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AUBF > SAS 4 - Various Methods of Renal Studies & Urine Collection > Flashcards

SAS 4 - Various Methods of Renal Studies & Urine Collection Flashcards

1
Q

Describe urinalysis.

A
  • It is the quickest way to study kidney function and find out the hydration and metabolic states, renal disorders, proof of poisoning among others.
  • It requires properly collected sample
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2
Q

Benefits of Common Urine Laboratory Tests

Type of Test: Urine Chemistry (Reagent strip)

A

AIMS: (GluProHeLeuIn)

a. Glucosuria
b. Proteinuria
c. Hematuria
d. Leukocyturia
e. Infection

(3-1-1-1)
SCREEN DIAGNOSIS MONITOR PROGNOSIS
+++ + + +

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3
Q

Benefits of Common Urine Laboratory Tests

Type of Test: Wet Urinalysis (Routine)

A

AIMS: (DiaGluProHeLeuInCyCry)

a. Diabetes
b. Proteinuria
c. Hematuria
d. Leukocyturia
e. Infection
f. Cylindruria
g. Crystalluria

(4-2-2-1)
SCREEN DIAGNOSIS MONITOR PROGNOSIS
++++ ++ ++ +

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4
Q

Benefits of Common Urine Laboratory Tests

Type of Test: Urine Microbiology

A

AIMS:
a. Infections

(2-4-2-1)
SCREEN DIAGNOSIS MONITOR PROGNOSIS
++ ++++ ++ +

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5
Q

Benefits of Common Urine Laboratory Tests

Type of Test: Urine Cytology (conventional)

A

AIMS: (CaInVi)

a. Cancer
b. Inflammation
c. Viral Infections

(1-2-1)
SCREEN DIAGNOSIS MONITOR PROGNOSIS
+ ++ + -

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6
Q

Benefits of Common Urine Laboratory Tests

Type of Test: Cytodiagnostic Urinalysis

A

AIMS: (GloRenLuNoLi)

a. Glomerular and renal tubular disorders
b. LUT disorders
c. Nonbacterial infections
d. Lithiasis

(1-4-3-2)
SCREEN DIAGNOSIS MONITOR PROGNOSIS
+ ++++ +++ ++

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7
Q

Benefits of Common Urine Laboratory Tests

Type of Test: Image cytometry and DNA analysis

A

AIMS:

a. Urothelial Cancer

(1-2-3-3)
SCREEN DIAGNOSIS MONITOR PROGNOSIS
+ ++ +++ +++

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8
Q

Benefits of Common Urine Laboratory Tests

Type of Test: Flow Cytometry

A

AIMS:

a. Urothelial cancer

(0-1-3-2)
SCREEN DIAGNOSIS MONITOR PROGNOSIS
- + +++ ++

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9
Q

What are the different Urinalysis Microscope Techniques

A

(BriPhaPoDaFluIn)

a. Bright-field microscopy
b. Phase-contrast microscopy
c. Polarizing microscopy
d. Dark-field microscopy
e. Fluorescence Microscopy
f. Interference-contrast

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10
Q

State the function of each Urinalysis Microscopic Technique

A

a. Bright-field microscopy - used for ROUTINE ANALYSIS
b. Phase-contrast microscopy - enhances VISUALIZATION OF ELEMENTS WITH LOW REFRACTIVE INDEX, such as hyaline casts, mixed cellular casts, mucous threads, and Trichomonas
c. Polarizing microscopy - aids in IDENTIFICATION OF CHOLESTEROL in oval fat bodies, fatty casts, and crystals
d. Dark-field microscopy - aids in IDENTIFICATION OF TREPONEMA PALLIDUM
e. Fluorescence microscopy - allows VISUALIZATION OF NATURALLY FLUORESCENT MICROORGANISMS or those stained by fluorescent dye
f. Interference - contrast - produces a THREE-DIMENSIONAL MICROSCOPY-IMAGE and LAYER-BY-LAYER IMAGING of a specimen

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11
Q

Enumerate the different types of Urine Specimens.

A

a. Random
b. First Morning
c. Fasting (2nd morning)
d. 2-hour postprandial
e. Glucose tolerance test

f. 24-h (or timed)
g. Catheterized
h. Midstream clean-catch
i. Suprapubic aspiration
j. Three-glass collection

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12
Q

Type of Urine Specimen: Random

Purpose: ______________

A

Routine Screening

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13
Q

Type of Urine Specimen: First morning

Purpose: ______________

A
  • Routine screening
  • Pregnancy tests
  • Orthostatic protein
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14
Q

Type of Urine Specimen: Fasting (Second morning)

Purpose: ______________

A

Diabetic screening/monitoring

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15
Q

Type of Urine Specimen: 2-hour postprandial

Purpose: ______________

A

Diabetic Monitoring

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16
Q

Type of Urine Specimen: Glucose Tolerance Test

Purpose:

A

Optional with blood samples in glucose tolerance test

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17
Q

Type of Urine Specimen: 24-h (timed)

Purpose: ______________

A

Quantitative chemical tests

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18
Q

Type of Urine Specimen: Catheterized

Purpose: ______________

A

Bacterial Culture

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19
Q

Type of Urine Specimen: Midstream clean-catch

Purpose: _____________________________

A
  • Routine screening

- Bacterial culture

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20
Q

Type of Urine Specimen: Suprapubic aspiration

Purpose: _____________________________

A
  • Bladder urine for bacterial culture

- Cytology

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21
Q

Type of Urine Specimen: Three-glass collection

Purpose: _____________________________

A

Prostatic infection

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21
Q

Type of Urine Specimen: Three-glass collection

Purpose: _____________________________

A

Prostatic infection

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22
Q

Three categories in laboratory testing of urine

A

a. chemical
b. bacteriologic
c. microscopic examinations

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23
Q

Random specimen may be collected at what time?

A

At any time

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24
Q

Describe first-morning

A

Voided aliquot is optimal for constituent concentration, as it is usually the MOST CONCENTRATED and has a LOWER pH caused by DECREASED RESPIRATION during sleep.

25
Q

Random urine specimen should be collected in a ______________

A

chemically clean receptacle, either GLASS or PLASTIC

26
Q

What is the most desirable specimen for bacteriologic examination.

A

Clean-catch midstream specimen

27
Q

What is the proper collection for a clean-catch urine specimen?

A

Patient should clean the external genitalia with an ANTISEPTIC WIPE, the patient next begins URINATION, STOPS MIDSTREAM, and DISCARDS the first portion of urine, then collects the remaining urine in a STERILE CONTAINER

28
Q

The vessel of the specimen should be?

A
  • tightly sealed
  • labeled with patient’s name & date of collection
  • submit for analysis
29
Q

For midstream specimens, it can be used to remove an aliquot from the sterile collection container, which then can be transported to the laboratory

A

Urine transfer straw kit

30
Q

What does the system (BD Vacutainer) consists?

A

It consists of an ADAPTER that attaches to a YELLOW EVACUATED STERILE TUBE

31
Q

How does the Vacuum works?

A

The vacuum draws the urine into the STERILE TUBE

32
Q

How should you treat the adapter assembly?

A

The adapter assembly must be treated like a needle assembly system and be discarded into a biohazard container.

33
Q

Similar product available for cultures uses _______

A

a sterile, gray-top tube containing 6.7 mg/L of Boric Acid and 3.335 mg/L of sodium formate, along with the adapter device described previously (BD Vacutainer)

34
Q

Timed specimens are obtained at designated intervals. Starting from _________

A

“time zero”

35
Q

Collection that is most difficult to obtain and require patient cooperation.

A

Urine specimens for 24-hour total volume collection

35
Q

Collection that is most difficult to obtain and require patient cooperation.

A

Urine specimens for 24-hour total volume collection

36
Q

The most frequent problem.

A

Incomplete or too much collection

37
Q

It is usually supervised by nurses and generally is more reliable than outpatient collection.

A

In-hospital collection

38
Q

It requires special attention to avoid stool contamination.

A

Pediatric Collections

39
Q

How to avoid problems with collecting a 24-hour specimens?

A

By giving patients COMPLETE WRITTEN and VERBAL INSTRUCTIONS with a WARNING that the test can be INVALIDATED by INCORRECT COLLECTION TECHNIQUE.

40
Q

What is the preferred container?

A
  • unbreakable
  • measures 4 L
  • plastic
  • chemically clean
  • with correct preservative already added
41
Q

One should remind the patient to?

A
  • discard the first morning specimen
  • record the time
  • collect every subsequent voiding for the next 24 hours
42
Q

An easy approach is to ________________

A

remind the patient to START with an empty bladder and to END with an empty bladder.

43
Q

When does overcollection occurs?

A

when the first morning specimen is included in this routine

44
Q

Creatinine formation is based on ___________ ?

A

muscle mass

45
Q

This analyte is subject to diurnal variation, with the highest levels reached in the afternoon.

A

Urobilinogen

46
Q

At what time is urine collected when a quantification or urobilinogen is requested?

47
Q

Special urine collection techniques that may cause infection but is necessary in some patients (e.g. for urine collection when patient are UNABLE TO VOID or CONTROL MICTURITION)

A

Catheterization of the urethra and bladder

48
Q

It can also be inserted via a CYTOSCOPE into the ureter.

A

Ureteral Catheters

49
Q

These specimens are useful in differentiating bladder from kidney function or for differential ureteral analysis, ang may be obtained separately from each kidney pelvis (labeled left and right).

A

Ureteral urine specimens

50
Q

It is optimal for CYTOLOGIC EXAMINATION

A

First morning urine

51
Q

This is essential in maintaining the integrity of urine specimen

A

Preservation

51
Q

This is essential in maintaining the integrity of urine specimen

A

Preservation

52
Q

Unpreserved urine specimens are subject to?

A

MICROBIOLOGIC DECOMPOSITION and to inherent CHEMICAL CHANGES

53
Q

How to prevent the growth of microbes?

A

The specimen should be REFRIGERATED PROMPTLY after collection and, when necessary, should contain the INDICATED CHEMICAL PRESERVATIVE

54
Q

Best to do to maintain analytes when performing 24-hour urine collections.

A

Addition of a chemical preservative

55
Q

True of False: If a preservative is added to the empty collection bottle, particularly if ACID PRESERVATIVE are used, a WARNING LABEL is placed on the bottle.

56
Q

It adds a risk of potential chemical burns, where patients should be warned about this potential danger, and the container should be labeled accordingly.

A

Concentrated acid

57
Q

What should the clinicians do in cases of concentrated acid risks?

A

Clinician must ASSESS THE PATIENT’S RISK OF EXPOSURE to the preservative, therefore, REFRIGERATION may be more appropriate, and the PRESERVATIVE may be ADDED UPON SUBMISSION to the laboratory.

58
Q

They are protected in AMBER PLASTIC BOTTLES

A

Light-sensitive compounds, such as BILIRUBIN

59
Q

This occurs unless the urine is acidified adequately before analysis

A

Precipitation of calcium and phosphates

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