UA/POC Flashcards
components of UA
color, clarity, odor
testing pH, glucose, protein, blood, ketones, bilirubin, urobilinogen, specific gravity
cells, crystals, casts, bacteria, yeast
types of UA
midstream clean catch (routine)
catheterized (sterile)
24 hour (assess kidney function + protein)
“clean catch” for
suspected infections-
wipe front to back, side to side, new wipe to clean midline
dirty and clean
first sample w/o cleaning, second w/ cleaning
Cr range
.6-.2
AST/SGOT range
10-30
ALT/SPGT
10-40
Na
135-145
WBC
4.5-11x10^3
K
3.5-5.5
total bili
.2-1
HDL
> 45m, >55f
normal pH range
4.5-8
acidic urine can be seen in
starvation, dehydration, metabolic acidosis
alkaline urine can be seen in
UTIS
specific gravity measures
urine conc
1.005-1.030
low=kidney disease/overhydration
high=dehydration, glucose, protein
normal nitrite
negative
what are we testing for with nitrite
bacteuria, bacteria in urine
positive nitrite but negative leukocytes
look for STD
indicator for UTI
leukocyte esterase
negative result of leukocytes does NOT rule out significant
bacteriuria, esp end of day after many urinations
mild positive can be from improper technique
What can glucose in the urine indicate?
DM, stress, renal tubular dysfunction
what can protein in the urine indicate?
kidney disease
What can ketones in the urine indicate?
DKA, starvation, high protein diet
trace = 5
small = 15
moderate = 40
large = 80-160
blood in urine can mean
hematuria (UTI, stones, trauma) or hemoglobinuria
bilirubin in urine means
liver dysfunction or bile duct obstruction
increased urobilinogen in urine means
liver disease, hemolysis, intestinal issues
what can more than >0-5 RBCs in urine mean?
hematuria, glomerulonephritis, trauma, stones
What can more than 0-5 WBCs in urine mean?
infections
what can epithelial cells in urine mean?
contamination or kidney injury
types of casts in urine
hyaline
RBC
WBC
granular
help diagnose glomerular or tubular disease!
RBC cast
glomerulonephritis, vasculitis
WBC cast
pyelonephritis, interstitial nephritis
granular cast
CKD, acute tubular necrosis
common crystals in urine
clacium oxalate (also kidney stones), uric acid (gout and dehydration), struvite (UTIs), cystine (cystineuria)
crystals can indicate
UTI
If a patient has a UTI, they will have
leukocyte esterase, nitrites, WBCs, bacteria
If a patient has DM, they will have
glucosuria, ketonuria
If a patient has CKD, they will have
proteinuria, casts, decreased specific gravity
If a patient has nephrotic syndrome, they will have
massive proteinuria, lipiduria, fatty casts
If a patient has suspected renal calculus
hematuria
false pos/neg can be from
improper collection, contamination, storage, or interference from medications, diet, or dyes
often need other tests!
POC tests are
tests performed at/near site of patient care (no need for lab)
- fast
- bedside
- easy
- compact
PPM is
use of microscope by healthcare provider to examine patient specimens at POC
all patient specimens are considered
infectious
POC tests like
blood glucose
rapid strep, flu, COVID
pregnancy
ABG
hemoglobin A1C
PPM tests like
urinalysis
wet mount for vaginal infections
skin scrapings
sputum smear
peripheral blood smears
plain red top
no anticoags or preservatives. for serum chemistry and serology tests
red gold top
serum chemistry, has gel material that separate serum + clot
green top
contains heparin, used for plasma chemistry tests + chromosome analysis
lavendar top and pink top
contain potassium EDTA, used for hematological tests and CBC
blue top
contains sodium citrate for coagulation studies (drawn first)
yellow top
contains acid cirate dextrose ACD, for flow cytometry and HLA typing
when you test ascitic fluids, you are looking at
cell count
differential
protein
amylase
gram stain
culture
cytology
when you test CSF, you are looking at
cell count
differential
gram stain
culture
protein
glucose
LDH
VRDL
cytology
When you test pleural fluid, youre looking at
cell count, differential, protein, amylase, gram stain, culture, cytology
when you test synovial fluid, you analyze
cell count, differential, gram stain, culture, microscopic exam of crystals, cytology
when you test urine you look at
urinalysis, dipstick, microscopy, gram stain, culture, cytology
motile trichomonads, clue cells
bacterial vaginosis
budding yeasts mean
yeast infection!
needle-shaped, negatively birefringent urate crystals
gout
rhomboidal, positively birefringent calcium pyrophosphate crystals
pseudogout
fern test can detect
leakage of amniotic fluid during pregnancy
- vaginal swab
examine under microscope
pin work tape test
look for eggs or worms - oval, elongated, flattened, tiny, white, threadlike
patient presents with sore throat, fever, cervical LAD
test: strep, flu, COVID, mono
patient presents with dysuria
UA, yeast/BV eval, STD tests, glucoometer