Urinalysis Study Guide
MLT Hematology/Urinalysis Study Guide (MLT Phase II - Ft. Polk, LA)
Terms in this set (69)
What is the preferred specimen?
Early morning collection; concentrated urine specimen
When should urinalysis be performed?
Within 2-4 hours to avoid deterioration of sediment or a change in chemical composition
How can you inhibit bacterial growth in urine?
Refrigerate at 5C for up to 48 hours
When does bacterial division occur?
Within 45 minutes, at room temp
When do you perform a culture and why?
Before urinalysis, to avoid contamination
What gives urine it's color?
Urochrome pigment, to verify a specimen is urine, perform a chemistry test for creatinine and BUN
What does a cloudy urine with a negative dipstick indicate?
Whay does a cloudy urine with a positive dipstick indicate?
Abnormal cellular material (RBCs, WBCs, casts, etc.)
What does a red to reddish brown urine indicate?
BLood, hemoglobin or myoglobin
What does a black urine indicate?
Malaria parasite infection
What does a green urine indicate?
What controls are ran?
Positive and negative controls are run daily on both primary and backup tests
How are reagent strips stored?
Store with desiccant in an opaque, tightly closed container in a cool place, but do not refrigerate; keep from volatile fumes
How do you care for reagent strips?
Do not use past expiration date, use within three months, do not use if chemical pads become discolored
What is proteinuria associated with?
Early renal disease
When is Bence-Jones protein excreted?
Multiple myeloma cases
What is Bence-Jones characterized by?
Ability to precipitate at 60C and dissolve at 100C
Positive protein dipsticks are often found in conjunction with what?
Casts, RBCs, WBCs or bacteria
What is the clinical significance of urine protein?
Glomerular membrane damage, impared tubular reabsorption, multiple myeloma, preclampsia and diabetic nephropathy
What can the dipstick glucose oxidase reaction miss?
Reducing sugars, such as glactose and fructose
What is performed on all urines from children under two?
What is the clinical significance of urine glucose?
Diabetes mellitus, impared tubular reabsorption, CNS damage and possible diabetic pregnancy
What does Clinitest detect?
Non-glucose reducing substances
What is pass through?
Rapid reaction from blue to orange to blue; repeat test with 2 drop method
What are ketones?
Intermediate products of fat metabolism
What are the three ketones?
Acetone, acetoacetic acid and beta-hydroxybutyric acid
What ketone does the dipstick react strongly with?
What is ketosis most frequently associated with?
What is the clinical significance of urine ketones?
Diabetes acidosis, insulin dosage monitoring and starvation
What is the nitrite test based on?
Reduction of nitrate in the urine to nitrite by bacteria
What is the clinical significance of urine nitrite?
Cystitis, pyelonephritis, evaluation of antibiotic therapy, monitoring of patients at high risk for urinary tract in fection and screening of urine culture specimen
What is bilirubin an indication of?
Liver disease, seen before the onset of jaundice
What is the clinical significance of urine bilirubin?
Hepatitis, cirrhosis and biliary obstruction
What does urobilinogen come from?
Degradation of hemoglobin; useful in detection of liver disease
What is the clinical significance of urine urobilinogen?
Liver disease, hemolytic disorders and porphyrinuria
What is leukocyte esterase?
Standardized test for detection of leukocytes
What is leukocyte esterase an indication of?
What is the clinical significance of leukocyte esterase?
Urinary tract infection, screening of urine culture cpecimens, detection of lysed leukocytes and standardized detection of leukocytes
How is blood presented in urine?
As intact RBCs (hematuria, green spots on dipstick, cloudy red urine) or lysed RBCs (hemoglobinuria, solid green on dipstick, clear red urine)
What does a clear red urine contain?
Hemoglobin, myoglobin or lysed RBCs
What is the clinical significance of hematuria?
Renal calculi, glomerular nephritis, pyelonephritis, tumor, trauma, exposure to toxins or strenuous exercise
What is the clinical significance of hemogloblinuria?
Tranfusion reaction, hemolytic anemia, severe burns, infection or strenuous exercise
Where is myoglobin found?
Muscle tissue; produces a clear, red urine
What is the clinical significance of myoglobinuria?
Muscular trauma, prolonged coma, convulsions, muscle-wasting disease or extensive exertion
What is the glucose backup test?
What is the bilirubin backup test?
What is the protein backup test?
What is the ketone backup test?
What is the leukocyte esterase backup test?
How is urine centrifuged for a microscopic exam?
10-12mL centrifuged at 1400-2000 rpm for 5 minutes
What is hematuria?
Presence of RBCs in urine
What is hemoglobinuria?
Presence of lysed RBCs or hemoglobin in urine
What is pyuria?
Presence of WBCs in urine
Which epithelial cells contain lipids?
Renal tubular epithelial cells
What are oval fat bodies?
Renal tubular cells filled with numerous fat droplets
What are ideal conditions for cast formation?
Presnce of protein in an acidic environment
In what sequence do casts appear?
Hyaline, granular and broad
What is the clinical significance of hyaline casts?
Acute glomulerulonephritis, pyelonephritis, chronic renal disease and congestive heart failure
How are casts reported?
Number per low power field; #/lpf
What is the clinical significance of RBC casts?
Acute pyelonephritis, glomerulonephritis and renal inflammation
Which crystals look like coffin lids?
Which crystals look like thorny apples?
Which crystals look like envelopes?
Which crystals look like dumbbells?
Which crystals look like spheres with concentric circles?
Which crystals have notched corners?
Which crystals look like fine needles?
Which crystals look like hexogonal plates?
What are clue cells?
Squamous epithelial cells inundated with coccoid bacteria