Urine and Nonblood Specimens Flashcards by SAM EMMANUEL FORMALEJO

what is the most analyzed nonblood sample?

Urine

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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)

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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

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when should u label nonblood specimens?

immediately after collection in presence of the patient

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what specimen can provide info on the body’s major metabolic functions and has been studied since the very beginning of laboratory medicine?

Urine

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Inpatinent urine specimen collection is typically handled by whom?

nursing personnel (nurses)

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Outpatient urine specimen collection is often handled by whom?

phlebotomists

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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

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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

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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

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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

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Identify the type of urine specimen

collected two hours after a meal and tested for glucose

2-hr postprandial specimen

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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

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Identify the type of urine specimen

tests for creatinine clearance (kidney function) and urobilinogen (liver function)

24-hr specimen

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Identify the type of urine specimen

typically used for glucose monitoring

Fasting urine

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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

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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

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two types of timed urine specimen

2-hr postprandial specimen
24-hour specimen

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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

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performed to obtain a specimen that is generally free of genital secretions, pubic hair, and bacteria that normally surround the urinary opening

midstream catch

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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

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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

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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

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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

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# 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 ## Footnote 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

1. Physical 2. Chemical 3. 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 ## Footnote 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 ## Footnote 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 ## Footnote 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 ## Footnote 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 ## Footnote 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 ## Footnote 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

1. pericardial fluid 2. pleural fluid 3. 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 ## Footnote 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) ## Footnote 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 ## Footnote Fecalysis eong name ng analysis ng feces or stool

3 types tests in fecalysis

1. Chemical tests 2. Microscopic analysis 3. 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 ## Footnote 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* ## Footnote 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