

A

○ Tubular Necrosis
○ Tubular Injury
○ Glomerular Disorders

76
Q

NOT NORMALLY PRESENT IN URINE except Catheter or collection-container contamination

77
Q

APPEARANCE: Small
spherical and rod-shaped

78
Q

● Present in the form of cocci (spherical) or bacilli (rods)
● Most are motile

79
Q

most common cause of UTI and also causes diarrhea
○ Most common water contaminant

A

Escherichia coli

80
Q

To be considered significant for UTI, bacteria should be accompanied by WBCs

81
Q

APPEARANCE:
Tapered oval head with
long, thin tail

A

SPERMATOZOA

82
Q

Urine is toxic to spermatozoa; therefore,
they rarely exhibit the motility observed when examining a semen specimen

A

SPERMATOZOA

83
Q

Present in cases of diabetes mellitus due to the fact that dead glucose serves as a food for yeast

A

SPERMATOZOA

84
Q

APPEARANCE:
Small, oval, refractile structures with buds
and/or mycelia/branched (in severe infections)

85
Q

Candica albicans in:

A

○ Diabetic patients
○ Immunocompromised patients
○ Women with vaginal moniliasis

86
Q

PARASITES IN URINE:

A
  • Trichomonas vaginalis
  • Schistosoma haematobium
  • Enterobius vermicularis
87
Q

● MOST COMMON PARASITE FOUND IN URINE
● APPEARANCE:
Pear-shaped flagellate with an undulating membrane
● Darting movement

A

Trichomonas vaginalis

88
Q

Associated with
hematuria (cloudy,
red urine) and bladder
cancer

A

Schistosoma haematobium

89
Q

MOST COMMON FECAL
CONTAMINANT FOUND IN
URINE

A

Enterobius vermicularis

90
Q

● Lower power magnification is used for examination
● Represent a biopsy of an individual renal tubule

91
Q

MOST DIFFICULT and MOST IMPORTANT urinary sediment
○ Because of its translucence
○ Should be seen in low lighting

91
Q

Observation under subdued light, along the edges of
the cover slip

92
Q

Major constituent of cast is

A

Tamm-Horsfall protein
(UROMODULIN)

93
Q

If cast has no sediment

A

renal failure

94
Q

● MOST FREQUENT SEEN CAST
● Clinical Significance:
○ Glomerulonephritis
○ Pyelonephritis
○ Chronic Renal Disease
○ Congestive Heart Failure
○ Stress
○ Exercise

A

HYALINE CAST

95
Q

● Frequently seen cast that may be pathologic or not
● Clinical Significance:
○ Glomerulonephritis
○ Pyelonephritis
○ Stress
○ Exercise

A

COARSE/GRANULAR CAST

96
Q

● Frequently found in the urine
● RARELY of clinical significance
● Detect disorders:
○ Liver disease
○ Inborn errors of metabolism
○ Renal damage cause by crystallization of
medication compounds within tubules

A

URINE CRYSTALS

97
Q

NORMAL URINE CRYSTALS:

A
  1. URIC ACID
  2. CALCIUM OXALATE
  3. AMORPHOUS URATES
  4. TRIPLE PHOSPHATE
98
Q

● ACIDIC
● Yellow-brown but maybe colorless
(six-sided shaped like crystine)
● Increased uric acid in the blood = increased uric acid in urine
● Leukemia (receiving chemotherapy),
Lesch-Nyhan Syndrome and Gout

99
Q

● ACIDIC/NEUTRAL (alkaline)
○ Dihydrate
■ Most common
○ Monohydrate
■ Renal calculi
■ Food high in oxalic acid
(tomatoes, asparagus, and
ascorbic acid)
■ Ethylene Glycol (antifreeze
poisoning)
● Uric acid and Calcium oxalate is often seen
in acidic urine

A

CALCIUM OXALATE

100
Q

● ACIDIC
● Brick dust or yellow
● Present in pink urine

A

AMORPHOUS URATES

101
Q

● ALKALINE
● (Ammonium magnesium phosphate)
● Prism shape–resembles a “coffin lid”

A

TRIPLE PHOSPHATE

102
Q

ABNORMAL URINE CRYSTALS:

A
  1. CRYSTINE CRYSTALS
  2. CHOLESTEROL CRYSTALS
  3. TYROSINE CRYSTALS
  4. LEUCINE CRYSTALS
  5. BILIRUBIN CRYSTALS
103
Q

● Often seen in acidic urine
● Often associated with cystinosis

A

ABNORMAL URINE CRYSTALS

104
Q

● ACID
● As colorless, hexagonal plates, and may
be thick or thin
● Metabolic disorder (inherited cystinuria

A

CRYSTINE CRYSTALS

105
Q

● ACID
● Rectangular plate with a notch in one or
more corners
● Seen in conjunction with fatty casts and oval fat bodies
● Associated disorder: Lipiduria (nephrotic
syndrome)
● Only seen when REFRIGERATED

A

CHOLESTEROL CRYSTALS

106
Q

CRYSTALS ASSOCIATED TO LIVER DISORDERS

A
  1. TYROSINE CRYSTALS
  2. LEUCINE CRYSTALS
  3. BILIRUBIN CRYSTALS
107
Q

● ACID/NEUTRAL
● Appear as fine colorless to
yellow needles that frequently form clumps or rosettes

A

TYROSINE CRYSTALS

108
Q

● ACID/NEUTRAL
● Yellow-brown spheres that demonstrate
concentric circles and radial striations
● WHEN PRESENT, should be accompanied
by tyrosine crystals
● Liver disease

A

LEUCINE CRYSTALS

109
Q

● ACID
● Clumped needles or granules with the
characteristic yellow color
● A POSITIVE CHEMICAL TEST RESULT for
bilirubin would be expected
● Liver disease (hepatitis)

A

BILIRUBIN CRYSTALS

110
Q

R–RBC
O–Oval Fat Bodies
W–WBC
R–RTE CELLS
Average number per L

A

Average number per HPF

111
Q

Cast
CrAb–Abnormal Crystals

A

Average number per LPF

112
Q

T–Transitional Epithelial Cells
T–Trichomonas
Ba–Bacteria
Ya–Yeast
N–Normal Crystals

A

RFMoMa per HPF

113
Q

Mucus
Secs–Squamous Epithelial Cells

A

RFMoMa per LPF

Analysis of Urine and Body Fluids (5 decks)

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