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clin micro hehe mod 1 > INTRODUCTION TO URINALYSIS > Flashcards

INTRODUCTION TO URINALYSIS Flashcards

1
Q

Wrote the book of “uroscopy”

A

Hippocrates

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2
Q

Discovered albuminuria by boiling urine

A

Frederik Dekker

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3
Q

Published a book about “Pisse Prophets”

A

Thomas Bryant

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4
Q

Addis Count

A

Thomas Addis

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5
Q

Introduced the concept of urinalysis as part of a doctor’s routine patient examination

A

Richard Bright

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6
Q

Urochrome - the pigment that causes yellow color or urine

A

Thudichum

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7
Q

Reasons for performing urinalysis (CLSI): (4)

A
  1. Diagnosis of disease
  2. Screening asymptomatic populations for undetected disorder
  3. Monitoring the progress of disease
  4. Monitoring the effectiveness of therapy
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8
Q

Primary organic component. Product of protein and amino acid metabolism

A

Urea

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9
Q

Product of creatine metabolism by muscles

A

Creatinine

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10
Q

Product of nucleic acid breakdown in food and cells

A

Uric acid

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11
Q

Primary Inorganic component. round in combination with sodium and many other inorganic substances

A

Chloride

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12
Q

Primarily from salt, varies by intake

A

Sodium

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13
Q

Combined with chloride and other salts

A

Potassium

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14
Q

Combines with sodium to buffer the blood

A

Phosphates

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15
Q

Regulates blood and tissue acidity

A

Ammonium

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16
Q

Combines with chloride, sulfate, and phosphate

A

Calcium

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17
Q

A normal urine constituent

A

Nitrate

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18
Q

The single most useful substance that identifies a fluid as urine

A

uniquely high creatinine concentration (approximately 50 times that of plasma)

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19
Q

Factors that influence urine volume include: (4)

A
  1. Fluid intake
  2. Fluid loss from non-renal sources
  3. variations in the secretion of ADH
  4. need to excrete increased amounts dissolved solids such as glucose or salts
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20
Q

DM or DI:

  1. Due to defect in the pancreatic production of insulin
  2. Increase Urine Specific gravity
  3. Increase urine Glucose (glucosuria)
A

Diabetes mellitus

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21
Q

DM or DI:

  1. Due to decrease production or function of ADH
  2. Decreased Urine Specific gravity
A

Diabetes insipidus

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22
Q

Urine specimens should be delivered to the laboratory promptly and tested within 1 hour. Never discard a specimen before checking with a supervisor.

A. First statement is true, second statement is true.
B. First statement is false, second statement is true.
C. First statement is true, second statement is false.
D. First statement is false, second statement is false.

A

B. First statement is false, second statement is true.

  1. Within 2 hours
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23
Q

Characteristics of urine specimen container: (4)

A
  1. Clean, Dry, Leak-proof
  2. With Screw top lids - they are less likely to leak than snap-on lids
  3. Wide mouth, and wide flat bottom
  4. Made of sterile material
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24
Q
  1. Recommended container capacity
  2. Required specimen volume for microscopic analysis
A
  1. 50 mL
  2. 15 mL
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25
Q

This must accompany specimens delivered to the laboratory

A

Requisition form

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26
Q

When to reject specimen? (6)

A
  1. Specimen in unlabeled containers
  2. Non matching labels and requisition forms
  3. Specimens contaminated with feces or toilet papers
  4. Containers with contaminated exteriors
  5. Specimens of insufficient quantity
  6. Specimens that have improperly transported
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27
Q

Collect urine after 2 hours of meal. Measures the amount of glucose and correlated with the renal threshold.

A

2 hour post prandial

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28
Q

For quantitative measurement of analytes that shows
diurnal variation. Urine specimen for clearance test. Urine specimen evaluation of fistulas

A

Timed specimen

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29
Q

This specimen is collected under sterile conditions by passing a hollow tube through the urethra into the bladder

A

Catheterized specimen

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30
Q

Ideal for screening microalbuminuria (brunzel). For determination of urine albumin, creatinine, and the albumin-to creatinine ratio.

A

12 hours urine specimen

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31
Q

Preferred for urobilinogen measurements

A

Afternoon urine (20m to 40m)

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32
Q

Easy to collect and convenient. For Routine screening.

A

Random specimen

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33
Q

Urine specimen that is ideal for cytology

A

Random urine “clean catch” with prior hydration

34
Q

Specimen that is ideal to test for substances that require concentration or incubation for detection. These specimens are often preferred for cytology studies because the number epithelial cells present can be significant.

A

First morning or 8-hour specimen

35
Q

Specimen for glucose or diabetic monitoring and screening

A

Second morning/fasting specimen

36
Q

Specimen for glucose or diabetic monitoring and screening

A

Second morning/fasting specimen

37
Q

For bacterial culture (especially for anaerobic microbes). It is used for cytological examination.

A

Suprapubic aspiration

38
Q

This specimen is safer, less traumatic method for obtaining urine for bacterial culture and routine urinalysis

A

Midstream Clean catch

39
Q

Urine specimen in soft, clear plastic bags with hypoallergenic skin adhesive to attach to the genital area of both boys and girls

A

Pediatric specimen

40
Q

If both urinalysis and culture are requested on a midstream or catheterized collection, which should be performed first and why?

A

Culture. This is to prevent contamination of the specimen

41
Q

blank

A
42
Q

Process that provides documentation or proper sample identification from the time of collection to the receipt of laboratory results

A

Chain of custody

43
Q

This is added to the toilet water reservoir to prevent an adulterated specimen

A

Bluing agent (dye)

44
Q

Most common adulterant

A

Water

45
Q

Container capacity for drug testing

A

60 mL

46
Q

Urine volume required for drug testing

A

30-45 mL

47
Q

Urine temperature for drug testing

A

Within 4 mins, the temp should be 32.5-37.7°C

48
Q

This is inspected to identify any signs of contaminants during drug testing

A

Urine color

49
Q

Explain each container in the three-glass collection for prostatitis test

A

1st sterile container - contains the first urine passed
2nd sterile container - contains the midstream portion of urine
3rd sterile container - contains the urine with prostate fluid after massaging the prostate

50
Q

Which of the specimens in 3-glass collection is/are examined microscopically?

A

1st and 3rd specimen

51
Q

In 3-glass collection, what is the 2nd specimen used for?

A

Serves as control or bladder and kidney infections and should not be positive for bacteria. can be used for routine UA if additional testing is required

52
Q

This is performed in all specimens of 3-glass collection

A

Qualitative culture

53
Q

In Stamey-Mears, what are the types of four glass specimen

A

a) VB1 Initial voided urine, For bacterial cultures, Urethral infection or inflammation testing
b) VB2 Midstream urine and is used to tests for urinary bladder infection.
c) EPS Expressed prostatic secretion
d) V63 Post prostatic massage urine

54
Q

Changes in unpreserved urine:

Which of the analytes are increased?

A

pH
Bacteria
Odor
Nitrite

55
Q

Changes in unpreserved urine:

Which of the analytes are decreased?

A

Clarity
Glucose
Ketones
Bilirubin
Urobilinogen
RBC, WBC, Casts
Trichomonas

56
Q

Which of the analytes is the least or not affected by unpreserved urine?

A

Protein

57
Q

Changes in unpreserved urine:

Cause of increase in Trichomonas

A

None.

Trichomonas is decreased in unpreserved urine due to loss of characteristic, motility and death.

58
Q

Changes in unpreserved urine:

Cause decrease of RBC, WBC, and Cast

A

Disintegration in dilute alkaline urine

59
Q

Changes in unpreserved urine:

Cause of decrease in Urobilinogen

A

Oxidation to urobilin

60
Q

The decrease in bilirubin in unpreserved urine is due to photooxidation to urobilin.

A. True
B. False

A

B. False.

Bilirubin is photo oxidized to biliverdin.

61
Q

This analyte is increased due to bacterial multiplication or breakdown of urea to ammonia

A

Odor

62
Q

This analyte is affected due to oxidation or reduction of metabolites

A

Color (Modified/Darkened)

63
Q

pH is _______ due to breakdown of urea to ammonia by urease-producing bacteria loss of CO2

A. Increased
B. Decreased

A

A. Increased

64
Q

Why is Nitrite increased in an unpreserved specimen

A

Multiplication of nitrite reducing bacteria

65
Q

Explain why clarity of unpreserved specimen decreases.

A

Due to bacterial growth and precipitation of amorphous material

66
Q

This analyte is decreased due to glycolysis and bacterial consumption

A

Glucose

67
Q

Urine preservative that can be used to preserve urine for catecholamines (e.g., epinephrine & norepinephrine) measurement

A

Concentrated HCl

68
Q

Urine preservative that is Inexpensive, stabilizes porphyrins, porphobilinogen, etc. but unacceptable for urinalysis testing. Used for quantitative analysis of porphyrins, porphobilinogen, etc.

A

Sodium carbonate

69
Q

Urine preservative that preserves cellular elements, and used for cytological examination.

A

Saccomanno fixative

70
Q

Component of Saccomanno fixative

A

Ethanol + Carbowax

71
Q

Urine preservative used for automated instrument with round or conical bottom. Must refrigerate within 2 hours.

A

Yellow plain UA

72
Q

Urine preservative that is stable for 72 hours, which contains sodium propionate. This decreases bilirubin and urobilinogen when left exposed at room temperature and light.

A

Cherry red/Yellow top tube

73
Q

Urine preservative that preserves bacteria using boric acid and is stable at room temperature for 48 hours. However, this decreases pH if urine is below minimum fill line.

A

Gray C and S tube

74
Q

Urine preservative that does not interfere with routine test and uses 1 drop per ounce of specimen. This causes changes in odor.

A

Phenol

75
Q

Urine preservative that is good for drug analysis and prevents glycolysis. It Inhibits reagent strip tests for glucose, blood, and leukocytes. May use sodium benzoate instead of fluoride for reagent strip testing.

A

Sodium fluoride

76
Q

Urine preservative that does not interfere with routine test but floats on surface of specimens and clings to pipette and testing materials

A

Toluene

77
Q

Excellent sediment preservative and can also be used for cytology (Brunzel). But act as reducing agent, interferes with chemical tests for glucose, blood, leukocyte esterase, and copper reduction, and gives false-negative reagent strip test for blood and urobilinogen

A

Formalin

78
Q

Urine preservative that preserves protein and formed elements well, does not interfere with routine analysis other than pH, and prevents bacterial growth and metabolism. However, it may precipitate crystals when used in large amounts and interferes with drug and hormone analyses. Keeps pH at 6.0 and Bacteriostatic at 18 g/L

A

Boric Acid

79
Q

Urine preservative that preserves glucose and sediments well but interferes with acid precipitation test for protein.

A

Thymol

80
Q

Urine preservative that does not interfere with chemical test, but precipitates amorphous crystals and raises specific gravity by hydrometer. Prevents bacterial growth for 24 hours.

A

Refrigeration

clin micro hehe mod 1 (4 decks)

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