Urinalysis
Urinalysis aids in _________________________________
disease diagnosis and therapy
Urine is formed from ____________
plasma
Urine is _______% water and _______% solutes
95; 5
The main organic urine solutes are ____________________________
urea, creatinine, and uric acid
The main inorganic solids dissolved in urine is _______________________
chloride, sodium, and potassium
The normal urine output is _______________mL
1200-1500
For lab testing, ________________mL of urine is normal
600-2000
Oliguria:____________
< 400 mL/day urine output
Anuria: ____________
no urine output
Nocturia: ________________________________
increased urine excretion at night
Polyuria: _____________________
2.5 L/day
Polyuria is often associated with _______________________________________________ along with Polydipsia
diabetes mellitus/ insipidus
________________________ is an insulin defect causing increased glucose and high SG
Diabetes mellitus
______________________ is an ADH defect, causing low SG
Diabetes insipidus
_________ mL of urine is the recommended amount of urine to collect
50
Specimens should be delivered promptly and tested within ____________, if not tested immediately it should be refrigerated at 2-8℃ or have a chemical preservative added
2 hours
_____________________________ are the most commonly recieved and is used for routine screening
Random Specimen
The __________________________ is ideal due to it being the most concentrated
First morning void
_____________________________ interprets the patients ability to metabolize a measured amount of glucose
Glucose tolerance specimens
________________________ tests for infections in the bladder
Catherized Specimens
__________________________ is used for routine screening but is less contaminated than random specimens
Midstream clean-catch specimen
_______________________ stabs a needle through the abdomen into the bladder, keeping the sample completely free of extraneous contamination
Suprapubic Aspiration
_________________________ uses clear plastic bags that attach to the genital area
Pediatric Specimen
Normal urine color is a pale to ____________________ yellow color
darkish/ orangish
__________________ is what primarily gives urine its yellow color
Urochrome
Darkish/ orangish yellow urine can also be abnormal if _________________ is present
Bilirubin
Bilirubin will be detected during the chemical examination and will also produce a slowly dissipating ______________ when shook
yellow foam
______________________ (a medication) causes urine to turn orange
Pyridium
Red/pink/brown urine shows the presence of _________ in the urine
blood
Old, Acidic RBC specimens have a brown urine due to the oxidation of hemoglobin to __________________
methemoglobin
Intact _____________ make urine red and cloudy
RBCs
_____________________ makes urine red and clear
Hemoglobin or myoglobin
Brown/ Black urine (if not RBCs) is caused by the use of certain medications or the presence of __________________________________
melanin or homogentisic acid
Blue/ Green urine suggest ______________ or medication/ Cloret use
bacterial infections
Specimen that are allowed to stand or are refrigerated may develop tubididty from the precipitation of ____________________
amorphous phosphates and urates
Non pathologic turbidity could show the presence of _____________________________ or improper preservation
squamous epithelial cells and mucus
Pathologic turbidity is caused by the presence of _____________________________ from infections or organ disorders
RBCs, WBCs, and Bacteria
Reagent Strip QC should be done every _______ hrs, if you recevive questionable results, or the strips are questionable
24
The kidneys are the major regulators of the bodys ______________ content
acid-base
The pH of most random specimen samples range from _______, but never exceed _____
4.5-8.0; 8.5
Urinary pH is helpful in determining the existence of systemic acid base disorders as well as the ______________________ and if the specimen was stored properly
identification of crystals
Multistix and chemstrip brands use a double indicator system of _____________________ (4-6 pH) and ____________________ (6-9 pH)
methyl red and bromythol blue
___________ between reagent strip pads may affect pH
Run-over
testing for proteins in urine is the most indicative test for _______________
renal disease
_______________ is the major protein in urine
Albumin
Proteinuria is indicated at ⪰____ mg/dL or ⪰____ mg/day and can be from prerenal, renal, or postrenal origin
30; 300
_________________________________ is seen in the urine of Multiple myeloma patients
Bence Jones Protein
Protein reagent strip testing is sensitive to albumin and contains _________________________________________
tetrabromophenol blue
The strip appears yellow (pH 3) in the absence of proteins and trace values are considered less than ___mg/dL
30
Highly buffered alkaline urine, Highly pigmented urine, container contamination, and high specific gravity urine may cause a _____________ result for proteins
false positive
The ___________ test is a confirmatory test for proteins of all forms
SSA
The renal threshold for glucose is _________________ mg/dL and remaining is excreted in the urine
160-180
The _______________ test is the most frequently preformed chemical analysis on urine
glucose
Glycosuria is excess amounts of glucose in urine and usually seen in ______________________
diabetes mellitus
Hyperglycemia during pregnancy is called ___________________________
gestational diabetes
The reagent strips use ______________________ to measure urine glucose with a double sequential enzyme reaction
glucose oxidase
Urine glucose is measured in ranges of _____ mg/dL (0.1%) to ____ g/dL (2%)
100; 2
Ascorbic acid, ketones, high SG, and bacterial growth may cause ___________________ for glucose
false negatives
peroxide or oxidizing detergents may cause a _______________ for glucose
false positive
The _______________ reduces copper sulfate to cuprous oxide and tests for glucose and galactosemia in newborns
Clinitest
Ketones consist of ______________________________
Acetone, Acetoiacetic acid, and Beta-hydroxybutyrate
Ketones appear in urine when body fat must be metabolized in cases of vomiting, starvation, and inability to metabolize carbs (such as in ______________________)
diabetes mellitus
Reagent strips for ketones primarily measures __________________ which reacts with sodium nitroprusside to produce a purple color
acetoacetic acid
__________________________________ may cause atypical colors for ketones
Levodopa and sulfer-based medications
Bacteria and the volatilization of acetone may produce a ________________ for ketones
false negative
__________________ are a non-confirmatory test for ketones and gives better color differentiation due to the addition of lactose
Acetest tablets
___________________ can be from nonpathological or pathological causes (such as kidney stones)
Hematuria
____________________ may result from RBC lysis caused by brown recluse spider bites and the presence of Hemosiderin
Hemoglobinuria
_________________ may be present in rhabdomyolysis patients
Myoglobinuria
Reagent strips use the pseudoperoxidase activity of hemoglobin and uses the chromagen ___________________________
tetramethylbenzidine
Free hemoglobin/ myoglobin will range from yellow-green-blue and ______________ result in a speckled pattern on the pad
intact RBCs
Reagent strip tests can detect concentrations as low as ____ RBCs/microL
5
Oxidizing detergents, vegetable peroxidase, Bacterial Enzymes, and menstrual contamination may cause ____________________ for blood
false positives
Failure to mix and Ascorbic Acid may cause _____________________ for blood
false negatives
10-15 mL of fresh or adequately preserved urine is gently mixed and centrifuged at _________________ minutes, leaving a small amount of urine and sediment ready for microscopic examination
400 RCF for 5
When examining sediment under a microscope, you first look under low power to detect casts and the general composition of the sediment, then high power for ____________________
identification
_____________________________ is the most frequently used and shows WBCs, epithelial cells, and casts
Sternheimer-Malbin Stain
_________________________________ enhances nuclear details
Toluidine Blue
___________________ enhances nuclear detail however it lyses all RBCs, so should be done after initial analysis
2% Acetic Acid
______________________ stains triglycerides and fats
Lipid Stain
__________________ is preferred for detecting urinary eosinophils
Hansel Stain
Prussian blue stain is to detect the iron from ____________________
hemoglobin breakdown
______________ suggest the presence of urinary RBCs
Ghost cells
Urinary RBCs suggest _________________________________ in the genitourinary tract
glomerular damage or vascular injury
______________ suggest the presence of urinary WBCs
Glitter Cells
______________ in the urine suggest drug induced nephritis or a UTI
Eosinophils
Mononuclear cells along with eosinophils suggest _______________________
renal transplant rejection
Urinary WBCs suggest glomerular or capillary trauma and ________________________ of the genitourinary system
infection or inflammation
___________ is an increase in the number of urinary WBCs
Pyuria
_____________________ are classified as squamous, transitional, or as RTEs according to their site of origin
Epithelial cells
_________________ are the largest found and has a prominent nucleus
Squamos EC
Clue Cells are a variation of Squamos EC and suggest vaginal infection by the bacterium ___________________
Gardnerella Vaginalis
_________________ have bacteria covering most of the cell and extending beyomg the edges
Clue cells
______________________ can be Spherical, Polyhedral, or have "Tails", but all forms have a centrally located nucleus
Transitional EC
RTEs can be columnar, round, oval, or cuboidal and have an ________________________
eccentrically placed nucleus
The presence of large amounts of __________ indicates tubular necrosis
RTEs
____________________ are RTEs that absorbed lipids and are usually present with free floating fat droplets
Oval Fat Bodies
Oval Fat bodies and Lipiduria suggest ______________________ from nephrotic syndrome
glomerular damage
Bacteria along with WBCs suggest a ___________
UTI
A true yeast infection is accompanied by ___________
WBCs