Test 4 Flashcards
Best specimen for urinalysis?
First morning specimen, it’s the most concentrated
Best for culture other than catheterized or suprapubic
Clean catch, midstream
List the types of urine specimens.
Random First morning Fasting 2hour prandial Clean catch mid stream Catheterized Suprapubic
Legal specimens, require chain of custody and have specific collection procedures
Drug screening
List the specific security procedures
No purses
Empty pockets
Water turned off
Pale yellow urine indicates?
Low specific gravity
Dark yellow urine indicates?
High specific gravity
Urochordata causes what?
Causes yellow color
Pink or red urine indicates
RBC’s or hemoglobin
Brown urine?
Myoglobin
Concentrated specimen would be most likely what color?
Dark yellow
Orange urine and yellow foam?
Bilirubin if yellow foam also, if no yellow foam then it could be a dye or contaminant
If you had dehydration or burns what color would your urine be?
Amber
If you had a pseudomonas infection your urine would be?
Green
List the types of urine clarities
Clear…. Normal
Hazy….. Can see news print through
Cloudy…… Milky
Turbid….. Can’t see through
Can be pathologic or non pathologic
Turbidity
Precipitation of amorphous unrated or phosphates or even carbonates, mucus,epithelial cells are all examples of what?
Non pathologic turbidity
RBC’s and WBC’s, bacteria, yeast, and crystals are examples of what?
Pathologic crystals
List three ways to measure urine.
Dipstick
Urinometer
Refracts ether
What reflects the tubular reabsorption ability of the kidneys?
Specific gravity
Density of urine is what?
Specific gravity
Dipstick gives you what type of measurement?
Rough
Uses a large amount of specimen, and must be corrected for temperature?
Urinometer
Reflected light, very precise measurement, and only uses one to two drops of pee
Refractometer
Constant specific gravity of ——- is abnormal?
1.010
List the ways to Handle and store dipsticks.
Room temperature storage Urine at room temperature Desiccant...... To remove moisture No volatile fumes Use before expiration date
Useful for identifying crystals and measures acidity and alkalinity of a specimen
pH
Urine is ——- most of the time?
Acidic
What’s the normal ph range for urine?
4.5 to 8.0
A pH of 9 would indicate what?
Proliferation of bacteria –urease breaking down of urea—- old specimen
What is the system we use to measure pH?
Double indicator system
What are the two stains we would use for a PH measurement?
Methyl red
Bro thymol blue
Protein in what is significant?
Absence of blood
Finding protein in urine can indicate what?
Normal overflow or renal damage
What are a few things that can cause proteinuria?
Exercise and dehydration
also from muscle injury and glomerular disorder
SSA detects how many types of proteins?
All of them
SSA has a dipstick specific for what?
Albumin
In multiple myeloma patients SSA detects what kind of proteins?
“Bence-Jones”
SulfosLicylic acid is a confirmatory test for what?
Protein
Glucose in urine when plasma levels exceed renal threshold (160-180mg/DSL) indicates what
Diabetes mellitus
T/F
There is a dipstick specific for glucose?
True
What uses glucose oxidase enzyme, per oxidase enzyme, and a chromgen?
Glucose dipstick
T/F
Glucose oxidase reacts with albumin to produce gluconic acid and peroxide
False— it reacts with glucose
T/F
Peroxide reacts with chromogen in presence of peroxidase to change the color
True
The clinitest is positive when?
With all reducing sugars
The clinitest detects what hereditary condition
Galactose
Galactose rica
Having galactose in the urine of a newborn represents what?
An inborn error of metabolism—- no breakdown of galactose….. Failure to thrive, death
In your clinitest cupric sulfate is converted to what?
Cuprous oxide
What color indicates positive, what colors indicate negative reactions in an clinitest?
Blue—positive
Yellow green red orange —– negative
Table sugar is not a what?
Reducing sugar
The clinitest detects what?
Galactose, fructose, lactose, maltose, ect.
A real high sugar can cause what in a clinitest?
It can cause it to turn back to a positive called a “pass through phenomenon “
List the tree ketones
Acetone
Acetoacetic acid
Beta-hydroxybutyric acid
What Is the test that is available for a beta-hydroxybutyric acid?
There is none
The dipstick for ketones is more sensitive for ——— than ————-.
Acetoacitic acid
Acetone
Ketones in urine from increased fat metabolism occur in?
Diabetic acidosis Starvation Strenuous exercise Vomiting Anorexia Inadequate insulin dosage
In diabetic acidosis we see what?
A real high glucose level
Ketones react with sodium nitroprusside to produce what color?
Purple
Acetest tablet has what added to help detect acetone in addition to acetoacedic acid
Glycine
Blood in the urine indicates what?
Positive for both RBC’s ( hematuria) and hemoglobin (hemeglobinuria)
When testing for blood on a dipstick what else could also react?
Myoglobin
Pseudo peroxidase method is used to measure what?
Amount of blood in urine
When measuring blood in the urine, hydrogen peroxide plus a chromogen in the presence of hemoglobin converts the chromogen to what color?
A green-blue color
When using the pseudoperoxidase method to measure blood in the urine hemoglobin acts like a ——– for the reaction
Enzyme
T/F
Ascorbic acid causes a positive reaction?
False…… It causes a false- negative
Bilirubin is what?
A breakdown product of hemoglobin from red cell destruction
Elevated Bilirubin levels in the urine can result from what?
Liver disease—–hepatitis, cirrhosis, liver cancer
Bile duct obstruction
Hemolytic diseases
Bilirubin is measured with what?
The ‘Diazo’ reaction
In the measurement process of bilirubin diazonium salt is converted to what?
Azodye
Bilirubin is broken down by what?
Sun light
In the measurement of bilirubin interference can come from what?
Pyridium
The Ictotest is a conformation test for what?
Bilirubin
The Ictotest is considered more sensitive than what?
A dipstick
The end product of hemoglobin to conjugated bilirubin is what?
Urobilinogen
Small amounts of what are always present in the plasma and urine?
Urobilingen
Urobilingen is ——- in liver disease and hemolytic diseases?
Elevated
“Enrich”more agent is used in what?
The measurement of urobilinogen
When usin the “ehrlich’s” reagent the color changes to rede in the presence of what?
Urobilinogen
What test is used to distinguish urobilinogen from porphobilinogen?
“Watson-Schwartz”
When looking for urobilinogen what else can cause a positive?
Porphobilinogen
Some gram positive bacteria will convert nitrate to ——-?
Nitrite
Most urinary tract infections come from?
Gram-negative, nitrite producing bacteria
A pink color is produced from the reduction of nitrate in what reaction?
“Greiss” reaction
Esterases come from ——- detected?
Leukocytes
An acid ester is catalyzedby esterases from leukocytes today react with a ——- to produce a purple color.
Chromogen (Diazo salt)
A leukocyte esterase indicates a what ?
The presence of leukocytes above the normal amount
What is an indicator of an infection?
Leukocytes
Polyelectrolyte releases what?
Hydrogen ions in proportion to the number of ions in the solution……… The more ions the higher the specific gravity
Hydrogen ions cause a color change of what indicator?
Bromthymol Blue indicator
which is a chromogen
