Routine Urinalysis Flashcards by Gay Amor Tipolo Gacang

Q

3 types of urine examination

A

Macroscopic phase
Chemical phase
Microscopic phase

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Q

Recommended specimen

A

Midstream clean catch

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Q

If the urine cannot be delivered to the Laboratory within _____, it needs to be refrigerated

A

1-2 hours

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Q

Macroscopic phase includes:

A

Determination of
- urine color
- clarity
- specific gravity

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Q

The yellow colod of urine is caused by the presence of a pigment called

A

Urochrome

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Q

Who named urochrome in 1864

A

Thudichum

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Q

Is a product of endogenous metabolism, and under normal conditions, the body produces it at a constant rate

A

Urochrome

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Q

Refers to the transparency or turbidity of a urine specimen

A

Clarity

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Q

Urine clarity grading:

No visible particulates, transparent

A

Clear

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Q

Urine clarity grading:

Few particulates, print easily seen through urine

A

Hazy

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Q

Urine clarity grading:

Many particulates, print blurred through urine

A

Cloudy

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Q

Urine clarity grading:

Print cannot be seen through urine

A

Turbid

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Q

Urine clarity grading:

May precipitate or be clotted

A

Milky

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Q

Reagent strip principle and reading time:

Glucose

A

Double sequential enzyme reaction
30 sec

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Q

Reagent strip principle and reading time:

Bilirubin

A

Diazo reaction
30 sec

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Q

Reagent strip principle and reading time:

Ketones

A

Sodium nitroprusside reaction
40 sec

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Q

Reagent strip principle and reading time:

Specific gravity

A

pKa change of polyelectrolyte
45 sec

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Q

Reagent strip principle and reading time:

Blood

A

Pseudoperoxidase activity of hemoglobin
60 sec

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Q

Reagent strip principle and reading time:

pH

A

Double indicator system
60 sec

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Q

Reagent strip principle and reading time:

Protein

A

Protein error of indicators
60 sec

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Q

Reagent strip principle and reading time:

Nitrite

A

Greiss reaction
60 sec

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Q

Reagent strip principle and reading time:

Urobilinogen

A

Ehrlich’s reaction
60 seconds

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Q

Reagent strip principle and reading time:

Leukocyte esterase

A

Esterase reaction
120 sec

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Q

Contributes to the formed elements to the urine

A

Blood
Kidney
Lower genitourinary tract
External contamination

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Provides a point of reference in microscopic phase

Epithelial cell

Reporting urinary elements RFMOMA HPF

TTBYN - Trichomonas - Transitional EC - Bacteria - Yeast - Normal Crystals

Reporting urinary elements RFMOMA LPF

MuSECs - Mucus - Squamous Epithelial Cells

Reporting urinary elements RBC and WBC

Ave. Number per 10 HPF

RR of volume of urine

600-2000 mL/day

RR of pH

4.5-8.0

RR of specific gravity

1.002-1.035

RR of urobilinogen

3.2-3.6

Pink precipitate in urine color

Amorphous urates

White precipitate in urine

Amorphous phosphate

Green colored urine

Pseudomonas infection

Specific gravity: 1.010

Isothenuric

Specific gravity: >1.010

Hypersthenuric

Specific gravity: <1.010

Hyposthenuric

Renal glucose thereshold

160-180 mg/ dL

Urine contains

95% water and 5% solutes

Major organic compounds

Urea > Creatinine > Uric acid

Major inorganic compounds

Chloride > Sodium > Potassium

Caused by the pituitary gland in the brain. ADH (vasopressin is lacking)

Diabetes insipidus

Caused by the pancreas The islets of langerhans in the pancreas are not able to produce hormone to control blood glucose

Diabetes mellitus

Most routinely used for specimen preservation

Refrigeration

Temp for refrigeration

2-8 deg C

Name the preservative Does not interfere with Chemical test

Refrigeration

Name the preservative Preserves glucose and sediments

Thymol

Name the preservative Prevents bacterial growth

Boric Acid

Name the preservative Best preservative for Addis count and cells and casts

Formalin

Name the preservative Does not interfere with routine tests

Toluene

Name the preservative Best fixative for cytologic study

Sacommano’s fixative

Name the preservative Best for steroid and hormone analysis

Acids (Hypochloric acid and acetic acid)

Most common specimen and used for routine screening tests for abnormalities

Random specimen

Ideal screening (patient is in a basal state)

First morning specimen

Recommended for glucose monitoring

Fasting specimen

For analytes that exhibit diurnal variations

24 hour specimen

Most common test is bacterial culture

Catheterized specimens

Safer, less traumatic method for bacterial culture

Midstream clean catch specimen

Normal pigments in urine

Urobilin Urochrome Uroerythrin

Most common abnormal color of urine

Red

Best all-around preservative (Turgeon)

Toluene

Increased urine volume

Polyuria

Decreased urine volume

Oliguria

Complete cessation of urine flow

Anuria

Excretion of more than 500 mL of urine at night

Nocturia

Any increase in urine excretion

Diuresis

LABORATORY CORRELATIONS OF URINE COLOR: First morning specimen

Dark yellow to amber

LABORATORY CORRELATIONS OF URINE COLOR: Concentrated specimen: strenuous exercise, dehydration, fever, burns

Dark yellow to amber

LABORATORY CORRELATIONS OF URINE COLOR: Excessive urobilin, bilirubin, carotene

Dark yellow to amber

LABORATORY CORRELATIONS OF URINE COLOR: Bilirubin → (oxidized) → Biliverdin

Yellow-green Yellow-brown

LABORATORY CORRELATIONS OF URINE COLOR: Pseudomonas infection

Green

LABORATORY CORRELATIONS OF URINE COLOR: Porphyrins

Portwine

LABORATORY CORRELATIONS OF URINE COLOR: Homogentisic acid (alkaline urine): Alkaptonuria

Brown Black

LABORATORY CORRELATIONS OF URINE COLOR: Pyuria/leukocyturia (↑ WBCs)

Milky white

Normal night urine volume

<400 mL

COMMON CAUSES OF URINE ODOR Normal

AROMATIC

COMMON CAUSES OF URINE ODOR Bacterial decomposition, UTI

FOUL, AMMONIA-LIKE

COMMON CAUSES OF URINE ODOR Ketones (DM, starvation, vomiting)

FRUITY; SWEET

COMMON CAUSES OF URINE ODOR Maple syrup urine disease

MAPLE SYRUP

COMMON CAUSES OF URINE ODOR Phenylkentonuria

MOUSY

COMMON CAUSES OF URINE ODOR Tyrosinemia

RANCID

COMMON CAUSES OF URINE ODOR Isovaleric academia

SWEATY FEET

COMMON CAUSES OF URINE ODOR Methionine malabsorption

CABBAGE

COMMON CAUSES OF URINE ODOR Contamination

BLEACH

tablet test for Benidict’s

Clinitest

tablet test for Bilirubi

Ictotest

tablet test for Ketones

Acetest

Most common organisms that infect the Urinary Tract:

1. Proteus spp. 2. Klebsiella pneumonia 3. Pseudomonas aeruginosa

Source of interference due to its strong/reducing property leading to false negative results

ASCORBIC ACID

ASCORBIC ACID affects

(BBLENG) 1. Blood 2. Bilirubin 3. Leukocyte Esterase 4. Nitrite 5. Glucose

primary organic subs in urine

urea

primary inorganic subs in urine

chloride

straw-colored-dliuted; amber

concentrated