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Analysis of Urine and Bodily Fluids > Introduction to Urinalysis > Flashcards

Introduction to Urinalysis Flashcards

1
Q

____ is the testing of urine with procedures commonly performed in an expeditious, reliable, accurate, safe, and cost-effective manner (CLSI).

A

Urinalysis

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2
Q

Duration of manual urinalysis

A

15 minutes

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3
Q

Duration of automated urinalysis

A

6 minutes

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4
Q

____ is the foundation (beginning) of laboratory medicine.

A

Urinalysis

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5
Q

History of Urinalysis

5th BC

A

Hippocrates wrote a book on “Uroscopy”

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6
Q

References to the study of urine can be found in the ____ and in ____.

A
  • Drawings of cavemen
  • Egyptian hieroglyphics, such as Edwin Smith Surgical Papyrus
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7
Q

____ wrote a book on “Uroscopy”

A

Hippocrates

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8
Q

Hippocrates wrote a book on ____.

A

Uroscopy

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9
Q

History of Urinalysis

Middle Ages

A

Physicians were trained on the “Art of Uroscopy”

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10
Q

During the Middle Ages, physicians were trained on the ____.

A

Art of Uroscopy

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11
Q

History of Urinalysis

1140 AD

A

Color charts were developed

Describes the significance of 20 different colors

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12
Q

Color charts were developed to describe the significance of ____.

A

20 different colors

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13
Q

History of Urinalysis

1627

A
  • Thomas Bryant published a book called “Pisse Prophets” which was about charlatans.
  • The book inspired the passing of the first medical licensure laws in England
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14
Q

____ published a book about charlatans.

A

Thomas Bryant

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15
Q

Thomas Bryant published the book called ____.

A

Pisse Prophets

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16
Q

____ are predictors about health without proper medical background.

A

Pisse prophets (quack doctors/charlatans)

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17
Q

Pisse prophets are also called as ____.

A

Quack doctors or Charlatans

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18
Q

History of Urinalysis

1694

A

Frederik Dekker discovered albuminuria (white precipitates)

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19
Q

____ discovered albuminuria.

A

Frederik Dekker

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20
Q

Frederik Dekker discovered ____.

A

albuminuria

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21
Q

How did Dekker discovered albuminuria?

A

By boiling the urine

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22
Q

History of Urinalysis

17th Century

A
  • Discovery of Microscope by Anton van Leeuwenhoek
  • Development of methods for quantitating microscopic sediment by Thomas Addis
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23
Q

____ developed methods of quantitating microscopic sediments.

A

Thomas Addis

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24
Q

History of Urinalysis

1827

A

Richard Bright introduced urinalysis as part of a doctor’s routine patient examination

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25
Q

____ introduced urinalysis as part of a doctor’s routine patient examination.

A

Richard Bright

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26
Q

____ led to the passing of medical licensure laws in England.

A

The book “Pisse prophets”

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27
Q

The first medical licensure laws were passed in ____.

A

England

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28
Q

Importance of Urinalysis (Unique Characteristics)

A
  • Readily available and easily collected
  • Contains information which can be obtained by inexpensive lab tests
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29
Q

Reasons for performing Urinalysis

A
  • Aids in diagnosing of disease
  • Screen asymptomatic population
  • Monitor disease progression and effectiveness of therapy
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30
Q

Situation

A 2 year old patient submitted a 2 mL amount of urine. If the average amount of urine to be submitted is 10-15 mL, should you accept or reject the specimen?

A

Accept but take note in the result form

For patients that are geriatric, pediatric, or with special case.

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31
Q

In-born errors were discovered due to the ____.

A

peculiar odor of urine

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32
Q

Four Parts of Routine Urinalysis

A
  1. Specimen Evaluation
  2. Physical Examination
  3. Chemical Examination
  4. Sediment/Microscopic Examination
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33
Q

Identify which part of Routine Urinalysis

Checking for the following:
* Contamination
* Label
* Amount

A

Specimen Evaluation

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34
Q

What is the ideal amount when collecting a urine specimen?

A

10 - 15 mL

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35
Q

What is the average amount when collecting a urine specimen?

A

12 mL

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36
Q

In a 50 mL urine container, the specimen should be ____ full.

A

3/4

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37
Q

Identify which part of Routine Urinalysis

Accepting or rejecting a specimen

A

Specimen Evaluation

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38
Q

Identify which part of Routine Urinalysis

Checking for the following:
* Color
* Volume
* Clarity

A

Physical Examination

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39
Q

Identify which part of Routine Urinalysis

Testing the soluble substances or dissolved solids

A

Chemical Examination

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40
Q

Identify which part of Routine Urinalysis

Gold standard

A

Sediment/Microscopic Examination

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41
Q

Identify which part of Routine Urinalysis

Confirms the result of the latter examinations

A

Sediment/Microscopic Examination

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42
Q

If the urine specimen is clear red, then it means that ____.

A

The specimen is hemolyzed

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43
Q

If If the urine specimen is cloudy red, then it means that ____.

A

The RBCs are intact

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44
Q

Ascorbic acid is a ____ which causes a false negative result.

A

reducer

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45
Q

The kidneys convert approximately ____ of filtered plasma to the average daily urine output.

A

170,000 mL (170 L)

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46
Q

The average daily urine output is ____.

A

1,200 - 1,500 mL

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47
Q

The kidneys form urine as an ultrafiltrate of ____.

A

Plasma

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48
Q

Patients who undergo dialysis usually suffer from ____.

A

heart attack

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49
Q

TRUE OR FALSE.

Amino acids should be excreted out of the body.

A

False

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50
Q

Normal range of urine output

A

600 - 2,000 mL

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51
Q

Amount of glucose absorbed for patients with Diabetes Mellitus

A

160 - 180 mg/dL

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52
Q

If the amount of glucose reabsorbed exceeds the limit, what will happen?

A

The excess glucose will come out of the urine, therefore the patient will be positive for glucose

REMEMBER: kapag may solute, ang kasunod ay water.

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53
Q

Urine % Composition

A

95% water + 5% solutes

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54
Q

Variation in urine concentration may be due to ____.

A
  • Dietary intake
  • Physical activity
  • Body’s metabolism
  • Endocrine function
  • Body’s position
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55
Q

Dietary intake relationship to solute concentration

A

Directly proportional (the more we consume, the higher the solute concentration)

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56
Q

Physical metabolism relationship to solute concentration

A

Directly proportional (high physical activity = high metabolism = high concentration of solute)

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57
Q

What endocrine hormones affect the urine?

A
  • Antidiuretic hormone (ADH)
  • Aldosterone
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58
Q

Body Position relationship to solute concentration

A

Prolonged standing can cause increased protein

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59
Q

When urine is positive for protein it can be an indication of ____.

A

kidney problem

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60
Q

Organic Solutes in Urine

A
  • Urea
  • Creatinine
  • Uric acid
  • Hippuric acid
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61
Q

When will the urine be unsterile?

A

When it passes the urethra

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62
Q

____ is the primary organic component of urine.

A

Urea

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63
Q

Urea is produced in the ____.

A

liver

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64
Q

Urea is produced due to the ____.

A

Metabolism of protein and amino acids

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65
Q

____ is the solute that is predominant in urine.

A

Urea

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66
Q

Creatinine is a product of ____.

A

Metabolism of creatine by muscles

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67
Q

Uric acid is a product of ____.

A

Purine metabolism

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68
Q

____ is the product of creatine metabolism in the muscles.

A

Creatinine

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69
Q

____ is the product of purine metabolism.

A

Uric acid

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70
Q

Amount of urea in a 24 hour urine

A

25 - 35 g

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71
Q

Amount of creatinine in a 24 hour urine

A

1.5 g

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72
Q

Amount of uric acid in a 24 hour urine

A

0.4 - 1 g

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73
Q

Amount of hippuric acid in a 24 hour urine

A

0.7 g

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74
Q

Amount of other substances in a 24 hour urine

75
Q

Inorganic Solutes in Urine

A
  • Chloride
  • Sodium
  • Pottasium
  • Sulfate
  • Phosphate
  • Ammonium
  • Magnesium
  • Calcium
76
Q

____ is the primary inorganic component of urine.

77
Q

____ is the principal salt in urine.

A

Sodium Chloride

78
Q

Amount of sodium chloride in a 24 hour urine

79
Q

Amount of pottasium in a 24 hour urine

80
Q

Amount of sulfate in a 24 hour urine

81
Q

Amount of phosphate in a 24 hour urine

82
Q

Amount of ammonium in a 24 hour urine

83
Q

Amount of magnesium in a 24 hour urine

84
Q

Amount of calcium in a 24 hour urine

85
Q

Other substances in the urine

A
  • Hormones
  • Vitamins
  • Medications
86
Q

Formed elements in the urine

A
  • Cells
  • Casts
  • Crystals
  • Mucus
  • Bacteria
87
Q

Some changes in urine specimen are caused by ____.

A

viable cells

88
Q

Specimens should be tested within ____.

89
Q

A specimen that cannot be delivered and tested within 2 hours should be ____.

A

refrigerated or have a chemical preservative added

90
Q

Most of the changes in the urine specimen are related to the ____.

A

presence and growth of bacteria

91
Q

Changes in Upreserved Urine

Analyte: Color
Change:

A

Modified/Darkened

Cause: Oxidation or Reduction of metabolites

92
Q

Why does the color of our urine darken overtime?

A

Due to the oxidation of Urobilinogen which turns into Urobilin (gives brown pigment)

93
Q

Which component is responsible for the brown pigment of urine?

94
Q

Color of urobilinogen

95
Q

Changes in Upreserved Urine

Analyte: Clarity
Change:

A

Decrease

Cause: Bacterial growth and precipitation of material

96
Q

Why does the clarity of a urine specimen decreases when left unpreserved?

A

Due to the growth of bacteria and precipitation of amorphous material

97
Q

If the specimen clarity decreases, what will happen to the turbidity?

98
Q

If the specimen clarity decreases, what will happen to the transparency?

99
Q

As the cells increase, the turbidity will ____.

A

also increase

100
Q

Changes in Upreserved Urine

Analyte: Odor
Change:

A

Increased ammonia smell (ammoniacal)

Cause: Breakdown of urea to ammonia via urease-producing bacteria

101
Q

What is the normal odor of urine?

A

Aromatic or Fragrance

102
Q

Why does the odor of a urine specimen increases when left unpreserved?

A

Due to the growth of urease-producing bacteria, which converts urea to ammonia

103
Q

A chlorine-like smell of urine can be a possible indication of ____.

A

in-born error

104
Q

Changes in Upreserved Urine

Analyte: pH
Change:

A

Increased (alkaline)

Cause: Breakdown of urea to ammonia via urease-producing bacteria +

loss of CO2

105
Q

Why does the pH of a urine specimen increases when left unpreserved?

A

Due to the growth of urease-producing bacteria, which converts urea to ammonia, and leads to the loss of CO2

106
Q

Changes in Upreserved Urine

Analyte: Glucose
Change:

A

Decreased

Cause: Glycolysis and bacterial use

107
Q

Why does the glucose of a urine specimen decreases when left unpreserved?

A

Due to glycolysis and bacterial use

108
Q

Changes in Upreserved Urine

Analyte: Ketones
Change:

A

Decreased

Cause: Votalization and bacterial metabolism

109
Q

Why does the ketones of a urine specimen decrease when left unpreserved?

A

Due to votalization and bacterial metabolism

110
Q

Ketones are a product of ____ metabolism.

111
Q

Changes in Upreserved Urine

Analyte: Bilirubin
Change:

A

Decreased

Cause: Exposure to light/photo oxidation to biliverdin

112
Q

Bilirubin came from ____.

A

Heme of hemoglobin (via hemolysis)

113
Q

Heme is converted in the ____ to become bilirubin.

114
Q

Bilirubin is converted in the intestine to become ____.

A

Urobilinogen

115
Q

____ is the only analyte that will NEVER become negative.

A

Urobilinogen

116
Q

Urobilinogen travels to the intestine via ____.

117
Q

Why does bilirubin increase in urine?

A

Because it is not converted into urobilinogen

118
Q

Why does bilirubin not convert to urobilinogen?

A

Because there might be a blockage or tumor in the bile duct

Iikot sa blood, pupunta sa kidneys, lalabas sa urine.

119
Q

Changes in Upreserved Urine

Analyte: Urobilinogen
Change:

A

Decreased

Cause: Oxidation to urobilin

120
Q

Changes in Upreserved Urine

Why does urobilinogen of a urine specimen decrease when left unpreserved?

A

Because it undergoes oxidation to urobilin

121
Q

Changes in Upreserved Urine

Analyte: Nitrite
Change:

A

Increased

Cause: Multiplication of nitrate-reducing bacteria

122
Q

Why does nitrite of a urine specimen increase when left unpreserved?

A

Due to the multiplication of nitrate-reducing bacteria

123
Q

A positive result in nitrite can indicate the possibility of ____.

124
Q

Changes in Upreserved Urine

Analyte: RBCs, WBCs and casts
Change:

A

Decreased

Cause: Disintegration/lyse due to alkalinity

125
Q

Why does RBCs, WBCs, and casts of a urine specimen decrease when left unpreserved?

A

Because they disintegrate or lyse due to the alkalinity of urine

126
Q

Changes in Upreserved Urine

Analyte: Bacteria
Change:

A

Increased

Cause: Multiplication

127
Q

Changes in Upreserved Urine

Analyte: Trichomonas
Change:

A

Decreased

Cause: Loss of motility, death

128
Q

The most routinely used method of preservation is ____.

A

Refrigeration

129
Q

Temperature for refrigeration to preserve specimen

130
Q

Why is refrigeration commonly used as a method of preservation?

A
  • Decreases bacterial growth
  • Stops bacterial metabolism (bacteriostatic)
131
Q

Is sterile container required for routine urinalysis?

A

No (as long as the container is clean)

132
Q

Sterile container is only used in ____.

A

Culture and Sensitivity

133
Q

How do we mix urine?

A

By swirling

134
Q

All body fluids are considered biohazardous except ____.

135
Q

Characteristics of an ideal urine container

A
  • Clean, dry, leak-proof, disposable
  • Screw-top lid
  • Wide mouth and flat bottom
  • Clear plastic
136
Q

Specimen label contents

A
  • Name
  • Age
  • Gender
  • Date and Time of Collection
137
Q

____ causes a yellow foam in the urine.

A

Phenazopyridine

138
Q

Additional information on the requisition form

A
  • Method of collection
  • Type of Specimen
  • Interfering medications
  • Patient’s clinical information
  • Time specimen is received
139
Q

Criteria for specimen rejection

A
  • Unlabeled containers
  • Non-matching labels and requisition form
  • Contaminated
  • Insufficient quantity (depends on the situation)
140
Q

The ____ tells about the amount of solute present in urine.

A

Specific Gravity

141
Q

Specific gravity of urine

A

1.003 - 1.035

142
Q

Specific gravity of distilled water

143
Q

Specific gravity of a patient with diabetes insipidus

144
Q

Normal pH of urine

145
Q

Normal temperature of urine

A

32.5 - 37.5

146
Q

Creatinine of urine

A

50x that of plasma

147
Q

Types of Urine Specimen Collection

Most commonly received specimen because of its ease of collection and convenience.

A

Random Urine

148
Q

Types of Urine Specimen Collection

May be collected at any time

A

Random Urine

149
Q

Types of Urine Specimen Collection

Useful for routine screening tests to detect obvious abnormalities

A

Random Urine

150
Q

Types of Urine Specimen Collection

May show erroneous results resulting from dietary intake and physical activity.

A

Random Urine

151
Q

Types of Urine Specimen Collection

Ideal screening specimen

A

First Morning Urine

152
Q

Types of Urine Specimen Collection

Prevents false-negative pregnancy tests and for evaluating orthostatic proteinuria

A

First Morning Urine

153
Q

Types of Urine Specimen Collection

Most concentrated (acidic) urine

A

First Morning Urine

154
Q

Types of Urine Specimen Collection

The second voided specimen after a period of fasting

A

Fasting Specimen (Second Morning Urine)

155
Q

Types of Urine Specimen Collection

The specimen will not contain any of the metabolites from food ingested before the beginning of the fasting period.

A

Fasting Specimen (Second Morning Urine)

156
Q

Types of Urine Specimen Collection

Recommended for glucose monitoring

A

Fasting Specimen (Second Morning Urine)

157
Q

Types of Urine Specimen Collection

Used for monitoring insulin resistance

A

Two-Hour Postprandial Specimen

158
Q

Types of Urine Specimen Collection

Collected 2 hours after eating

A

Two Hour Postprandial Specimen

159
Q

Types of Urine Specimen Collection

The urine is tested for glucose and ketones, and the results are reported along with the blood test results as an aid to interpreting the patient’s ability to metabolize a measured amount of glucose and are correlated with the renal threshold for glucose.

A

Glucose Tolerance Specimens

160
Q

Types of Urine Specimen Collection

Usually performed for pregnant women

A

Glucose Tolerance Specimens

161
Q

Types of Urine Specimen Collection

Used to quantitate amount of solute in urine

A

Timed Specimen: 24 hour

162
Q

Types of Urine Specimen Collection

Used for Addi’s count or to quantitate amount of formed elements in the urine

A

Timed Specimen: 12 hour

163
Q

Types of Urine Specimen Collection

Used for nitrite determination

A

Timed Specimen: 4 hour

164
Q

Types of Urine Specimen Collection

Used for urobilinogen

A

Timed Specimen: Afternoon urine (2-4 pm)

165
Q

When is the best time to collect an afternoon urine specimen?

166
Q

Types of Urine Specimen Collection

The most commonly requested specimen for culture and sensitivity

A

Catheterized Specimen

167
Q

Types of Urine Specimen Collection

Collected under sterile conditions by passing a hollow tube through the urethra into the bladder.

A

Catheterized Specimen

168
Q

2 Types of Catheterized Specimen

A
  • Urethral
  • Ureteral
169
Q

Determine which type of Catheterized Specimen

Collects urine specimen up to the urinary bladder

170
Q

Determine which type of Catheterized Specimen

Used to check if the patient has cystitis, UTI, etc.

171
Q

Determine which type of Catheterized Specimen

Collect urine specimen up to the ureter

172
Q

Determine which type of Catheterized Specimen

Used to check if the patient has pyelonephritis

173
Q

Determine which type of Catheterized Specimen

To locate whether the infection is on the left, right, or both kidneys.

174
Q

If the infection progressed up to the urethra and bladder, then it could lead to ____.

A
  • Lower UTI
  • Cystitis
175
Q

If the infection progressed up to the ureter and kidneys, then it could lead to ____.

A
  • Upper UTI
  • Pyelonephritis
176
Q

Types of Urine Specimen Collection

A safer, less traumatic method for obtaining urine for bacterial culture and routine urinalysis.

A

Midstream Clean-Catch Specimen

177
Q

Types of Urine Specimen Collection

The most invasive among all methods of urine specimen collection

A

Suprapubic Aspiration

178
Q

Types of Urine Specimen Collection

Introduction of a needle through the abdomen into the bladder.

A

Suprapubic Aspiration

179
Q

Types of Urine Specimen Collection

The most sterile method of urine specimen collection, guided by an ultrasound.

A

Suprapubic Aspiration

180
Q

Types of Urine Specimen Collection

Performed to check if there is infection in the prostate gland

A

Prostatitis Specimen

181
Q

Individuals who undergo drug testing are called ____.

182
Q

Volume of urine for drug specimen

A

30 - 45 mL

183
Q

The container for drug specimen is ____.

A

translucent

Analysis of Urine and Bodily Fluids (3 decks)

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