Urinalysis procedures

Question 1

What are clinical reasons to perform a UA?

Answer 1

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

Question 2

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

Answer 2

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

Question 3

What are the two categories of urine colletion?

Answer 3

Non instrument collection

instrumented collection

Question 4

what are the non instrument collections?

Answer 4

First morning void
random urine specimen
clean catch
24 hr

Question 5

what are the instrumented urine collections?

Answer 5

urethral catherization
suprapubic needle aspiration
catherization and bladder irrigation

Question 6

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

Answer 6

1-2 hours

Question 7

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

Answer 7

3-6 hours

Question 8

what happens if urine is left at room temperature

Answer 8

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

Question 9

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

Answer 9

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

Question 10

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

Answer 10

changes in pH

Question 11

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

Answer 11

glucose

Question 12

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

Answer 12

preservatives

Question 13

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?

Answer 13

First morning void

Question 14

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”?

Answer 14

random urine

Question 15

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

Answer 15

cleat catch urines

Question 16

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

Answer 16

Clean catch urine

Question 17

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

Answer 17

24 hour collection

Question 18

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:

Answer 18

urethral catherization

Question 19

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:

Answer 19

suprapubic needle aspiration

Question 20

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

Answer 20

catheterization and bladder irrigation

Question 21

what are the three things involved in urine sample analysis

Answer 21

physical
chemical
microscopic

Question 22

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

Answer 22

volume
color
turbidity 
odor 
specific gravity

Question 23

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

Answer 23

600-2000 ml

Question 24

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

Answer 24

1500 ml

Question 25

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

Answer 25

volume of urine

Question 26

What is the word for urine pigment?

Answer 26

urochrome

Question 27

what is the normal color of urine?

Answer 27

straw color (light yellow) to dark amber

Question 28

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

Answer 28

ingested foods and medications

Question 29

Why would urine be blue green?

Answer 29

methylene blue (used as a dye in diagnostic procedures)

Question 30

why would urine be dark orange?

Answer 30

pyridium (used for UTI infection)

Question 31

what causes urine to be milky white?

Answer 31

chyle

Question 32

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

Answer 32

olive green to brown black

Question 33

the presence of bile will make your urine which color?

Answer 33

yellow to brown (turning greenish with foam when shaken)

Question 34

what color will urine be with the presence of blood?

Answer 34

red or red brown (smoky)

Question 35

what does amorphous phosphate and amorphous carbonate turn your urine?

Answer 35

turbid alkaline

Question 36

what makes your urine turbid alkaline? (pinkish turbidity)

Answer 36

amorphous urates

Question 37

what gives urine it's distinct smell?

Answer 37

volatile acids

Question 38

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

Answer 38

breakdown of urea by bacteria

Question 39

what causes urine odor or fruity smell?

Answer 39

ketones

Question 40

pungent smell or Ammonia smell is caused by what?

Answer 40

bacteria

Question 41

what causes maple syrup urine disease?

Answer 41

a congenital metabolic disorder, "maple syrup urine disease"

Question 42

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

Answer 42

musty or mousy

Question 43

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

Answer 43

sweaty feet

Question 44

Specific Gravity of random and 24 hours urine:

Answer 44

Random-1.003-1.035 | 24 Hr- 1.015-1.025

Question 45

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

Answer 45

blood glucose level rate of glomerular filtration degree of tubular reabsorption

Question 46

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

Answer 46

glucosuria

Question 47

what is ketonuria?

Answer 47

presence of ketones in urine because of incomplete fatty acid utilization

Question 48

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

Answer 48

ketosis

Question 49

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

Answer 49

hematuria

Question 50

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

Answer 50

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

Question 51

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

Answer 51

glomerulonephritis malignant hypertension polycystic kidney disease

Question 52

what would bilirubinuria indicate?

Answer 52

hepatocellular disease intra or extra hepatic biliary obstruction (any condition that causes jaundice will result in appearance of bilirubin in urine)

Question 53

is urobilinogen present in urine?

Answer 53

yes, normally in concentrations of 1 EU or less.

Question 54

an increase in urobilinogen is indicative of which diseases?

Answer 54

liver disease or hemolytic disease

Question 55

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

Answer 55

4.6 to 8.0, but averages 6.0, slightly acidic

Question 56

pathologic conditions that could cause acidic urine:

Answer 56

``` respiratory and metabolic acidosis UTI by E Coli Uremia Severe diarrhea Starvation ```

Question 57

conditions that could cause alkaline urine?

Answer 57

UTI's from proteus and pseudomonas species | respiratory and metabolic alkalosis

Question 58

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

Answer 58

protein

Question 59

what are the two mechanisms of proteinuria?

Answer 59

glomerular damage | defect in the reabsorption process of the tubules

Question 60

proteinuria ranges from minimal to significant

Answer 60

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

Question 61

what is bacteriuria indicative of in your urine?

Answer 61

UTI

Question 62

what is in a indirect test for bacteriuria?

Answer 62

Leukocyte esterase (LE)

Question 63

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

Answer 63

leukocyturia

Question 64

what are the strong critical values for glucose?

Answer 64

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

Question 65

what is a critical value high urine colony count?

Answer 65

>50,000 colonies/mL if a single organism

Question 66

what amount of protein do we excrete a day?

Answer 66

10-100mg daily

Question 67

ph greater than 7.0 is associated with what?

Answer 67

calcium carbonate calcium phosphate magnesium-ammonium stones

Question 68

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

Answer 68

5.5

Question 69

an increase in urobilinogen may the result of:

Answer 69

hemolytic anemia, cirrhosis or viral hepatitis.

Question 70

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

Answer 70

bilirubin

Question 71

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

Answer 71

>3

Question 72

RBC's may indicated what in urine?

Answer 72

glomerulonephritis kidney stones cancer infection

Question 73

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

Answer 73

myoglobin

Question 74

what is defined as significant pyuria?

Answer 74

3> WBC's HPF

Question 75

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

Answer 75

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

Question 76

increased number of epithelial cells may indicated what?

Answer 76

acute tubular necrosis or inflammation