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BOC Terms in this set (101)A patient with uncontrolled diabetes mellitus will most likely have pale urine with high specific gravity -High specific gravity is due to the glucose in the urine. People w/diabetes have polyuria, so the volume of urine dilutes the urochrome (color), making it pale. Urine specimen of a baby is giving a "mousy" ordor. What is it? Phenylpyruvic acid -Phenylkentonuria is genetic disorder results in a mousy odor. Urine specimen that gives off a "fruity" odor? Acetone Urine specimen with an ammonia odor? Bacterial infection **ammonia is byproduct of urea breakdown Urine specimen with no odor, but has a red color? Porphyrin Urine with a black pigment Melanin Urine with a amber/brown color Bilirubin Urine from a 50-year-old man was noted to turn dark red on standing. This change is caused by: Porphyrins -The 2 pigments in urine is porphrin and urochrome. Urochrome is the "urine color" which is yellow and porphyrin is red Milky urine from a 24 year old woman would most likely contain Many WBCs -Women's urine will be milky due to UTIs, in which many WBCs are present Urine that has a green/brown pigment Bile Urine that is red or white in color RBCs Red urine may be due to: myoglobin Dark urine while standing may be due to Homogentistic acid Urine specimen from healthy 25 year old was cloudy after he ate a meal. Everything was normal on reagent strip analysis. The cause of the cloudy turbidity is due to Phosphates -Since he is healthy, the turbidity is nonpathologic. After meals, urine is more alkaline; referred to alkaline tide. Due to the pH, amorphous phosphate may be found What metabolic disease will turn the urine dark brown to black upon standing Alkaptonuria Urine osmalaity is related to Specific gravity Urine specific gravity is an index of the ability of the kidney to Concentrate the urine Osmality is a measure of dissolved particles, including ions A patient urine sample has an increased protein and a high specific gravity. Which of the following would be a more accurate measure of urine concentration Osmolality To prep a solution appropriate for quality control of the refractometer, the laboratorian should use Sodium Chloride w/Specific Gravity of 1.022 -b/c it is the easiest control (6.5% NaCl) A urine's specific gravity is directly proportional to its Dissolved Solids -dissolved solids (salt, sugar, urea, etc.) contribute to specific gravity Isosthenuria is assoc. w/ specific gravity which is usually Fixed around 1.010 Specific gravity less than 1.010 Hyposthenuric Specific gravity greater than 1.010 Hypersthenuric the fluid leaving the glomerulus has a specific gravity of 1.010 -the fluid leaving the golmerulus is isosthenuria A deficiency in arginine vasopressin (antidiuretic hormone [ADH]) is assoc with Low urine Specific Gravity -Diurectics cause people to lose water as urine. Arginine Vasopressin (AVP) aka ADH, has opposite effect that retaining water. Deficiency of AVP result in a loss of water in urine. The amount of solutes is not altered, but diluted causing a low specific gravity When using refractometer to measure urine concentration, laboratorian must correct what calculation Glucose -corrections for glucose and protein must be calculated Calibration of refractometer is performed by measuring specific gravity of distilled water and Sodium Chloride Method used for performing specific gravity of urine following administration of x-ray contrast dye is Reagent Test Strip What urinary paramenters are measured during the course of concentration and dilution tests to assess renal tubular function Osmality
and Specific Gravity Refractive index is a comparison of light velocity in air to light velocity in solutions -light bends when it hits the surface of liquid, b/c liquid slows down its velocity. (Refraction) A patient has 2 separate urinalysis reports: Protein, glucose, and microscopy of A are false-negs. b/c of the specific gravity -The S.G. is very dilute. Thsi result in concentration of urine constitutes being too low, below ability to detect by chemical and microscopic examine After reciving 24- hr urine for quantitative total protein analysis, the labortorian must Measure the Total Volume Urine specimen stored uncapped at 5 degrees Celcius w/o preservation and retested, what value would be changed? Ketones -The sample is mistreated and ketones will evaporate What would be affected if a urine is sat out at room temp. for 3 hours before testing pH -it is affected by metabolism of urine components by bacteria, so the room temp. is warm enough to change the value 24-hour urine from a man with no evidence of kidney impairment was sent to the lab for hormone determination. Volume was 600 mL, but question as completeness of 24-hr collection. Next step? Check the Creatine level; if its >1, do the procedure -Approx. Volume of daily void is 1,500mL but can range 600-2,000 mL, eventhough 600 mL is low. Creatinine is excreted at approx. 1.2 g/24 hr eGFR calculated by the MDRD formula takes into account the age, BUN, race, albumin, and what else for its calculations? Creatinine -eGFR= Estimated
Glomerular Filtration Rate Test The creatinine clearance is reported in ml/min Which of the following can give a false-negative urine protein reading Very dilute urine The pH of a urine speciemen measures the Free hydrogen ions -urine pH is a number; NOT a concentration Upon standing at room temperature, a urine pH typically Increases, due to the breakdown of urea to ammonia by urease producing bacteria, and loss of CO2 The principle of the reagent strip test for urine protein depends on Protein error if indicators -2 pH indicators are incorporated in the strip. Protein accepts H+ ion from the pad, resulting a pH and color change Protein section of urine reagent test strip is most sensitive to Albumin, most abundant plasma protein and in nephrophathy it is abundant in urine. -Nephrophathy is disease in the kidneys damaging the blood vessels Routine screening of urine samples for glycosuria is performed primarily to detect Glucose -glycosuria is the excretion of glucose into the urine. The test pad for urine reagent strip impregnated w/ only sodium nitroprusside. The pad will react with acetoacetic (diacetic) acid -Sodium nitroprusside is the reagent for ketones. Ketones react with acetoacetic acid A reagent strip impregnated with stabilized, diazotized 2,4 dichloroaniline will yield a positive reaction with? Bilirubin, because diazo reagent is used for What interfere w/reagent test strip for leukocyte esterase and yield a false-negative result Protein >500 mg/dL -increased protein, glucose (>3 g/dL), and specific gravity can reduce sensitivity of the leukocyte esterase pad causing false-negs. Excess urine on the reagent strip can turn a normal pH result into a falsely acidi pH when which of the following reagents runs into the pH pad Citrate buffer -Protein pad if the strip is held together by citrate buffer. If urine gets on the buffer pad it can cause a falsely acidic pH. This is why it is important to blot A false-positive protein on a test strip may occur in the presence of Highly alkaline urine 17 year old decided to starve herself, what substance would most likely be found in her urine a week later Ketones -byproducts of fat metabolism, so during low carb or starvation diets, ketones can be found. Vomitting leads to dehydration and utilization of fat for energy A patient's urinalysis revealed a positive bilirubin and a decreased urobilinogen level. these results are associated with Biliary obstruction -it inhibits the normal flow of conjugated bilirubin into the intestine and backs up into the blood. It will be filtered in the urine. Urobilinogen is product of bacterial reduction of bilirubin in intestine. In the obstruction, less bilirubin reaches the intestine and less is converted to urobilinogen Urine specimen w/ elevated urobilinogen and neg bilirubin may indicate: Hemolytic Jaundice -total bilirubin (urobilinogen) goes up, but directed/conjugated bilirubin does not Microscopic analysis of urine specimen yields mod. amt of RBCs in spite of a negative result for occult blood using reagent strip. The labortorian should see if the patient has taken Vitamin C -Vit C is a ascorbic acid, which inhibits reactions that use peroxidase Principle of reagent strip test for microalbuminuria is an immunochemical reaction Reason that albumin:creatinine ratio can be performed on random specimen is Creatinine corrects for over or under body hydration -The amt of creatinine that is excreted at a constant rate can correct the hydration and dehydration rate To prep the reagent used in confirmatory protein testing, a laboratorian would Dissolve 3 g sulfosalicylic acid in 100 mL of water -3% SSA is used to confirm positive protein test A positive result for bilirubin on reagent test strip should be followed up Performing a Ictotest -this test is used to detect the presence of bilirubin in the urine, which is important to know to evaluate the liver function. All positive dipstick bilirubin test should be followed by the Ictotest Clear, red-brown urine specimen resulted in positive reaction for blood on the reagent test strip, but no RBCs were seen in the microscope. Most likely the presence of Myoglobin -tests positive w/reagent strip for blood. Myoglobin is heme-containing muscle protein A urine tested with Clinitest exhibits a passthrough reaction and is diluted by adding 2 drops of urine to 10 drops water. This is a dilution of? 1:6 -2 drops of urine + 10 drops of water= 2/12 proportional. 12 is the toatal volume (2 drops urine + 10 drops of water) 2/12 making it 1:6. Performing a routine urinalysis, the lab notes 2+ protein result. They should: Confirm w/acid precipitation test Confirmatory test for positive protein result by reagent strip method Sulfosalicyclic acid -this will precipitate protein Confirmatory test for positive urobilinogen Ehrlich Confirmatory test for positive bilirubin Diazo Confirmatory test for reducing substances Copper reduction Women in 9th month of pregnancy has neg urine glucose and positive reaction w/copper reduction method on the reagent strip. The reducing substance most likely responsible for Lactose -since the glucose is negative it cant be the glucose, but since she is pregno, she is developing milk, aka lactose A urinalysis performed on a 2-week-old infant with diarrhea shows a negative reaction with the glucose oxidase reagent strip. A copper reduction tablet test should be performed to check the urine sample for the presence of Galactose -Children that fail to thrive may have galactosuria (presence of galactose) Using sulfosalicyclic acid test, false-positive protein result may occur in presence of Radiographic contrast media -will precipitate in SSA Reagent strip tested positive for blood. Micro examine fails to yields RBCs. Patient condition is called Hemoglobinuria -Positive test strip for hemoglobin from lysed RBCs, filtered hemoglobin from intravascular hemolysis, and myoglobin. W/no RBCs in present, hemmoglobinuria indicate prescence of filtered hemoglobin A patient following an accident involving massive crash injures show large result for blood on the strip and absent of RBCs on microscope may explain the presence of myoglobin in the urine specimen -myoglobin is product of muscle destruction. The strip reaction for blood is positive for RBCs, hemoglobin, and myoglobin. Hemoglobin and myoglobin are toxic to renal tubules, resulting in a decrease of urine flow, favoring formation of cast Bence Jones protein Urine test used to monitor the course of multiple myeloma. Clinitest reagent table test that confirms the presence of reducing sugars in the urine (generally glucose) The reason for performing a Clinitest on a newborn's urine is to check for: galactose Reagent test strip pads for ketones primarily measure Acetoacetic acid Test strip pads for glycine measures for Acetone The presence of leukocytes in urine is known as pyuria -prefix py-means pus (leukocytes) and suffix -uria means pertaining to urine Oval fat bodies are renal tubular epithelial cells that contain lipids -these cells line the tubules absorb the urinary filtrate. Disorders producing fat in filtrate, the fat is absorbed into the cells. When the cells slough from the tubules, they appear as oval fat bodies microscopic examination of urine reveals ghost cells. These RBCs may be seen in urine with Specific gravity <1.007 -osmosis occurs thru RBC membrane. In dilute urine, the cells absorb water and swell,lyse, and release hemoglobin Glitter cells are a microscopic finding of: white blood cells in hypotonic urine -absorbing the water causes cells to swell. Granules in WBCs exhibit Brownian movement, producing glittering effect What cell is most commonly associated with vaginal contamination? Squamous -these cells line the vaginal wall Ghost RBCs are seen in urine that is alkaline and dilute -When the cells swell in alkaline urine, the cell membrane allows hemoglobin to leak from the cell, resulting an empty cell (ghost RBCs)
Eosinophil count may be requested on urine from a patient with suspected Acute Interstitial Nephritis -this condition is caused by an allergic reaction resulting inflammation of renal tubules. This will cause the eosinophil count to increase. Caused by a medication Clue cells are a form of squamous epithelial cell -Clue cells=Gardnerella vaginalis which cause vaginal infections. Cells that line the vagina are squamous epi. cells What cells is most likely to be seen in urine sediment following catheterization procedure Transitional Epithelial -these cells line the bladder, renal pelvis, and ureters Cystitis (Urinary Tract Infection) -WBCs, bacteria, possible RBCs Diagnosis given to this microscopic finding Microscopic finding that has RBC casts may indicate Glomerulonephritis Microscopic finding that has WBCs casts may indicate Pyeloneohritis Microscopic finding that has lipids and fatty casts Nephrotic
syndrome All casts typically composed of: Uromodulin -excreted by renal tubular cells. This aggregrates into fibrils that mesh to form matrix of casts Hyaline casts are usually found: under subdued light -these casts have low refractile index and may not visible under the bright light. Cast mainly found in healthy people Hyaline -strenous exercising or normal condition that produces decreased urine flow Casts most indicative of end stage renal disease Granular -broad cast indicate extreme stasis of urine flow through the nephron (part of the kidneys) What aids in differentiating a spherical transitional cell from a round renal tubular cell? Eccentrically-placed nucleus in the renal tubular cell The urine microscopic constituents that best differentiate between cystitis and pyelonephritis are: WBC casts -pyelonephritis is an inflammation/infection of renal tubules. WBC casts would indicate location of source of inflammation/infection. Cystitis is infection of the bladder Epithelial cell cast are most indicative of Tubular necrosis (damage to kidneys) -damage to the renal tubules (kidney) causes sloughing of the cells lining tubules Granular casts found in the urine of football player admitted to the hospital w/broken bone occuring during the game can result of Strenuous exercise -form of cast matrix is not uncommon in a hard exercise, especially when your dehydrated What cast most frequently appears to have brittle consistency Waxy -these casts are seen with extreme stasis of urine flow, indicating they have remained in the tubles for extended time. They often contain jagged edges, notches, refractile as result of granular disintegration Distinguish btw clump of WBCs and WBC cast, it is important to observe the presence of a cast matrix (the edge of the cast) Spherical transitional epithelial cells can be confused with Renal Tubular epithelial cells -both of these cells are round tubular epi cells. The nucleus in renal differs. them apart Prior to reporting a red blood cell cast, it is important to observe: Free floating RBCs Yeast Cells in urine -can be seen in people with diabetes When performing chemical examination if urine, a routine reagent strip test for protein is based on principle of Protein-error-of-indicators Sets with similar termsUrinalysis and Body Fluids!73 terms drayclipper Urinalysis and Body Fluids!73 terms selena_judgePLUS BOC 7 Urinalysis216 terms kkarlavaleria1 Success in CLS Ch. 11 UA & Body Fluids (…67 terms kkarlavaleria1 Other sets by this creatorWell Known Bacteria20 terms Kelsi_Foust7 Red Cell Morphology and Inclusions25 terms Kelsi_Foust7 Equations41 terms Kelsi_Foust7 Lab Ops17 terms Kelsi_Foust7 Other Quizlet setsComparative Data (Taiwan, Germany, India…59 terms mkneidigPLUS Ch. 10: Muscle Tissue Quiz 168 terms Dre_Cigliola Advanced Pharm - Exam 1 - Anti-epileptics28 terms Garry_Payne lecture 17: systems physiology57 terms Giana_Spinelli Related questionsQUESTION what does the chemistry panel analyze? 6 answers QUESTION What solution do we use to clean up a blood spill? 15 answers QUESTION What is the most common metaplasia? 15 answers QUESTION What is the signalment of a hypothyroid dog? 8 answers What are the pathological causes of urine turbidity?The main cause of abnormal urinary turbidity is the presence of pus cells resulting from infection. Urinary casts are also responsible for causing turbidity. These consist of cells and cellular debris from the distal collecting tubules. They are indicative of inflammatory or degenerative changes in the tubules.
Does urine turbidity always is or indicate a pathologic condition?Clarity/Turbidity
Cloudy or turbid urine may indicate health conditions such as chyluria, pyuria, or phosphate crystals. However, other factors can also be influenced, such as vaginal discharge, sperm or prostatic secretions.
Which of the following components will be decreased in an unpreserved urine?LBI UA/Body Fluids Exam # 1. Which of the following conditions would be a cause for specimen rejection for a routine urinalysis?The most common reasons to reject a specimen are due to the addition of a preservative (such as formalin or alcohol).
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Which of the following may be responsible for the non pathologic white turbidity of an alkaline urine quizlet?
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