Intro To Urinalysis Flashcards
Most frequent chemical analysis performed on urine; used for detection and monitoring of DM
Glucose
What is the white color in Hazardous Material Classification
Specific Hazard
Lysis of red blood cells
Hemoglobinuria
Measure of the density of dissolved chemicals in the urine specimen
Urine SG
Paired with Bilirubin to determine Liver Disease
Urobilinogen
Located within Bowman’s Capsule and forms the beginning of renal tubule
Glomerulus
Causes of Alkaline Urine
Diet high in fruits and vegetables
What is the change in the bilirubin of unpreserved urine, and it’s cause
Decreased, exposure to light/photo oxidation to biliverdin
The substance to be reabsorbed must combined with a carrier protein
Active Transport
Harm or Injury associated with the hazard
Risk
Extuingishing materials of Class A fire type
Wood, paper, and clothing
30 secs reading time in Reagent strip
Bilirubin
Glucose
Evident if there is an injury in the urinary tract
Blood
Type of urine preservative that is used for drug analyses
Sodium Flouride
An ultrafiltrate of plasma
Urine
What is the red hazard in Hazardous Material Classification
Fire Hazard
Nitrite (Reagent strip) Basis of Test
ability of certain bacteria to reduce nitrate to nitrite
Type of urine preservative that prevents bacterial growth and metabolism
Boric Acid (almost all acids)
It is any object with the potential to cause harm
Hazard
Reagent Strip (Glucose Oxidase) Reactions principle
Double sequential enzyme reaction
Uses a urine strip reader, or a urine analyzer in which a machine will do the chemical testing on your behalf.
Automated Reagent Strip
Buffering capacity of blood depends on
Biocarbonate (HCO3-) ions
It consists of a coil of approximately eight capillary lobes
Glomerulus
Abnormal volume of protein associated with Proteinuria
Greater than 30mg/dL or 300mg/L
What gives urine its yellow color; considered the most predominant pigment seen in fresh samples
Urochrome
Average daily urine output
1,200mL
Screening test for Bence Jones Protein
Solubility test
Aromatic odor
Normal
Source of Sharp Hazards
Needles, lancets, and broken glass
Decrease in urine output
Oliguria
Bleach odor
Contamination
60 secs reading time in Reagent Strip
Nitrite
Urobilinogen
Protein
pH
Blood
Ttpe of urine specimen that is used to produce accurate quantitatively results
24-hour Specimen
Surrounds the proximal and distal convoluted tubule
Peritubular Capillaries
Type of Diabetes wherein there is a decrease in insulin or decrease function of insulin
Diabetes Mellitus
It controls the regulation of the flow of blood to and within thr glomerulus
Renin-Angiotensis-Aldosterone System
pH of first morning specimens
5.0 to 6.0 (slightly acidic during the morning)
Bilirubin (Reagent strip) Principle
Diazo reaction
Pressure resulting from the smaller size of efferent arteriole
Hydrostatic pressure
The test most commonly associated with tubular secretion and renal blood flow
P-aminohippuric acid (PAH) test
It is often the first function affected in renal disease
Tubular Reabsorption Capability
Blood (Reagent Strip) Color Reaction
yellow- green – blue
Blood (Reagent Strip) Principle
Pseudoperoxidase activity of hemoglobin
Familial benign hypercalcemia
Blue urine
Soft, clear plastic bags with hypoallergenic akin adhesive attached to the genital area
Pediatric Specimen
Cause of pale yellow urine
Polyuria
DI and DM
DIlute random specimen
Non-reversible spontaneous decarboxylation product of diacetic acid
Acetone
Water is removed by
Osmosis
Cause of pink / red urine color
RBCs
Hemoglobin
Myoglobin
How many percent does acetone occupy in ketones
2%
How to check for urine color
Good light source
White background
Look down, well lit room
The more yellow, the more ________ it is
Acidic
Clear urine with positive chemical test for blood; muscle damage
Myoglobin
Consist of 85% of nephrons, located within the cortex of kidney, main function is removal of waste and reabsorption
Cortical Nephron
What is the change in the nitrite of unpreserved urine, and it’s cause
Increased, multiplication of nitrate-reducing bacteria
Cause of blue-green urine color
Methylene blue
Most random urine SG
1.015 to 1.030
The temperature not necessary of refractometer
15C to 38C
Primary organic component of urine
Urea
Relies on volume displacement; not recommended by CLSI
Urinometry
What are the cellular structures of the Glomerulus
Capillary wall membrane
Basement membrane
Visceral epithelium of bowman’s capsule
Source of Chemical Hazards
Preservatives and Reagents
Patients were deprived of fluids for 24 hours prior to measuring specific gravity
Fishberg test
Process that provides documentation of proper sample identification from the time of collection to the receipt of laboratory results
Chain of Custody (COC)
Hemoglobinuria
Clear red
Fruity sweet odor
Ketones
You will compare a strip to a color chart attached to the canister where the urine strips are placed, then compare and determine the concentration of a substance.
Manual Reagent Strips
Indicative of Liver Disease
Bilirubin
Final adjustment of the urinary composition
PCT or DCT
Distal Convoluted Tubule
Source of Electrical Hazards
Ungrounded or wet equipment; frayed cords
The liquid part of the blood
Plasma
Causes of Acidic Urine
Diet high in meat protein and with some fruits such as cranberries
What is the renal threshold of glucose
160mg/dl to 180mg/dl
Blood enters the capillaries of the nephrons through the
Afferent Arteriole
Represent multiple complex, state-of-the-art chemical reactions
Reagent Strips
Extinguishing material of Class K fire type
Grease, oils, and fats
What is the blue color in Hazardous Material Classification
Health Hazard
Immediate reabsorption of essential substance from the fluid
PCT or DCT
Proximal Convoluted Tubule
Presence of albumin in urine above the normal level but below the detectable range of conventional urine dipstick methods
Microalbuminuria
Specific Gravity (Reagent strip) Reagent
Multistix: Poly (methyl vinyl ether/maleic anhydride) bromthymol blue
Chemstrip: Ethyleneglycoldiaminoethylethertetraacetic acid,
bromthymol blue
Odor of freshly voided urine
Faint Aromatic
How many percent are the solutes in a normal urine composition
5%
Renal Functions
Renal blood flow
Glomerular filtration
Tubular reabsorption
Tubular secretion
Ketone (Reagent strip) Principle
Based on sodium nitroprusside (nitroferricyanide) reaction
Major serum protein found in the urine
Albumin
Cause of green urine color
Pseudomonas infection
Determines the concentration of dissolved particles by measuring refractive index; its principle is refractive index
Refractometer
Accurate pH measurement; Used in patients with disturbances of acid-base balance
pH Electrode
Cause of brown or black urine color
Malignant melanoma
Melanin
Melanogen
What is the change on the bacteria of unpreserved urine, and it’s cause
Increased, multiplication
Confirmatory for Bence Jones Protein
Serum Electrophoresis/IE
More accurate evaluation of renal concentrating ability; its principle is changes in colligative properties by particle number
Osmolality
How many percent does Beta-hydroxybutyric acid occupy in ketones
78%
Primary method used for the chemical examination of urine
Reagent Strips
Sweaty Feet odor
Isovaleric Acidemia
Most vulnerable part of drug testing program
Drug Specimen Collection
Not a urine SG
lower than 1.002
Reagent used in Reagent Strip
Tetrabromophenol blue; Tetrachlorophenol
tetrabromosulfophthalein
Type of Diabetes wherein there is a decrease in the production of antidiuretic hormone
Diabetes Insipidus
Test to determine the ability of tubules to reabsorb the essential salts and water
Concentration Test
Located adjacent to the ascending and descending loops of henle in juxtamedullary nephrons
Vasa Recta
What is the change in the clarity of unpreserved urine, and it’s cause
Decreased, bacterial growth and precipitation of amorphous materials
Cause of dark yellow urine
Concentrated specimen
Dehydration
Extinguishing materials of Class C fire type
Electrical
RACE means
Rescue, Alarm, Contain, and Extinguish
What is the total renal blood flow
1,200 mL/min
40 secs reading time in Reagent Strip
Ketone
pH of normal random specimen
4.5 to 8.0 (sometime acidic, sometime akaline)
Range of a normal daily urine output
1,200 to 1,500mL / 600 to 2000mL is considered normal
Assess urinary tract infection, presence of nitrate reducing bacteria
Nitrite
Urine volume required for drug testing program
30mL to 45mL (strasinger) while for DOH manual 60mL for single collection and 30mL for split-collection
Recommended temperature for the refrigeration of urine
2°C to 8°C
Maximum point at which kidneys are able to reabsorb substances
Maximal Reabsorptive Capacity
What gives urine pink pigment when specimen is refrigerated
Uroerythrin
Few particulates, print easily seen through urine
Hazy
What includes in physical examination of urine
Color, Clarity, Specific Gravity, and Odor
The movement of molecules across a membrane
Passive Transport
HGB or hemoglobinuria plasma color
Red plasma
Cause of orange-yellow urine color
Phenindione
It is considered the ideal screening specimen
First-morning specimen
Based on changes in sound wave frequency
Harmonic Oscillation Densitometry
MGB or myoglobinuria plasma color
Normal plasma
Recommended capacity of a urine container
50mL
Seen in case of multiple myeloma
Bence Jones Protein
It prohibits the filtration of large molecules
Shield of negativity
Principle of Protein Reagent Strip
Protein error of indicators
Factors influencing the actual filtration process
Bowman’s Capsule
Hydrostatic and Oncotic pressures, and
The feedback mechanism of the renin-angiotensis-aldosterone system (RAAS)
Bilirubin (Reagent strip) Reagent
Multistix: 2,4-dichloroaniline diazonium salt
Chemstrip: 2,6-dichlorobenzene diazonium salt
Frequent night urination
Nocturia
Parameters of Reagent Strips
pH
Protein
Glucose
Ketones
Blood
Bilirubin
Urobilinogen
Nitrite
Leukocyte
Specific gravity
Perform urine testing within how many hours
2 hours
Normal random urine SG
1.002 to 1.005
2mins reading time in Reagent Strip
Leukocyte
Type of urine preservative that is excellent for sediment preservation
Formalin
Alternative for catheterized specimen, provides a less-traumatic method
Midstream clean catch
Precursor of melanoma
Melanogen
Collected under sterile conditions by passing a hollow tube through the urethra into the bladder
Catheterized Specimen
Specific Gravity (Reagent strip) principle
pKa change (dissociation constant) of a
polyelectrolyte in an alkaline medium
Many particulates, print blurred through urine
Cloudy
No visible particulates, transparent
Clear
Cause of yellow-green urine color
BIlirubin oxidized to biliverdin
Nitrite (Reagent strip) Principle
Greiss reaction
Print cannot be seen through urine
Turbid
Compared the volume and specific gravity of day and night urine
Mosenthal test
What is the change in the trichomonas of unpreserved urine, and it’s cause
Decreased, Loss of Motility and Death
Contains a shield that repels molecules with a positive charge
Shield of Negativity
Maple syrup odor
Maple syrup urine disease
Test that measures the rate at which kidneys are able to remove filterable substance from the blood
Clearance Test
What is the change on the odor of unpreserved urine, and it’s cause
Increased, bacterial multiplation causing breakdown of urea to ammonia
Cause of colorless urine
Recent fluid consumption
Mousy odor
Phenylketonuria
Functional Proteinuria happens due to
Strenuous exercise
Primary inorganic component of urine
Chloride
Clear urine with positive chemical test for blood; intravascular hemolysis
Hemoglobin
What is the total renal plasma flow
600mL/min to 700mL/min
Sequence of renal blood flow
Renal Artery -> AA -> Glomerolus -> EA -> Pertibular capillaries and vasa recta -> Renal Vein
What gives urine orange-brown color; not fresh or left for sometime
Urobilin
Extinguishing material of Class B fire type
Flammable organic chemicals or flammable liquids
Cessation in urine output
Anuria
Can be valuable to measure the viability of a transplanted kidney
Radionucleotides
Source of Biologic Hazard?
Infectious Agents
Proteins from prostatic, seminal, vaginal secretions
Tamm-Horsfall protein (uromodulin)
Corrections for glucose and protein
Subtract 0.003 for each gram of protein
Subtract 0.004 for each gram of glucose
pH indicator
Bromthymol Blue
Breath deodorizer color
Green urine
Extinguishing material of Class D fire type
Combustible metals
How many percent is water in a normal urine composition
95%
Routine laboratory measurements of GFR
Creatinine Clearance
Depends on the number of particles present in a solution and the density of these particles
Specific Gravity
What is the change of the color of unpreserved urine, and it’s cause
Modified/darkened, oxidation or reduction of metabolites
Source of Radioactive Hazards
Equipment and Isotopes
A heme containing protein found in
muscle tissue
Myoglobin
Source of Radioactive Hazards
Equipment and Isotopes
Indicative of Diabetes Mellitus
Glucose
Indicative of Kidney Disease
Protein
Organs that maintain the acid-base equilibrium
Kidney (reabsorption of bicarbonate and
secretion of hydrogen ions) and Lungs (excretion of carbon dioxide)
How many percent does acetoacetic acid occupy in ketones
20%
Principle: double indicator system of Methyl Red (red to yellow, pH 4.0-6.0) and Bromothymol blue (yellow to blue, 6.0-9.0)
pH Reagent Strip
Type of urine preservative that does not interfere with chemical tests
Refrigeration
45 secs reading time in Reagent Strip
Specific Gravity
Disorders of renal or genitourinary origin
Hematuria
A polymer of fructose, extremely stable substance
Inulin
What is the change in the ketones of unpreserved urine, and it’s cause
Decreased, volatilization and bacterial multiplication
Normal color of urine
Yellow
The plasma concentration at which active glucose transport stops
Renal Threshold
How many nephrons are in the kidney
1 to 1.5 million nephrons
Albumin Qualitative test principle
Precipitation of protein by heat and coagulation by chemical reagents
Relies on the ability of glucose and other substances to reduce copper sulfate to cuprous oxide in the presence of alkali and heat
Copper Reduction Test
Specific Gravity (Reagent strip) Color reaction
Blue (1.000) to shades of green-yellow(1.030)
Acid-base balance of the patient
pH
Excreting usually less than 0.5g of protein per day
Functional Proteinuria
Assess urinary tract infection, Presence of
Leukocytes
Leukocyte Esterase
Eight capillary lobes referred to collectively as the
Capillary Tufts
Recommended urine capacity for microscopic analysis
12mL
Many precipitate or be clottede
Milky
Normal volume of protein
Less than 10 mg/dL or 100 mg per 24 hours
Begins in the descending loops and ascending loops of henle
Tubular Concentration
Foul, ammonia-like odor
Bacterial decomposition, UTI
Hematuria
Intact RBC (cloudy red)
Standard tests used to measure the filtering capacity of glomeruli
Clearance Test
What is the change in the glucose of unpreserved urine, and it’s cause
Decreased, glycolysis and bacterial use
What is the change on the pH of unpreserved urine, and it’s cause
Increased, breakdown of urea to ammonia by urease-producing bacteria
Substance that is completely removed from the blood
P-aminohippuric acid
Transparency or turbidity of the urine specimen
Clarity
Type of urine specimen that is considered most common
Random Specimen
Measures change in pKa (dissociation constant) of a polyelectrolyte in an alkaline medium
Reagent Strip SG
What is the kidney’s functional units
Nephrons
Use ________ to measure SG of urine
Osmometer
Many particulates, print blurred through urine
Cloudy
SG of urine
1.010
What influences color of urine
Normal metabolic function
Physical Activity
Ingested material
Pathologic Condition
The most indicative of renal disease; Associated with early renal disease
Protein
Principle of Reagent Strip
Double sequential enzymatic reaction
Cabbage odor
Methione malabsorption
Source of Physical Hazards
Wet floors, heavy boxes, and patients
Source of Fire Hazard
Open flames and Organic chemicals
Bilirubin (Reagent strip) Color Reaction
tan or pink to violet
Ketones (Clinical Importance)
Diabetic ketoacidosis (IDDM)
Insulin dosage monitoring
Starvation
Excessive carbohydrate loss
Blood flows through the glomerulus and into the
Efferent Arteriole
Blood (Reagent Strip) Chromogen
Tetramethylbenzidine
Simple, rapid means for performing medically significant chemical analysis of urine
Reagent Strips
What is the yellow color in Hazardous Material Classification
Instability
What is the change in the RBC, WBC, and Casts of unpreserved urine, and it’s cause
Decreased, disintegration in dilute alkaline urine
Intermediate products of fat metabolism
Ketones
Have longer loops of henle, located near the medulla, and its function is concentration of urine
Juxtamedullary Nephron
Is responsible for the bulk of the
bicarbonate reabsorption/generation
Proximal renal tubule
What is the change in the urobilinogen of unpreserved urine, and it’s cause
Decreased, oxidation to urobilin
Process which provides for almost 100% reabsorption of filtered bicarbonate occurs primarily in the
Proximal Convoluted Tubule
Human kidneys receive approximately how many percent of the blood pumped
25%
Indicative of Diabetes Mellitus, Starvation, Malnourishment
Ketones
Increase in urine output
Polyuria
Is a small protien produced at a constant rate by all nucleated cells
Cystatin C
PASS means
Pull pin, Aim at base of fire, Squeez handles, and Sweep nozzle side to side
Types of clarity in urine specimen
Clear
Hazy
Cloudy
Turbid
Milky
What includes urine routine analysis
Physical examination, Chemical examination, and Microscopic examination
Rancid odor
Tyrosinemia
Assessing hydration of the patient
Specific Gravity
Cause of port wine urine color
Porphyrins
Pressure of unfiltered plasma proteins in the glomerular capillaries
Oncotic pressure
Dissociate from human leukocyte antigens
Beta2 microglobulin
