PRELIM-INTRO TO URINALYSIS Flashcards
The kidneys continuously form ___ as an ultrafiltrate of
plasma.
urine
HOW MANY ML OF PLASMA DOES KIDNEY FILTERED DAILY?
approximately 170,000 mL
out of the 170 000 ml of filtered plasma, how much urine output is being filtered out daily?
average daily urine output - 1200 ml
____, a metabolic waste product produced in the liver from
the breakdown of protein and amino acids
Urea
where is the urea produced?
in the liver
Urea, a metabolic waste product produced in the liver from
the breakdown of __ and ___
protein and amino acids
what component serves half of the total dissolved solids in the urine
urea
what is themajor inorganic solid dissolved in the urine
chloride, followed by the sodium and the potassium
the component we can test if it the specimen is really a urine
urea and creatinine
Because both
these substances are present in much higher concentra
tions in urine than in other body fluids, a high urea and
creatinine content can identify a fluid as urine
Primary organic component. Product
of protein and amino acid
metabolism
urea
Product of creatine metabolism by
muscles
creatinine
Product of nucleic acid breakdown in
food and cells
uric acid
Primary inorganic component. Found
in combination with sodium (table
salt) and many other inorganic
substances
chloride
Primarily from salt, varies by intake
SODIUM
Combined with chloride and other
salts
potassium
Combines with sodium to buffer the
blood
phosphate
Regulates blood and tissue fluid
acidity
ammonium
Combines with chloride, sulfate, and
phosphate
calcium
is a urine output of 600 to 2000 ml is still considered normal
yes
___, a decrease in urine output
Oliguria
values of oliguria in infants, children and adults
1 mL/kg/hr in infants
less than 0.5 mL/kg/hr in
children,
less than 400 mL/day in adults)
a cessation of urine flow/output
anuria
possible causes of anuria
serious damage in the kidney or the decrease in the flow of blood to the kidney
An increase in the nocturnal ex
cretion of urine is termed ___.
nocturia
a fluid lost in diabetes mellitus and diabetes insipidus is compensated by increase water intake known as
polydipsia
what is the first symptom of either dm and di
Polyuria accompa
nied by increased fluid intake (polydipsia)
the desired temperature for refrigeration
2 - 8 * celcius
what is the ideal preservative
bactericidal,
inhibit urease
preserve formed elements in the sediment
cause of color darkening
Oxidation or reduction of metabolites
cause of turbity in urine
Bacterial growth and precipitation of amorphous material
cause of odor turning ammoniacal or foul
Bacterial multiplication causing breakdown of urea to ammonia
causes of the increase of the urine’s ph
Breakdown of urea to ammonia by urease-producing bacteria/loss
of CO2
other reason why the glucose decreased in unpreservced urine
Glycolysis
cause of decrease amount of ketone in unpreserved urine
Volatilization and bacterial metabolism
cause of decrease amount of bilirubin in unpreserved urine
Exposure to light/photo oxidation to biliverdin
cause of decrease amount of urobilinogen in unpreserved urine
Oxidation to urobilin
unpreserved urine: nitrite
Multiplication of nitrate-reducing bacteria
converting nitrate to nitrite
unpreserved urine: decrease amount of rbc and wbc cells and casts
Disintegration in dilute alkaline urine
decrease amount of trichomonas in unpreserved urine
loss of motility and death
Specimens must be returned to room
temperature before chemical testing by reagent strips
because the enzyme reactions on the strips perform best
at room temperature.
true or false
true
When preserving samples that will be
transported to another laboratory, be sure to check with
that laboratory concerning the appropriate preservative.
true or false
true
This is the most commonly received specimen because of
its ease of collection and convenience for the patient.
random specimen
The ___ is useful for routine screening tests to detect obvious abnormalities
random specimen
. It is also essential for preventing false-negative pregnancy tests
first morning urine specimen
urine specimen for evaluating orthostatic proteinuria
first morning specimen
The ____ is a concentrated specimen, thereby assuring detection of chemicals and formed elements that may not be
present in a dilute random specimen.
first morning specimen
- The ideal screening specimen
first morning specimen
also known as 8hour specimen
first morning specimen
The second voided specimen after a period of fasting.
fasting specimen (second morning)
*This specimen will not contain any metabolites from food ingested before the
beginning of the fasting period.
fasting specimen (second morning)
urine specimen Recommended for glucose monitoring
fasting specimen
The patient is instructed to void shortly before consuming a routine meal and
to collect a specimen 2 hours after eating.
2 hour- Postprandial specimen
- Specimen is tested for glucose
- Results are used primarily for insulin therapy monitoring
2 hour- Postprandial specimen
*Collected correspond with blood samples drawn during glucose tolerance test (GTT)
GLUCOSE TOLERANCE SPECIMEN
*Urine is tested for glucose and ketones
The number of specimens
varies with the length of the test
glucose tolerance specimens
Specimen used for urine quantitative
assay.
24 hour (timed) specimen
The patient must begin and end the
collection period with empty bladder.
24 hour (timed) specimen
The most common error encountered
in 24 hour (timed) specimen is related to ___
improperly timed specimen collection
- Less traumatic method for obtaining urine
midstream clean catch specimen
for bacterial culture and routine urinalysis.
Midstream “clean catch” specimen
Used to avoid contamination (ex. Vaginal discharge)
Midstream “clean catch” specimen
a urine specimen which there’s an insertion of a sterile catheter
through urethra into the bladder.
Catheterized specimen
a urine specimen wherein the Urine flows directly from the
bladder through the indwelling
catheter and accumulates in a
plastic reservoir bag
Catheterized specimen
- Most often these specimen are sent
for bacterial culture.
Catheterized specimen
Involves collecting urine directly
from the bladder by puncturing
the abdominal wall and
distended bladder using needle
and syringe.
Suprapubic aspiration specimen
provides a sample for bacterial
culture that is completely free of
extraneous contamination.
Suprapubic aspiration specimen
The specimen can also be used
for cytologic examination.
Suprapubic aspiration specimen
Commercially available plastic urine collection bags with
hypoallergenic skin adhesive are used.
PEDIATRIC COLLECTION
The bag is placed over the penis in the male and around the
vagina (exluding the anus) in the female, and the adhesive is
firmly attached to the perineum.
PEDIATRIC COLLECTION
Also known as “three glass collection”
PROSTATITIS SPECIMEN
how many container does PROSTATITIS SPECIMEN need
4 containeri
indicate the containers for PROSTATITIS SPECIMEN and their uses
–1st container -> Urethral infection or inflammation
–2nd container -> urinary bladder infection
–3rd and 4th container -> Prostatic infection
* (+ WBC and 10x bacteria compared to 1st container)
provides this documentation of proper sample identification
from the time of collection to the receipt of laboratory results
- Chain of custody
is a standardized form that must document and
accompany every step of drug testing
chain of custody
urine required amount for drug testing
30-45 ml
advantage of refrigeration
- Acceptable for
routine U/A for 24
hours - Acceptable for urine
culture; inhibits
bacterial growth for
24 hours - INEXPENSIVE
disadvantage of refrigeration
- Precipitates
amorphous and/ or
crystalline solutes - Increases Specific
gravity
use of refrigeration
serves as a Storage before and
after testing
advantage of thymol as a preservative
- Preserves glucose
& sediment
elements (cast &
cell) - Inhibits bacterial
and yeast growth
disadvanatge of thymol as a preservative
Interferes with acid
precipitation test for
protein
use of thymol as a preservative
sediment preservation
advantage of formalin as a preservative
- Excellent cellular
preservative
disadvantage of formalin
- Act as reducing
agent, interfere with
urine chemical test
(glucose, blood,
leukocyte esterase
& copper reduction)
use of formalin
for cytology
advantage of sarccomano fixative
- Preserves cellular
elements
disadvabatge of sarccomano fixative
potential chemical hazard
use of sarccomano fixative
for cytology
advatage of concentrated hcl
A good preservative
for drug analyses
disadvatage of concentrated hcl
Unacceptable for
urinalysis testing
use of concentrated hcl
For quantitative
analysis
advatage of boric acid
- Preserves protein
- Does not interfere
with routine
analyses except pH
disadvatage of boric acid
- Interferes pH
determination
advatange of sodium carbonate
- Inexpensive
- Stabilizes
porphyrins,
porphobilinogen
disadvanateg of sodium carbonate
- Unacceptable for
urinalysis testing
use of sodium carbonate
Quantitative analysis
of porphyrins,
porphobilinogen
advanatage of sodium fluoride
- Prevents glycolysis
disadvanatge of sodium flouride
- Inhibits reagent
strip tests for
glucose, blood, and
leukocytesad
advantage of toluene
Does not
interfere with
routine tests
disadvantage of toluene
- Floats on
surface of
specimen and
clings to pipettes
advanatge of phenol
Does not
interfere with
routine tests
disadvatange of phenol
Causes an odor
change
urine temperature for drug testing
32.5 37.7 and measured within 4 minutes
a type of nephron that is Approximately 85%
» Responsible for removal of waste
products & reabsorption
Cortical nephron
a type nephron that is Primary function is concentration of the
urine
Juxtamedullary nephron (15%)
