UNIT 2 Flashcards
Most commonly received specimen
random specimen
Useful for screening tests to detect obvious abnormalities
May show erroneous result resulting from dietary intake orphysical activity just before collection.
random
Ideal screening specimen
Prevents false negative pregnancy tests
For evaluating orthostatic proteinuria
first morning specimen
For quantitative testing
timed
Collected under sterile conditions by passing a hollow tube
(catheter) through the urethra into the bladder
For bacterial culture
cathetherized specimen
Ideal specimen
Safer, less traumatic method for obtaining urine for bacterial
culture and routine urinalysis.
Less contaminated by epithelial cells and bacteria
midstream clean-catch specimen
Strong bacterial agents, such as hexachlorophene or
povidone-iodine, should not be used as cleansing agents.
TRUE
External introduction of a needle through the abdomen
suprapubic specimen
for bacterial culture that is completely free of extraneous
contamination, particularly in infants or children.
can be used for cytological examination.
suprapubic specimen
Three-Glass Collection
○ 1st urine passed = collected in a sterile container
Midstream portion = collected in a separate container
Prostate is massaged so that prostate fluid will be
passed with the remaining urine
prostatitis specimen
Quantitative cultures are performed on all specimens
prostatitis specimen
1st and 3rd specimens are examined microscopically
Prostatic Infection: 3rd specimen will have WBC/hpf
and bacterial count 10x that of the first specimen
2nd specimen: control for kidney and bladder infection
prostatitis specimen
will have WBC/hpf
3rd specimen
control for kidney and bladder infection
2nd specimen
clean-catch midstream urine specimen
○ A second urine sample is collected after the prostate
is massaged.
○ A positive result is significant bacteriuria in the
postmassage specimen of greater than 10 times the
premassage count
pre and post massage test
The first urine specimen is voided bladder (VB1),
represents the urethral specimen.
■ Then the patient voids another 100 to 150 mL of
urine.
Stamey-Mares Test for Prostatitis (Four-glass urine
collection technique)
represents the bladder
specimen
VB2
is the expressed prostatic
specimen (EPS), which is the fluid collected during
prostatic massage.
3rd specimen EPS
consists of urine collected
after EPS; it contains any EPS trapped in the prostatic
urethra.
VB3
The three urine specimens are centrifuged, and the
sediment is examined for white blood
cells/aggregates, macrophages, oval fat bodies,
bacteria, and fungal hypha.
TRUE
tested for by
the VB1
Urethral infection or inflammation
urinary bladder
infection
VB2
Having more than 10 to 20 white blood cells per
highpower field is considered
ABNORMAL
Soft, clear plastic bags
Hypoallergenic skin adhesive to attach to the cleaned
genital area for boys and girls
pediatric specimen
A urine pH of greater than _____ suggests adulteration of
the urine
GREATER THAN 9
A specific gravity of less than ______ could indicate dilution of
the urine specimen and requires re-collection
LESS THAN 1.005
Second voided urine after a period of fasting
FASTING SPECIMEN
Fasting urine, 1-hour, 2-hour, 3-hour and possibly 4-hour,
5-hour, and 6-hour specimens.
tested for glucose and ketones, and the results were
reported along with the blood test results
GLUCOSE TOLERANCE SPECIMEN
ODOR
PH
NITRITE
BACTERIA
ALL INCREASED
Prevents bacterial growth and metabolism
Interferes with analysis of drugs and
hormones
Keeps pH at about 6.0m;
Can be used for transport of urine
cultures
Acids
(boric acid, HCL, acetic acid,
tartaric acid)
Excellent sediment preservative
Acts as a reducing agent, interfering with
chemical tests for glucose, blood,
leukocyte esterase, and copper reduction
Rinse specimen container with
formalin to preserve cells and casts
Formalin
(formaldehyde)
Good preservative for drug analyses
Inhibits reagent strip tests for glucose,
blood, and leukocytes
sodium floride
Convenient when refrigeration not possible;
Have controlled concentration to minimize
interference
commercial preservative tablets
Contains collection cup, transfer straw,
culture and sensitivity preservative tube, or
UA tube
Urine Collection Kits
(Becton, Dickinson,
Rutherford, NJ)
Specimen stable at room temperature (RT)
for 48 hours; prevents bacterial growth and
metabolism
Preservative is boric acid, sodium
borate, and sodium formate;
Keeps pH at about 6.0
Light gray and gray C&S tube
48 hrs
Use on automated instruments
Must refrigerate within 2 hours
Round or conical bottom, no
preservative
Yellow UA Plus tube
Specimen stable for 72 hours at RT;
instrument-compatible
Must be filled to minimum fill line;
Bilirubin and urobilinogen may be
decreased if specimen is exposed to light
and left at RT
Preservative is sodium propionate,
ethyl paraben, and chlorhexidine
Round or conical bottoms
Cherry red/yellow
Preservative Plus tube
72/hes
Oxidation or Reduction of metabolites
color
modified/ darkened
Bacterial growth and of amorphous material
clarity
Bacterial multiplication or breakdown of urea to ammonia to ammonia
odor
Breakdown of urea to ammonia by
urease-producing bacteria/ loss of CO2
pH
Glycolysis and bacterial use
glucose
Volatilization and bacterial metabolism
ketones
Exposure to light/ photo-oxidation to biliverdin
bilirubin
Oxidation to urobilin
urobilinogen
Multiplication of nitrate-reducing bacteria
nitrite
Disintegration in dilute alkaline urine
RBC, WBC & Casts
Multiplication
bacteria increased
Loss of motility, death
trichomonas decreased
wrote a book on “uroscopy”
hippocrates
discovery of albuminuria by boiling
urine
frederick dekkers
These charlatans,
called “pisse prophets,
” became the subject of a book
published by
thomas bryant
developed methods of quantitating
microscopic sediments
○ The invention of the microscope in the 17th century
led to the examination of urinary sediment and to the
development by
thomas addis
introduced the concept of urinalysis as
part of a doctor’s routine patient examination
richard bright
Ideal preservative is _______: inhibits urease and
preserves formed elements in the sediment
bactericidal
Routine is ________; this is a must for culture
specimens
refrigeration
Must return to room temperature for chemical
testing
TRUE
More concentrated than a random specimen
first morning specimen
Actually is second specimen voided - collected after
the first morning specimen
Does not contain metabolites from evening meal
Recommended for glucose monitoring
FASTING SPECIMEN
second specimen voided
Monitors insulin therapy
Results can be compared with fasting urine specimen and blood test result
Patient voids before eating routine meal
Eats meal
Collects next specimen 2 hours after finishing meal
2 hour postprandial specimen
Specimens are collected at the same intervals as the
blood samples
Used to correlate renal threshold with patient’s ability to metabolize glucose
glucose tolerance specimen
Principle: collection must begin and end with an empty bladder
24 hour (timed) specimen
7 a.m. – patient voids and discards urine
Patient begins collecting urine
7 a.m. second day – patient voids and adds this urine to the specimen container
24 HOUR TIMED SPECIMEN
Alternative to catheterized specimen
Less contaminated than routine collection
Provide patient with mild cleansing material and
container and instructions:
midstream clean catch specimen
Positive culture in specimen 2 invalidates positive
culture in specimen 3 (cannot differentiate urinary
tract infection from prostate infection)
TRUE
________ on VB1 and VB2 and _________ on
EPS and VB3 show prostatitis
VB1 and VB2 negative cultures
EPS AND VB3 Positive
