Urinalysis Flashcards
1
Q
Red color in biosafety indicates
A
Stop / danger / fire protection equipment
2
Q
Accepted “biohazard” label color
A
Fluorescent orange
3
Q
_____ chemicals should be labeled as poisonous, corrosive or carcinogenic
A
Hazardous
4
Q
All biological wastes EXCEPT URINE must be placed in a container with the _____ symbol
A
Biohazard
5
Q
Empty urine containers can be discarded as _____ hazardous waste
A
Nonbiologically
6
Q
Disinfectant for equipment and countertop surfaces
A
1:10 Bleach
7
Q
Best way to break the chain of infection
A
Handwashing
8
Q
When hands are not visibly soiled,
A
Apply sanitizer
9
Q
When hands are visibly soiled,
A
Wash hands with soap and water
10
Q
Most important part of handwashing procedure
A
Friction
11
Q
Handwashing song
A
Happy birthday (2x)
12
Q
Benedict’s reagent splashes on eyes, what to do? (MSDS)
A
Flash eyes with plenty of water
13
Q
What reference material will you consult after accidentally spilling a hazardous chemical?
A
MSDS
14
Q
MSDS stands for
A
Material Safety Data Sheet
15
Q
Work related hazard that includes strain due to repeated positions
A
Ergonomic hazard
16
Q
A hazard due to extremely low temperature
A
Cryogenic hazard
17
Q
_____ hazards include fire/explosion, asphyxiation, pressure buildup, tissue damage similar to burns
A
Liquid nitrogen
18
Q
Centrifuges, refrigerators, autoclaves, homogenizers, and glasswares are examples of _____ hazards
A
Mechanical
19
Q
Centrifuge accidents or improper removal of rubber stoppers from test tubes may produce _____
A
Aerosols
20
Q
Grinding, mixing, vortexing, centrifuging, and preparation of direct smears are known to produce _____
A
Aerosols
21
Q
It is required that all electrical equipment is grounded in a _____ plug to avoid electrical shock
A
Three-pronged
22
Q
Flammable chemicals should be stored in a (an) _____ in a remote area
A
Explosion-proof refrigerator
23
Q
Functional unit of the kidney
A
Nephron
24
Q
Part of the nephron that resembles a “sieve”
A
Glomerulus
25
MW of plasma substances that can be filtered by the glomeruli
>70,000 Daltons
26
Reference method for measuring glomerular filtration rate
Inulin
27
Analyte (s) used to identify unknown body fluid as urine
Urea and creatinine
28
If the voided sample PRIOR to collection period is included in the 24-hour sample, clearance will be falsely _____
High / elevated
29
If the voided sample PRIOR to collection period is included in the 24-hour sample,
Repeat the collection
30
The greatest source of error in any clearance procedure is the use of _____
Improperly timed urine specimens
31
Blood vessel that supplies blood to the kidneys
Renal artery
32
Normal renal blood flow
1,200 mL/min
33
Normal renal plasma flow
600 mL/min
34
Normal glomerular filtration rate
120 mL/min
35
The fluid leaving the glomerulus normally has a specific gravity of
1.010
36
65% of reabsorption occurs at what part of the nephron?
PCT
37
Substances reabsorbed in the proximal convulated tubule include
Salts, water, amino acids, glucose, urea
38
Passive reabsorption of water takes place in all parts of the nephron except the _____
Ascending loop of Henle
39
A SELECTIVE urine concentration process in the ascending and descending loops of Henle
Countercurrent mechanism
40
A high level of ADH increases permeability of _____ & _____, resulting in increased water reabsorption, and a low-volume concentration
DCT and CD
41
Region of the kidney with the highest solute comcentration
Loop of Henle (bottom part)
42
Effect of high ADH on the walls of DCT and CD
Increased permeability to water
43
Renal threshold for glucose
160-180 mg/dL
44
Renal threshold for ketones
70 mg/dL
45
Renal threshold for sodium
120 mmol/L
46
Renal threshold for water
None
47
Renal threshold for potassium
None
48
Renal threshold for magnesium
0.60 - 0.85 mmol/L
(1.46 - 2.07 mg/dL)
49
Major composition of urine
Water, urea, sodium chloride
50
Major organic substance in the urine
Urea
51
Major inorganic substance in the urine
Chloride
52
Patient is deprived of fluid for 24 hours, then urine SG is measured
Fishberg test
53
Comparison of day and night urine in terms of volume and SG
Mosenthal test
54
Urine pH in renal tubular acidosis
Alkaline
55
Ideal specimen for routine urinalysis, PREGNANCY TESTING, and crystal identification
First morning urine
56
Why is 1st morning urine the most ideal specimen in urinalysis?
Most comcentrated
57
Urine specimen for urobilinogen determination
Afternoon urine specimen (2-4 pm)
58
Preferred specimen for measuring urine creatinine
24-hour urine
59
Urine specimen should be tested within
2 hours
60
Urine specimen should be examined within 2 hours because bacterial contamination will cause _____ of urine
Alkalinization
61
This will integrate in an ALKALINE HYPOTONIC urine
Casts
62
LEAST AFFECTED urine parameter in a unpreserved urine specimen
Protein
63
Most routinely used method of urine preservation
Refrigeration
64
Chemical preservative for urine albumin
Boric acid
65
Unlabeled urine received in the laboratory. What will you do?
Reject the specimen
66
UA is done first. Then 3 hours later, urine is sent for culture. The specimen should be
Rejected
67
Method of preservation if urine is not processed immediately for culture
Refrigeration (up to 24 hours)
68
Specimen for urine culture (out-patient)
Midstream clean-catch
69
Purpose of the 2nd container used in the three-glass collection
Control for UTI
70
Urine volume produced in polyuria
>2,000 mL/day
71
Disorder associated with polyuria
Diabetes Mellitus, Diabetes Insipidus
72
Single parameter used to differentiate DM and DI
SG (specific gravity)
73
Urine volume produced in oliguria
<500 (or 400) mL/day
74
Complete cessation of urine flow
Anuria (<100 mL/day)
75
Definition of nocturia
>500 mL of urine at night
76
For urine CLARITY determination, thoroughly mix the specimen then view through a _____
Newspaper print
77
For urine COLOR determination, look down through the container against a _____
White background
78
Major pigment in urine
Urochrome
79
Excess urobilin in urine causes what color?
Yellow-orange / orange-brown
80
White foamy bubbles in urine indicates the presence of
Albumin (protein)
81
Urine that produces yellow foam when shaken contains
Bilirubin
82
Recent consumption of B-complex vitamins or CAROTENE can make the urine appear
Dark yellow
83
Phenol in urine produce what color
Green (when oxidized)
84
Cloudy or smoky red urine
Hematuria
85
Clear red urine
Hemoglobin / myogblobin
86
Causes of tea-colored urine
Bilirubin and myoglobin
87
Portwine or red urine
Porphyria (porphyrin)
88
Homogentisic acid, melanin, and methemoglobin all causes what urine color?
Brown or black
89
Normal urine odor
Aromatic / fragrant / distinct / faint
90
Large numbers of COLIFORMS in urine will produce
Foul / ammoniacal odor / Nitrite (+)
91
Rancid butter urine odor
Tyrosinemia
92
Sulfur urine odor
Cystinuria / Cystinosis
93
Significance of rotting fish (galunggong) urine odor
Trimethylaminuria
94
Significance of cabbage-urine odor
Methionine malabsorption
95
Significant of fruity odor urine
Diabetes mellitus (ketones)
96
Asparagus urine odor is caused by ingestion of
Asparagus (methylmercaptan)
97
Ingestion of onions, garlic, and asparagus, UTI urine odor
Pungent
98
Cause of menthol-like urine odor
Phenol-containing medications
99
Peculiar amount of ODORLESS urine can be seen in
Acute tubular necrosis
100
_____ the edge of the strip on a disposable absorbent pad
Blot
101
Store __________ with desiccant in an opaque, tightly closed container
Reagent strips
102
Store reagent strips in a __________ area
Cool, dry
103
When reading the color reaction, urine reagent strips should be held at what position?
Horizontal
104
Normal pH range (random urine)
4.5 - 8.0
105
pH range in the first morning
5.0 - 6.0
106
A fruit that can cause acidic urine and is used as a home remedy for bladder infections
Cranberry
107
A vegetarian individual will produce urine that is
Alkaline
108
Normal daily protein excretion
Less than 150 mg/day
109
A protein that originate from the urinary tract itself
Uromodulin (THP)
110
Increased filtration of APRs leads to what category of proteinuria?
Pre-renal
111
It has an indicator that changes color with the pH being constant
Protein reagent strip
112
Reason behind protein error of indicators
Protein accepts H+ from indicator
113
The protein section of urine reagent strip is most sensitive to
Albumin
114
Negative reagent strip for protein and positive SSA test indicates
Proteins other than albumin
115
Bence-Jones protein coagulates at _____, then dissolves at _____
40-60C; 100C
(50-60C); 100C
116
Bence-Jones protein is seen in
Multiple myeloma
117
Purpose of determining the albumin:creatinine ratio
To detect microalbuminuria
118
Principle of Micral test strip
Enzyme immunoassay
119
PRE-ECLAMPSIA produces positive reaction with what reagent parameter?
Protein
120
Patient preparation for detecting orthostatic proteinuria
Empty bladder before going to bed
121
Increased pressure on the renal vein when in the vertical position is believed to account for _____ proteinuria
Orthostatic
122
A non-specific test for reducing sugars
Clinitest (copper reduction test)
123
Copper sulfate is used to determine what ability of glucose?
Reducing / reduction
124
Cause of FALSE-POSITIVE copper reduction test for urine sugars
Ascorbic acid, uric acid
125
Cause of FALSE-NEGATIVE copper reduction test for urine sugars
Detergents / pass-thru phenomenon
126
To prevent pass-through phenomenon, use how many drops of urine?
2 drops
127
Rubner's test detects what sugar (s)?
Lactose and glucose
128
If glucose reagent strip is 4+ what other parameter (s) should be checked?
Ketones and protein
129
Patient is on a starvation diet. What can be found in urine?
Ketones
130
Ketone body not detected by reagent strip?
Beta-hydroxybutyrate (78%)
131
Percentage of acetoacetic acid in the ketone bodies
20%
132
Ketone body detected when glycine is included in the reagent strip
Acetone (2%)
133
Toxic to the renal tubular epithelium
Hemoglobin, myoglobin
134
A person suffering from crush injuries will manifest _____ in urine
Myoglobinuria
135
Drug that causes rhabdomyolysis leading to myoglobinuri
Statin (cholesterol-lowering drug)
136
Test to differentiate hemoglobin and myoglobin
Blondheim's test
137
A red PRECIPITATE in urine is formed after adding ammonium sulfate. What is present?
Hemoglobin
138
A red SUPERNATANT in urine is formed after adding ammonium sulfate. What is present?
Myoglobin
139
Urine specimen handling for bilirubin testing
Wrap the specimen in foil
140
Bilirubin reagent strip detects what bilirubin fraction?
Conjugated (direct, B2)
141
Positive Ictotest result
Blue to purple after 60 seconds
142
Parameter reported in Ehrlich units
Urobilinogen
143
Convert 0.4 mg/dL urobilinogen to Ehrlich units?
0.4 EU (CF : 1)
144
Differentiates urobilinogen, porphobilinogen, and other Ehrlich-reactive compounds
Watson-Schwartz test
145
Soluble in (extracted by) both chloroform and butanol
Urobilinogen
146
Insoluble in (not extracted) both chloroform and butanol
Porphobilinogen
147
Soluble in (extracted by) butanol, insoluble in (not extracted by) chlorofom
Other Ehrlich reactive compounds
148
Patient preparation prior to testing urinary nitrite
Eat vegetables the night before
149
Bacteria that produces positive nitrite reagent strip
E.coli (gram-negative bacilli)
150
What is responsible for pink color reaction in the nitrite reagent pad?
Azo dye reacting with aromatic compounds
151
All leukocytes contain esterase enzyme except?
Lymphocytes
152
Nitrite should NOT INTERFERE with the reagent strip test for
Leukocytes
153
Relationship of urine SG to urine volume
Inversely proportional
154
Urine SG is equal to 1.010
Isosthenuria
155
Urine SG >1.010
Hypersthenuria
156
Urine SG <1.010
Hyposthenuria
157
Actual SG formula
Actual SG = Decimal portion of given SG x Dilution factor
158
If urine specimen yielded an SG reading of 1.014 after using 1:4 dilution, the actual SG is?
1.056
159
Urine volume requirement for urinometry
10-15 mL
160
Used to calibrate a urinometer to base (1.000)
Distilled water
161
Instrument based of refractive index
Total solids meter (refractometer)
162
Refractive index is a comparison of
Light velocity in air to light velocity in solution
163
Urine volume needed by the refractometer?
1 or 2 drops
164
Specific gravity of (triple) distilled water
1.000
165
Specific gravity of 3% sodium chloride
1.015 +/- 0.001
166
Specific gravity of 5% sodium chloride
1.022 +/- 0.001
167
Specific gravity of 7% sodium chloride
1.035 +/- 0.001
168
Specific gravity of 9% sucrose
1.034 +/- 0.001
169
Specific gravity of potassium sulfate solution
1.015 +/- 0.001
170
_____ for every 3C that the specimen temperature is ABOVE calibration temperature
+0.001
171
_____ for every 3C that the specimen temperature is BELOW calibration temperature
-0.001
172
Correction factor in urinometer or refractometer for every 1 g/dL of glucose present in urine
-0.004
173
Correction factor in urinometer or refractometer for every 1 g/dL of protein present in urine
-0.003
174
Temperature correction factor when using REFRACTOMETER
None
175
Reading of distilled water using refractometer is 1.002. What should you do?
Adjust set screw to 1.000
176
11th pad in the reagent strip
Ascorbic acid
177
Specimen used for Addis count
12-hour urine
178
Preservative for Addis count urine specimens, excellent sediment preservative
Formalin
179
Normal values for Addis count
0-500,000 RBCs
0-1,800,000 WBCs and EC
0-5,000 Hyaline casts
180
Primary components of the microscope LENS system
Oculars
Objectives
Adjustment knobs
181
Components of the microscope ILLUMINATION system
Light source
Condenser
Diaphragms
182
Components of the microscope BODY
Base
Body tube
Nosepiece
183
They perform the INITIAL magnification of object on the mechanical stage
Ojectives
184
Objective used for preliminary assessment (screening) of the urine sediment
10x (LPO)
185
Magnification power of ocular lens
10x
186
_____ illumination precisely focuses and centers the light path and spreading the light uniformly over the field of view
Kohler
187
A type of microscope that forms a HALO around the specimen
Phase-contrast
188
Microscope for identifying hyaline/mixed cellular casts and mucus threads
Phase-contrast
189
To convert a brightfield into a darkfield microscope, what should be replaced?
Condenser
190
To convert a brightfield into a polarizing microscope, what should be installed?
2 polarizing filters
191
Microscope that produces 3D image and layer-by-layer imaging of the specimen
Interference-contrast
192
Nomarski and Hoffman are examples of _____ microspcope
Interference-contrast
193
_____ microscopes can be adapted for Hoffman and Nomarski microscopes
Bright-field
194
Optical surfaces of the microscope should be cleaned with
Lens paper
195
Used to remove DUST on the optical surface of the microscope
Camel-hair brush
196
Clean any contaminated lens immediately with
Commercial lens water
197
If lens cleaning solution is not available, what can be used as an alternative?
Alcohol-based solution
198
Supravital stain that differentiates WBCs from RTE cells
Toluidine blue
199
Lipid stains can stain triglycerides and neutral fats, but not
Cholesterol
200
Color produced by neutral fats using Sudan III stain
Orange-red
201
Preferred stain for urinary eosinophils
Hansel stain
202
Stain for hemosiderin in urine
Prussian blue
203
Stain used in automated UA to visualize WBC, mitochondria, nuclear and cell membrane
Carbocyanine (green)
204
Stain used in automated UA to visualize DNA elements
Phenathridine (orange)
205
RBCs in hypotonic urine will
Swell / hemolyze (ghost cell)
206
RBCs in hypertonic urine will
Shrink / crenate
207
RBCs in glomerular membrane damage or bleeding appear as
Dysmorphic
208
When blood is negative but RBCs were reported on microscopy, recheck sediment and look for __________
Budding yeasts
209
Uniform blue color on blood reagent pad, 8 ghost cells seen/HPF. This indicates?
Hematuria (RBCs are lysed)
210
Positive for blood reagent strip, 0-1 RBC/HPF. What indication?
Hemoglobinuria / myoglobinuria
211
Term that indicates presence of WBCs in urine
Pyuria / leukocyturia
212
Glitter cells are seen in urine with
Low specific gravity
213
Normal value for urinary eosinophils
1% or less
214
TRUE OR FALSE: The percentage of eosinophils in 100-500 cells is NOT determined
False; determined
215
If eosinophils in urine are >1%, this is associated with what condition?
Acute interstitial nephritis
216
Largest cell in the urine sediment
Squamous epithelial cell
217
Epithelial cell variant associated with bacterial vaginosis / Gardenella vaginalis
Clue cell
218
Epithelial cell known as "bladder cell"
Transitional epithelial cell
219
These cells originate from the lining of renal pelvis, calyces, ureters, & bladder and from upper portion of male urethra
Urothelial cells
220
Most clinically significant epithelial cell
RTE (renal tubular epithelial) cell
221
Clinically significant squamous epithelial cell
Clue cell
222
Epithelial cell in urine with eccentric nucleus
RTE cell
223
Shape of proximal convulated tubule RTE cells
Oblong / cigar / rectangular / columnar
224
Shape of distal convulated RTE cells
Round / oval
225
Shape of collecting duct RTE cells
Polygonal, cuboidal, columnar
226
Number of RTE cells per HPF indicative of tubular injury
>2 per HPF
227
Oval fat bodies are derived from what cell?
RTE cell
228
Highly refractile RTE cell
Oval fat body
229
Oval fat bodies are seen in what condition?
Nephrotic syndrome
230
RTE cell variant seen in acute tubular necrosis
Bubble cell
231
RTE cell inclusion that are formed after prolonged hemoglobinuria
Hemosiderin granules
232
Glucose (+); Round cells insoluble in dilute acetic acid. What is present?
Moniliasis (yeast)
233
To consider as significant for yeast infection, yeast cells should be accompanied by?
WBC
234
Most frequently encountered parasite in urine; Leukocyte esterase (+)
Trichomonas vaginalis
235
When not moving, Trichomonas is more difficult to identify. Observe for the presence of
Undulating membrane
236
Mistaken for non-motile Trichomonas vaginalis in urine
RTE cell / WBC / Transitional epithelial cell
237
Most common fecal contaminant in urine
Enterobius vermicularis
238
Most common urine contaminant in female patients
Squamous epithelial cells
239
Might be missed if the coverslip is overflowed
Casts
240
Objective used for DETECTING cast
LPO
241
Objective used for IDENTIFYING cast
HPO
242
Total magnification for reporting casts
100x (LPO x ocular lens)
243
Major component of urinary casts
Uromodulin (THP)
244
Other protein component of urinary casts
Albumin, immunoglobulins
245
Order of casts degeneration
Hyalin > cellular > coarsely granular > finely granular > waxy
246
The most commonly seen broad cast are
Granular and waxy
247
This can occur following strenuous exercise
Cylinduria
248
RBC casts can be easily identified due to its
Orange-red color
249
Final degenerative form of all cast types; Seen in chronic renal failure
Waxy cast
250
Also known as renal failure cast
Broad cast
251
As a mold of the distal convoluted tubules, the presence of broad casts indicates _____ of the tubular walls
Destruction (widening)
252
Pink sediment in urine
Amorphous urates
253
What to do in a precipitated specimen containing pink precipitates before testing?
Heat urine at 60C
254
White precipitate in urine
Amorphous phosphates and carbonates
255
Envelope or pyramid-shaped, octahedral, square with an "X" crystal
Calcium oxalate dihydrate
256
Common form of calcium oxalate crystals
Dihydrate or Weddellite
257
Calcium oxalate crystals are also associated with foods high in oxalic acid, such as _____ and asparagus, and ascorbic acid
Tomatoes
258
Amorphous urates + acetic acid
Uric acid
259
Gold lemon-shaped crystals
Uric acid
260
Crystal associated with chemotherapy, leukemia, lymphoma or polycythemia vera
Uric acid
261
Shape of ammonium biurate crystals
Thorny apples
262
Feathery, fern-leaf, coffin-lid, prism
Triple phosphate
263
Other name for struvite
Triple phosphate, magnesium ammonium phosphate
264
Colorless, flat rectangular plates or thin prisms often in rosette forms
Calcium phosphate
265
Other name for apatite
Calcium phosphate
266
Most abnormal crystals are found in what urinary pH?
Acidic or neutral
267
Colorless hexagonal crystals
Cystine
268
Staircase pattern with notch in one or more corners
Cholesterol
269
Notched crystals are seen in what condition?
Nephrotic syndrome (lipiduria)
270
Bilirubin, tyrosine, and leucine crystals are seen together in
Liver disease
271
Yellow needle-shaped crystals in amber urine; what significance?
Bilirubin, liver disease
272
Crystal precipitated with tyrosine crystals if alcohol is added to urine
Leucine
273
Yellow-brown SHEAVES OF WHEAT, rosettes, arrowheads, PETALS, needles
Sulfonamide
274
Colorless needles that tend to form BUNDLES following refrigeration
Ampicillin
275
Cigarette butt urinary crystal
Calcium sulfate
276
Urinary artifact with DIMPLED appearance
Starch granules
277
Urinary elements exhibiting maltese cross formation
Oval fat bodies
Fatty casts
Fat droplets
Starch granules
278
UA result: pH 5.0, WBCs and struvite crystals present. What to do?
Repeat testing
279
Screening for specific substances associated with IEMs in infant's blood sample
MS/MS (tandem mass spectrophotometry)
280
Metabolic disorder that lacks phenylalanine hydroxylase
Phenylketonuria
281
The most well known of the aminoacidurias
Phenylketonuria
282
The most common in IEM detected in the Philippines
MSUD (maple syrup urine disease)
283
Metabolic disorder where urine turns black after opening the container
Melanuria
284
Cetyltrimethylammonium bromide (CTAD) is screening test for
Mucopolysaccharides
285
Positive result in the CTAB test
White turbidity
286
Positive color in the MPS (mucopolysaccharide) paper test
Blue
287
Increased aminolevulinic acid (ALA) in urine is seen in
Lead poisoning
288
When testing urinary ALA, the specimen must be pre-treated with
Acetyl acetone
289
Infant urine yielded negative glucose but positive Clinitest results, suspects for
Galactosemia
290
Deficient melanin production results in
Albinism
291
Metabolite of serotonin
5-HIAA (5-hydroxyindoleacetic acid)
292
Preservative for urine 5-HIAA testing
HCl or boric acid
293
Serotonin-rich foods include
Bananas
Pineapples
Tomatoes
Avocadoes
Chocolates
Plums
Walnuts
294
Findings in Henoch-Schonlein purpura include heavy _____ & _____ with RBC casts
Proteinura & hematuria
295
Crystal seen in Fanconi's syndrome
Cystine
296
Protein in urine seen microscopically in renal diseases
Tamm-Horsfall protein (cast)
297
Precursor of acute glomerulonephritis
Respiratory infection (S. pyogenes)
298
Progressive, irreversible renal disease
Chronic kidney disease (CRF / CGN)
299
Renal disease with the greatest proteinuria (>3.5 g/day)
Nephrotic syndrome
300
Main characteristics of nephrotic syndrome
Proteinuria and lipiduria
301
Urine SG in acute tubular necrosis
1.010 (isosthenuric)
302
Presence of WBCs, bacteria and casts is seen in
Acute pyelonephritis
303
Presence of WBCs and bacteria, and absence of CASTS is seen in
Cystitis
304
Presence of WBCs and WBC casts; absence of BACTERIA
Acute interstitial nephritis
305
Tumor markers for urinary bladder cancer
NMP, BTA (nuclear matrix protein, bladder tumor antigen)
306
Primary urinalysis finding in renal lithiasis
Microscopic hematuria
307
Urinary calculi are most commonly formed from
Calcium
308
Renal calculi may form in the
Renal calyces
Renal pelvis
Ureters
Urinary bladder
