Urinalysis Exam 2 Flashcards
What is SSA used for?
To confirm protein in the urine
Cells are recorded as what per powered field?
high
Flat, hexagonal, colorless crystals are found in the urine, what constituent is suggested?
Cystine crystals
What are some organisms whose urinary presence indicates contamination?
Parasites, trichomonas, yeast
In relation to the refractive index, why is using phase contrast microscopy better?
The refractive index of casts and cellular components are similar to the refractive index of urine
Approximately how many patients with multiple myeloma is Bence-Jones proteins seen in?
Approximately 50%
What sugar, especially in infants, is most likely indicated by a negative dipstick reaction for glucose, but a positive Clinitest?
Galactose
What are shadow cells?
Red blood cells that have lost their hemoglobin
What is the normal range for urinary urobilinogen?
0.1 to 1 mg/dL
2,4-dichlorbenzenediazonium tetrachlorozincate (aka diazotized 2,4-dichloroaniline) is the reagent for what test pad?
bilirubin
What is the reagent used to detect bilirubin in the Ictotest?
2,4-dichlorobenzenediazonium tetrachlorozincate
How does the pH of urine relate to it hydrogen ion concentration?
Inversely proportional
How many fields should be examined in a microscopic exam?
10
How does the Watson-Schwartz test differentiate between urobilinogen and porphobilinogen?
Urobilinogen is soluble and chloroform and butanol whereas porphobilinogen is soluble in the aqueous layer
Which test is the most sensitive for bilirubin?
Ictotest
What is the use of the polarizing microscope in urine microscopies?
Confirms the presence of lipids and crystals
What does the test pad for ketone bodies detect?
Acetoacetic acid
What is the general purpose of test strip screening?
give an indication of what further testing should be done to make or confirm a diagnosis
When detecting reducing sugars in the urine what would be expected in the microscopic examination?
Nothing
What type of casts maybe found in the urine of a normal pH?
Hyaline casts
What is the appearance of the waxy casts?
Waxy, refractile, well-defined edges, and sharp, blunt, or uneven ends with cracks and/or fissures from their lateral margins; appear homogenous
3,3’,5,5’-tetramethylbenzidine and hydrogen peroxide are the reagents for what test pad?
blood
What is the principle of the automated instruments for dipstick reading?
Reflectance photometry
Casts should be reported as the number per what power field?
Low powered field
What substance is most likely to be present in urine in urine that could cause a false (=) negative reaction on the dipstick for glucose?
ascorbic acid or vitamin C
What types of epithelial cells are indicative of vaginal contamination?
Squamous epithelial cells
What is the order for the aging process of casts?
Cellular cast, coarse granular cast, fine granular cast, waxy cast
What unusual urinary protein is associated with multiple myeloma?
Bence-Jones protein
Ketone bodies in the urine are suggestive of elevated __ metabolism
fat
What causes myoglobinuria?
extensive muscle injury
In what type of diseases, in general, are red blood cell casts found?
Where the basement membrane of the glomerulus has been damaged
What disease is indicated when tyrosine and leucine are found in the urine?
Severe liver disease
Candida albicans, a yeast, is often found in the urine of patients with what?
Diabetes mellitus
Sodium nitroprusside is the reagent for what test pad?
Ketones
What test is used for detecting reducing sugars in the urine?
Clinitest
Cast containing cells indicate problems in what part of the urinary tract?
Kidneys
What specific type of epithelial cells are found in epithelial cells casts?
Renal tubular epithelial
What two dipstick reactions are usually positive in pyelonephritis and cystitis?
Leukocytes and nitrites
What is the principle of the dipstick method for protein referred to as?
Protein error of indicators principle
tetrabromphenol blue is the reagent for what test pad?
protein
How would you interpret a negative nitrites but a positive for bacteria?
The bacteria cannot convert nitrate to nitrite, urine hasn’t been in the bladder long enough, no nitrate in the diet, so many bacteria that the nitrates are further reduced to nitrogen gas
Casts in urine are usually accompanied by a positive test for what?
Protein
How can I precipitate of amorphous phosphate be removed?
Diluting in acetic acid
bromthymol blue and methyl red are the reagent for what test pad?
pH
What is the active ingredient in Ehrlich’s reagent?
Para-dimethylaminobenzaldehyde
What type of specimen is used to detect orthostatic proteinuria?
First morning specimen and after patient has been erect for a few hours
What is the advantage of using phase contrast microscopy in the examination of urinary sediment?
Allows you to see unstained cellular components and casts easier
Why do we use the refractometer for specific gravity rather than the dipstick?
Dipstick is not sensitive to non-ionic solutes such as glucose, urea, protein, or radiographic dye
Why is there normally no glucose in the urine?
It is reabsorbed in the convoluted tubules
Where are transitional epithelial cells found?
They line the renal calyces, renal pelvis, ureters, bladder, and 2/3 of the male urethra
Casts which have at least two distinct components are called what?
Mixed casts
What is the principle of the dipstick method for protein?
Tetrabromphenol blue buffered at a constant pH 3 without proteins is yellow, but in the presence of proteins, hydrogen ions are released by the indicator dye causing color changes ranging from yellow-green to blue-green
Name several conditions that can cause hemoglobinuria
Any condition resulting in intravascular hemolysis; transfusion reactions, hemolytic anemia, extensive burns
Can the multistix detect a negative urobilinogen?
No, the smallest amount that is detected is 0.2 mg/dL
What temperature should urine for testing always be at?
Room temperature
How can red blood cells and yeast be differentiated?
Red blood cells lyse in acetic acid and yeast does not
glucose oxidase, gluconic acid, hydrogen peroxide, potassium iodide, and peroxidase are the regents for what test pad
glucose
What objectives should be used for reporting casts?
10 X
What specific portions of the nephron are casts formed?
In the lumen of distal and collecting tubules
What should a technologist do prior to reporting out cystine crystals?
A chemical confirmation for cystine
Para-dimethylaminobenaldehyde is the reagent for what test pad?
urobilinogen
Calcium oxalate crystals are normally found in the urine of what pH?
Acidic pH
What is the term for the presence of elevated numbers of casts in urine?
Cylindruria
What color is a (+) nitrite on the dipstick?
pink
Glitter cells are associated with the urine of what type of specific gravity?
Low specific gravity
Glucose in the urine is referred to as what?
Glucosuria and glycosuria
What would be the appearance of red blood cells in hypertonic urine?
Small and crenated
What is ketonuria?
Ketones in the urine
What is the action of the enzyme peroxidase?
Pseudoperoxidase activity; catalyzes the oxidation reaction of the reagent 3,3’,5,5’-tetramethylbenzidine, a chromogen, by the O2 release from peroxide
What objective is used to record cells?
The 40-45x
What does a reagent strip for hemoglobin detect?
Hemoglobin, myoglobin, and intact red blood cells
What is the significance of the shape and size of a cast?
Shape and size aide in the identification
1,2,3,4-tetrahydrobenzoquinoline-3-ol para-arsanilic acid is the reagent for what test pad
nitrite
The two different forms of blood in the urine are described as?
Hematuria and hemoglobinuria
What are several conditions that could be indicated by an elevated urinary urobilinogen?
Liver disease, hemolytic states, hepatitis, cirrhosis, hemolytic anemia, pernicious anemia
What happens if you dipped the reagent strip too much?
Can cause leaching or run over of reagent
What reagent is used to differentiate urinary hemoglobin and myoglobin?
Ammonium sulfate, hemoglobin is precipitated out by this
Nephrotic syndrome is characterized by what?
Proteinuria and lipiduria
What is the most common type of white blood cell found in urinary sediment?
Neutrophil
Which white blood cell is most likely to be found and a transplant rejection?
Lymphocytes
What is specificity (as related to dipstick reactions)?
Each test zone reacts specifically to the substance being tested and to no other
How can a precipitate of amorphous urates be removed?
Dissolving in an alkali or heated to about 60°C using warm saline
Amorphous phosphates are found in urine of what pH?
Alkaline
When would you suspect orthostatic proteinuria?
It is most often seen in children and adolescents
What condition is indicated by large numbers of uric acid crystals?
Gout
