Urinalysis - AUBF (Lec)

TRUE

TRUE OR FALSE?

Analyzing urine analyzing urine was actually the beginning of laboratory medicine

TRUE

TRUE OR FALSE?

Physical evidence include drawings of cavemans and egyptian hieroglyphics

Edwin Smith Surgical Papyrus

An example of egyptian hieroglyphics that served as a physical evidence

Hieroglyph

the character of the ancient egyptian writings

TRUE

Basic observation of urine includes color, turbidity, odor, volume, viscosity, and sweetness

FALSE

TRUE OR FALSE?

Sweetness is still part of the basic observation of urine until now

TRUE

TRUE OR FALSE?

Modern urinalysis includes physical examination, chemical analysis, and microscopic examination

Hippocrates

During the 15th century he wrote a book on “uroscopy”

1140 AD

When did color charts which describes the significance of 20 different colors have been developed?

Frederik Dekkers

At 1694, he discovered or started albumin determination or albuminuria

Albuminuria

there is presence of albumin in the urine

Thomas Bryant

At 1627, he published a book about “pissed prophets”

17th century

When was microscope invented?

Anton Van Leeuwenhoek

Who invented the microscope?

Thomas Addis

He developed methods in quantitating urinary sediments

Richard Bright

At 1827, he introduced the concept of urinalysis as part of a doctor's routine patient examination

Urine

• Is from the filtration of blood in the kidney

• kidneys form this as an ultrafil trade of plasma

• an aqueous solution of various organic and inorganic substances

95, 5

Urine is __ % water and __% solutes

170,000

Urine is __ mL filtered plasma

1200

How many mL of urine per day?

Urea

• Primary organic component of urine

• is a product of protein and amino acid metabolism

• most numerous

Creatinine

Product of creatine metabolism by muscles

Uric Acid

Product of nucleic acid break down in food and cells

Chloride

• Primary inorganic component

• found in combination with sodium and many other inorganic substances

Sodium

Comes primarily from salt and varies by intake

Potassium

Combined with chloride and other salts

Phosphate

Combines with sodium to buffer the blood

Ammonium

Regulates blood and tissue fluid acidity

Calcium

Combines with chloride sulfate and phosphate

25-35g

Normal value of urea in urine

1.5g

Normal value of creatinine in urine

0.4-1g

Normal value of uric acid in urine

15g

What is the normal value of sodium in urine?

3.3g

What is the normal value of potassium in urine?

2.5g

What is the normal value of phosphate in urine?

0.7g

What is the normal value of ammonium in urine?

0.3g

What is the normal value of calcium in urine?

Urine Composition

• This is determined by the body state of hydration

• influenced by fluid intake, nonrenal fluid loss, antidiuretic hormone variations, and excretion of large amounts of dissolved solids

1200-1500

How many milliliters is the usual daily volume of urine?

600-2000 mL

What is the normal range of urine?

Antidiuretic hormone (ADH)

This is responsible for preventing too much urination

TRUE

TRUE OR FALSE?

ADH and Urination have an inverse relationship

low ADH = frequent urination

high ADH = fewer urination

Oliguria

• Decrease in urine output

• commonly seen when the body enters a state of dehydration

• result of excessive water loss from vomiting diarrhea perspiration or severe burns

Anuria

• Cessation of urine flow

• absence of urine

• may result from any serious damage the kidneys or from a decrease in the flow of blood to the kidneys

• decrease renal blood flow

Nocturia

• Increase urine excretion at night

• the kidneys excrete two to three times more urine during the night than during the day

Polyuria

• Increase daily urine volume

• associated with diabetes mellitus or diabetes insipidus

• associated with juices soft drinks coffee alcohol and any other related to diuretics

Diabetes Mellitus

Is caused by a defect either in the pancreatic production of insulin or in the function of insulin which results in an increased body of glucose concentration

Diabetes insipidus

• Results from a decrease in the production or function of antidiuretic hormone

• the water necessary for adequate body hydration is not reabsorbed from the plasma filtrate

Insulin

It breaks down the glucose to become ATP

Polydipsia

Increase ingestion of water

FALSE

TRUE OR FALSE?

Diabetes mellitus - low specific gravity

Diabetes insipidus - high specific gravity

TRUE

Fluid loss for Diabetes mellitus and Diabetes insipidus is compensated by increased ingestion of water

50mL

What is the recommended capacity of the containers for specimen handling?

12 mL

A 50 ml container allows how much of specimens needed for microscopic analysis

TRUE

TRUE OR FALSE?

All specimens must be labeled properly with the patient's name and identification number and the date and time of collection

FALSE

TRUE OR FALSE?

Labels must be attached to the lid and not to the container

TRUE

TRUE OR FALSE?

Specimen should always have a test request

2 hours

Specimens should be delivered to the laboratory promptly and tested within how many hours?

FALSE

TRUE OR FALSE?

Color, Turbidity, pH, Nitrite, Bacteria, Odor, and Glucose is increased in unpreserved urine

TRUE

TRUE OR FALSE?

Glucose, Ketones, Bilirubin, Urobilinogen, RBCs, WBCs, Casts is decreased in unpreserved urine

TRUE

TRUE OR FALSE?

A specimen that cannot be delivered and tested within 2 hours should be refrigerated or have an appropriate chemical preservative added

Refrigeration

What is the most routinely used method of preservation

2-8

Refrigeration is at __°C

FALSE

TRUE OR FALSE?

Refrigeration increases bacterial growth and metabolism

TRUE

TRUE OR FALSE?

The specimen is going to be cultured it should be refrigerated until cultured for up to 24 hours

TRUE

TRUE OR FALSE?

Specimens must be returned to room temperature before chemical testing by reagent street

FALSE

TRUE OR FALSE?

When the bacteria multiplied breaks down the nitrite to nitrate

Bactericidal

• What is the ideal preservative to be used when refrigeration is impossible

• it inhibits urease and preserves formed elements in the sediment

Glucose tolerance specimens

Sometimes collected to correspond with the blood samples drawn during a glucose tolerance test

8 hours

How long is the fasting for oral glucose tolerance test

Three glass collection

Type of specimen for prostatic infection

First Morning

Type of specimen for pregnancy test and orthostatic protein

24 hour

Type of specimen for quantitative chemical test

Suprapubic aspiration

Type of specimen for bladder urine for bacterial culture and cytology

Spx

Is used for the detection of prostatic infection

3

How many containers will you collect for a prostatis specimen

1st

Which container will have the first urine passed for a prostatis specimen

2nd

Which container will have the midstream clean catch for a prostatis specimen

3rd

Which container will have the prostate massage for a prostatitis specimen

Color

If there is oxidation or reduction of metabolites which analyte will change and unpreserved urine

Odor

If there is bacterial multiplication that causes breakdown of urea to ammonia what analyte of unpreserved urine will change

pH

Which analyte of unpreserved urine will change when there is breakdown of urea to ammonia by urease producing bacteria or loss of carbon dioxide?

Nitrite

Which analyte in unpreserved urine will change when there is multiplication of nitrate reducing bacteria

Multiplication

What causes an increase in bacteria and unpreserved urine

Ketones

Which analyze and unpreserved urine will change when there is volatilization and bacterial metabolism

Bilirubin

Which analyte of unpreserved urine will change when there is exposure to light or photo oxidation to biliverdin

Urobilinogen

Which analyte of unpreserved urine will change when there is oxidation to urobilin

RBC, WBC, casts

Which analyte of unpreserved urine will change when there is disintegration in the dilute alkaline urine

Loss of motility, death

What causes a decrease in trichomonas in unpreserved urine

Clarity

Which analyte of unpreserved urine changes when there is bacterial growth and precipitation of amorphous materials

Glucose

Which analyte of unpreserved urine changes when there is glycolysis and bacterial use

Refrigeration

• This preservative do not interfere with chemical test

• but it precipitates a morphous phosphates and amorphous urates

• it prevents bacterial growth for 24 hours

Boric acid

• This preservative prevents bacterial growth and metabolism

• but it interferes with drug and hormone analyses

• it keeps ph at about 6.0

• can be used for urine culture transport

Formalin

• This is an excellent sediment preservative

• but it acts as a reducing agent that interferes with chemical test

• it can preserve cells and casts

Sodium Fluoride

• Is a good preservative for drug analyses

• but it inhibits reagent strip tests for glucose, blood, and leukocytes

Commercial Preservative Tablets

• This preservative is convenient when refrigeration is not possible

• it has a controlled concentration to minimize interference

Urine Collection Kits

This contains collection cup, transfer straw, culture and sensitivity, preservative tube or UA tube

Yellow UA Plus Tube

• This preservative is used on automated instruments

• its disadvantage is it must be refrigerated within 2 hours

Cherry red/yellow preservative plus tube

• This preservative is stable for 72 hours at room temperature

• it is instrument compatible

• it's disadvantage is that bilirubin and neurobilinogen may be decreased if specimen is exposed to light and left at room temperature

Light gray and gray C&S tube

• Sample is stable at room temperature for 48 hours and this preservative

• it prevents bacterial growth and metabolism