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urinalysis > exam II > Flashcards

exam II Flashcards

1
Q

how does the pH of urine relate to it’s hydrogen ion concentration?

A

it’s an inverse relationship
increased hydrogen ion : decreased pH
decreased hydrogen ion : increased pH

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2
Q

Ketone bodies in the urine are suggestive of elevated _____ metabolism

A

fat

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3
Q

what causes myoglobinuria?

A

extensive muscle injury

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4
Q

what is the general purpose of test strip screening?

A

immediate answer to whether or not pathological concentrations of substances are present in the urine

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5
Q

what color is a (+) positive nitrate on the dipstick?

A

pink

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6
Q

what substance is most likely to be present in urine that could cause a false (=) negative reaction on the dipstick for glucose?

A

ascorbic acid or vitamin C

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7
Q

what is SSA used for?

A

confirmatory test for proteins

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8
Q

what test is used for detecting reducing sugar in the urine?

A

clinitest

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9
Q

what would be expected in the microscope examination, if reducing sugars are detected?

A

nothing

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10
Q

what two dipstick reactions are usually (+) positive in pyelonephritis and cystitis?

A

leukocytes and nitrates

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11
Q

name several conditions that could be indicated by an elevated urinary urobilinogen

A

hepatitis & cirrhosis
hemolytic anemia
pernicious anemia

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12
Q

name several conditions that can cause hemoglobinuria

A

extensive burns

incompatable blood transfusions

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13
Q

what is specificity (as related to dipstick reactions)?

A

each test zone should react specifically to the substance being test and to no other

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14
Q

the test pad for ketone bodies detects _____?

A

acetoacetic acid

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15
Q

what is the principle of the dipstick method for protein?

A

protein of error indicators:
-tetrabromphenol blue buffered at a constant pH 3 without proteins is yellow, but in the presence of proteins, hydrogen ions are released by indicator dye causing color changes ranging from yellow-green to blue-green

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16
Q

what unusual urinary protein is associated with multiple myeloma?

A

bence-jones

50% of patients have this

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17
Q

what sugar (especially in infants) is most likely indicaated by a (=) dipstick reaction for glucose but a (+) clinitest?

A

galactose

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18
Q

what specimen is used to detect orthostatic proteinuria?

A

2 specimens:

first morning and a second after the patient has been upright for a few hours

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19
Q

what is the active ingredien in ehrlich’s reagent?

A

P-dimethylamino-benzaldehyde

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20
Q

what is the reagent used to detect bilirubin in the icotest?

A

2,4 dichlorobenzene diazonium tetrachlorozincate

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21
Q

the reagent strip for hemoglobin detects ___,___&___

A

hemoglobin
myoglobin
RBC

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22
Q

what is the action of the enzyme peroxidase?

A

to catalyze the oxiation of chromogen (3,3,5,5 tetramethyl benzidine) by the O2 released from peroxidase on reagent pad to produce a color changing from yellow-green
pseudo peroxidase activity

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23
Q

why is there normally no glucose in the urine?

A

because it is absorbed in convoluted tubules

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24
Q

what is the advantage of using phase contract microscopy in the examination of urinary sediment?

A

allows to see unstained cellular components and casts

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25
Q

how does the phase contrast microscope relate to the refractive index?

A

the refractive index (mucus, hyaline casts) is the same as urine making them hard to see

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26
Q

what is the use of the polarizing microscope in urine microscopics?

A

lipid material and crystals

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27
Q

cells are recorded as number per __ power field (__x)

A

high

40

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28
Q

how many field should be expmined in a microscopic exam?

A

10

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29
Q

what is the most common type of WBC found in the urinary sediment?

A

neutrophils

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30
Q

casts in urine are usually accompanied by a (+) test for what

A

protein

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31
Q

casts containing cells indicate problems in what part of the urinary tract?

A

kidneys

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32
Q

where are transitional epithelial cells found?

A

bladder, renal pelivs , 2/3 male urethra

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33
Q

amorphous phosphates are found in urine of what pH?

A

alkaline

34
Q

what disease is indicated when tyrosine and leucine are found in the urine?

A

severe liver disease

35
Q

nephrotic syndrome is characterized by

A

proteinuria and lipiduria

36
Q

casts which have at least two distinct components are called

A

mixed casts

37
Q

casts should be reported as the number per ___ power field (_-x)

A

low

10

38
Q

which WBC is most likely to be found in a transplant rejection

A

lymphocyte

39
Q

in what specific portions of the nephron are casts formed?

A

lumen of DCT and collecting ducts

40
Q

what specific type of epithelial cells are found in epithelial cell casts

A

renal tubular epi. cells

41
Q

in what type of diseases (in general) are RBC casts found?

A

basement membrane ducts of glomerulus has been damaged

42
Q

glitter cells are associaed with urine of ___ specific gravity

A

low

43
Q

what type of epithelial cells are indicative of vaginal contamination?

A

squamous

44
Q

calcium oxalate crystals are normally found in __ pH urine

A

acidic

45
Q

what condition is indicated by large numbers of uric acid crystals?

A

gout

46
Q

candida albicans (a yeast) is often found in the urine of patients with __________

A

diabetes mellitus

47
Q

if flat, hexagonal, colorless crystals are found in the ruine what constituent s suggested?

A

cystine

48
Q

what should the technologist do prior to reporting out cystine crystals?

A

chemical confirmation for cystine

49
Q

how can RBC and yeast be differentiated?

A

acetic acid will lyse RBC’s not yeast.

50
Q

what is the appearance of waxy casts?

A

waxy, highly refractive, colorless or gray-yellow uneven ends, cracks/fissures

51
Q

name several organisms whose urinary presence indicates contamination?

A
  • RBC’s with no casts , proteinuria (menstrual/ hemorrhoidal)
  • squamous
  • sperm
  • parasites
52
Q

the order for the aging process of casts is ….

A

cellular,
coarsely granular
finely granular
waxy

53
Q

what is the term for the presence of elevated numbers of casts in urine?

A

cylinduria

54
Q

how can a precipitate of amorphous phosphate be removed?

A

soluble in dilute acetic acid

55
Q

how can a precipitate of amorphous urates be removed?

A

heated to 60C / dissolved in alkali

56
Q

what would be the appearance of RBC in hypertonic urine?

A

crenated

57
Q

can the multistix detect a negative urobilinogen?

A

no

58
Q

how would you interpret a (=) nitrate but a (+) bacteria?

A
  • bacteria cannot convert NO3 to NO2
  • no nitrates in diet
  • urine hasn’t been in bladder long enough
  • so much bacteria that it further reduces NO3 to N2
59
Q

what happens if you dip the reagent strip too much?

A

leeching or run over of reagents

60
Q

what type of casts may be formed in the urine of a normal pH?

A

hyaline

61
Q

what are shadow cells?

A

RBC that have lost HB

62
Q

what is the significance of the shape and size of a cast?

A

shape and size aid in ID

63
Q

urine for testing should be at ___ temperature

A

room

64
Q

why do we use the refractometer for specific gravity rather than the dipstick?

A

because the refractometer can detect ionic and nonionic solutes

65
Q

how does the watson-schwartz test differentiate between urobilinogen and porphobilinogen?

A

urobilinogen is solube in chloroform and butenol

porphobilinogen is soluble in the aqueous layer

66
Q

what is the principle of the automated instruments for dipstick reading?

A

reflectance photometrey

67
Q

glucose in the urine is referred to as ___ or ___

A

glucosuria

glycosuria

68
Q

the two different forms of blood in the urine are described as ___ and ___

A

hemoglobinuria

hematuria

69
Q

what reagent is used to differentiate urinary hemoglobin and myoglobin?

A

80% ammonium sulfate ( precipitates out hemoglobin)

70
Q

what is the normal range for urinary urobilinogen?

A

0.1 - 1

71
Q

which test is the most sensitive for bilirubin?

A

icotest

72
Q

what is ketonuria?

A

ketones present in urine

73
Q

what symptoms would make you suspect the patient is suffering from orthostatic proteinuria

A

children and adolescence who have proteinuria

74
Q

what are some possible causes of hematuria?

A 
kidney stones
glomerulonephritis
pyelonephritis
trauma
strenuous exercise
smoking
75
Q

ketones

A

sodium nitroprusside

76
Q

urobilinogen

A

para-dimethlyaminobenzaldehyde

77
Q

protein

A

tetrabromphenol blue

78
Q

pH

A

bromthymol blue

methyl red

79
Q

nitrite

A

1,2,3,4-tetrahydrobenzoquinoline-3-olpara-arsanilic acid

80
Q

bilirubin

A

2,4-dichlorobenzenediazonium tetrachlorozincate (aka-diazotized 2,4-dichloroaniline)

81
Q

glucose

A 
glucose oxidase
gluconic acid
hydrogen peroxide
potassium iodide
peroxidase
82
Q

blood

A

3,3,5,5-tetramethylbenzidine hydrogen peroxide

urinalysis (3 decks)

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