2. Urinalysis Continued

What would require a microscopic examination of urine?

Urines containing elements visible under a microscope, such as protein, RBCs, WBCs, and nitrites.

What is the RPM and time for spinning urine in centrifuge?

1500 RPM for 5 minutes.

What is the purpose of resuspending sediment in urine?

To prepare it for microscopic examination.

What microscope power is used initially when reading microscopics?

Low power, 10x.

What should be checked for on low power when reading urine microscopics?

Crystals, elements present in a few fields, and casts.

What is used to classify the type of casts in urine?

High power, 40x.

What elements should be checked on high power in urine microscopics?

Cells, bacteria, crystals, and parasites.

How are WBCs reported in urinalysis?

As a range per high power field or graded on a scale.

What does a 1+ WBC count represent?

6-20 WBCs per high power field.

What does a 4+ WBC count indicate?

Packed fields of WBCs.

What is the significance of a RBC cast in urine?

It is seen in glomerulonephritis.

What do fatty casts indicate in a urinalysis?

Seen in nephrotic syndrome and diabetes with renal degradation.

What happens if QC fails?

Document the failure and follow thorough follow-up procedures.

What is the standard for quality control in urine analysis?

Two levels of QC, positive and negative, should run each shift.

What is the consequence of running patient samples without QC?

It can lead to misdiagnosis and legal issues.

What could a trace amount of blood indicate in QC?

A failed QC if the expected value is negative.

What is a urinary sediment?

Particles that settle at the bottom of a urine sample after centrifugation.

What are hyaline casts?

Casts formed from proteins in urine, appearing clear under microscopy.

What are granular casts associated with?

Degenerative changes in renal tubules.

What do waxy casts indicate?

Final step of cellular casts, often seen in severe chronic renal failure.

What is a common cause for UTI?

Bacterial infection.

What equipment is used for automated urinalysis?

Automated urinalysis analyzer.

What is the required temperature for QC strips?

Room temperature.

When should QC results be documented?

Every time QC is performed.

What does 'too numerous to count' mean?

Count greater than 50 WBCs per high power field.

What is the function of quality control in the lab?

To ensure accuracy and reliability of lab results.

What could a false negative for leukocytes indicate?

A missed diagnosis of a UTI.

What is the Clinical significance of protein-to-creatinine ratio?

It helps assess proteinuria and kidney function.

How often should QC be run in a lab setting?

Each shift every day.

What is the maximum number of WBCs in a 3+ rating?

Greater than 50 but less than packed fields.

Why should reagents and analyzer be checked?

To prevent errors in lab results and ensure they are functioning correctly.

What does QC Troubleshooting involve?

Identifying errors and re-checking QC results.

What is one action to take if QC fails?

Try rerunning the QC with a fresh aliquot.

What signifies a successful QC process?

That the results match the expected control values.

Define Levey Jennings Graphs in quality control.

Graphs used to monitor QC values and detect trends over time.

What do you do if reagent strips are expired?

Do not use them and replace with fresh strips.

What does a negative finding of glucose in urine indicate?

Normal result for glucose levels.

What could an abnormal bilirubin level indicate in urine?

Potential liver dysfunction or hemolysis.

What is evaluated in Levey Jennings chart?

Trends and performance of lab test results over time.

What is the significance of certifications in lab QC?

They ensure compliance with standards and safety protocols.

What can cause systematic error in QC?

A trend affecting multiple results, such as a consistent deviation.

What to examine when checking urine under a microscope?

Scan borders for additional elements or abnormalities.

What should not be done if QC is not performed?

Do not release patient results.

What is one reason for quality control in the lab?

To prevent medical errors that could harm patients.

What happens if discolouration occurs in QC vials?

Discard and open a new vial.

What does it mean when QC is marked as RANDOM error?

The error was not systemic and can be corrected.

What is critical to note on urine slides?

Quantitative versus qualitative results.

What is the emphasis on trace results for QC?

Trace results must be treated as failed if the expected value is negative.