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Lab > URINALYSIS PROCEDURES > Flashcards

URINALYSIS PROCEDURES Flashcards

1
Q

What test fits these clinical reasons

(a) An important indicator of health
(b) Cost-effective in-vitro diagnostic test
(c) Non-invasive procedure
(d) Simple to perform

A

Urinalysis testing

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2
Q

Uranalysis is used to detect and assess what?

A

1) Renal function/disorder
2) Endocrine or Metabolic function/disorder
3) Urinary tract infection
4) Systemic diseases

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3
Q

What are the Methods of Urine Collection

A

(1) Non-instrumented Collection

(2) Instrumented collection

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4
Q

These are what method of urine collection?

(a) First-morning void
(b) Random urine specimen
(c) Clean catch urine specimen
(d) 24-hour urine specimen

A

Non-instrumented Collection

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5
Q

These are what method of urine collection?

(a) Urethral Catheteration
(b) Suprapubic Needle Aspiration
(c) Catheterization and Bladder Irrigation

A

Instrumented

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6
Q

Urine specimens should be analyzed while fresh, preferably within how long?

A

1-2 hours

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7
Q

If unable to test the urine specimen at time of delivery, refrigerate the specimen ____ after collection.

A

3-6 hours

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8
Q

If left at room temperature, it will begin to decompose and deliver _______ .

A

inaccurate results

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9
Q

Specimens left at room temperature will soon begin to decompose, mainly due to the presence of __________

A

bacteria in the sample

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10
Q

Urea splitting bacteria produces ammonia, which then combines with hydrogen ions to ____________.

A

increase pH of the urine

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11
Q

If glucose is present, the bacteria may use it as a source of energy resulting in…

A

negative glycosuria

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12
Q

True/False

Certain urinary elements, such as blood cells and casts, will deteriorate if left standing with of preservative.

A

False

Without any kind of preservative

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13
Q

What type of Non-instrumented Collection:

(a) Most concentrated
(b) Increase number of abnormal elements
(c) Decreased deterioration of formed elements
(d) Recommended specimen for chemical and microscopic examination

A

First-morning void

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14
Q

What type of Non-instrumented Collection:

(a) Collected anytime
(b) Most convenient and most common
(c) Can detect abnormalities but not as sensitive as first morning void

A

Random urine specimen

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15
Q

What type of Non-instrumented Collection:

(a) Specimen of choice for bacterial cultures.
1) May perform cultures within 12 hours after collection, only if specimen was refrigerated.
2) Genitalia must be cleaned with mild antiseptic solution
3) Collect midstream in a sterile container

A

Clean catch urine specimen

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16
Q

What type of Non-instrumented Collection:

(a) Gives quantitative results
(b) Preservatives may be needed

A

24-hour urine specimen

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17
Q

What type of instrumented collection?

(a) Not recommended for bacteriologic examination
(b) Use only if no other way to collect urine
(c) Commonly used on marked obese patient with difficulty in urine collection

A

Urethral Catheteration

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18
Q

What type of instrumented collection?

(a) In place of catheterization for obtaining a single urine sample
(b) Inserting the needle directly into the distended bladder
(c) Avoids vaginal and urethral contamination
(d) Performed for Bladder outlet obstruction (urinary retention)

A

Suprapubic Needle Aspiration

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19
Q

What type of instrumented collection?

(a) Utilizes vigorous transcatheter agitation of the bladder.
1) 50-72 mL saline inserted into bladder.
2) Bladder content is then removed for cytologic study.
(b) This method yields optimum cellular sample of bladder epithelium.
(c) Urine Sample Analysis:
1) Physical
2) Chemical
3) Microscopic

A

Catheterization and Bladder Irrigation

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20
Q

how much saline is inserted into the bladder for transcatheter agitation?

A

50-72 mL

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21
Q

Urine Sample Analysis covers what 3 things?

A

1) Physical
2) Chemical
3) Microscopic

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22
Q

Physical analysis of urine covers what?

A

(1) Volume
(2) Color
(3) Turbidity
(4) Odor
(5) Specific gravity

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23
Q

Physical analysis of urine covers what?

A

(1) Volume
(2) Color
(3) Turbidity
(4) Odor
(5) Specific gravity

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24
Q

chemical analysis of a urine covers what?

A
  1. Glucose
  2. Ketones
  3. occult blood
  4. bilirubin
  5. urobilinogen
  6. pH
  7. protein
  8. nitrate
  9. Leukocyte esterase (LE)
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25
Q

Indicator of urine odors

Sweet or fruity smell

A

Ketones

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26
Q

Indicator of urine odors

Pungent smell -

A

due to ammonia produced by bacteria

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27
Q

Indicator of urine odors

Maple syrup

A

“Maple syrup urine disease” a congenital metabolic disorder

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28
Q

Indicator of urine odors

Musty or Mousy

A

Infant with phenylketonuria

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29
Q

Indicator of urine odors

Sweaty feet

A

Isovaleric acidemia, presence of butyric or hexanoic acid in urine

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30
Q

Indicator of urine odors

ammonia odor

A

Urine that has been standing for a long time

Due to breakdown of urea by bacteria.

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31
Q

True/False

Odor of the urine is considered to be of special diagnostic importance

A

False

IS NOT

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32
Q

Causes what turbidity?

1) Amorphous phosphate
2) Amorphous carbonate

A

Turbid Alkaline urine

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33
Q

Causes what turbidity?

1) Amorphous urates
2) A pinkish turbidity frequently indicates the presence of urates

A

Turbid Acidic urine

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34
Q

True/False
Turbidity
Normal urine is clear

A

True

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35
Q

True/False

Color is dependent on pigment (urochrome) concentration

A

True

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36
Q

Normal color for urine

A

straw (light yellow) to dark amber

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37
Q

Diagnostic significance of urine color:

Blue green

A

Methylene blue (Used as dye or stain in diagnostics procedure)

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38
Q

Diagnostic significance of urine color:

Dark orange

A

Pyridium (used for UTI infection)

39
Q

Diagnostic significance of urine color:

Milky white

A

caused by chyle

40
Q

Diagnostic significance of urine color:

Olive green to brown black

A

Phenols (poisonous compound used for

antimicrobial agent)

41
Q

Diagnostic significance of urine color:

Yellow to brown (turning greenish with foam when shaken)

A

Presence of bile

42
Q

Diagnostic significance of urine color:

Red or red-brown (Smokey appearance)

A

presence of blood

43
Q

Normal volume in a 24-hour period ranges from….

-The average is about…..

A

600-2000 mL

1500 mL

44
Q

What does these directly relate to

1) Fluid intake
2) Temperature and climate
3) Amount of perspiration that occurs.

A

urine output volume

45
Q

Specific gravity

(a) Random urine: _________
(b) 24-hour urine: _________

A

(a) Random urine: 1.003-1.035

(b) 24-hour urine: 1.015-1.025

46
Q

Chemical analysis.

Normal urine is _____ for glucose.

A

Negative

47
Q

Chemical analysis.

________ will appear in the urine once the threshold level of 160-180 mg/dL in the blood is exceeded.

A

Glucosuria

48
Q

What may indicate diabetes mellitus, or any condition that causes hyperglycemia

A

Glucose in urine

49
Q

Normal urine is _____ for ketones

A

negative

50
Q

______ presence of ketones in urine as a result of incomplete fatty acid utilization.

A

Ketonuria

51
Q

True/False

ketones may indicate diabetes mellitus

A

True

52
Q

What is seen on a UA with these issues

a) Decreased intake of carbohydrates (starvation)
b) Decreases utilization of carbohydrates (diabetes mellitus)
c) Digestive disturbance or dietary imbalance (high fat diet, low carbohydrate diet)
d) Eclampsia
e) Prolonged vomiting
f) Diarrhea

A

Ketosis - increase ketone in blood and urine

53
Q

_____ is increase ketone in blood and urine

A

Ketosis

54
Q

Normal urine is _____ for occult blood

A

negative

55
Q

Occult blood May cause the sample to appear

A

red and “smoky”.

56
Q

Presence of blood is termed

A

hematuria

57
Q

These issues may show up with what on UA
a) Damage/trauma to the kidney or urinary tract.
b) Renal diseases such as:
(1 Glomerulonephritis
(2 Malignant hypertension
(3 Polycystic kidney disease.
c) May also be due to menstrual contamination or exercise

A

Intact RBCs present in the urine

58
Q

Normal urine is ______ for bilirubin

A

negative

59
Q

Any condition that causes _____ will result in appearance of bilirubin in urine.

A

jaundice

60
Q

What color will the urine be if there is bilirubin?

A

Yellow to brown (turning greenish with foam when shaken).

61
Q

Bilirubinuria indicates

A

1) Hepatocellular disease

2) Intra or extra-hepatic biliary obstruction

62
Q

Urobilinogen

Normally present in the urine in concentrations of….

A

1 EU or less.

63
Q

Urobilinogen – small urobilinogen amounts up to _____ is normal

A

1 mg/dL

64
Q

Urobilinogen

Any increase indicates _____ and ____

A

liver disease and hemolytic disease.

65
Q

The range for pH is ___to ___, but since it averages around ____ , it is usually slightly acidic

A

4.6 to 8.0

avg 6.0

66
Q

These issues may cause acidic or alkaline urine?

1) Respiratory and metabolic acidosis.
2) UTI by E. coli.
3) Uremia.
4) Severe diarrhea.
5) Starvation.

A

acidic urine

67
Q

These issues may cause acidic or alkaline urine?

1) UTIs caused by Proteus and Pseudomonas species.
2) Respiratory and metabolic alkalosis.

A

alkaline urine

68
Q

Normal urine is ____ for protein.

A

negative

69
Q

What is an important indicator of renal disease.

A

Protienurea

70
Q

Proteinuria mainly occurs by two mechanisms:

A

1) Glomerular damage.

2) Defect in the reabsorption process of the tubules.

71
Q

What type of proteinuria?

a) Polycystic kidneys.
b) Chronic pyelonephritis.
c) Inactive chronic glomerulonephritis
d) Benign orthostatic proteinuria.

A

Minimal proteinuria (<0.5 g/day):

72
Q

What type of proteinuria?

a) Nephrosclerosis.
b) Tubular interstitial disease.
c) Preeclampsia.
d) Multiple myeloma.
e) D diabetes nephropathy.
f) Malignant hypertension.
g) Pyelonephritis with hypertension.
h) Toxic nephropathies.

A

Moderate proteinuria (0.5-3.5 g/day)

73
Q

What type of proteinuria?

a) Glomerulonephritis.
b) Lupus nephritis.
c) Amyloid disease.
d) Lipoid nephrosis.
e) Intercapillary Glomerulosclerosis.
f) Severe venous congestion of the kidney.

A

Severe proteinuria (>3.5 g/day)

74
Q

Normal urine is ______ for nitrites

A

negative

75
Q

What is is formed by breakdown of nitrates by organisms that cause UTIs.

A

Nitrite

76
Q

True/False

E. coli can cause nitrates to show up on UA

A

True

77
Q

What is Bacteriuria

A

presence of bacteria in urine, indicative of UTI

78
Q

Normal urine is negative for LE, which detects esterase released by the ______ in the urine.

A

neutrophils

79
Q

True/false

Leukocyte esterase is an enzyme

A

True

80
Q

__________ is associated with an inflammatory process in or around the urinary tract (i.e. UTI, acute glomerulonephritis)

A

Leukocyturia

81
Q

These are what values?

(1) Strong positive test for glucose and ketones
(2) Glucose on urine dipstick >1000 mg/dL with small, medium, or large ketones
(3) Urine colony count >50,000 colonies/mL if a single organism

A

Critical Values

82
Q

Normal/Abnormal/Critical

Protein- Negative to trace

A

Normal

83
Q

Normal/Abnormal/Critical

pH-4.6 to 8.0

A

Normal

84
Q

Normal/Abnormal/Critical

RBC- 0-3 HPF (High Power Field)

A

Normal

85
Q

Normal/Abnormal/Critical

WBC 0-2 HPF

A

Normal

86
Q

Normal/Abnormal/Critical

Bacteria- Negative to trace

A

Normal

87
Q

Normal/Abnormal/Critical

Epithelial cells 0-1 HPF

A

Normal

88
Q

Normal/Abnormal/Critical

Strong positive test for glucose and ketones

A

Critical

89
Q

Normal/Abnormal/Critical

Glucose on urine dipstick >1000 mg/dL with small, medium, or large ketones

A

Critical

90
Q

Normal/Abnormal/Critical

Urine colony count >50,000 colonies/mL if a single organism

A

Critical

91
Q

______ Proteinuria <0.5g/day may be caused by:

1) HTN
2) Lower UTI
3) Fever
4) Exercise

A

Mild

92
Q

________ proteinuria 0.5-3 g/day may be the result of:

1) CHF
2) Chronic glomerulonephritis
3) Acute glomerulonephritis
4) Diabetic nephropathy
5) Pyelonephritis

A

Moderate

93
Q

_______ proteinuria > 3 g/day is the result of:

1) Amyloid
2) Chronic glomerulonephritis (severe)
3) Diabetic nephropathy
4) Lupus nephritis

A

Significant

94
Q

Persistent pH greater than 7.0 are associated with

A

calcium carbonate,
calcium phosphate
magnesium-ammonium phosphate stones;

Lab (10 decks)

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