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ANURBF LEC > URINE COMPOSITION, COLLECTION, AND PRESERVATION > Flashcards

URINE COMPOSITION, COLLECTION, AND PRESERVATION Flashcards

1
Q

URINE COMPOSITION
 [?] water
 [?] solutes (~60 grams of total solids in 24 hours)

A

95-97%
3-5%

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2
Q

Influenced by dietary intake, physical activity, body metabolism, endocrine functions and even body position

A

URINE

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3
Q

INORGANIC COMPONENTS

A

Chloride > Sodium > Potassium
NaCl
Others: sulfate, phosphate, ammonium, magnesium, calcium

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4
Q

principal salt

A

NaCl

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5
Q

major INORGANIC COMPONENT

A

Chloride

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6
Q

ORGANIC COMPONENTS

A

 Urea
 Uric acid
 Hippuric acid
 Creatinine
 Others: carbohydrates, pigments, fatty acids, mucin, enzymes, hormones

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7
Q

(60 to 90%): major organic component

A

 Urea

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8
Q

Containers

A
  • clean, dry, leak-proof, clear
  • Disposable
  • wide-mouthed with a secure lid, and a wide, flat bottom
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9
Q

Labels

A
  • patient’s name and identification number
  • Date and time of collection
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10
Q

Requisitions
- Information on the form must match the information on the [?]
- [?] the specimen is received in the laboratory

A

specimen label
time

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11
Q

Urine container capacity

A
  • 50 ml capacity
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12
Q

Specimen Rejection
- [?] labeled specimens
- Nonmatching labels and [?]
- Specimens contaminated with [?]
- containers with [?] exteriors
- Specimens with [?] quantity
- Specimens that have been [?]

A

Unlabeled or improperly
requisition forms
feces or toilet paper
contaminated
insufficient
improperly transported

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13
Q

Specimen Integrity

A

 within 2 hours

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14
Q

 Physical, chemical and microscopic characteristics of urine specimen begin to change as soon as the urine is

A

voided

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15
Q

Specimen Preservation: Increased

A
  1. pH
  2. Bacteria
  3. Odor
  4. Nitrite
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16
Q

Specimen Preservation: Decreased

A
  1. Clarity
  2. Glucose
  3. Ketones
  4. Conjugated bilirubin
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17
Q

Specimen Preservation: Modified

A

Color

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18
Q

Urea——(urease)—- > Ammonia

A

Increased pH
Increased Odor

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19
Q

Multiplication

A

Increased Nitrite (nitrate-reducing bacteria)
Increased Bacteria
Decreased Clarity

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20
Q

Precipitation of amorphous materials

A

Clarity

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21
Q

Glycolysis and bacterial use

A

Decreased

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22
Q

Volatilization

A

Decreased Ketones

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23
Q

Light exposure

A

Decreased Conjugated bilirubin

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24
Q

Oxidation or reduction of metabolites

A

Modified Color

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25
Q

Oxidation to urobilin

A

Decreased Urobilinogen

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26
Q

Disintegrates in ALKALINE urine

A

Decreased Casts

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27
Q

Loss of motility: death

A

Decreased Trichomonas

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28
Q

TYPES OR PRESERVATION

A
  1. PHYSICAL
  2. CHEMICAL
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29
Q

REFRIGERATION

A

PHYSICAL PRESERVATION

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30
Q

 ↓ Bacterial growth and metabolism
 ↑ Specific gravity

A

REFRIGERATION

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31
Q

 Precipitation of Amorphous phosphates and urates

A

REFRIGERATION

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32
Q

REFRIGERATION TEMP

A

2C - 8C

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33
Q

Does not interfere with chemical tests

A

Refrigeration

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34
Q

Increases SG by hydrometer

A

Refrigeration

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35
Q

Precipitates amorphous substances

A

Refrigeration

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36
Q

Prevents bacterial growth for 24 hours

A

Refrigeration

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37
Q

Preserves glucose and sediments well

A

Thymol

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38
Q

Interferes with acid precipitation test for CHONS

A

Thymol

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39
Q

Preserves CHONS and formed elements well

A

Boric acid

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40
Q

Does not interfere with routine analyses other than pH

A

Boric acid

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41
Q

May precipitate crystals when used in large amounts

A

Boric acid

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42
Q

Keeps pH about 6.0

A

Boric acid

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43
Q

Bacteriostatic at 18g/L; may be used for culture transport

A

Boric acid

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44
Q

Excellent sediment preservative

A

Formaldehyde

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45
Q

Reducing agent, interferes with chemical tests for glucose, blood, LE, and Copper reduction

A

Formaldehyde

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46
Q

Rinse specimen container with formalin to preserve

A

Formaldehyde

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47
Q

Does not interfere with routine tests

A

Toluene

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48
Q

Floats on urine surface; clings to glass wares

A

Toluene

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49
Q

Prevents glycolysis; good preservative for drug analysis

A

NaF

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50
Q

Inhibits reagent strip tests for glucose, blood and leukocytes

A

NaF

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51
Q

May use Na benzoate instead of fluoride for reagent strip testing

A

NaF

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52
Q

Does not interfere with routine tests

A

Phenol

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53
Q

Causes odor change

A

Phenol

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54
Q

Use 1 drop per ounce of specimen

A

Phenol

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55
Q

Preserves cellular elements

A

Saccomanno (50% ethanol + 2% carbowax)

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56
Q

Used for cytology studies (50 mL urine)

A

Saccomanno (50% ethanol + 2% carbowax)

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57
Q

Convenient when refrigeration is not possible

A

Commercial tablet preservatives

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58
Q

May contain one or more of the preservatives including NaF

A

Commercial tablet preservatives

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59
Q

Check tablet composition to determine possible effects on desired test

A

Commercial tablet preservatives

60
Q

Contains collection cup, C&S preservative tube or UA tube

A

Urine Collection Kits

61
Q

Sample stable @ RT for 48 hrs; bacteriostatic

A

Gray C&S tube

62
Q

Decreases pH; do not use if urine is below min fill line

A

Gray C&S tube

63
Q

Boric acid is the preservative and may not be used for UA

A

Gray C&S tube

64
Q

Used on automated instruments

A

Yellow plain UA tube

65
Q

Must refrigerate within 2 hours

A

Yellow plain UA tube

66
Q

Round/conical bottom

A

Yellow plain UA tube

67
Q

Stable for 72 hours at RT; instrument compatible

A

Cherry red/yellow top tube

68
Q

Bilirubin and urobilinogen may be decreased if specimen is exposed to light and left at RT

A

Cherry red/yellow top tube

69
Q

Na propionate is the preservative

A

Cherry red/yellow top tube

70
Q

METHODS OF URINE COLLECTION

A
  1. Bottle Method
  2. Plastic Bag with Adhesive
  3. Urethral Catheterization
  4. Suprapubic Aspiration
71
Q

most-commonly used method; performed via midstream clean catch

A
  1. Bottle Method
72
Q

for pediatric patients

A
  1. Plastic Bag with Adhesive
73
Q

catheter is inserted up to the urinary bladder or ureter

A
  1. Urethral Catheterization
74
Q

collected via external introduction of a needle through the abdomen and into the bladder

A
  1. Suprapubic Aspiration
75
Q

Routine screening

A

Random specimen
First Morning Specimen
Midstream CleanCatch Specimen

76
Q

Pregnancy tests

A

First Morning Specimen

77
Q

Orthostatic protein

A

First Morning Specimen

78
Q

Diabetic screening/monitoring

A

Second Morning Specimen (Fasting Specimen)
2-hour Post Prandial Specimen

79
Q

Urobilinogen testing

A

Afternoon specimen
Early Afternoon specimen (2-4pm)

80
Q

Addis Count (Sediments)

A

12-hour urine sample

81
Q

Quantitative chemical tests

A

24- hour (Timed) Specimen

82
Q

Accompaniment to blood samples in glucose tolerance test

A

Glucose Tolerance Specimen

83
Q

Bacterial culture

A

Catheterized Sample
Midstream CleanCatch Specimen
Suprapubic Aspiration

84
Q

Cytology

A

Suprapubic Aspiration

85
Q

Prostatic infection

A

3- glass collection

86
Q
  • Ideal specimen for routine UA and Pregnancy test
A

First Morning Specimen

87
Q
  • Concentrated, most acidic: for well preservation of casts
A

First Morning Specimen

88
Q
  • For evaluation of Orthostatic Proteinuria
A

First Morning Specimen

89
Q
  • 2nd voided urine after a period of fasting
A

Second Morning Specimen (Fasting Specimen)

90
Q
  • For Nitrite determination
A

4-hour urine

91
Q
  • Urine remains in the bladder for at least 4 hours before voiding
A

4-hour urine

92
Q

 By Thomas Addis(1926)

A

Addis count

93
Q

 Quantitates formed elements in a 12-hour overnight urine collection

A

Addis count

94
Q

 used primarily to monitor the course of diagnosed cases of renal disease

A

Addis count

95
Q

Addis count

 Casts:
 RBC:
 WBC:

A

 Casts: >5, 000
 RBC: >500, 000
 WBC: >2,000,000

96
Q

 First specimen voided.

A

First Morning Specimen

97
Q

 Most ideal specimen for screening/ testing

A

First Morning Specimen

98
Q

 Most concentrated specimen.

A

First Morning Specimen

99
Q

 Essential specimen for pregnancy test and orthostatic/ lordotic proteinuria

A

First Morning Specimen

100
Q

 Second voided specimen after a period of fasting.

A

Second Morning Specimen (Fasting Specimen)

101
Q

 Best specimen for glucose monitoring.

A

Second Morning Specimen (Fasting Specimen)

102
Q

 Specimen collected after 2 hours of eating.

A

2-hour Post Prandial Specimen

103
Q

 Specimen used for monitoring insulin therapy in patients with DM.

A

2-hour Post Prandial Specimen

104
Q

 Glucose result from this specimen is compared with 2PPBS.

A

2-hour Post Prandial Specimen

105
Q

Begins and ends with an empty bladder; requires preservative depending on the test to be performed

A

24- hour (Timed) Specimen

106
Q

 Most commonly requested for urine specimen for bacterial culture.

A

Catheterized Sample

107
Q

 Used to measure functions in the individual kidneys

A

Catheterized Sample

108
Q

 Safer, less traumatic specimen that is suitable for routine urinalysis and bacterial culture.

A

Midstream CleanCatch Specimen

109
Q

 Females: separate the skin folds

A

Midstream CleanCatch Specimen

110
Q

 Collected directly from the urinary bladder.

A

Suprapubic Aspiration

111
Q

 For bacterial bladder urine culture.

A

Suprapubic Aspiration

112
Q

 Also used for cytologic examination

A

Suprapubic Aspiration

113
Q

 Specimen used for the detection of prostatic infection.

A

3- glass collection

114
Q

 1st glass sample-

A
  • first urine passed
115
Q

 2nd glass sample-

A
  • midstream portion
116
Q

 3rd glass sample-

A
  • prostate massage, remaining urine
117
Q

Urine after prostatic massage
Examine the 1st and 3rd specimen microscopically, then compare the number of WBC and bacteria

A

3- glass collection

118
Q

in the number of WBC and bacteria in the 3rd specimen is 10x greater than that of the 1st specimen

A

Prostatic Infection=

119
Q

= CONTROL for bladder and kidney infection. If (+) for WBCs and bacteria, the result from the 3rd specimen is INVALID

A

2nd Specimen

120
Q

 -tested for urethral infection or inflammation

A

VB1

121
Q

 -tested for urinary bladder infection

A

VB2

122
Q

 - cultured and examined for white blood cells(>10-20 WBCs/HPF is considered abnormal)

A

EPS

123
Q

 - postprostatic massage urine specimen

A

VB3

124
Q

 Clean-catch midstream urine is collected

A

PPMT(PRE AND POSTMASAGE TEST)

125
Q

 Second urine is collected after the prostate is massaged

A

PPMT(PRE AND POSTMASAGE TEST)

126
Q

 Positive result: >10 x the premassage count

A

PPMT (PRE AND POSTMASAGE TEST)

127
Q

 Specimen collected from pediatric patients.

A

Pediatric Specimen

128
Q

 Uses weebag, a soft, clear plastic bag with adhesive, for collection.

A

Pediatric Specimen

129
Q

soft, clear plastic bags with hypoallergenic skin adhesive to attach to the genital area of both boys and girls

A

Pediatric Specimen

130
Q

: process that provides documentation of proper sample identification from the time of collection to the receipt of laboratory results.

A
  • Chain of Custody
131
Q
  • Required volume: 30-45 ml
A

Drug Specimen

132
Q

Drug Specimen

  • Temperature (within 4 minutes):
A

Drug Specimen
32.5-37.7°C

133
Q
  • Bluing agent is added to the toilet water reservoir to prevent specimen adulteration
A

Drug Specimen

134
Q
  • At least 2 voided collection
A

Fractional Specimen

135
Q
  • Series of blood and urine samples are collected at specific time intervals to compare concentration of a substance in urine with its concentration in the blood (diagnosis of diabetes)
A

Fractional Specimen

136
Q

 Specimens collected anytime of the day

A

Random specimen

137
Q

 Most commonly received specimen in the laboratory.

A

Random specimen

138
Q

 Useful for routine screening tests to detect obvious abnormality

A

Random specimen

139
Q

 It is the total daily urine output.

A

24- hour (Timed) Specimen

140
Q

 Used for quantitative urine testing.

A

24- hour (Timed) Specimen

141
Q

 Begins and ends with an empty bladder

A

24- hour (Timed) Specimen

142
Q

 If placed in 2 containers, mixed the urine samples well first before aliquoting

A

24- hour (Timed) Specimen

143
Q

 Urine Creatinine determination

A

24- hour (Timed) Specimen

144
Q

 4-aminobenzoic acid (gold standard)

A

24- hour (Timed) Specimen

145
Q

24- hour (Timed) Specimen

o Adult -
o Less than 1 year old -
o 1 to 14 years old -

A

600-2000 mL/ 24 hours
100-500 mL/ 24 hours
500-1400 mL/ 24 hours

146
Q

 Specimen for used to check for the ability of the kidney to metabolize a measured amount of glucose.
 Correlated with renal threshold.
 side by side specimen with OGTT.

A

Glucose Tolerance Specimen

ANURBF LEC (9 decks)

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