Urine and Nonblood Specimens Flashcards
what is the most analyzed nonblood sample?
Urine
who collects nonblood specimens?
phlebotomist
The phlebotomist may be involved in obtaining the specimens (e.g., throat swab collection), test administration (e.g., sweat chloride collection), instruction (e.g., urine collection), processing (accessioning and preparing the specimen for testing), or simply verifying labeling, and transporting the specimens to the lab. (McCall, 7th Ed)
what do u call the specimens that include liquid and semiliquid substances produced by the body and found in the intracellullar and interstitial spaces, various organs, body cavities, and some joints
nonblood specimen
when should u label nonblood specimens?
immediately after collection in presence of the patient
what specimen can provide info on the body’s major metabolic functions and has been studied since the very beginning of laboratory medicine?
Urine
Inpatinent urine specimen collection is typically handled by whom?
nursing personnel (nurses)
Outpatient urine specimen collection is often handled by whom?
phlebotomists
Identify the type of urine specimen
specimens that can be collected at any time and are the most convenient type for patients
Random urine
Random refers only to the timing of the specimen and not the method of collection
Identify the type of urine specimen
usually collected immediately upon awakening in the morning after approx. 8 hours of sleep
first-morning or eight-hour urine
Identify the type of urine specimen
type of specimen that has a high specific gravity
high specific gravity = more concentrated, thus, may contain substanced and formed elements (cells and casts) that would not be detected in a random specimen
first-morning or eight-hour urine specimen
Identify the type of urine specimen
it differs from a first-morning specimen in that it is the second specimen voided after a period of fasting
fasting urine
Identify the type of urine specimen
collected two hours after a meal and tested for glucose
2-hr postprandial specimen
Identify the type of urine specimen
pooled urine specimen collected over a 24-hr period to allow quantitative analysis of a urine analyte
24-hr specimen
Identify the type of urine specimen
tests for creatinine clearance (kidney function) and urobilinogen (liver function)
24-hr specimen
Identify the type of urine specimen
typically used for glucose monitoring
Fasting urine
Identify the type of urine specimen
one that requires emptying the bladder and then waiting a specific amount of time (usually 30 mins or less than an hour) before collection
double-voided specimen
Identify the type of urine specimen
most commony used to test urine for glucose and ketones and it thought to more accurately reflect the blood concentration of the analyte tested
double-voided specimen
two types of timed urine specimen
- 2-hr postprandial specimen
- 24-hour specimen
Identify the type of urine collection method
requires no special px prep and is collected by having the px void into a chemically clean container
regular voided specimen
Identify the type of urine collection method
performed to obtain a specimen that is generally free of genital secretions, pubic hair, and bacteria that normally surround the urinary opening
midstream catch
Identify the type of urine collection method
collected in a sterile container and yields a specimen that is suitable for microbial analysis or culture andsensitivity (C&S) testing.
midstream clean-catch specimen
Identify the type of urine collection method
collected from a sterile catheter inserted through the urethra into the bladder and is collected when a patient is having trouble voiding
catheterized urine
Identify the type of urine collection method
collection of urine involves inserting a needle directly into the urinary bladder and aspirating (withdrawing by suction) the urine directly from the bladder into a sterile syringe.
suprapubic aspiration
Identify the type of urine collection method
plastic urine collection bag with hypoallergenic skin adhesive is used to collect a urine specimen from an infant or small child who is not yet toilet-trained.
pediatric urine collection
Identify the type of urine collection method
used for microbial analysis or cytology studies; used if UTI has reached the bladder
suprapubic aspiration
Identify the urine test
most commonly requested urine test because it screens for urinary and systemic disorders
routine urinalysis
Identify the urine test
requested on a patient with symptoms of a urinary tract infection (UTI) such as a frequent urge to urinate or pain or burning on urination. The culture involves placing a measured portion of urine on a special nutrient medium that encourages the growth of microorganisms, incubating it for 24 to 48 hours
Culture and Sensitivity
Identify the urine test
performed to detect cancer, cytomegalovirus, and other viral and inflammatory diseases of the bladder and other structures of the urinary system.
Cytology studies
Identify the urine test
test wherein a smear from urine sediments is prepared and examined under a microscope for presence of abnormal cells
Cytology studies
Identify the urine test
performed to detect illicit (unlawful) use of recreational drugs, use of anabolic steroids to enhance performance in sports, and unwarranted use of prescription drugs.
drug testing
Identify the urine test
test wherein reagent strips are used to screen for diabetes and monitor both glucose and ketone levels
glucose and ketone screening
Identify the urine test
test wherein urine is tested for the presence of human chorionic gonadotropin (hCG)
pregnancy testing
hCG = a hormone produced by cells within the developing placenta that appears in serum and urine approximately 8 to 10 days after conception (fertilization)
a minimum of how many mL is typically required for routine urinalysis?
10 mL
for up to how many hours can the urine be held at room temp and protected from light if prompt transportation is not possible?
for up to 2 hours
what compares the density of the urine to water? This can be determined using a refractometer.
Specific gravity
what do you call the measure of dissolved particles per unit of water and is more accurate than specific gravity?
Osmolality
3 steps involved in routine urinalysis
- Physical
- Chemical
- Microscopic
The UA chemical examination is commonly performed using a plastic reagent strip, often called a ____, that contains absorbent pads impregnated with test reagents.
dipstick
what do you call bilirubin presence in the urine?
bilirubinuria
glucose presence in the urine is called?
glycosuria
presence of hemoglobin in urine is called?
hemoglobinuria
blood in urine is a condition known as?
hematuria
protein in urine is known as?
proteinuria
After urine centrifugation for microscopic analysis, what do you call the liquid that is discarded to obtain the sediment?
supernatant
in culture and sensitivity test, for how many hours should the urine be placed on a special nutrient medium to allow incubation of bacteria and monitor presence of microorganisms?
for 24 to 48 hours
what method of urine collection is used for culture and sensitivity tests?
midstream clean-catch
what do you call the stain applied to a urinary smear to detect presence of abnormal cells?
Papanicolaou smear (Pap)
for how many hours should you stop taking drugs that affect urine samples?
24 to 48 hours
preanalytical part i2 ehehe. drugs that interfere w/ blood samples should be stopped for 4 to 24 hours
what is the normal pH of urine?
4.5 - 8
lower than 6 = acidic urine; higher than 8 = basic
what can u infer if the specific gravity of urine is less than 1.010?
px is well hydrated
what can u infer if the specific gravity of urine is between 1.010 - 1.020?
px is slightly dehydrated
what can u infer if the specific gravity of urine is between 1.021 - 1.030?
px is significantly dehydrated
if specific gravity is greater than 1.030, px has?
serious dehydration
____ are created when the body breaks down fat for energy because the diet is deficient in carbohydrates or the body does not metabolize glucose properly
Ketones
Testing for urine ketone levels can be used to diagnose ____, a build-up of ketones in the blood
ketosis
____ may lead to diabetic ketoacidosis (DKA), a dangerous decrease in blood pH due to excess ketones that requires medical intervention.
Ketosis
what type of urine specimen is preferred in pregnancy tests?
first-morning specimen
preferred because it is normally more concentrated and would therefore have the highest HCG concentration.
what do u call the clear, almost colorless pale yellow fluid that fills the membrane that surrounds and cushions a fetus in the uterus?
amniotic fluid
what do u call the clear, almost colorless pale yellow fluid that fills the membrane that surrounds and cushions a fetus in the uterus?
amniotic fluid
The most common reasons for testing amniotic fluid are to detect problems in fetal development and assess fetal lung maturity. Amniotic fluid can also be analyzed to detect genetic disorders, determine gestational age, and identify hemolytic disease.
how is amniotic fluid obtained by the physician?
transabdominal amniocentesis
The procedure, which is typically performed with ultrasound guidance, involves inserting a needle through the mother’s abdominal wall into the uterus and aspirating approximately 10 mL of fluid from the amniotic sac.
fluid that surrounds and helps cushion the brain and spinal cord?
Cerebrospinal fluid
CSF specimens are most often obtained by a physician through what?
lumbar puncture
or spinal tap
CSF is generally collected in how many tubes?
3 to 4 sterile screw top tubes
the first CSF tube is used for?
Chemistry and Immuno-Serology
the second CSF tube is used for?
Microbiology
the third CSF tube is used for?
cell count and differentials
hematology (from ppt)
the fourth CSF tube is used for?
cytology, other special tests, or xtra tube
microbiology (accdg to ppt)
most CSF tests require a minimum of how many mL?
1 mL
CSF specimens that are over how many hours are considered unacceptable by the lab?
over 24 hours
should CSF be transported STAT?
yes or no
yes
CSF should be delivered STAT, at room temp, and analyzed immediately
A ____examines stomach contents for abnormal substances and measures gastric acid concentration to evaluate stomach acid production
gastric analysis
how is gastric fluid obtained?
aspiration tube passed through oropharynx or nasopharynx into stomach
how are nasopharyngeal secretions collected?
sterile cotton-tipped wire swab
or Dacron
what is analyzed to assess fertility or determine the effectiveness of sterilization following vasectomy. It is also sometimes examined for forensic (or legal) reasons?
Semen
____ is the pale yellow, watery, serum-like fluid found between the double-layered membranes enclosing the pleural, pericardial, and peritoneal cavities. It lubricates the membranes and allows them to slide past one another with minimal friction.
Serous fluid
if cell count or smears are ordered from serous fluid, what type of tube is needed?
EDTA tubes
if chemistry tests are ordered from serous fluid, what type of tube is needed?
heparin or sodium fluoride tubes
what are the 3 types of serous fluid?
type is accdg to body cavity of origin
- pericardial fluid
- pleural fluid
- peritoneal fluid
aspiration of serous fluid from the pericardial cavity is called? inflammation of the pericardium is called?
pericardiocentesis; pericarditis
aspiration of serous fluid from the pleural cavity is called? inflammation of pleural cavity? what abt the chest pain caused by the inflammation?
pleurocentesis; pleuritis; pleurisy
aspiration of serous fluid from the abdominal cavity? inflammation of the lining of the abdominal cavity?
paracentesis; peritonitis
____ is mucus or phlegm that is ejected from the trachea, bronchi, and lungs through deep coughing. These specimens are sometimes collected in the diagnosis or monitoring of lower respiratory tract infections such as tuberculosis
Sputum
what do you call the pathogen that causes tuberculosis?
Mycobacterium tuberculosis
what do you call the process wherein a px is asked to cough up and expel sputum forcefully into a special sterile container?
expectoration
a minimum of how much sputum is typically required?
3-5 mL
what type of nonblood specimen is analyzed for chloride content in the diagnosis of cystic fibrosis?
sweat
what do you call the disorder of the exocrine glands that affects primarily the upper respi tract, liver, and pancreas? Pxs w/ this disease have their sweat 2-5 times saltier because chloride content is 2-5 times the normal amt of chloride
Cystic fibrosis
process of transporting pilocarpine into the skin by means of electrical stimulation from electrodes placed on the skin of the forearm or thigh or leg
sweat chloride test
electrical stimulation from electrodes placed on the skin is iontophoresis
____ is a clear, pale yellow, moderately viscous fluid that lubricates and decreases friction in movable joints. It normally occurs in small amounts but increases when inflammation is present.
Synovial fluid
what do you call the process that is used to detect and amplify small segments of DNA?
PCR (Polymerase Chain Reaction)
this is typically used in buccal swab specimens
what do you call the most successful cancer screening technique in history and is used to detect cervical cancer in women?
Cervical Smear/Pap Test/ Pap Smear
The test can also detect ____ (HPV), a known cause of cervical cancer.
human papillomavirus
aim of this specimen is to detect pathogenic organisms in the stool that may be indicatives of disorders of the digestive tract, liver, and pancreas. what is this specimen?
Feces
Fecalysis eong name ng analysis ng feces or stool
3 types tests in fecalysis
- Chemical tests
- Microscopic analysis
- Microbiological analysis
Additional information typically required on a nonblood specimen label includes the
a. billing code.
b. party to be charged.
c. physician.
d. specimen type.
d. specimen type
Which type of urine specimen is the best one for detecting a UTI?
a. 24-hour
b. First morning
c. Clean-catch
d. Random
c. Clean-catch
Which of the following statements describes proper 24-hour urine collection?
a. Collect the first-morning specimen, start the timing, and collect all urine for the next 24 hours except the first specimen voided the following morning.
b. Collect the first-morning specimen, start the timing, and collect all urine for the next 24 hours including the first specimen voided the following morning.
c. Discard the first-morning specimen, start the timing, and collect all urine for the next 24 hours except the first specimen voided the following morning.
d. Discard the first-morning specimen, start the timing, and collect all urine for the next 24 hours including the first specimen voided the following morning.
d. Discard the first-morning specimen, start the timing, and collect all urine for the next 24 hours including the first specimen voided the following morning.
Which nonblood specimen is most frequently analyzed in the lab?
a. CSF
b. Pleural fluid
c. Synovial fluid
d. Urine
d. Urine
Which of the following fluids is associated with the lungs?
a. Gastric
b. Peritoneal
c. Pleural
d. Synovia
c. Pleural
A procedure called iontophoresis is used in the collection of what specimen?
a. CSF
b. Saliva
c. Sweat
d. Synovial fluid
c. Sweat
Saliva specimens can be used to detect
a. alcohol.
b. drugs.
c. hormones.
d. all of the above.
d. All of the above
Which test typically requires a refrigerated stool specimen?
a. Fecal fat
b. Guaiac
c. Occult blood
d. Ova and parasites
a. Fecal fat
A breath test can be used to detect organisms that cause
a. meningitis.
b. peptic ulcers.
c. tuberculosis.
d. whooping cough.
b. peptic ulcers
Which of the following is a type of serous fluid?
a. Amniotic fluid
b. Pleural fluid
c. Spinal fluid
d. Synovial fluid
b. Pleural fluid
A quick, noninvasive means of paternity testing is performedn on cells from a
a. 24-hour urine.
b. buccal swab.
c. CSF specimen.
d. feces sample.
b. Buccal swab
Which type of sample is commonly used to identify arsenic poisoning in agricultural workers?
a. Blood
b. Feces
c. Hair
d. Saliva
c. Hair
A positive FIT test indicates
a. bleeding in the colon or rectum.
b. C. diff colonization of intestines.
c. presence of intestinal parasites.
d. sizeable fecal fat accumulation.
a. bleeding in the colon or rectum
A first-morning specimen is unacceptable for urine cytology because
a. cells may have disintegrated in the bladder overnight.
b. concentrated urine has many interfering substances.
c. shedding of cells into the bladder at night is minimal.
d. the pH level is usually too high for testing purposes.
a. cells may have disintegrated in the bladder overnight
Alcohol testing of urine is problematic because
a. alcohol can evaporate from uncapped specimens.
b. fermentation by bacteria can cause false positives.
c. results may not correlate with blood alcohol levels.
d. all of the above.
d. all of the above
What type of specimen is needed for a guaiac test?
a. Blood
b. Breath
c. Feces
d. Urine
c. Feces
A throat swab is most often collected to test for
a. cystic fibrosis.
b. group A strep.
c. M. tuberculosis.
d. whooping cough.
b. group A strep
Pregnancy can be confirmed by testing urine for the presence of
a. AFB.
b. AFP.
c. hCG.
d. HPV.
c. hCG
A refractometer can be used to measure urine
a. clarity and color.
b. protein level.
c. specific gravity.
d. urobilinogen.
c. specific gravity
Which rapid diagnostic tests are now commonly used to detect foodborne illnesses?
a. CIDTs
b. PCRs
c. RIDTs
d. All the above
a. CIDTs
what do you call the part of urobilinogen from bile that gives color to pupu?
stercobilin
what is done on urine to test for turbidity?
print test
tapat sa letters stuff then see if readable letters
for how many days should you abstain sexually before semen collection?
2-7 days
how many samples are collected for semen?
2-3 samples for a week
no interval stated, basta for a week 2-3 samples
each sample has 1.5 - 5 mL of semen
normal pH of semen?
7.2 - 8.0 pH
in adults, on what bone will u perform bone marrow aspiration?
posterior iliac crest or sternum
