Unit 4 Part 1 - Urinalysis Flashcards
1
Q
oldest and most common test order
A
urinalysis
2
Q
composition of urine
A
95% water
5% solutes (urea, Na, K, P and S ions, creatinine, uric acid)
3
Q
absence of urine production
A
anuria
4
Q
excessive urination at night
A
nocturia
5
Q
decreased production of urine
A
oliguria
6
Q
increased production of urine
A
polyuria
7
Q
blood in the urine
A
hematuria
8
Q
the yellow pigment that gives urine its color
A
urochrome
9
Q
excessive beets and rhubarb (in alkaline urine) give urine a ___ color
A
red
10
Q
excessive carrots and some antibiotics give urine a ___ color
A
yellow-orange
11
Q
excessive clorets and amitryptiline give urine a ___ color
A
green, blue-green
12
Q
excessive methyldopa and metronidazole give urine a ___ color
A
brown-black
13
Q
presence of RBCs, hgb and myoglobin in urine gives it a ___ color
A
red, red-brown
14
Q
presence of blood in urine gives it a ___ color
A
wine-red
15
Q
presence of melanin and hgb in acid urine gives it a ___ color
A
brown-black
16
Q
presence of bilirubin in urine gives it a ___ color
A
dark yellow, green-brown
17
Q
normal volume of urine in newborns
A
25-350 ml/day
18
Q
normal volume of urine in 1 year olds
A
300-600 ml/day
19
Q
normal volume of urine in 10 year olds
A
750-1500 ml/day
20
Q
normal volume of urine in adults
A
750-2000 ml/day
21
Q
regulate the volume of fluid in the blood
keeps chemical components of the blood at constant level
A
kidneys
22
Q
urine collected at any time and anywhere in a urine container, collected for routine urinalysis
A
random
23
Q
specimen of choice for urinalysis and microscopic analysis
generally more concentrated, has higher levels
A
first morning specimen
24
Q
collected in the middle of the process
patient urinates in the toilet, then the bottle, then toilet again
A
midstream
25
similar collection method as midstream, but urine contact with skin is prevented, and an antimicrobial wipe is used
midstream clean catch
26
collected using a sterile container, sterile straw and gray stopper tube with boric acid as preservative
urine for C&S
27
delay in urine processing and prolonged exposure at RT may result in microbial ___ and changes in pH (shift to __)
urine glucose may ___
growth, alkaline
decrease
28
urine is collected for a 24 hour period
patient discards first morning void, but all other ones are placed in container (including first morning specimen of the next day)
preservative may be added depending on the chemistry testing
24-hr collection
29
Do not void directly in the 24-hr container as it might contain a ___ preservative, and cause splashing
caustic
30
When measuring the volume of a 24 hr urine specimen, use a ___ to record the volume
graduated cylinder
31
what is the color of urine containers and why?
amber to protect from light in case of bilirubin
32
urine preservatives
tartaric acid
boric acid
sodium carbonate
hydrochloric acid
acetic acid
33
best specimen collection method
first morning (most concentrated)
34
specimens exceeding the 2 hour limit and have not been refrigerated is rejected due to
potential bacterial overgrowth and disintegration of cells and casts
could lead to errors in chemical urinalysis
35
should be done within 2 hours after collection
routine urinalysis
36
3 parts of routine urinalysis
1. physical examination
2. chemical testing
3. microscoping examination
37
tests in routine urinalysis under physical examination
color
turbidity
specific gravity
38
measures the weight of urine compared to the weight of water
1.000 - very dilute
1.030 - very concentrated
specific gravity
39
specific gravity is done at the __ only when the chemical strip does not have specific gravity on the strip
physical
40
physical examinations of urine are ___
subjective (personal impressions)
41
___ is not done in routine urinalysis because it is unsafe and reliable, and volume is done in other special collections
odor
42
device used to measure specific gravity, no longer used due to danger
refractometer
43
chemical examination tests in routine urinalysis
1. pH
2. protein
3. glucose
4. ketones
5. bilirubin
6. blood
7. nitrites
8. urobilinogen
9. leukocytes
10. specific gravity
44
main abnormalities being looked at in chemical examination, if urine is normal the rest should be negative
pH and SG
45
tests the acidity or alkalinity of urine
pH
46
increase of this in urine indicatedf kidney disease
protein
47
presence in urine indicates increased blood glucose (diabetes)
glucose
48
increased amounts of this in urine indicates diabetes or starvation
ketones
49
checked in urine to test for liver disease
bilirubin
50
present in urine during infection, trauma, cancer, kidney stones or other bleeding (menstruation)
blood
51
presence of this in urine indicates presence of bacteria
nitrites
52
tests urine for jaundice and other liver disorders
urobilinogen
53
presence in urine could indicate kidney disease and UTI
leukocytes
54
time for reading the urine strip starts at the time of __
blot
55
performed when urinalysis renal workup is ordered (positive for blood, protein or leukocyte esterase)
urine microscopy
56
provides information on presence of casts, cells, and other formed elements (crystals no longer reported)
urine renal workup
57
microscopy is done on the ___ of centrifuged urine
sediment
58
urine microscopy is examined under
high power (400x)
59
oil immersion is used when examining
stains
60
normal amount of epithelial cells, RBCs and WBCs (usually neutrophils) found in urine per high power field
1-3
61
formed in the kidney tubules and expelled during kidney damage
main component is gel-like protein
casts
62
4 factors that lead to formation of a cast
1. decreased urine flow
2. increased acidity (low pH)
3. increased concentration (high SG)
4. increased plasma proteins
63
types of cells that can be found in urine
RBC
WBC
epithelial
64
types of casts
RBC/WBC
Hyaline (most common)
Granular
Waxy (square ends)
* most casts share rounded edges and parallel lines
65
formed by the precipitation of urine salts when changes occur in the pH, temperature (form at low temperatures) or concentration of the urine
crystals
66
most important aid in identification of urine crystals is
pH of urine
67
2 kinds of crystals found in urine
form in acid
form in alkaline
68
most common crystal found in acid pH, look like stars
calcium oxalate crystals
69
type of crystal(s) that form in acidic urine
calcium oxalate (star-shaped, most common)
cystine crystals (hexagon-shaped)
70
type of crystal(s) that form in alkaline urine
triple phosphate crystals (coffin-shaped)
71
leading cause of UTI
E. coli
72
parasite found in urine that is an indicator of an STD
trichomonas vaginalis
73
examples of things that can be found in urine
fat droplets
debris from fibre
oil/air bubble
mucous
sperm
trichomonas vaginalis
bacteria
yeast (Candida albicans)
crystals - alkaline/acidic
casts - RBC/WBC, hyaline, granular, waxy
cells - WBC, RBC, epithelial
74
very common and curable STD, passed from person to person during vaginal, oral and anal sex
chlamydia
75
bacterial cause of chlamydia
chlamydia trachomatis
76
test done for chlamydia and gonorrhea before
cervix/urethra samples sent for cultures
77
chlamydia tests now
first catch urine test
78
rapid method for detection of red blood cells in stool
fecal occult blood test (FOBT)
79
FOBT is used for detection of
colorectal cancer
80
diet for FOBT follows high ___ for ___ before test
fiber, 48 hrs/2 days
81
Things to avoid when doing FOBT
vit C (excess of 250 mg per day)
iron supplements
aspirin/other medications that can cause GI irritation
toilet bowl cleaner
red meat
protect slides from heat, light or volatile liquids
82
do not collect FOBT specimen when
during or 3 days after menstrual period
blood in urine
blleding hemorrhoids
iron supplements
83
false positives for FOBT
red meat
aspirin (> 325 mg/dl) and ibuprofen and naproxen
alcohol in excess
bleeding
84
false negatives for FOBT
an excessive amount of Vit C
85
2 drops of __ is added to each slide and control area when doing FOBT
developer
86
trace of __ color is positive for occult blood
blue
87
FOBT usually repeated for __ consecutive bowel movements
3
