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Clinical Microscopy 2 > Urinalysis > Flashcards

Urinalysis Flashcards

0
Q

Milky urine

A

1 Pyuria
2 Lipiduria
3 Chyluria
4 Emulsified paraffin

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1
Q

Anaerobes in urine vs. anaerobes in bladder

A

Normal flora

Etiologic agent

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2
Q

Vitamins

A

Ascorbic acid

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3
Q

Crystals in concentrated urine samples

A

Uric acid

Phosphate crystals

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4
Q

Formed elements

A 
Erythrocytes
Leukocytes
Renal tubular epithelial cells
Transitional epithelial cells
Squamous epithelial cells
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5
Q

Preserves sediments

A

One crystal thymol per 10-15 mL urine

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6
Q

Preserve or refrigerate urine specimen at

A

4 Celsius

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7
Q

Container for suprapubic aspirate

A

Anaerobic transporter

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8
Q

Container for typical urinalysis

A

Clean container

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9
Q

Functions of the kidney

A

1 Elimination of excess body water
2 Elimination of waste products of metabolism (i.e. urea, creatinine)
3 Elimination of foreign substances
4 Retention of substances necessary for normal body function (i.e. proteins, amino acids, glucose)
5 Regulation of electrolyte balance and osmotic pressures of the body fluids

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10
Q

Contents of transport tubes which preserve bacteria without refrigeration for 24 hours when 100,000 CFU/mL is present in the initial urine specimen

A

Boric acids
Glycerol
Sodium formate

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11
Q

Suitable specimen for protein and microscopic sediments

A

Concentrated specimen (morning urine)

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12
Q

Consequences of a urine sample that has deteriorated

A

1 Destroyed RBCs and WBCs by hypotonicity of urine
2 Decomposed casts
3 Bacterial contamination
4 Decreased pH

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13
Q

Artifacts

A

1 Cotton, hair, other fibers
2 Granules of starch
3 Oil droplets

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14
Q

Indicates UTI

A

Greater than 100,000 CFU/mL

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15
Q

Collection for asymptomatic patients

A

3 consecutive early morning specimens

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16
Q

Suitable specimen for quantitative analysis

A

24-hour urine specimen

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17
Q

Suitable specimen for bacteriologic exam

A

Voided midstream urine

Catheterized specimen

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18
Q

Smokey urine

A

RBCs

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19
Q

Procedure for routine analysis

A

1 Number the urine specimens and the corresponding request
2 Number the 15 mL centrifuge tube corresponding to urine sample
3 Mix each specimen thoroughly and place 12 mL to the corresponding tube (Note color, turbidity, and reactions)
4 Measure specific gravity
5 Centrifuge for 5 minutes at 1500 to 2000 rpm

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20
Q

Abnormal cells and other formed elements

A 
1 Tumor cells
2 Viral inclusion cells
3 Platelets
4 Bacteria, fungi, parasites
5 Contaminants
6 Artifacts
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21
Q

Composition of urine

A 
1 Water
2 Urine solute
3 Sugars
4 Intermediary metabolites
5 Free fatty acids and trace amounts of cholesterol
6 Hormones
7 Biogenic amines
8 Vitamins
9 Trace amounts of porphyrins
10 Crystals
11 Formed elements
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22
Q

Physical tests

A 
1 Color
2 Turbidity
3 Odor
4 Volume
5 Osmolality and specific gravity
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23
Q

Chemical tests

A

1 pH
2 Protein
3 Reducing substances
4 Glucose

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24
Q

Orange urine

A

Concentrated urine

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25
Q

Preserves sediments and formed elements

A

One drop of formalin per 10 mL urine

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26
Q

Preservative that kills bacteria

A

One drop of formalin per 10 mL urine

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27
Q

Color of urine with amidopurine drugs

A

Bright orange

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28
Q

Opalescent urine

A

Lipiduria

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29
Q

Components preserved by freezing

A

1 Bilirubin
2 Urobilinogen
3 Ketones

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30
Q

Urine solute components

A 
1 Urea
2 Sodium chloride
3 Potassium
4 Sulfate (organic or inorganic)
5 Phosphates
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31
Q

Milky urine due to many neutrophils

A

Pyuria

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32
Q

Procedure for clean-catch midstream specimens

A

1 Clean urethral area with sponge and soap
2 Retract skin folds (labia or prepuce)
3 The first-void urine is passed into the toilet to clear the urethra
4 Collect the midstream specimen
5 Continue voiding

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36
Q

Container for culture

A

Sterile, wide-mouthed, screw-capped

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37
Q

Preserve glucose and other constituents

A

Preservative tablets

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38
Q

Methods for sample collection

A

1 Suprapubic aspiration and straight catheterization
2 Clean-catch midstream specimens
3 Collection bags for specimens from children
4 Indwelling catheters

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38
Q

General considerations for urine specimen collection

A

1 Transport urine to the lab as soon as possible
2 Culture urine specimens within 2 hours after collection or refrigerate and culture them within 8 hours whenever possible
3 Refrigerated urine specimens may be held for < 24 hours
4 Request for another specimen when there is no evidence of refrigeration and the specimen is < 24 h old
5 Request for another specimen when the collection time and method of collection have not been provided
6 If an improperly collected, transported or handled specimen cannot be replaced, document in the final report that specimen quality may have been compromised
7 Always use dry containers

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39
Q

Components preserved by HCl

A

Calcium

Phosphorus

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40
Q

Sugars

A

Pentoses

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41
Q

Suitable specimen for glucose

A

Urine after eating

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42
Q

Deep yellow urine

A

Riboflavin

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43
Q

Components preserved by refrigeration

A

1 Barbiturates
2 Drug abuse
3 Protein

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44
Q

Normal turbidity of urine

A

Absent (clear)

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45
Q

Biogenic amines

A

Catecholamines

Serotonin metabolites

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46
Q

Substances present in cloudy urine

A 
1 Phosphates and carbonates
2 Leukocytes
3 Bacteria and yeast
4 Prostatic fluid
5 Mucus threads
6 Clumps, pus, tissue
7 Urates and uric acid
8 RBCs
9 Spermatozoa
10 Mucin
11 Calculi
12 Radiographic dye
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47
Q

Greenish-orange urine

A

Bilirubin

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48
Q

Used for pediatric patients

A

Urine bag

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50
Q

Almost colorless urine

A

Dilute urine

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51
Q

Mousy smell

A

Phenylketonuria

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52
Q

Brown to black urine

A

Melanin

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53
Q

Time of collection

A

Early in the morning

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54
Q

Normal volume of water in the urine

A

1,000 mL to 1,500 mL/24 h

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55
Q

Reddish orange urine in alkaline solution

A

Rhubarb or serra

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56
Q

Hormones

A

Ketosteroids
Estrogens
Aldosterone
Pituitary gonadotropins

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57
Q

Normal pH of urine

A

4.6-8.0

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58
Q

Color of urine with excess indican

A

Dirty green in standing

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59
Q

Suitable specimen for chemical and microscopic exams

A

Voided specimen

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60
Q

Interferes with protein test

A

One crystal thymol per 10-15 mL urine

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61
Q

Average daily volume of one-year olds

A

360-600 mL

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62
Q

Intermediary metabolites

A

Oxalic acid
Citric acid
Pyruvate

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63
Q

Factors that cause acidic urine

A

1 Diet high in meat protein and some fruits

2 Drugs with ammonium chloride, methionine, methenamine mondelate, and acid phosphatase

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64
Q

Lack of odor

A

Acute renal failure

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65
Q

Rancid urine

A

Tyrosinemia

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66
Q

Normal urine color

A

Yellow or straw to amber

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67
Q

Methionine malabsorption

A

Cabbage

Hops

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68
Q

Microscopic analysis

A 
1 Red blood cells
2 White blood cells
3 Crystals
4 Epithelial cells
5 Casts
68
Q

Preservative used for routine screening

A

Preservative tablet

69
Q

Polyuria

A

Increase in volume > 2000 mL in 24 hrs

70
Q

Signifies that tubule mechanisms of acidification are intact

A

ph of 5.5 and below

71
Q

Night urine volume of adults

73
Q

Causes of glycosuria with hyperglycemia

A 
1 Endocrine disorders
2 Alpha or beta cell pancreatic tumors
3 Hyperthyroidism
4 Phaechromocytoma
5 Pancreatic diseases
6 CNS disorders
7 Disturbances in metabolism
8 Liver disease
9 Glycogen storage disease
10 Obesity and feeding after starvation
74
Q

Preferred in critical conditions

A

Osmolality of urine and plasma

75
Q

Excretion of urine of low specific gravity (< 1.007)

A

Hyposthenuria

76
Q

Isosthenuria

A

Excretion of urine that has not been concentrated by the kidneys and has the same osmolality as that of plasma (1.010)

77
Q

Color of urine with hemoglobin pigments

77
Q

Maple syrup urine

A

Maple syrup urine disease

80
Q

Normal range of specific gravity of urine

A

1.005-1.030

81
Q

Causes of decrease in urine volume

A

1 Dehydration
2 Renal ischemia
3 Renal disease
4 Obstruction

83
Q

Translucent, colorless gels from protein in the tubules or nephrons

84
Q

pH of urine

A

A reflection of the ability of the kidneys to maintain normal hydrogen ion concentration in plasma and extracellular fluids

85
Q

Inclusions (Cast Classification)

A 
1 Granules 
2 Fat globules
3 Hemosiderin granules
4 Crystals
5 Melanin granules
86
Q

Detects all proteins and indicates the presence of globulins

A

Acid-precipitation test

87
Q

Normal osmolality of urine

A

800-1400 mOsm/kg water

88
Q

Causes of alkaline urine

A

1 Renal tubular acidosis
2 Early pyelonephritis
3 Primary aldosterone secretory tumor
4 Hypokalemia

89
Q

2 general methods for chemical tests

A

Reagent strip methodology

Confirmatory tests

91
Q

Principle of Fouchet’s test

A

Barium chloride and urine –> barium sulfate (ppt)

Bilirubin adsorbed and filtered –> Add Fouchet’s ferric chloride –> Biliberon

92
Q

Color of biliberon

A

Greenish-blue

93
Q

Cells (Cast Classification)

A 
1 RBCs and remnants
2 WBCs
3 Renal tubular epithelial cells
4 Mixed cells
5 Bacteria
94
Q

Causes of hyaline casts

A 
1 Acute glomerulonephritis
2 Malignant hypertension
3 Chronic renal disease
4 Congestive heart failure
5 Diabetic nephropathy
95
Q

Accumulation of acid in the body due to failure of the kidneys to appropriately acidify urine

A

Renal tubular acidosis

96
Q

Color of urine with urobilin

A

Orange-brown

96
Q

Sweaty feet and glutaric acidemia

A

Isovaleric acidemia

97
Q

Causes of increased renal tubular epithelial cells

A 
1 Malignant nephrosclerosis
2 Acute glomerulonephritis
3 Acute tubular necrosis
4 Papilitis
5 Acute renal allograft rejection urates
100
Q

Crystals present in acidic urine

A 
1 Calcium oxalate
2 Uric acid
3 Urates
4 Cysteine
5 Tyrosine
6 Leucine
101
Q

Milky urine

102
Q

Factors that affect glucose appearance

A

1 Blood level
2 Glomerular blood flow
3 Tubular reabsorption rate
4 Urine flow

103
Q

Heavy proteinuria

104
Q

Almost always indicate significant renal disease

A

Granular casts

105
Q

Inflammation caused by UTI in the upper urinary system (kidney and ureters)

A

Early pyelonephritis

106
Q

Average daily volume of ten year-olds

A

750-2000 mL

106
Q

Factors which cause alkaline urine

A

1 Diet high in certain fruits and vegetables

2 Drugs with sodium bicarbonate, potassium citrate, and acetacolamide

107
Q

Confirmatory tests for protein in urine

A

1 Sulfosalicylic acid test

2 Quantitative methods

109
Q

Give an indication of the urinary total solute concentration

A

Osmolality

Specific gravity

110
Q

Test for acetone and acetoacetic acid

A

Rothera’s test

111
Q

Rotting fish odor

A

Trimethylaminuria

111
Q

Normal amount of protein in urine

A

150 mg/24 h

112
Q

Causes of heavy proteinuria

A 
1 Nephrotic syndrome
2 Acute and chronic glomerulonephritis
3 Lupus nephritis
4 Amyloid disease
5 Severe venous congestion of the kidney
113
Q

Crystals present in basic urine

A

1 Phosphates
2 Calcium carbonate
3 Ammonium urate

114
Q

Methods used for amount of protein in urine

A

1 Reagent strip method

2 Acid-precipitation test

115
Q

Responsible for yellow color of urine

A

1 Urochrome

2 Urobilins

115
Q

Sulfosalicylic acid test

A

3 mL urine + 3 mL 10% sulfosalicylic acid in 50% methanol

117
Q

Indicate pyelonephritis

118
Q

Average daily volume of newborns

118
Q

Moderate proteinuria

A

0.5-4 g/day

119
Q

Method sensitive to albumin

A

Reagent strip method

120
Q

Causes of moderate proteinuria

A 
1 Nephrotic syndrome
2 Acute and chronic glomerulonephritis
3 Lupus nephritis
4 Amyloid disease
5 Severe venous congestion of the kidney
6 Nephrosclerosis
7 Pyelonephritis with hypertension
8 Diabetic nephropathy
9 Preeclampsia of pregnancy
10 Toxic nephropathies
11 Radiation nephritis
12 Chronic pyelonephritis
13 Inactive phase of glomerular disease
14 Polycystic kidney
15 Renal tubular disease
121
Q

Increased number of casts

A

Kidney disease

122
Q

Components preserved by boric acid

A

1 Creatinine
2 Uric acid
3 Glucose

123
Q

Benedict’s qualitative test

A

0.5 mL urine + Benedict’s solution

126
Q

Test for total urobilinogen and urobilin

A

Schlesinger’s test

127
Q

Presence of renal tubular epithelial cells

128
Q

Indicate gout

129
Q

Denser and waxy casts

A

Chronic renal disease

130
Q

Causes of polyuria

A

1 Excessive intake of water
2 Increased salt intake and high protein diet
3 Certain drugs with diuretic effect (caffeine, alcohol, thiazides)
4 Intravenous saline or glucose
5 Pathologic states (diabetes, chronic renal failure)

131
Q

Based on specific glucose oxidase and peroxidase method

A

Reagent strip method

132
Q

Normal odor of urine

A

Faint aromatic odor

132
Q

Test for bilirubin

A

Fouchet’s test

132
Q

Found in localized nephron obstruction

A

Waxy casts

135
Q

Confirmatory tests for glucose

A

1 Copper reduction test

2 Copper reduction tablet tests

136
Q

Other term for copper reduction test

A

Benedict’s test

137
Q

Found in asymptomatic or chemical diabetes

A

Hyperglycemia with no significant glycosuria

138
Q

(++) Approx. 1.0% reducing substance in Benedict’s test

A

Greenish brown

139
Q

Causes of glycosuria without hyperglycemia

A 
1 Renal tubular dysfunction
2 Drugs, poison, endogenous toxins
3 Franconi's syndrome
4 Galactosuria
5 Amino acid disorders
139
Q

Substances that should be absent in the urine

A 
1 Glucose
2 Ketone
3 Bilirubin
4 Bacteria (Nitrate)
5 Leukocyte esterase
139
Q

Increased number of leukocytes

139
Q

Causes of increased WBCs in urine

A 
1 Renal disease
2 Calculous disease
3 Bladder tumors
4 Acute inflammatory disease
5 Chronic inflammatory disease
140
Q

Benedict’s test: Red

A

(++++) Approx. 2.0% reducing substance

141
Q

Benedict’s test: Yellow

A

(+++) Approx. 1.5% reducing substance

142
Q

Principle of Schlesinger’s test

A

Urobilinogen is oxidized with alcoholic solutions of zinc acetate –> green fluorescent complex

142
Q

Acidic urine

144
Q

Causes of increased RBCs in urine

A

1 Renal diseases
2 Lower urinary tract disease
3 Extrarenal disease

145
Q

Components preserved by sodium bicarbonate

A

Porphyrins

Urobilinogen

145
Q

Principle of Rothera’s test

A

Both acetone and acetoacetic acid give a purple color with alkaline sodium nitroprusside

145
Q

Increased transitional epithelial cells

A

Transitional cell carcinoma of the renal pelvis or bladder

148
Q

Classification of casts

A

1 Matrix
2 Inclusions
3 Pigments
4 Cells

149
Q

Basic urine

149
Q

Flat and wide with notch

A

Waxy casts

151
Q

Pigments (Cast Classification)

A

1 Hemoglobin
2 Myoglobin
3 Bilirubin
4 Drugs

153
Q

Feature of nephrotic syndrome

A

Fatty casts

153
Q

Found in tubular damage

A

Crystal casts

153
Q

Hemoglobin casts

A

Tubular bleeding

154
Q

Obstructive jaundice

A

Bilirubin casts

155
Q

Causes of renal tubular epithelial casts

A

1 Acute tubular necrosis
2 Viral disease
3 Exposure to a variety of drugs

156
Q

Casts

A 
1 Hyaline 
2 Granular 
3 RBC
4 Waxy
5 Fatty
6 Crystal
7 Hemoglobin
8 Myoglobin
9 Bilirubin
10 Renal tubular epithelial
158
Q

Methods for glucose in urine

A

1 Reagent strip method

2 Confirmatory tests

159
Q

Classification of hyaline casts

160
Q

Classification of waxy casts

161
Q

Myoglobin casts

A

Muscle damage

161
Q

Benedict’s test: traces of reducing substance

A

Greenish blue

161
Q

Benedicts’s test: Green

A

(+) Approx. 0.5% reducing substance

162
Q

A rough test and at best an approximate guide on the amount of sugar

A

Benedict’s qualitative test

162
Q

Causes of granular casts

A

1 Pyelonephritis
2 Viral disease
3 Chronic lead intoxication

162
Q

Negative result of Benedict’s test

Clinical Microscopy 2 (5 decks)

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