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Analysis of Urine and Body Fluids > PRELIM LEC: INTRODUCTION TO URINALYSIS > Flashcards

PRELIM LEC: INTRODUCTION TO URINALYSIS Flashcards

1
Q

Wrote a book on “uroscopy”

A

Hippocrates

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2
Q

– Urine Color charts had been developed
– Chemical testing progressed from “ant testing” and “taste testing” for glucose

A

1140 CE

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3
Q

Discover Albuminuria by boiling the urine

A

Frederik Dekkers (1694)

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4
Q
  • Published the book “Pisse Prophets”
A

Thomas Bryant (1627)

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5
Q

Thomas Bryant (1627)
* - Invention of the microscope
* - Led to the examination of urinary sediment

A

17 centuries

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6
Q

Developed the method for quantitating the microscope sediment

A

Thomas Addis

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7
Q

Introduced the concept of urinalysis as part of a doctor’s routine patient examination

A

Richard Bright (1827)

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8
Q

Began to disappear from routine examination.

A

1930s

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9
Q

2 unique characteristics of urine specimen

A
  • Urine is a readily available and easy collected specimen
  • Urine contains information, w/c can be obtained by inexpensive laboratory tests, about many of the body’s major metabolic functions.
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10
Q

Defines urinalysis as “the testing of urine with procedures commonly performed in an expeditious, reliable, accurate, safe, and cost effective manner.”

A

Clinical and Laboratory Standards Institute (CLSI)

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11
Q

Fountain of information

A

URINE

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12
Q

Liquid tissue biopsy of the urinary tract

A

URINE

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13
Q

Tests need to be carefully performed and properly controlled

A

URINE

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13
Q

Painlessly obtained (EASY)

A

URINE

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13
Q

Yields a great deal of information quickly and economically

A

URINE

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14
Q

The _______ continuously form ______as an ultrafiltrate of plasma.

A

kidneys; urine

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15
Q

Reabsorption of water and filtered substances essential to body function converts approximately ______of filtered plasma to the daily urine output of 1200 mL

A

170,000 mL

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16
Q

Urine consist of ____and other organic and inorganic chemicals dissolved in water

A

urea

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17
Q

Urine is normally _____ water and ______ solutes

A

95%; 5%

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18
Q

These solutes can occur owing to the influence of factors such as:

A

dietary intake, physical activity, body metabolism and endocrine functions

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19
Q

Other substances found in urine include:

A

hormones, vitamins and medications

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20
Q

May contain formed elements, such as:

A

cells, casts, crystals, mucus and
bacteria (increase amount is often
indicative of disease)

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21
Q

Diagnosis and management of renal or urinary tract diseases

A

EXAMINATION OF URINE

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22
Q

Detection of metabolic or systemic diseases not directly related to the kidney

A

EXAMINATION OF URINE

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23
Q

MEDICAL INFORMATION-physiologic and structural disorders of the kidney and the urinary
tract

A

EXAMINATION OF URINE

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24
Q

Elevated formed elements in urine may indicate?

A

disease

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25
Q

The normal odor of freshly voided urine is_____ due to volatile acids

A

faintly aromatic

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26
Q

is a major body constituent

A

Water

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27
Q

Factors that influence urine volume
include:

A

fluid intake, fluid loss from nonrenal sources, variations in the secretion of antidiuretic hormone and need to excrete dissolved solids

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28
Q

Main determinant of urine volume is

A

water

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29
Q

Normal range (24h) daily urine output is usually

A

600-2000mL

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30
Q

Average volume (24hrs)

A

1200-1500 mL

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31
Q

Maintain fluid in the body

A

Anti-diuretic hormone (vasopressin)

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32
Q

acceptable urine containers:

A

disposable containers should be used
clean/sterile
dry
leak-proof
screw-top lids
wide mouth
clear
50ml capacity

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33
Q

Bacteriologic examination is done first if

A

requested

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34
Q

Normal night urine volume:

A

<400 mL

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34
Q

Urine less than the standard volume requirement is acceptable only for following cases:

A

acute renal failure
pediatric patient
gastric patient

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35
Q

OLIGURIA CAN CAUSE

A

DEHYDRATION

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36
Q

POLYURIA CAN CAUSE

A

DIABETES INSIPIDUS
DIABETES MELLITUS
DIURETIC

37
Q

ANURIA CAN CAUSE

A

serious damage to the kidneys

38
Q

DEFECY IN PRODUCTION OR FUNCTION OF INSULIN

A

DIABETES MELLITUS

39
Q

DECREASED PRODUCTION OR FUNCTION OF ANTIDIURETIC HORMONE(ADH) / VASOPRESSIN

A

DIABETES INSIPIDUS

40
Q

SYNOVIAL FLUID NEEDLE ASPIRATION

A

arthrocentesis

41
Q

MOST COMMON USED METHOD OF PRESERVATION

A

REFRIGERATION AT 2C TO 8C

42
Q

DOES NOT INTERFERE WITH CHEMICAL TESTS AND PREVENTS BACTERIAL GROWTH FOR 24 HOURS

A

REFRIGERATION AT 2C TO 8C

43
Q

SPECIMEN MUST BE RETURNED TO ROOM TEMPERATURE BEFORE CHEMICAL TESTING BY REAGENT STRIPS

A

REFRIGERATION AT 2C TO 8C

44
Q

INTERFERES WITH DRUG AND HORMONE ANALYSES

A

BORIC ACID

45
Q

PREVENTS BACTERIAL GROWTH AND METABOLISM

A

BORIC ACID

46
Q

MAY BE USED FOR URINE TRANSPORT

A

BORIC ACID

47
Q

EXCELLENT SEDIMENT PRESERVATIVE

A

FORMALIN/FORMALDEHYDE

48
Q

REDUCING AGENT; INTERFERES WITH TESTS FOR GLUCOSE, BLOOD, LE AND COPPER REDUCTION

A

FORMALIN/FORMALDEHYDE

49
Q

GOOD PRESRVATIVE FOR DRUG ANALYSES

A

SODIUM FLUORIDE

50
Q

CHANGES IN UNPRESERVED URINE:
INCREASED ANALYTES (pBaON)

A

ph
bacteria
odor
nitrite

51
Q

breakdowns of urea to ammonia by urease, producing bacterial/loss of CO2

A

pH

52
Q

multiplication

A

BACTERIA

53
Q

bacterial multiplication causing breakdown of urea to ammonia

A

ODOR

54
Q

multiplication of nitrate, reducing bacteris

A

Nitrate

55
Q

CHANGES IN UNPRESERVED URINE:
DECREASED ANALYTES (BGC KURT)

A

Bilirubin (conjugated bilirubin)
Glucose
Clarity
Ketones
Urobilinogen
RBCs and WBCs
Trichomonas

56
Q

photo-oxidation

A

Bilirubin (conjugated bilirubin)

57
Q

glycolysis and bacterial use

A

Glucose

58
Q

bacterial growth and precipitation of amorphous materials

A

Clarity

59
Q

volatilization and bacterial metabolism

A

Ketones

60
Q

oxidation or urobilin

A

Urobilinogen

61
Q

disintegration to dilute alkaline

A

RBCs and WBCs

62
Q

loss of motility, death

A

Trichomonas

63
Q

pink precipitate (microscope)

A

amorphous urates

64
Q

white precipitate (microscope)

A

amorphous phosphate

65
Q

Normal day:night ration of urine output

A

2 to 3:1

66
Q

Container capacity of urinalysis

A

50 ml

67
Q

Required volume for urinalysis

A

10 to 15 ml

68
Q

Average volume of urinalysis

A

12 ml

69
Q

Increased specific gravity (due to increased glucose excretion)

A

DIABETES MELLITUS

70
Q

Decreased specific gravity (truly dilute urine)

A

DIABETES INSIPIDUS

71
Q

TYPES OF URINE SPECIMEN

A
  1. RANDOM SPECIMEN
  2. FIRST MORNING SPECIMEN
  3. FASTING SPECIMEN
  4. 2-HOUR POST PRANDIAL
  5. GLUCOSE TOLERANCE SPECIMENS
  6. 24- hour (or Timed) Specimen
  7. EARLY AFTERNOON SPECIMEN
  8. 12-HOUR URINE
  9. CATHETERIZED SPECIMEN
  10. MIDSTREAM-CLEAN CATCH SPECIMEN
  11. SUPRAPUBIC ASPIRATION
  12. PROSTATIS SPECIMEN
  13. PEDIATRIC SPECIMEN
  14. THREE-GLASS COLLECTION
  15. DRUG SPECIMEN COLLECTION
  16. FOUR-GLASS METHOD (STAMEY-MEARS TEST)
72
Q
  • This is the most commonly received specimen
  • It may be collected anytime but the actual time of voiding should be recorded on the container
  • It is use for ROUTINE SCREENING TEST
  • ease of collection and convenience patients
A

RANDOM SPECIMEN (occasional/single)

73
Q
  • also called as 8 hour specimen
  • prevents false-negative pregnancy test results
  • IDEAL SPECIMEN FOR ROUTINE URINALYSIS and Pregnancy Test
  • Most concentrated and acidic specimen
  • It is use for evaluation of orthostatic proteinuria
A

FIRST MORNING SPECIMEN

74
Q
  • second voided specimen after period of fasting
  • does not contain any metabolities
  • recommended for glucose monitoring
A

FASTING SPECIMEN

75
Q
  • collected shortly after consuming a routine meal and collecting again 2 hours after eating
  • for monitoring of insulin therapy
A

2-HOUR POST PRANDIAL

76
Q
  • collected to correspond with the blood samples drawn during an OGTT (Oral glucose tolerance tests)
  • The urine is tested for glucose and ketones
  • The results reported along with the blood test results
  • Correlated with renal threshold for glucose
  • FASTING URINE, 2-HOUR POSTPRANDIAL, GLUCOSE TELERANCE, FRACTIONAL SPECIMEN
  • These specimens is an INSTITUTIONAL OPTION
A

GLUCOSE TOLERANCE SPECIMENS

77
Q
  • for analytes that exhibit diurnal variation
  • patients must be instructed on the procedure
  • Begin and end the collection period with an EMPTY BLADDER
  • It should be refrigerated or keep on ice during the collection
  • It must be thoroughly mixed, and the volume accurately measured and recorded
  • 12-HOUR SPECIMEN, 4-HOUR SPECIMEN, AFTERNOON SPECIMEN (2PM-4PM)
  • Measuring the exact amount of a urine chemical (Quantitative Chemical Tests)
A

24- hour (or Timed) Specimen

78
Q
  • for urobilinogen determination
  • collected between 2pm to 4pm
  • this collection correlates with the ‘‘alkaline tide’’
A

EARLY AFTERNOON SPECIMEN

79
Q
  • for ADDIS count
  • quantitates formed elements using hemocytometer
A

12-HOUR URINE

80
Q

ADDIS NORMAL VALUE:

A

RBC: 0-500,000
WBC AND EPITHELIAL CELLS: 0-1,800,000
HYALINE CAST: 0-5000

81
Q
  • FOR BACTERIAL CULTURE
  • It is collected under sterile conditions by passing a hollow tube(catheter) through the urethra into the bladder.
  • also used to measure function of individual kidney
A

CATHETERIZED SPECIMEN

82
Q
  • FOR ROUTINE SCREENING AND BACTERIAL CULTURE
  • Alternative to the catheterized specimen
  • Provides a safer, less traumatic method
  • Provides a safer, less traumatic method
A

MIDSTREAM CLEAN-CATCH SPECIMEN

83
Q
  • collected by external introduction of needle through abdomen into bladder
  • FOR BACTERIAL CULTURE AND URINE CYTOLOGY
  • Provides a sample that is free of extraneous contamination
A

SUPRAPUBIC ASPIRATION

84
Q
  • aka THREE-GLASS COLLECTION
  • for prostatic infection determination
  • quantitative
A

PROSTATIS SPECIMEN

85
Q
  • should be collected in soft, clear plastic bags with hypoallergic skin adhesive to attach to the genital area
A

PEDIATRIC SPECIMEN

86
Q
  • for drug testing
A

DRUG SPECIMEN COLLECTION

87
Q

Process that provides documentation of proper sample identification from time of collection to the receipt of the laboratory

A

CHAIN OF CUSTODY (COC)

88
Q

Required urine volume for DRUG SPECIMEN COLLECTION

A

30-45 ml

89
Q

urine container capacity for DRUG SPECIMEN COLLECTION

A

60 ml

90
Q

Temperature (with in 4 min) for DRUG SPECIMEN COLLECTION

A

32.5- 37.7 °C

91
Q

is added to the toilet water
reservoir to prevent specimen adulteration

A

Bluing Agent (dye)

92
Q
  • also used for testing for prostatitis
  • same procedure as the three-glass method, with the addition of expressed prostatic secretions (EPS) prior container 3
A

FOUR-GLASS METHOD (STAMLEY-MEARS TEST)

Analysis of Urine and Body Fluids (5 decks)

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