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urinalysis rotation > final > Flashcards

final Flashcards

1
Q
  1. What are dysmorphic red blood cells? What do they indicate if found in the urine?
A

RBCs with abnormal morphology
-suggests glomerulonephritis

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2
Q
  1. Does a positive pregnancy test always indicate a patient is pregnant? Explain your answer.
A

no. a number of conditions can cause elevated hCG levels.
-trophoblastic disease and certain non-trophoblastic neoplasms (testicular tumors, prostate cancer, breast cancer & lung cancer)

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3
Q
  1. A urine was done on a pediatric patient, 3 months old, with a positive bile, negative glucose, and Clinitest of 3+.
    a. what is the possible pathological condition?
    b. what test would you need to check the bile result with?
A

a. galactosemia
b. an Icto test

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4
Q
  1. UA results from routine physical
    pH- 6.0
    protein- 2+
    glucose, ketone & blood- neg
    RBC- 50-200/hpf
    ascorbic acid- 40 mg

a. abnormal results?
b. explain discrepancies

A

a. protein 2+, RBCs 50-200/hpf

b. positive RBCs in microscopic but neg blood chemistry result
-ascorbic acid may cause a false neg blood result

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5
Q
  1. Identify any abnormal result(s) in the following urinalysis done on the Velocity. Explain the most likely cause, and the tech follow-up:
    pH- 7.0
    protein- trace
    glucose, blood & ketones- neg
    SG- 1.060
A

-SG of 1.060
-x-ray contrast media may falsely elevate SG
-repeat urine on clinitek to check SG result

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6
Q
  1. A family practice resident doing her nephrology rotation ordered a urinalysis on a patient who came in for her afternoon appointment, and is suspected of having glomerulonephritis. The results were as follows:
    pH- 7.5
    protein- 1+
    glucose & ketones- neg
    blood- 1+
    SG- 1.005
    microscopic- normal

a. why was she disappointed? what was she expecting to find?

b. what type of urine specimen would give her a satisfying result?

A

a. no results indicating glomerulonephritis. dysmorphic RBC, RBC in micro, RBC casts

b. first morning urine- most concentrated

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7
Q
  1. Identify two possible causes for a clear red urine from a trauma patient having a 4+ dipstick reaction for blood and no RBCs microscopically.
A

hemoglobin or myoglobin

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8
Q
  1. The following results were obtained on a urine from a 30 year old female
    color- brown
    clarity- cloudy
    pH- 5.5
    blood- 2+
    urobilinogen- 1+
    SG- 1.027
    nitrite- positive
    bile, glucose & ketone- neg

indicate whether or not you would expect to see the following in a microscopic analysis & why

a. RBC
b. WBC
c. tri phos crystals
d. hyaline casts
e. bacteria

A

a. yes, positive blood
b. yes, nitrite result
c. no bc of acidic pH
d. yes, protein result
e. yes, nitrate result

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9
Q
  1. Why is it necessary to identify the type of epithelial cells in a female patient who has a large number of these cells in her urine microscopic?
A

Squamous epithelial cells suggest contamination during collection (not a clean catch specimen). Transitional epithelial cells may suggest serious conditions.

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10
Q

hyaline clinical significance

A

strenuous exercise, dehydration, emotional stress, kidney issues, congestive heart failure

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11
Q

RBC cast clinical significance

A

acute glomerulonephritis, lupus nephritis, subactute bacterial endocarditis

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12
Q

WBC cast clinical significance

A

pyelonephritis

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13
Q

granular cast clinical significance

A

damaged glomeruli, cellular degeneration, strenuous exercise, stress, dehydration, fever

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14
Q

waxy cast clinical significance

A

prolonged sepsis & tubular obstruction
-transplant rejection, chronic renal rejection

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15
Q

bilirubin crystals

A

pathological conditions- Bilirubinuria associated with liver disease or obstruction. Severe liver disease, and jaundice

visual description- fine needles that form clusters

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16
Q

leucine crystals

A

pathological conditions- severe liver disease, maple syrup disease & amino aciduria

visual description- spheres with concentric circles or striation

17
Q

tyrosine crystals

A

pathological condition- liver disease & amino aciduria

visual description- fine delicate needles with in clusters or sheaves

18
Q

cholesterol crystals

A

pathological condition- lipiduria, found in proteinuria, nephrotic syndrome, renal tubular disease

visual description- flat rectangular plated with notched corners

19
Q

cystine crystals

A

pathological conditions- cystinosis, cystinuria, cysteine metabolic disorders

visual description- hexagonal plates

20
Q
  1. One morning, a mission partner was pouring the QC reagents for the Velocity into the QC rack. The phone started ringing right as she finished, so she left the QC rack there and answered the phone call that ended up taking her 20 minutes to resolve, because there was a missing specimen. She came back to the UA aisle and ran the Velocity QC. She noticed that the QC failed for CA—it is supposed to have a positive bilirubin result, but the result was negative. What did the mission partner do wrong, and what is the next step she should take to get a passing QC result?
A

She left it out and the bilirubin degraded in the light. She should pour off a new tube of CA reagent.

21
Q
  1. What is the purpose of the color compensation field on the strips?
A

The color compensation pad assesses urine color and modifies the test results by subtracting the urine color from the color change obtained on the test reaction pads.

22
Q
  1. What pigment gives urine its characteristic yellow color?
A

urochrome

23
Q
  1. What are the two critical values in the urinalysis department that must be called within 20 minutes?
A

4+ glucose and 3+ ketones, positive legionella

24
Q
  1. A 24 year old obese diabetic woman had the following blood and urine test results from specimens obtained at the same time. Her blood glucose result was 275 mg/dl (Normal range 60-120 mg/dl).
    pH 7.5
    protein 1+
    glucose, bili, blood, nitrite- neg
    ketone- moderate
    urobilinogen- 1.0
    SG- 1.008
    epis- occasional
    bacteria & yeast- low amount
    amorphous crystals- moderate
    ascorbic acid- 40.0

a. identify discrepant results

b. explain them

A

a. blood glucose high & urine glucose neg

b. ascorbic acid is giving a false neg glucose result (decreased glomerular filtration rate)

25
Q
  1. Does a negative nitrite result rule out a UTI?
A

No. Not all bacteria reduce nitrates, it may not have sat in the bladder long enough, ascorbic acid may be interfering, and nitrates may not be in diet

26
Q
  1. Does a negative Legionella Urinary Antigen Test rule out a Legionella infection? Explain your answer.
A

No. The test only will detect legionella pneumophilia sero group 1 (unlike the serology test that will detect 1-6)

27
Q
  1. When interpreting a Vaginitis Affirm test, if the spot next to Gardnerella is blue, this indicates bacterial vaginosis. Explain why an increase in Gardnerella indicates bacterial vaginosis.
A

In a bacterial vaginosis infection, the lactobacillus population decreases, so the environment is not as acidic, therefore allowing the overgrowth of Gardnerella vaginosis and other anaerobic bacteria.

28
Q
  1. Why must one result a positive leuko on a one year old baby as an unconfirmed positive?
A

False positives can occur in breast fed babies.

29
Q
  1. Round, refractile globules, noted during bright light microscopy of a urinary sediment, were birefringent with polarized light and appeared as perfect Maltese crosses. These urinary globules are most likely:
A

c. oval fat bodies

30
Q
  1. A two hour old urine specimen, submitted for routine urinalysis and culture, yielded the following results:
    pH- 7.5
    SG- 1.008
    nitrite- neg
    culture- strep faecalis

Factors that may account for the negative nitrite result include:
1. pH of the urine
2. Species of the bacteria
3. Specific gravity
4. Retention time in the bladder

A

b. only 2 and 4 are correct

31
Q
  1. A 28 year old woman is taking an antibiotic for a urinary tract infection and was told that the antibiotic would be most effective if her pH was acidic. The woman should be on a diet rich in:
A

b. protein

32
Q
  1. Colorless, clear, hexagonal crystals were found in a urine specimen. The patient is most likely to have which of the following clinical conditions?
A

d. cystinosis

33
Q
  1. A urine specimen with an elevated urobilinogen and a negative bilirubin may indicate:
A

d. hemolytic disease of the newborn

34
Q
  1. The method of choice for performing a specific gravity measurement of urine from a patient who was administered x-ray contrast dye for an x-ray earlier that afternoon would be:
A

a. reagent strip

35
Q
  1. A patient with Multiple myeloma has a protein result of 3+ on the Velocity. This elevated protein result is due to a large amount of Bence Jones proteins in the urine. What type of proteinuria is this?
A

a. prerenal proteinuria

36
Q
  1. All of the following are ketone bodies that appear in urine, except:
A

b. acetophenone

urinalysis rotation (2 decks)

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