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lab #2 > Urinalysis procedures > Flashcards

Urinalysis procedures Flashcards

1
Q

What are clinical reasons to perform a UA?

A 
indicator of health
screening test 
cost effective 
non invasive 
simple to perform
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2
Q

the UA screening test is used to detect and assess what disorders?

A

renal function/disorder
endocrine or metabolic function disorder
urinary tract infection
systemic diseases

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3
Q

What are the two categories of urine colletion?

A

Non instrument collection

instrumented collection

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4
Q

what are the non instrument collections?

A

First morning void
random urine specimen
clean catch
24 hr

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5
Q

what are the instrumented urine collections?

A

urethral catherization
suprapubic needle aspiration
catherization and bladder irrigation

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6
Q

urine specimens are analyzed while fresh, preferably within what time frame?

A

1-2 hours

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7
Q

if unable to test the urine at delivery, what is the timeline for refrigeration?

A

3-6 hours

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8
Q

what happens if urine is left at room temperature

A

it will decompose and deliver inaccurate results. Mostly due to the presence of bacteria.

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9
Q

How is the pH of urine increased while sitting in room temperature?

A

urea splitting bacteria produce ammonia, which then combines with hydrogen ions.

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10
Q

What will contribute to casts that are present (if any) being dissolved?

A

changes in pH

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11
Q

what will bacteria use as a source of energy in urine that is sitting out? resulting in a false negative glycosuria?

A

glucose

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12
Q

what is something you can put in urine to prevent elements such as blood cells and casts from deteriorating?

A

preservatives

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13
Q

which non instrument collection method is the most concentrated, increase number of abnormal elements, decreases their deterioration, and is the recommended specimen for chemical and microscopic examination?

A

First morning void

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14
Q

which non instrument collection is good to be collected anytime, is the most convenient and common, and can detect abnormalities but not as sensitive as “first morning”?

A

random urine

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15
Q

this type of specimen (non instrumented collection) is the specimen of choice for bacterial cultures?

A

cleat catch urines

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16
Q

this type of specimen can have cultures performed 12 hours after collection as long as the specimen is refrigerated?

A

Clean catch urine

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17
Q

this type of specimen gives quantitative results and preservatives may be needed?

A

24 hour collection

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18
Q

this type of collection is used on obese patients, not recommended for bacteriological testing, and should be used only of no other way to collect:

A

urethral catherization

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19
Q

this method of urine collection is the urine collection of choice on infants and young children, performed to confirm positive cultures, and prior to institution of specific therapy:

A

suprapubic needle aspiration

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20
Q

this method of urine collection yields optimum cellular sample of bladder epithelium.

A

catheterization and bladder irrigation

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21
Q

what are the three things involved in urine sample analysis

A

physical
chemical
microscopic

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22
Q

what are the things looked at for PHYSICAL analysis of urine?

A 
volume
color
turbidity 
odor 
specific gravity
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23
Q

what is the normal value of urine in a 24 hour period?

A

600-2000 ml

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24
Q

what is the average volume of urine in a 24 hr period?

A

1500 ml

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25
Q

fluid intake, temperature and climate, and amount of perspiration all contribute directly to what?

A

volume of urine

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26
Q

What is the word for urine pigment?

A

urochrome

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27
Q

what is the normal color of urine?

A

straw color (light yellow) to dark amber

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28
Q

urine color may also vary because of what other factors besides hydration?

A

ingested foods and medications

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29
Q

Why would urine be blue green?

A

methylene blue (used as a dye in diagnostic procedures)

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30
Q

why would urine be dark orange?

A

pyridium (used for UTI infection)

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31
Q

what causes urine to be milky white?

A

chyle

32
Q

phenols, a poisonous compound used for antimicrobial agent, will turn your urine which color?

A

olive green to brown black

33
Q

the presence of bile will make your urine which color?

A

yellow to brown (turning greenish with foam when shaken)

34
Q

what color will urine be with the presence of blood?

A

red or red brown (smoky)

35
Q

what does amorphous phosphate and amorphous carbonate turn your urine?

A

turbid alkaline

36
Q

what makes your urine turbid alkaline? (pinkish turbidity)

A

amorphous urates

37
Q

what gives urine it’s distinct smell?

A

volatile acids

38
Q

what gives urine it’s ammonia odor after standing for a long time?

A

breakdown of urea by bacteria

39
Q

what causes urine odor or fruity smell?

A

ketones

40
Q

pungent smell or Ammonia smell is caused by what?

A

bacteria

41
Q

what causes maple syrup urine disease?

A

a congenital metabolic disorder, “maple syrup urine disease”

42
Q

an infant with phenylketonuria will have what smell in his/her urine?

A

musty or mousy

43
Q

isovaleric acidemia, presence of butyric or hexanoic acid in urine gives what smell?

A

sweaty feet

44
Q

Specific Gravity of random and 24 hours urine:

A

Random-1.003-1.035

24 Hr- 1.015-1.025

45
Q

the amount of glucose in urine is dependent on what three things?

A

blood glucose level
rate of glomerular filtration
degree of tubular reabsorption

46
Q

what is the term for when glucose exceeds the threshold of 160-180mg/dL in the blood?

A

glucosuria

47
Q

what is ketonuria?

A

presence of ketones in urine because of incomplete fatty acid utilization

48
Q

starvation, diabetes mellitus, high fat, low carb diets, eclampsia and prolonged vomiting and diarrhea will cause what condition?

A

ketosis

49
Q

what is the term for presence of blood in the urine?

A

hematuria

50
Q

What could it indicate if RBC’s are present in the urine?

A

damage/trauma to the kidney or urinary tract
renal diseases
or menstrual contamination or exercise

51
Q

what types of renal diseases is having RBC’s indicative of?

A

glomerulonephritis
malignant hypertension
polycystic kidney disease

52
Q

what would bilirubinuria indicate?

A

hepatocellular disease
intra or extra hepatic biliary obstruction

(any condition that causes jaundice will result in appearance of bilirubin in urine)

53
Q

is urobilinogen present in urine?

A

yes, normally in concentrations of 1 EU or less.

54
Q

an increase in urobilinogen is indicative of which diseases?

A

liver disease or hemolytic disease

55
Q

What is the range for pH and the average in urine?

A

4.6 to 8.0, but averages 6.0, slightly acidic

56
Q

pathologic conditions that could cause acidic urine:

A 
respiratory and metabolic acidosis 
UTI by E Coli 
Uremia 
Severe diarrhea 
Starvation
57
Q

conditions that could cause alkaline urine?

A

UTI’s from proteus and pseudomonas species

respiratory and metabolic alkalosis

58
Q

What in the urine would be a good indicator of renal disease?

A

protein

59
Q

what are the two mechanisms of proteinuria?

A

glomerular damage

defect in the reabsorption process of the tubules

60
Q

proteinuria ranges from minimal to significant

A

minimal <.5
moderate .5-3.5
severe >3.5

61
Q

what is bacteriuria indicative of in your urine?

A

UTI

62
Q

what is in a indirect test for bacteriuria?

A

Leukocyte esterase (LE)

63
Q

what is associated with an inflammatory process in or around the urinary tract

A

leukocyturia

64
Q

what are the strong critical values for glucose?

A

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

65
Q

what is a critical value high urine colony count?

A

> 50,000 colonies/mL if a single organism

66
Q

what amount of protein do we excrete a day?

A

10-100mg daily

67
Q

ph greater than 7.0 is associated with what?

A

calcium carbonate
calcium phosphate
magnesium-ammonium stones

68
Q

ph in urine below what threshold are associated with cystine and uric acid stones?

A

5.5

69
Q

an increase in urobilinogen may the result of:

A

hemolytic anemia, cirrhosis or viral hepatitis.

70
Q

if there is an obstruction of the bile duct, what will show up as a dark yellow or greenish brown color?

A

bilirubin

71
Q

greater than how many RBC’s HPF is considered abnormal?

A

> 3

72
Q

RBC’s may indicated what in urine?

A

glomerulonephritis
kidney stones
cancer
infection

73
Q

what can lead to a false positive of blood and hemo in urine and is highly suggestive of rhabdomyolysis?

A

myoglobin

74
Q

what is defined as significant pyuria?

A

3> WBC’s HPF

75
Q

when glucose reaches what mg/dL in the blood what happens?

A

180 mg/dL, the ability of the proximal tubule to reabsorb is exceeded and shows up in urine, called glycosuria

76
Q

increased number of epithelial cells may indicated what?

A

acute tubular necrosis or inflammation

lab #2 (4 decks)

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