Exam 1- Body Fluid Analysis- Short Answer

A program of checks and balances to ensure
the quality of a laboratory’s serviceses

Quality assessment

mimic patient samples in physical and chemical
characteristic

internal Qc materials

Established formal regulation of health and safety for all employees • Administered by Occupational
Safety and Health Administration (OSHA)

Occupational Health and Safety Act of 1970

what are the categories of transmission-based precautions

Contact, droplet, airborne precaution

what are the routes of infection or disease transmission

inhalation, ingestion, direct inoculation or skin conctact

All specimens must be handled as if they are

infectious

Laboratory surfaces and equipment must be decontaminated daily with

10% bleach or a phenolic disinfectant

urine is a what of plasma

ultrafiltrate

what is the preferred specimen in urine analysis

the most concentrated one

urines analysis results can be affect by

excess fluid intake or exercise

random urine samples are taken during

routine screenings

what is the mid stream “clean catch” used for

bacterial cultures or to prevent vaginal contamination

a catheterized specimen and suprapubic aspiration requires collection by

medical personnel

what is suprapubic aspiration used principally for

cultures and infants

bladder urine is usually

sterile

what do changes in unpreserved urine result from

-alteration of urine solutes to a different form

-bacterial growth

-solute precipitation

changes in unpreserved urine cause false negative what

glucose and ketones

changes in unpreserved urine cause decreased and increased what

decreased- urine clarity; increased- odor, nitrite, and pH

changes in unpreserved urine can cause what

disintegration of formed elements and possible color changes from solute alteration

12 and 24 hour timed collection require addition of what to maintain integrity of analyte to be tested 12-

chemical preservative

what do you need to do during the collection period

keep it on ice or refrigerate

what do you need to check in order to identify necessary preservative

collection manual

deliver specimens _______ after collection

immediately

Normal ranges are wide as urine volume and solute
composition can vary greatly depending on

diet, physical activity, health

Wastes exclusively excreted by kidneys can be used to assess

kidney function (creatinine, urea) Urine Composition

osmolarity is affect by _____ not

solute number, size or weight

Final osmolality determined in distal and collecting tubules when what is present

ADH

Normally urine osmolality is how many times that of plasma

1 to 3

what is the normal range for specific gravity

1.002 - 1.035

specific gravity depends on what

number of particles and mass

Conditions with water diuresis has an osmolality of what

<200

Conditions with solute diuresis have an osmolality of what

≥300

what conditions arise because of oliguria

Urinary obstruction, tubular dysfunction, fluid loss lo

what conditions arise because of anuria

progressive renal disease or renal failure

what is preferred in testing renal concentrating ability because it is a more accurate reflection of kidney’s concentrating ability, since only solute number affects it

osmolality

what the three most prevalent solutes:

urea, chloride, sodium

in a fluid deprivation tests, when does the test end and continue

if concentrated, test ends, if not, test continues

normal color of pee is yellow because of

urochrome

Blood or myoglobin, Bilirubin, Porphyrins, Melanin, Indican, Homogentisic acid are all substances that do what

change urine color

what are ingested molecules that change the color of urine

medications, dyes, vitamins, pigmented foods

a very rare inherited disorder that prevents the body fully breaking down the amino acids _____e

alkaptonuria; tyrosine and phenylalanine

alkaptonuria is known as what

black urine disease

Normal urine whenshaken will produce

white foam

Stable white foam indicates what

large amounts of albumin in urine

what color foam is caused by increased bilirubin

yellow

Urine on standing becomes odorous due to what

bacterial conversion of urea to ammonia

produce sweet or fruity smell in urine

ketones

often produce odd odors in urine

amino acid disorders

Urine normally consists of

94% water and 6% solutes

Dilute urine has fewer what

solutes particles per volume of urine

color is what type of indicator of concentration

crude

Both number of solute particles and molecular size

affect specific gravity

The greater the density, the greater the

specific gravity

As number of solutes increases, light velocity and light angle

decreases

what are the factors that affect the refractive index of a solution

Wavelength of light used; concentration and temperature of solution

Refractometry measures

all solutes present, including protein and glucose

Most common wavelength used is

589 nanometers

the most common method to preserve urine is

refrigeration

the least invasive urine speciman

routine void sample

The preferred specimen for urinalysis is

first morning void

what is the normal daily urine output

1 - 2 liters

diabetes mellitus shows what in urine

glucose

Diabetes Insipidus shows what in rurine

low solute concentration

Ex. urea, creatinine, uric acid, and various organic acids

organic constituents

Ex. electrolytes (sodium, potassium, etc.), ions, and minerals (calcium, magnesium, etc.)

inorganic constituents

List changes that may take place in a urine specimen remaining at room temperature for more than 2 hours

-Bacterial growth leading to changes in pH and odor

-Precipitation of crystals

-Potential degradation of certain analytes

Testing methods of GFR include using markers like _____ or estimating GFR based on _____

insulin; serum creatinine levels

Elevated levels of Blood Urea Nitrogen (BUN) and creatinine can indicate

impaired kidney function

 Low creatinine clearance may indicate _______ and ___________

reduced GFR; impaired kidney function

eGFR helps classify _______ and _______

stage of chronic kidney disease (CKD); guide treatment decisions

An eGFR value below  60 mL/min/1.73 m² for three or more months is indicative of

chronic kidney disease

Urine formation occurs where through what mechanisms

kidneys; filtration, reabsorption, and secretion.

The purpose of urine formation is to

remove waste products, excess ions, and water from the blood

urine formation does all of its process while still maintaining what

a stable internal environment

Kidneys do what

filter blood, regulate fluid and electrolyte balance, and produce hormones like erythropoietin

what are the components of the urinary tract for men

kidneys, ureters, bladder, urethra, prostate gland

what are the components of the urinary tract for women

kidneys, ureters, bladder, urethra

Renal blood flow provides

oxygen and nutrients to the kidneys

If Maximal reabsorptive capacity is exceeded, the substance appears in

the urine

tubular secretion helps eliminate excess hydrogen ions (acid) from the blood into the urine, maintaining

acid-base balance

red or pink urine can be a sign of

including urinary tract infections, kidney stones, or more serious kidney disease or bladder cancer

dark brown or black urine is caused by what

the presence of myoglobin, muscle injury, or hemolysis

dark brown or black urine can be an indicator of conditions such as

 rhabdomyolysis or hemolytic anemia

cloudy urine may indicate the presence of substances such as

mucus, white blood cells, bacteria, or crystals

mucus, white blood cells, bacteria, or crystals can be an indication of what

utis, kidney stones, or other pathological conditions

Cloudy urine can be caused by

infections, stis, excess protein

order that can be associated with urinary tract infections (UTIs) or dehydration

ammonia-like oder

May be a sign of uncontrolled diabetes (due to the presence of ketones in urine)

fruity oder

Can result from the breakdown of certain foods or be related to bacterial overgrowth in the urinary tract

fishy oder

oder that can be due to dietary factors, medications, or metabolic disorders

strong or unusual oder

here is the cause what is the odor

Tyrosinemia
Bleach Contamination

rancid

here is the odorr what causes it

aromatic

normal

here is the odor what causes it

foul, ammonia-likectn

Bacterial decomposition, urinary tract infection

here is the odor what causes it

fruity, sweet

Ketones (diabetes mellitus, starvation, vomiting)

here is the odor what causes it

maple syrup

Maple syrup urine disease

here is the odor what causes it

mousy

Phenylketonuria

here is the odor what causes it

rancid

Tyrosinemia

here is the odor what causes it

sweaty feet

sovaleric acidemia

here is the odor what causes it

cabbage

Methionine malabsorption

here is the odor what causes it

bleach

contamination