UA physical and chemistry Flashcards
24 urine collection
Timed specimen
Urine Volume
Normal daily output - __________
Polyuria - ___________________
Anuria -____________________
Oliguria - ___________________
Nocturia- ___________________
Normal daily output - 600-2000 mL
Polyuria- > 2500 ml
Anuria. - No urine output
Oliguria - <. 400 mL/day
Nocturia- Increased in nocturnal excretion of urine
Random specimen
First morning specimen
Catheterized specimen
Single collection specimen
This is caused by a defect either in pancreatic production of insulin or in the function of insulin.
Diabetes mellitus
This is caused from a decreased in production or function of antidiuretic hormone.
Diabetes insipidus
The kidneys do not reabsorb an excessive glucose concentration in the body, necessitating excretion of increased water to remove dissolved glucose. In this situation urine sample of the patient will appear as: _________________
Diluted urine sample with a high specific gravity
The water necessary for adequate body hydration is not reabsorbed from the plasma filtrate due to ADH def. will make urine sample appear as:
Diluted urine sample with low specific gravity
Once specimen collected, it should be delivered to the lab and tested in ________________.
2 hrs.
Urine specimen best preserved at __________ temp.
2-8 C
Urine specimens are bring to the room temp prior to testing due to ______________.
The enzyme reactions on the chem strips perform best at room temp.
24 hrs urine collection is most useful in __________________ testing.
Quantitative chemical tests
The first morning urine collection is most useful in _______________________ conditions.
Routine screening
Pregnancy
Orthostatic protein
The first morning specimen are more concentrated.
The urine sample collected by catheterized, midstream clean catch or suprapubic aspiration are most useful in ________________.
Bacterial culture
______ and ______ tests will determine whether the fluid received in the lab is urine.
Urea and creatinine
The changes occur in the unpreserved urine specimen:
Clarity _____________-
Odor ______________
pH ________________
Bact. and nitrite ________________
Glucose, ketone , bilirubin and urobilinogen ___________________
Clarity - decreased
Odor - increased
pH - increased
Bact. and nitrite- increased
Glucose, ketone , bilirubin and urobilinogen - decreased
Urine Color
Red and cloudy ________________
Red and clear __________________
Green __________________________
Black ___________________________
Red and cloudy - Hematuria/RBCS
Red and clear- hemoglobin
Green- Pseudomonas infection
Black- malignancy, melanoma,
A thick turbidity caused by amorphous phosphates and carbonates produce ___________, and amorphous urates produces a ____________ .
A thick turbidity caused by amorphous phosphates and carbonates produce white precipitates , and amorphous urates produces a pink brick dust .
Urine Odor
Ammonia like odor is due to ___________
Fruity sweet _______________
Bleach _________________________
Mousy _________________________
Ammonia like odor is due to ___bacterial contamination
Fruity sweet ___ diabetes
Bleach ___ contamination
Mousy __ phenylketonuria
Urine collected in a non sterile container can produce ___________ pH.
Alkaline pH if alkaline detergent remains in the container.
_____________ is the major serum protein found in the normal urine.
Albumin, due to its low molecular weight.
The Bence Jones protein present in the urine is suspected in the ____________ condition.
Multiple myeloma
A benign proteinuria is observed after a period in the vertical position and resolves when a horizontal position is assumed.
Orthostatic Proteinuria
The reagent strip testing for protein uses the principle of the _________________.
protein errors of indicators, protein (albumin) present in the urine accepts hydrogen from the indicator.
The ________________ test is a cold precipitation test that reacts with all forms of protein.
sulfosalicylic acid test (SSA)
Due to reagent strips detecting albumin, would pre-renal proteinuria discovered in a routine urinalysis?
No, pre-renal proteinuria caused by increased low molecular weight plasma proteins includes hemoglobin, myoglobin, acute phase reactants and therefore not discovered in routine urinalysis.
The blood glucose level of ____________ at which tubular reabsorption capacity stops (renal threshold).
160-180 mg/dL
A patient with a normal blood glucose and positive glucose in the urine (glycosuria) is indicative of ________.
Renal disease, renal tubules is compromised.
The principle of the reagent strip test for glucose is ___________________.
Glucose oxidase reaction
The main purpose of conducting a clinitest is ____________.
In addition to glucose it check for reducing sugars of which galactose is the most clinically significant (newborn galactosuria).
What is “inborn error of metabolism’?
Deficiency of enzyme galactose-1-phosphate uridyl transferase which prevents breakdown of galactose leads to complication including failure to thrive, and death.
The three intermediate products of fat metabolism include:
Acetone, acetoacetic acid and B-hydroxybutyrate
Clinical significance of positive ketones on the urine:
Diabetes mullitus, vomiting, starvation etc.
The reagent test strips uses ________ to measure ketones.
Sodium nitroprusside reaction.
In this reaction, acetoacetic acid reacts with sodium nitroprusside and produce purple color. It does not react with B-hydroxybutyrate and little sensitive to acetone.
The confirmatory test for ketones?
Ace test
The clinical significance of positive reagent test strip test for blood:
Indicative of presence of red cells, hemoglobin or myoglobin in the urine.
Positive bilirubin is indicative of _______________
Bile duct obstruction and liver damage (hepatitis, and cirrhosis)
Positive bilirubin and urobilinogen are indicative of ______________
Liver disease
The reagent test strip for bilirubin uses ______________.
Diazzo reaction
A confirmatory test for urine bilirubin _________________-
Ictotest
Why there is a small amount of urobilinogen is present in the urine (less than 1 mg/dL)?
Urobilinogen from the intestine is recirculates to the liver, it passes thru the kidney and filtered by the glomerulus. Therefore a small amount is found normally in the urine.
An increased urine urobilinogen is seen in :
liver disease and hemolytic disorders.
An absence of urobilinogen in the urine and feces represents:
bile duct obstruction that prevents the normal passage of bilirubin into the intestine.
False negative nitrite reading can be caused by:
Gram positive bacteria (reductase is only found in gram negative bacteria).
Heavy bacterial infection (further reduction of nitrite to nitrogen).
Random urine specimen
Clinical significance of urine nitrite test:
UTI
The leukocyte esterase test detects_______________.
Detects the presence of esterase in the granulocytes WBCs, monocytes, histiocytes and trichomonas.
Measurement of SG provides information regarding a patient ____________________________________________________.
Hydration or dehydration status.
Used to determine loss of renal tubular concentration ability.
Terms:
SG of UA 1.010-
SG of UA < 1.010-
SG of UA > 1.1-
SG of UA 1.010- isothenuric
SG of UA < 1.010- hyposthenuric
SG of UA > 1.1- hypersthenuric
For urine SG, when using refractometers or urinometers, it is necessary to subtract ________________________ and subtract ________________________ to correct the value.
subtract 0.003 for every 1 g/dl of protein
subtract 0.004 for every 1 g/dl of glucose
