Introduction to Urinalysis Flashcards
_____ was actually the beginning of lab medicine
Analyzing Urine
References to the study of urine can be found in the drawings of cavemen and in ______
Egyptian Hieroglyphics
Who wrote the book about Egyptian Hieroglyphics to and what is it’s title?
Edwin Smith / Surgical Papyrus
Pictures of Early Physicians commonly showed them examining what?
Bladder Shaped Flask
6 Physical Characteristics of Urine
- Color
- Clarity
- Odor
- Volume
- pH
- Specific Gravity
Who is the Father of Medicine and wrote the book on Uroscopy?
Hippocrates
When did Hippocrates wrote the book on Uroscopy?
5th Century
When and What had been developed that described the significance of 20 different colors?
1140 AD / Color Charts
2 Old chemical tests for glucose?
- Ant Testing
- Taste Testing
How did Frederik Dekker discover albuminuria?
By boiling urine
When and who discovered Albuminuria by boiling urine?
1694 / Frederik Dekkers
What do you call the charlatans that provides false information?
Pisse Prophets
The Pisse Prophets became the subject of the book published by whom and when?
Thomas Bryant / 1627
What was invented in the 17th Century?
Microscope
Who discovered the methods for quantitating the microscope sediments?
Thomas Addis
When and who implemented the concept of urinalysis as a part of doctor’s routine examination?
1827 / Richard Bright
When did Urinalysis began to disappear from routine examinations?
1930s
The ____ is the only organ with such noninvasive means by which to directly evaluate its status.
Kidney
Urine is an _____ of Plasma
Ultrafiltrate
According to CLSI, Urinalysis is commonly performed in an….. (5)
- Expeditious
- Reliable
- Accurate
- Safe
- Cost Effective
Reasons for performing Urinalysis (4)
- Aids Diagnosis of Disease
- Screening asymptomatic populations for undetected disorders
- Monitor Progress of Disease
- Monitor Effectiveness of Theraphy
2 Essential to Body Function
- Reabsorption of Water
- Filtered Substances
Average daily output of urine?
1200 mL
4 Main components Of Urinary System
- Kidney
- Ureters
- Bladder
- Urethra
This is where urine is formed by filtration of blood
Kidney
Carries the urine to the bladder
Ureters
Stores the urine produced
Bladder
Delivers the urine for Excretion
Urethra
3 Internal Structure of the Kidney
- Cortex
- Medulla
- Renal Pelvis
The outer layer of the kidney and it is located just below the Renal Capsule
Cortex
Regions of the Cortex
Renal Columns
Innermost part of the kidney
Medulla
The renal medulla is split up into a number of sections, known as?
Renal Pyramids
Funnel-like dilated part of the ureter in the kidney
Renal Pelvis
The functional unit of the kidney?
Nephron
Approximately how many nephron in each kidney?
1 - 1.5 million
2 Types of Nephron
- Cortical
- Juxtamedullary
Approximately how many percent is the Cortical Nephron?
85%
Approximately how many percent is the Juxtamedullary Nephron?
15%
Responsible for the removal of waste products and Reabsorption
Cortical Nephron
it’s primary function is the concentration of urine
Juxtamedullary Nephron
9 Parts of Nephron
- Glomerulus
- Bowman’s Capsule
- PCT
- Loop of Henle
- DCT
- Afferent Arteriole
- Efferent Arteriole
- Peritubular Capillaries
- Vasa Recta
Glomerulus is also known as?
Renal Corpuscle
Glomerulus consists of how many capillary lobes which is also called?
8 / Capillary Tuft
Where is the point of entry for Unfiltered blood?
Afferent Arteriole
Point of Exit for Filtered Blood?
Efferent Arteriole
This surrounds the PCT and DCT?
Peritubular Capillaries
It is located adjacent to the A/D Loop of henle
Vasa Recta
It is responsible for the salt concentration
Vasa Recta
Urine composition (2)
- 95% Water
- 5% Solutes
4 Organic Components of Urine
- Urea
- Creatinine
- Uric Acid
- Hippuric Acid
Major organic component
Urea
Urea is a product of ____ and _____
Protein / Amino Acid Metabolites
Creatinine is a product of _____ by _____
Creatinine metabolism / Muscles
Common component in kidney stones
Uric Acid
Uric Acid is derived from ________
Catabolism of Nucleic Acid
Inorganic Components of Urine (7)
- Cl
- Na
- K
- Sulfate
- Phosphate
- Ammonium
- Ca
Primary Inorganic Component
Chloride
This is primarily from salt
Sodium
Potassium can be combined with?
Chloride
This is derived from amino acids
Sulfate
Combines with Sodium to buffer blood
Phosphate
This regulates blood and tissue fluid acidity
Ammonia
Calcium combines with ___, _____ and ______
- Chloride
- Sulfate
- Phosphate
The single most useful substance that identifies a fluid as urine is?
High Creatinine Concentration (50x of Plasma)
3 other concentrations of that are higher in urine than other body fluids
- Urea
- Sodium
- Chloride
Normal Daily Urine output range is?
1200 - 1500 ml
A decrease in urine output
Oliguria
Urine volume considered as Oliguria for infants?
<1ml/kg/hr
Urine volume considered as Oliguria for children and adults?
<0.5ml/kg/hr & <400ml/day
Cessation of Urine Flow
Anuria
Increase nocturnal Excretory of urine
Nocturia
Increase in daily urine volume
Polyuria
urine volume considered as Polyuria for adult?
> 2.5 L / Day
Urine volume considered as Polyuria for children
> 2.5-3 mL/kg/day
Polyuria is associated with what diseases? (2)
- Diabetes Mellitus
- Diabetes Insipidus
Polyuria is artificially induced by? (3)
- Diuretics
- Caffeine
- Alcohol
Dilute Urine with High SG
DM
Dilute Urine with low SG
DI
Caused by defect in production of insulin
DM
Decrease in production of ADH
DI
Exceed Renal Threshold for glucose
DM
Water is not reabsorbed from plasma filtrate
DI
Urine container for Pediatrics
Wee Bag
Routine Urinalysis requires how many mL of Urine?
10-15 mL
Specimens should be tested within?
2 Hours
6 types of specimen
- First Morning Specimen
- Random Specimen
- Fasting Specimen
- 2-Hour PostPrandial Specimen
- GT Specimen
- 24 Hour Specimen
First Morning is also known as?
8 Hour Specimen
Ideal Screening Specimen
First Morning Specimen
It is a concentrated specimen and is essential for preventing false-negative pregnancy
8 Hour Specimen
First morning specimen is for the evaluation of what disease?
Orthostatic Proteinuria
Satisfactory for routine screening
Random Specimen
Capable of detecting abnormalities
Random Specimen
Fasting Specimen is also known as?
Second Morning
To collect specimen 2 hours after eating
2 Hour post prandial
Results of 2 Hour post prandial specimen are used primarily for?
Insulin Therapy Monitoring
Urine is tested for Glucose and Ketones
Glucose Tolerance Specimen
Specimen used for Quantitative Assay
24 Hour Specimen
Less traumatic method for obtaining urine
Midstream Clean Catch Specimen
Midstream clean catch Specimen is used for? (2)
- Bacterial Cultures
- Routine Urinalysis
Insertion of a sterile catheter through urethra
Catheterized Specimen
Involves collecting urine directly from bladder
Suprapubic Aspiration Specimen
Specimen used for cytologic examination
Suprapubic Examination
Prostatitis Specimen is also known as?
Three Glass Collection
Order of Containers and contents in Prostatitis Specimen
- First Passed Urine
- Midstream Portion
- Urine with Prostatic Fluid
- Post Prostatic Massage Urine
1st Container for Prostatitis Specimen Detects?
Urethral Infection or Inflammation
2nd Container for Prostatitis Specimen Detects?
Urinary Bladder Infection
3rd and 4th container for prostatitis Specimen detects?
Prostatic Infection
Provides documentation of proper sample identification for drug testing
Chain of Custody
Volume required for drug testing
30-45 ml
Urine temperature for drug testing must be checked within?
4 mins (32.5-37.7°c)
Most Routinely used method of preservation is?
Refrigeration
Refrigeration preservation is at what degrees celsius?
2-8
Criteria for Ideal Preservative (4)
- Bactericidal
- Inhibit Urease
- Preserves Formed Elements
- Must not interfere with the chem tests