Urinalysis Flashcards
What is urinalysis?
Why do it?
Screening/diagnostic tool for detection of urinary substances or cellular material associated with various disorders
Reveal asymptomatic diseases & confirm clinically suspected diagnoses
What are the types of urine collection & what is the most common?
- Random/spot urine (most common)
- clean catch
- clean the genitals
- catheterized
- in & out catheter to get a cleaner sample
- suprapubic
- across the skin above the pubic bone & into bladder
- mostly done w/ children
- first morning
- if you are looking for certain metabolites or looking for mycobacteria (tuberculosis)
- 24-hr urine
How quickly should you test the urine specimen?
What should you do to the specimen just prior to testing?
test as soon as possible
mix the urine just before testing
What is the very first thing you do when performign a urinalysis?
- Visual inspection
- Normal: clear to slightly hazy, pale yellow
- Cloudy urine from crystals or urinary tracty infection
- often crystal will precipitate out at room temperature
What are common causes for cloudy urine?
- Crystals
- Cells
- leukocytes
- RBC
- Microorganisms
- sperm
- mucin
- fecal contamination
- radiographic dye
What are common causes for milky urine?
- many neutrophils (pyuria) – pus
- lipiduria (nephrosis, crush injury)
- chyluria (lympatic obstruction)
- emulsified paraffin (vaginal creams)
Pink, red, or red-brown urine could indicate the presence of what substances in the urine?
blood, hemoglobin, or myoglobin
Yellow-brown or green-brown urine could indicate the presence of what substances in the urine?
bile pigments (mainly bilirubin), may foam when shaken
Orange-red or orange-brown urine could indicate the presence of what substances in the urine?
urobilinogen
b/c urobilinogen is converted urobilin in presence of light
Dark brown-black urine could indicate the presence of what substances in the urine?
methemoglobin, homogentisic acid, or melanin
What is the second step in performing a urinalysis?
Urine dipstick (reagent test strip)
can test a whole bunch of things at once & results are available within minutes
Urine dipstick test for the presenc of what substances?
- leukocytes
- nitrites
- pH
- protein
- glucose
- ketones
- urobilinogen
- bilirubin
- blood
- specific gravity
What are normal findings for specific gravity on urinalysis?
1.016 to 1.022 in healthy adults
What are normal findings for pH on urinalysis?
4.6 - 8.0 ave ~6
What are the normal “negatives” on the dipstick?
- glucose
- ketones
- blood, hemoglobin, hemosiderin & myoglobin
- protein
- bilirubin
- urobilinogen
- nitrites
- leukocyte esterase
What is the third step to a urinalysis?
microscopic examination if necessary
During a microscopic evaluation, urine sediment is searched for what substances?
- cells
- casts
- crystals
- organisms
Why would you see ketones in someones urine?
defects in carbohydrate metabolism
diabetic ketoacidosis
or are starving
Why would you see hematuria?
glomerulonephritis
trauma
(micro) marathon runners
The presence of nitrites in the urine is suggestive of what condition?
nitrites produce by a lot of bacteria - indicates bacteria in urine
(UTI)
What dietary supplement can interfere with reagent testing strip?
ascorbic acid – vitamin C supplement
What parameters indicate an abnormal RBC finiding in microscopic examination of urine?
This is indicative of what type of problem?
- Normal: 0-2/ High power field (HPF)
- >3/HPF = abnormal
- Increased in
- renal disease
- lower urinary tract diseases
- extrarenal diseases
- physiologic causes (exercise)
What are normal parameters for concentration fo white blood cells in urine microscopic analysis? Abnormal?
This is increased in what conditions?
- Normal: 3-5/HPF
- Pyuria
- increased urine neutrophils
What type of cells are these?
Why would you look for them in the urine?
Squamous/Transitional epithelium
Renal tubular epithelial cells (from kidney- increased # = tubular damage)
they are coming from the urinary tract & you can deciphere where in the tract they are coming from
