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97 Cards in this Set
- Front
- Back
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Clinical reasons for performing urinalysis testing
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important indicator of health, used to detect renal, unrinary tract and systemic disease.
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What happens to urine when left at room temperature?
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It will decompose and leave inaccurate results due to presence of bacteria
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Urine specimens should be analyzed while fresh and preferably within how many hours?
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1
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If immediate analysis is not possible, then urine should be
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refrigerated until examined
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Urea splitting bacteria in unpreserved urine will cause what?
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amonia (which causes pH to increase in combination with hydrogen ions)
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An increase in pH will disolve what in urine if present?
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casts
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How much Toluene should be used in a specimen?
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2mL per 100 mL of urine
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What effect does tolune have?
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floats on the surface of specimen creating an airtight seal from the environment
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How much Formalin should be used in a specimen?
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1 drop per 30 mL of urine
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What is Formalin used for?
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to preserve urinary sediment/cells
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Thymol has what effect?
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preserves urine by inhibiting bacteria/fungus
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What does thymol cause?
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false positive protein level
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How much preservative should be used?
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1 tablet per 30 mL of urine.
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What do preservatives release?
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formaldehyde
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What does chloroform do?
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inhibits bacterial growth
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Name the benefits of first morning void.
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Most concentrated
Increase number of abnormal elements Decreased deterioration of formed elements |
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What is recommended for chemical and microscopic exams?
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First morning void
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What is the advantage of collecting a random urinalysis?
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collect anytime
most convenient and most common can detect abnormalities, but not as sensitive as FMV |
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What is specimen of choice for bacterial cultures?
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clean catch (midstream)
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What is the purpose of the 24 hour urine specimen?
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quantitative results
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Describe the physical examination of urine
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color, odor and clarity
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Describe the chemical examination of urine.
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pH, protein, glucose, ketones, occult blood, leukocyte esterease, nitrate, urobilirubin and bilirubin
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Normal value of a 24 hour period?
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600-2000 mL
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Normal average of urine in 24 hour period?
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1500mL
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Pigment of urine is called what?
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urochrome
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Dark Orange urine indicates what?
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pyridium
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Blue green urine?
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methylene blue
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olive green to brown urine?
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phenols
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Why would urine have a cloudy or turbid appearance?
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phosphate and carbonates
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If urine had a pinkish turbidity what may be present?
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urates (crystals)
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Why would tones be present?
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decrease intake of carbohydrates, , digestive disturbance, dietary imbalance, eclampsia, prolonged vomiting and diarhhea.
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What is ketonuria?
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result of imcomplete fatty acid utilization.
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What may ketones indicate?
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DM, restricted carbohydrates and following anesthesia
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What is the presence of blood in urine termed as?
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hematuria
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Intact RBC's present is indicative to what?
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damage to kidney or urinary tract
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Urine may appear as what if blood is present in urine?
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red and "smoky"
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Normal range for specific gravity?
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1.015-1.030
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Purpose of specific gravity?
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measures the concentrating and diluting ability of kidney
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If bilirubin is present in the urine what condition does the patient most likely have?
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jaundice
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How does bilirubin appear in the urine?
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brown to black (amber)
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What does bilirubinuria indicate the prescense of?
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hepatocellular disease or intra or extra hepatic biliary obstruction
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What is normally present in urine, but concentration of 1 EU or less?
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Urobilinogen
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May be indicative of UTI
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Bacteriuria
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Severe proteinuria
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greater than 3.5 g/day
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Proteinuria is an important indicator for what disease?
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renal disease
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Proteinuria may cause what in patients?
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Glomerular damage
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What is Intercapillary glomerulosclerosis?
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severe venous congestion of the kidney.
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Severe Proteinuria is indicative of what?
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Glomerulonephritis
Lupus nephritis amyloid disease lipoid nephrosis intercapillary glomerulosclerosis |
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Range for Moderate proteinuria
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0.5-3.5 g/day
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Moderate proteinuria is indicative of what?
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Nephrosclerosis
Tubular Interstitial disease Preeclampsia |
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Range for Minimal proteinuria
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less than 0.5 g/day
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What is indicative to minimal proteinuria?
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polycystic kidneys
chronic pyelonephritis |
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What is the quanity of glucose in the urine dependent on?
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blood glucose level, rate glomerular filtration, and the degree of tubular reabsorption.
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Most concentrated urine psecimen?
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First morning void
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squamous epithelial cells are considered what?
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contaminents in urine
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Cystine crystals are what shaped?
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hexagonal
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Triple phosphate crystals are what shaped?
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coffin lid
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If urine is exposed to light what happens to the pH?
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increases
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Crystals found in alkaline urine are what?
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triple phosphate, calcium carbonate and ammonium biurates
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If uric acid in urine is present suspect what?
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gout
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what crystals are seen together in urine?
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tyrosine and luecine
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Describe calcium oxalate crystals
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octahedral, envelope shaped ot biconcave discs
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Important indicator for renal disease
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protein
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Glucose will appear in urine once the threshold of what in the blood if exceeded?
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160-180 mg/dl
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What is polyuria?
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increase urine output
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What is oliguria?
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decrease urine output.
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UTI by E.coli is
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acidic urine
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UTI by pseudomonas is
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alkaline urine
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pH of urine is
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4.6-8.0
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average pH of urine is
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6.0
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most common casts found in urine
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hyaline
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increase of hyaline cast are due to what?
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strenuous exercise and dehydration
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Red cell casts are due to what?
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glomerulonephritis, nephritis and renal trauma
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Granular casts are due to what?
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renal disease or following strenuous exercise
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How are crystals and casts documented
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present
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Waxy casts are due to what?
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renal failure, malignant HTN, renal amyloidosis, diabetic nephrology, tubular inflammation and degeneration, and during renal allograft rejection
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How is yeast and mucous documented?
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present
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How is bacteria documented?
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trace
few moderate many |
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How are parasites and sperm documented?
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noted
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Fields that must be counted when counting wbc's in urine is
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10-15 fields
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Fecal oocult blood is defined as the presence of what in the stool?
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hidden or unseen blood
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When fecal occult blood is present in large amounts, fecal blood may be readily indentified how?
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macroscopically
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Bright red blood can coat the surface of the stool with what kind of condition?
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Lower GI tract bleeding
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Upper GI tract may cause the stool to appear how?
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dark or mahogany
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Fecal blood is a frequent and early symptom of what?
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colorectal cancer
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50% of GI tract cancers are what?
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colorectal cancer
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What type of diet should a patient be on before collecting a fecal sample
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meat free for 3 days and high fiber
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How many specimens and for how many days should a patient collect a fecal sample for?
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3 specimens from 3 seperate days
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Before placing the stool sample on the test card where would you collect the sample from
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use aliquot from the center of the stool sample
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Test kits are designed to pick up samples between __________, passages of more than_________ may be an important sign of GI disease
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5-10 mL
2.8 mL |
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How many times must a test be repeated to be completely valid?
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3-6 times
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Patient's diet should be free of meats, fish and vegetables with _______ activity
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peroxidase (Vitamin C)
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What test should be completed if results require further studies?
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colonoscopy
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What drugs can cause false positives?
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Boric Acid
Bromides Colchicine Iodine Inorganic iron Oxidizing agents |
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Within how many days should a sample be tested within?
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6 days
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What percentage of false positives occur in tests?
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10%
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What color will a positive reaction show?
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blue
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