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Urinalysis > Intro to Urinalysis II > Flashcards

Intro to Urinalysis II Flashcards

0
Q

Is there interference from glucose, protein, or radiographic dyes when measuring specific gravity by reagent strip?

A

NO

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1
Q

In measuring specific gravity by reagent strip, when urine pH is > or equal to 7.0 add ______ to the strip reading if it is being read manually

A

0.005

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2
Q

What is the specific gravity of the filtrate as it leaves the glomerulus?

A

1.010

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3
Q

This term is used to describe urine with a specific gravity of 1.010

A

isosthenuria

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4
Q

This term is used to describe urine with a specific gravity of <1.010

A

hyposthenuric

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5
Q

If a urine is constantly <1.010 (hyposthenuric) what does this represent?

A

the kidney’s inability to concentrate urine, diabetes insipidus, renal disease

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6
Q

What does urine with a specific gravity constantly >1.010 represent?

A

adrenal insufficiency, congestive heart failure, hepatic disease, dehydration

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7
Q

What is the physiological limit of specific gravity?

A

1.040, could be due to radiographic dyes

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8
Q

Low fluid intake = _____ specific gravity

A

High

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9
Q

high fluid intake = ____ specific gravity

A

low

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10
Q

If the specific gravity is greater than 1.035 what should you do?

A

make a 1:2 dilution with distilled water and multiply all digits to the right of the decimal by your dilution factor

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11
Q

this is the measure of the concentration of dissolved particles in a solution expressed in osmoles of solute particles per kg of solvent

A

osmolality

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12
Q

osmolality only measures dissolved particles, thus _____ and ______ are not measured

A

lipids and protein

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13
Q

Reference range for specific gravity

A

1.003 to 1.030

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14
Q

Reference Range for urine color

A

colorless to yellow

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15
Q

Reference Range for Urine volume

A

600-2000 mL/day

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16
Q

What does a specific gravity of 1.003 represent ?

A

Usually a diluted urine

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17
Q

What causes changes in urine volume in pathologic states?

A

solute diuresis in diabetes mellitus

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18
Q

What causes changes in urine volume in non-pathologic states?

A

fluid intake, vomiting, diarrhea, sweating, variation in secretion of ADH, water loss, medications, diuretic therapy, caffeine, alcohol

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19
Q

This term is used when describing urine output <400mL/24hrs; decreased volume is due to excess water loss

A

oliguria

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20
Q

this is known as the cessation of urine flow

A

anuria

21
Q

this is increased volume of urine at night, caused by renal failure

A

nocturia

22
Q

this is known as increased daily urine volume, caused by diabetes mellitus, diabetes insipidus, medications, diuretic therapy, caffeine, and alcohol

A

polyuria

23
Q

List the proper criteria for a good specimen (3 things)

A

1 proper patient ID (name, location, physician, collection date, collection time, test requested)
2 Fresh collection (should be tested within two hours after collection)
3 If testing delayed urine should be refrigerated

24
Q

this technique requires no preparation; good for screening; not good for urine cultures

A

routine

25
Q

technique often used with random specimens; good for urine culture and routine analysis; noncompliance in collection technique; difficult for some patients to collect

A

clean catch midstream (CCMS)

26
Q

specimen good for urine cultures and routine analysis; can enter the bladder or either of the ureters and provide information about each kidney independently; can cause UTIs; can cause discomfot in patients

A

Catheterization

27
Q

involves collecting urine directly from the bladder by puncturing the abdominal wall with a needle and a syringe; usually performed for bacterial cultures (especially anaerobes); used on infants when specimen contamination is unavoidable; sterile but invasive

A

suprapubic aspiration

28
Q

what testing Is a pediatric urine collection bag used for?

A

for screening purposes, not for urine culture because of contamination

29
Q

This urine requires no preparation, can be collected anytime, used for routine screening and to detect disease processes, affected by variances in fluid intake and exercise

A

random urine

30
Q

this urine is collected as soon as waking up, ideal for testing specimens that require concentration and incubation (nitrates, protein, bacteria), confimation of orthostatic proteinuria, formed elements more stable, cells have better morphology, more epithlial cells for cytology studies

A

First morning urine

31
Q

What is a disadvantage of a first morning urine?

A

additional crystals may precipitate upon cooling, specimen must be preserved if not tested within 2 hours

32
Q

In this type of collection the goal is to eliminate metabolites from food ingested prior to the beginning of the test, often used for glucose monitoring for patients with diabetes mellitus or gestational diabetes

A

fasting urine

33
Q

This type of urine requires the patient to void immediately before eating and the collect urine 2 hours post eating; used for diabetes mellitus monitoring; also known as a fractional collection

A

2 hour postprandial

34
Q

this type of urine collection is used because of circadian and diurnal variations in hormones, proteins, glomerular filtration rates, exercise, hydration, etc; usually 12 or 24 hour collection; preservative is usually in the bottle before patient takes it home

A

Timed

35
Q

When measuring a urine’s specific gravity using a reagent dipstick, are you required to correct for elevated urine glucose?

A

NO, the reagent strip is not affected by elevated glucose levels

36
Q

pH ________ (increases/decreases) due to decomposition of urea to ammonia and loss of CO2 as a specimen is allowed to sit out, unpreserved

A

increases

37
Q

glucose is _______ (increased/decreased) due to bacterial consumption as a urine is allowed to sit.

A

decreased

38
Q

Ketones ______ (increase/decrease) due to bacterial action and will vaporize as a urine is allowed to sit

A

decrease

39
Q

Bilirubin _____ (increases/decreases) due to photo-oxidation as it sets out

A

decreases

40
Q

Urobilinogen _______ (increases/decreases) due to oxidation to urobilin

A

decreases

41
Q

Nitrites _______ (increase/decrease) due to bacterial production

A

increase

42
Q

If urines are left unpreserved what 3 structures are affected?

A

RBCs and WBCs degrade, Casts degrade, and bacteria increase

43
Q

What is the most common method of preservation?

A

refrigeration at 4-6*C, REMEMBER allow urine to reach room temp before testing

44
Q

What is a disadvantage of refrigerating urine?

A

precipitation of amorphous urates and phosphate crystals that interfere with microscopic analysis

45
Q

Culture of a refrigerated specimen is preferred in ___ Hours but will be accepted up to ___ Hours

A

8 hours, 24 hours

46
Q

Culture on an unrefrigerated specimen must be performed within ___ Hours post collection

A

2 hours

47
Q

commonly used preservative for 24 hour urines, preserves protein and formed elements, bacteriostatic/not bactericidal so can be used for culture, precipitates out crystals, decreases pH, interferes with drug and hormone analysis

A

Boric acid

48
Q

preservative that is an excellent cell preservative, interferes with glucose, blood, leukocyte esterase, and copper reduction testing (clinitest)

A

formalin

49
Q

preserves sediments such as cells and casts

A

mucolexx

50
Q

this preservative does not interfere with most chem tests, prevents contamination from only airborne bacteria, does not prevent proliferation of bacteria already in specimen and floats on the surface

A

toluene

Urinalysis (10 decks)

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