Laboratory PT2 Flashcards
What are the clinical reasons to perform urinalysis testing?
Indication of health Screening test Cost effective Non-invasive Simple to perform
What disorders can a screening UA test detect?
Renal disorder
Endocrine/Metabolic disorder
UTI
Systemic disease
What are the two methods of urine collection?
Non-instrumented
Instrumented
What are the non-instrumented collection methods?
First-morning void
Random
Clean catch
24-hour
What are the instrumented collection methods?
Urethral cath
Suprapubic Needle Aspiration
Catherization and Bladder Irrigation
Urine should be analyzed while fresh within how many hours?
1-2 hours
If urine can’t be analyzed in the first 2 hours, it must be refrigerated by what time frame?
3-6 hrs after collection
What decomposes urine?
Urea-splitting Bacteria
urea splittling bacteria produces ammonia that combines with hydrogen ions which increases what in urine?
pH
What does bacteria use as an energy source?
Glucose
What are the urine preservatives methods and chemicals?
Freezing Toluene Thymol CHloroform Formaldehyde Hydrogen Chloride Boric Acid Preservative tablet
What are the advantages and disadvantages of the freezing preservative?
A-for transpo/store, no cost, simple
D-May destroy formed elements
What are the advantages and disadvantages of the toluene preservative?
A-Preserves acetone, diacetic acid and proteins by floating on top making seal
D-Flammable, difficult to separate from specimen
What are the advantages and disadvantages of the thymol preservative?
A-inhibits bacteria/fungi
D-False positive for protein
What are the advantages and disadvantages of the Chloroform preservative?
A-Preserves urine aldosterone levels
D-Settles to bottom of containers
What are the advantages and disadvantages of the formaldehyde preservative?
A-Preserves urine sediment/cells
D-Interferes with gluclose evaluation
What are the advantages and disadvantages of the Hydrogen Chloride preservative?
A-Stabilize steriods
D- Hazardous liquid and fumes. Formed elements are destroyed
What are the advantages and disadvantages of the boric acid preservative?
A-preserves chemical and formed elements
D-Uric acid may precipitate
What are the advantages and disadvantages of the preservation tablet preservative?
A- Preserves urine for dipstick chemical analysis and sediment eval for transport
D-unsuitable for sodium, potassium and hormone analysis
What is the most concentrated UA method that shows an increase of abnormal elements, decreases deterioration of formed elements and is recommended for chemical and microscopic examination?
First-morning void
What UA collection method is collected anytime, most convenient and common?
Random
Which UA collection method is choice for bacterial cultures?
Clean catch
How is the clean catch method performed?
Genitalia cleaned with mild antiseptic solution
Collect urine midstream in a sterile container
Which UA collection method gives quantitative results and may require preservatives?
24-hour urine specimen
What type of urine collection method is used for marked obese patients and is used when there is no other way to get urine?
Urethral catheterization
Which urine collection method inserts a needle directly into a distended bladder for a single sample and is choice for infants and young children?
Suprapubic needle aspiration
What urine collection method includes vigorous transcatheter agitation of the bladder with 50-72ml of saline?
catheterization and bladder irrigation
Which urine collection yields optimum cellular sample of bladder epithelium?
Cath and bladder irrigation
What are the three urine sample analysis methods?
Physical
Chemical
Microscopic
What is included in the physical analysis of urine?
Volume Color Turbidity Odor Specific gravity
What is the normal and average volume of urine in 24 hrs?
600-2000ml
avg 1500ml
Urine output is directly related to what factors?
Intake
Temperature and climate
Amount of perspiration that occurs
What is the pigment concentration of urine that determines color called?
urochrome
Blue green urine has what diagnostic significance?
Methylene blue used as dye for diagnostic procedure
Dark orange urine has what diagnostic significance?
Use of Pyridium for UTI infection
Milky white urine has what diagnostic significance?
caused by chyle (fats and lymphs)
Olive green to brown black urine has what diagnostic significance?
Phenols
Yellow to brown, turns green w/ foam when shaken, urine has what diagnostic significance?
Bile
Red or red-brown urine has what diagnostic significance?
Blood
Normal urine has what turbidity?
Clear
What would sweet or fruity smell in urine indicate?
Ketones
What would a pungent smell in urine indicate?
ammonia produced by bacteria
What would a maple syrup smell in urine indicate?
maple syrup urine disease (congenital metabolic disorder)
What would a musty or mousy smell in urine indicate?
Infant with phenylketonuria
What would a smelly feet smell in urine indicate?
isovaleric acidemia, presence of butyric or hexanoic acid in urine
What is the specific gravity of a random urine collection?
1.003-1.035
What is the specific gravity of a 24-hour urine collection?
1.015-1.025
What chemical analysis chemicals or elements are normally present in urine?
Urobilinogen, 1 EU or less concentration
What is the threshold for glucosuria?
Will appear in urine when 160-180 mg/dL in blood is exceeded
What is the threshold for glucosuria?
Will appear in urine when 160-180 mg/dL in blood is exceeded
Glucose in urine could indicate what condition?
DM or conditions that cause hyperglycemia
Ketones in the urine are from what?
Incomplete fatty acid utilization
Ketosis, ketones in blood and urine, could indicate what condition(s)?
DM Starvation KETO diet Eclampsia Prolonged vomiting Diarrhea
Blood in urine is termed what?
Hematuria
Intact RBCs in urine may indicate what condition(s)?
Damage to kidney or urinary tract Renal disease -Glomerulonephritis -Malignant hypertension -PKD Menstrual contamination or exercise
What condition would result in appearance of bilirubin in urine?
Jaundice
Bilirubinuria indicates what condition(s)?
Hepatocellular disease
Intra or extra-hepatic biliary obstruction
Urobilinogen may be up to 1mg/dL in urine and could indicate what condition(s)?
liver disease
hemolytic disease
What is the normal and average pH range for urine?
4.6 - 8.0
6.0
Slightly acidic
What conditions may cause acidic urine?
Resp or metabolic acidosis UTI by E. coli Uremia Severe diarrhea Starvation
What conditions could cause alkaline urine?
UTI caused by Proteus or Pseudomonas species
Respiratory or metabolic akalosis
What is an important indication in the chemical analysis of urine to indicate renal disease?
Protein
Proteinuria mainly occurs by what two mechanisms?
Glomerular damage
Defect in the reabsorption process of tubules
What are the levels and their values of proteinuria?
minimal - <0.5g/day
moderate - 0.5-3.5 g/day
significant >3.5g/day
Nitrites are breakdowns of nitrates in urine caused by what?
E. coli that causes UTIs
Bacteriuria indicates what?
UTI
What is the chemical in urine that is an enzyme, and is released by neutrophils?
Leukocyte esterase (LE)
What is the most common clinical tool used for renal and nonrenal problems?
UA
UAs consists of what analysis?
Macro (apperance or physical)
Chemical (dip stick)
Micro (formed elements)
How much protein is usually excreted by adults per day?
10-100mg
What is the condition that is defined as excretion of >500mg/day of protein in urine?
Proteinuria
Persistant pH greater than 7 is assocatied with what?
calcium carbonate, calcium phosphate and magnesium ammonium phosphate stones
Persistent pH below 5.5 is associated with what?
Cystine and uric acid stones
What is a non-treponemal test for serologic detection of the antibody reagin?
Rapid Plasma Reagin
Reagin is produced in response to what?
Syphilis infection
Syphilis infections are caused by what?
Treponema pallidum
Reagin is found where?
in the serum/plasma
What is the carbon charcoal particle used to see results macroscopically on an RPR test called?
Vehicle or “antigen”
RPR is a ____________ test.
Screening
If flocculation is present on an RPR test it is what?
Reactive (positive)
