Urinalysis Flashcards
-Ideal for routine UA and pregnancy test
Most
-Most acidic concentrated, well preserved cells and casts
-Evaluation of orthostatic proteinuria
First morning Urine
-For routine and qualitative UA
- Obtained anytime of the day
-Usually requested for employment purposes
Random Urine
A urine specimen for quantitative, intended for certain test
Timed specimen
Urine sample for screening and monitoring of DM patients
2-hour postprandial specimen
How is urine collected in a 2-hour postprandial urine specimen
The patient is instructed to vod shortly before consuming a routine meal and to collect a specimen 2 hours after eating.
Urine specimen for the quantitative exam of urinary sediment; for Addiss count
12-hour urine
What time is afternoon urine collected?
2-4pm
Urine specimen best for determination of bilirubin and urobilinogen
Afternoon urine
-A second voided urine after a period of fasting
-Recommended for glucose determination
Fasting Second Morning
Collected using a catheter
Catheterized
Recommended for bacterial culture and cytology
Catheterized sample
Most sterile; also recommended for bacterial culture and cytology
Subrapubic aspirated urine sample
Recommended for determination of prostatic infection
Three-glass collected urine specimen
What comprises the three-glass urine specimen
-First portion of voided urine
-Middle portion of voided urine
-Urine after prostatic massage
Sample used for routine screening and bacterial culture
Midstream clean-catch specimen
What is the required volume for drug test sample?
30-45 mL
Urine temperature in drug test sample must be measured within?
4 minutes
How to preserve a urine specimen for bacte studies
Should not be preserved
[Unpreserved urine] color
darkens due to oxidation or reduction or metabolites
[Unpreserved urine] Clarity
Decreased due to bacterial growth and ppt of amorphous material
[Unpreserved urine] Odor
Increased due to bacterial multiplication or breakdown of urea to ammonia
[Unpreserved urine] pH
Increased due to breakdown of urea to ammonia by urease-producing bacteria/loss of CO2
[Unpreserved urine] Glucose
Decreased due to glycolysis and bacterial use
[Unpreserved urine] Ketones
Decreased due to volatilization and bacterial metabolism
[Unpreserved urine] bilirubin
Decreased due to Exposure to light/photo oxidation of biliverdin
[Unpreserved urine] Urobilinogen
Decreased due to oxidation to urobilin
[Unpreserved urine] Nitrite
Increased due to multiplication of nitrate-reducing bacteria
[Unpreserved urine] Red and white blood cells and casts
Decreased due to disintegration in dilute alkaline urine
[Unpreserved urine] Bacteria
Increased due to multiplication
[Preservative] Best for protein testing and barbiturates and drug screening
refrigeration
[Preservative] Preserves glucose and sediments well but interferes with acid ppt tests for protein
Thymol
[Preservative] Preserves protein, glucose, uric acid, creatinine, and formed elements but may precipitate crystals when used in large numbers
Boric acid
[Preservative] An excellent sediment preservative. Interferes with glucose, blood, leukocyte esterase and copper reduction tests
Formalin
[Preservative] does not interfere with routine tests. Floats on surface of specimens and clings to pipettes and testing material
Toluene
Normal volume of CSF
Neonates: 10-60 mL
Adults: 90-150 mL
Site for CSF puncture
Neonates: intervertebral space b/w 4th and 5th lumbar vertebra
Adults: intervertebral space b/w 3rd and 4th lumbar vertebra
Tube 1 in CSF
Microbiology and Serology
Tube 2 in CSF
Microbiology
Tube 3 in CSF
hematology
Storage for CSF tube 1
Frozen
Storage for CSF Tube 2
Room
Storage for CSF Tube 3
Refrigerated
Normal volume for semenalysis sample
2-5 mL
Abstinence period prior to collection
at least 2 days not more than 7 days
Storage for semenalysis sample
Room temp if collection is outside the lab, must be delivered within an hour
Kept at 37C if specimen is awaiting analysis
Synovial fluid normal volume
<3.5 mL
Synovial fluid NV when there is inflammation
> 20 mL
Tube for Synovial fluid hematology test
Heparin or EDTA
Synovial fluid for microbio tests
sterile
Synovial fluid for glucose analysis
Sodium fluoride
Synovial fluid for All other tests
non-coagulated
Pleural fluid collection
thorancentesis
Pericardial fluid collection
pericardiocentesis
Peritoneal/Ascitic fluid collection
paracentesis
Proper storage for pH determination
maintained anaerobically on ice
Serous fluid for Hema test
EDTA
Serous fluid for Microbio and cytology test
Sterile heparinized or SPS
Serous fluid for Chemistry test
Heparin or plain
Amniotic fluid volume collected
max 30 mL
Amniotic fluid method of collection
amniocentesis
When is it safe to collect amniotic fluid?
After 14th week of gestation
What are the Triple Marker Screening Test
AFP
hCG
Unconjugated estriol
Specimen handling for Fetal Lung Maturity Test
Kept on ice during delivery
Kept refrigerated
Bilirubin tests
Immediately protected from light
Cytogenetic and microbiological studies
Processed aseptically, kept at RT or body temperature
STAT for CM
1 hour
Preservative of choice for routine urine culture
Refrigeration
Normal urine output in 24 hrs
600-2000 mL
Night urine output
<400 mL
Required urine volume analysis specimen
10mL-15mL
Enumerate the colors of urine
Clear, light yellow, yellow, dark yellow, amber, red, green, brown to black
Enumerate transparency of urine
Clear, Hazy, Cloudy, Turbid, Milky
Principle of Glucose in Reagent strip test
double sequential enzyme reaction
Positive color: green/blue to brown
Principle of bilirubin in Reagent strip test
diazo reaction
Postivie color: Tan or pink to violet
Principle of ketones in Reagent strip test
Sodium nitroprusside rxn (Legal’s test)
Positive color: Purple
Principle of SG in Reagent strip test
pKa change of a polyelectrolyte
Positive color: blue to yellow
Principle of Protein in Reagent strip test
Protein (Sorensen’s) error of indicators
Pos color: blue
Principle of pH in Reagent strip test
Double indicator system
Pos color: Orange to blue
Principle of Blood in Reagent strip test
Pseudoperoxidase activity of haemoglobin
Pos color: Uniform green/blue (Hgb/Mb)
Speckled/spotted (intact RBCs)
Principle of Urobilinogen in Reagent strip test
Ehrlich reaction
Pos color: Red/pink
Principle of Nitrite in Reagent strip test
Greiss reaction
Pos color: uniform pink
Principle of Leukocyte in Reagent strip test
Leukocyte esterase
Pos color: purple
Reporting of Squamous, transitional ep cells, Mucus threads, and crystals
LPO (plus system/rare,few, many)
Reporting of bacteria and yeast
HPO (plus system/rare, few, many)
Reporting of renal tubular epi cells and casts
LPO (ave # per field)
Reporting of WBC and RBC
HPO (ave # per field)
Uric acid
Acid, Normal
Amorphous urtes
Acid, Normal
Calcium oxalate
acid/neutral, normal
Amorphous phosphates
alkaline, normal
Calcium phosphate
alkaline, normal
Triple phosphate
alkaline, normal
Ammonium biurate
Alkaline, normal
Calcium carbonate
alkaline, normal
Cystine
Acid, abnormal
Cholesterol
acid, abnormal
Leucine
acid/neutral, abnormal
Tyrosine
Acid/neutral, abnormal
Bilirubin
acid, abnormal
Sulfonamides
acid/neutral, abnormal
Radiographic dye
acid, abnormal
Ampicillin
acid/neutral, abnormal