Module 10

Question 1

What is routine urinalysis and the procedures commonly performed?

Answer 1

Testing of urine.

Macroscopic evaluation.

Physical measurements.

Chemical reagent strip testing.

Microscopic evaluation.

Question 2

What should urinalysis reqs have?

Answer 2

Patient name

Date of birth

Patient location

ID number

Accession number

Physician

Diagnosis or major symptoms

Question 3

Urinalysis reqs are designed to include what?

Answer 3

Specimen type

Date and time the collection is required

Actual date and time of collection

Whether the sample was refrigerated

Time the specimen was received

Question 4

What specific situations should be noted on the req?

Answer 4

Preservatives

Medications

Menstruation

Strenuous exercise prior

Other clinical info

Question 5

What are the characteristics of a proper urine container?

Answer 5

Leakproof, clean, clear disposable material

Inert material

Sterile for micro or if >2hrs before analysis

50-100mL

Question 6

What kind of collection methods for urinalysis are there?

Answer 6

Routine/regular void

Midstream urine/clean catch

Catheter specimens

Suprapubic aspiration

Paediatric

Question 7

What is the purpose of random urine collection?

Answer 7

General screen for physical health.

Several hours of urinary continence is desirable.

Conditions may be missed because the urine isn’t concentrated enough.

Question 8

What is a UBAG and when is it used?

Answer 8

Bag for collection

Used with young patients

12mL must be collected

Question 9

What is a first morning/8hr urine? What is it used for?

Answer 9

The most concentrated specimen, more likely to contain abnormal specimens.

Pregnancy testing

Cytology (increased number of epithelial cells)

Question 10

When are specimens to confirm orthostatic proteinuria collected?

Answer 10

After 8hrs lying down

Question 11

What are timed specimens?

Answer 11

Collected at specific times in the 24hr period or at a specific time in relation to another activity.

Question 12

What collections may require supervision?

Answer 12

Midstream/clean catch

Specimen for microbiological culture

Paediatric

Question 13

What is the purpose of MSU/clean catch?

Answer 13

Used for for routine microbiological culture and sensitivity.

Avoids sources of external bacteriological contamination.

Question 14

What are the types of assisted collections?

Answer 14

Catheter- collected directly from the bladder, collect from outflow line

Suprapubic- collected directly from bladder by puncturing the abdominal wall by the physician, uncontaminated specimen

Question 15

How are specimens stored prior to testing?

Answer 15

If not tested within 2hrs, should be refrigerated.

Refrigeration may ppt some crystals.

Room temperature for analysis.

Aliquoting may be required.

Question 16

What may happen if urine is allowed to stand?

Answer 16

Bacteria can destroy glucose.

pH changes can occur.

Question 17

What compounds is refrigeration not adequate for?

Answer 17

Bilirubin and urobilinogen.

They are unstable.

Question 18

How can microbiology specimens be handled?

Answer 18

Refrigerated until culture.

Aliquoted with bacteriostatic preservative.

Inoculated to a dip slide.

Question 19

What are specimens inspected for once they’re received?

Answer 19

Proper labelling

Elapsed time between collection and receipt

Refrigeration or the presence of preservative

Container suitability/condition

Adequate volume

Absence of contaminants

Chemical preservative consistent with intended specimen use

Question 20

What information does QA ensure is documented?

Answer 20

Specimen type is correct

Labels are correct

Collection techniques are correct

Containers are suitable

Volume is adequate

Transportation is timely

Inspection after arrival

Storage is correct

Question 21

What is a 24hr urine? What is it used for?

Answer 21

Total volume of urine voided in a 24hr period.

Many substances exhibit circadian/diurnal variation.

Used to evaluate renal clearance, hormone levels, glucose loss.

Question 22

How are 24hr urine samples preserved?

Answer 22

Preservative depends on substance to be analyzed.

Minimizes oxidation and bacterial growth.

Acidic or alkaline conditions may be required.

Organic solvents (toluene)- protects the specimen from oxidation

HCl- 5-HIAA

Question 23

What is required on the 24hr urine label?

Answer 23

WHMIS label for preservative.

Question 24

How is a 24hr urine collected?

Answer 24

Discard first sample and note time.

Collect all voids for 24hrs.

Do not rinse or discard.

Question 25

What diet restrictions are there for 24hr urine collections?

Answer 25

24hr catecholamine/metanephrine- withdraw from meds for 72-96hrs prior and during

24hr uric acid- 3 days prior eat one meat serving/day, avoid alcohol, aspirin, aceytlsalicylic acid, phenylbutazone, liver, kidney, sweet breads, heart, herring, sardines, anchovies and caviar

24hr serotonin (5-HIAA)- abstain from bananas, avocados, plums, eggplants, tomatoes, cough syrup, other meds for 72-96hrs

Question 26

How are urine collections completed?

Answer 26

Record total volume (cylinder or weight)

Determine pH

Determine the number of aliquoted required

Question 27

How are samples weighed?

Answer 27

Assume 1mL of water weighs 1g.

Use specific gravity (weight divided by specific gravity).

Minus container weight.

Question 28

What are aliquot containers labelled with for urine?

Answer 28

Patient name

ID number

Accession number

Volume of 24hr sample

pH

Test requested

Question 29

How are aliquots pH adjusted?

Answer 29

If collected without preservative.

Add preservative until pH is in a specific range.

Question 30

How are samples disposed of?

Answer 30

Flush down designated sink with water.

Containers in biohazard.

Question 31

What is the purpose of urinalysis?

Answer 31

Aids in disease diagnosis.

Screens population for asymptomatic, congenital or hereditary diseases.

Monitors the progress of disease.

Monitors the effectiveness or complications of therapy.