BODY FLUIDS LAB FINAL

What does bright yellow urine indicate?

some vitamins, B complex vitamins like riboflavin

What does some light yellow urine indicate?

Dilute urine, over hydrated, diabetes

If a patient has negative glucose in the reagent strip, but positive for reducing sugars what does that indicate? 

Reducing substance other than glucose is present 

Positive ictotest but negative bilirubin on reagent strip, what do these results mean?

Positive for bilirubin but in small amounts because the ictotest is more sensitive than the strip.

A positive glucose reagent strip and a negative test for reducing sugar (Clinitest) indicates what?

low concentration of glucose (glucosuria)

Normal ranges for microscopic RBCs in urine 

0-4 RBC/hpf

Normal ranges for microscopic WBCs in urine

0-5 WBC’s/hpf

Normal ranges for microscopic bacteria in urine

absent to few bacteria/hpf

Normal ranges for microscopic casts in urine

0-5 hyaline casts/lpf

A urine specimen is tested by a reagent strip method and the SSA test to determine whether protein is present. The reagent strip yields a negative protein, whereas the SSA results in a reading of 2+ protein. Which of the following statements best explains this difference? 

Protein other than albumin is present

Yellow foam in urine

Bilirubin

What enhances cast formation in the kidney

Urinary stasis, concentrated urine, and acidic pH

Anuria

No urine production

Polyuria

increased urination

Broad casts are formed when which of the following have become dilated? 

dilated tubules or collecting ducts

In what type of microscope can you see the Maltese cross?

Polarized light

Low powered field is used to look at what?

Casts, epithelial cells, mucus, and crystals

High powered field is used to look at what?

RBC’s, WBC’s, bacteria, yeast, transitional, and renal tubular cells.

Positive nitrite?

Likely bacteria

Clear red urine due to?

Hemoglobin or myoglobin-(usually brown)

Common stain in routine urinalysis?

Crystal violet and gram stain

Tyrosine and Leucine indicate?

severe liver failure

The leukocyte esterase pad can detect an enzyme in most WBC’s except what cell?

Lymphocytes

What is responsible for the yellow color in urine?

Urobilin

What is the colorimetric reagent strip test principle for hemoglobin based on? 

Peroxidase-like activity of hemoglobin 

Protein test on the urine strip is most reactive to what? 

Albumin

Timed collection requires a written protocol for what?

the starting and ending times of the collection, what urine to collect (discarding the first void and collecting all subsequent urine), proper storage and labeling of the specimen, and any dietary or medication restrictions

Blue green color?

Certain drugs, UTI, food dyes.

Are calcium oxalate crystals pathogenic?

Some calcium oxalate crystals are normal the calcium oxalate dihydrate, Ingesting ethylene glycol and seeing calcium oxalate monohydrate is pathogenic.

Do you report foam?

No

How are granular casts formed?

When cells or proteins degrade in the renal tubules

In what conditions can oliguria be observed?

Dehydration, some medications, obstruction, kidney damage

In what part of the nephron do casts form?

Distal and collecting ducts

What do waxy casts indicate?

Severe kidney damage and renal failure.

What is the principle of the colorimetric reagent strip determination for SG?

PKa change of polyelectrolyte

Where would you find transitional epithelial cells? 

Lining of the bladder and ureters 

When would you see ghost cells (red blood cell lysis)? 

intravascular hemolysis

Which of the following does not affect the formation of urinary crystals within nephrons? 

Diameter of tubular lumen 

What sediment is unique to the kidneys? 

Hyaline casts

What type of bilirubin is detected on the reagent strip? 

conjugated

What can resemble RBCs? 

Yeast or air bubbles

What type of WBC is seen most often under the microscope of a urine sediment? 

Neutrophil

What is the most frequent urine collection method for general screening? (the patient randomly went to the ER) 

Midstream clean catch 

What is the advantage of getting first morning urine? 

Most concentrated

Why should you discard the first sample in a 24-hour urine? 

Most concentrated and can falsely increase the results

How does exposure to light affect bilirubin? 

Degrades it

Which of the following would be least affected in a specimen that has remained unpreserved at room temperature for more than 2 hours? 

Protein

Does bacterial growth affect clarity in an unpreserved specimen? 

Yes makes it more cloudy

What is the most sterile specimen collection method? 

Suprapubic aspiration

Which of the following specimens usually eliminates contamination of the urine with entities form the external genitalia and the distal urethra? 

Midstream clean catch 

What type of cast is seen in pyelonephritis? How does it look? 

WBC cast

What casts can be seen in renal failure? 

Waxy and granular

What stain is used to enhance lipid content

sudan III and red O

Proper care of reagent strips includes all of the following except: 

Should be stored in original container below 30 C, tight lid to prevent moisture from affecting the regent tabs. 

Quality control on reagent strips must be performed whenever a/an: 

A new bottle of strips is opened and a certain time a day or per shift, also when patient results are questionable. 

Failure to blot the edge of the reagent strip may result in errors in color interpretation caused by: 

Can cause contamination of the pads by chemicals mixing from others. 

All of the following will produce an alkaline urine except: 

Cranberry juice

Major solutes found in normal urine include: 

Urea, sodium, potassium, chloride, ammonium, inorganic phosphate, organic phosphate, creatinine, uric acid, glucose, albumin 

The normal range of urine pH is: 

4.5-8.0

In which of the following would you find a negative urine urobilinogen? 

Blockage in bile flow like gallstones, or liver function problem 

False positive readings may be obtained on the protein reagent strip when the  

Contaminated with ammonium, chlorhexidine 

The principle of the reagent strip test for the detection of glucose in the urine is based on which of the following reactions? 

Double sequential enzyme reaction  

The reagent test strip for the detection of ketone bodies is sensitive to the presence of  

Acetoacetic acid and acetone 

False positives may develop on the reagent test strip for blood when the urine specimen contains 

Bleach and menstrual blood 

A routine urinalysis is performed on a young child suffering from diarrhea.  The reagent test strip is negative for glucose but positive for ketone.  These results may be explained by which of the following statements. 

Malabsorption of carbohydrates 

A regent test strip impregnated with a diazonium salt such as diaotized 2,4- dichloroaniline may be used to determine which analyte? 

Bilirubin 

The reagent test strips commonly used for the detection of urobilinogen in urine specimens are impregnated with 

Ehrlichs reagent, dimethylaminobenzaldehyde 

A condition characterized by an increased excretion of protein in the urine during the day while at night there is a normal excretion of protein, is known as 

Orthostatic proteinuria  

The diluting and concentrating ability of the kidneys may be measured by performing which of the following urine tests? 

Specific gravity

 A urine specimen containing the substance indicated below is kept unpreserved at room temperature for 4 hours.  Identify the probable change to the substance. (increase or decrease) 

Bacteria, nitrite, and pH increase, all others decrease and protein no change 

Which statement about the Watson-Schwartz test is true? 

Urobilinogen is extracted in chloroform and gives a pink color in the lower layer and not significant for porphyria, in upper layer it is significant for porphyria’s 

Which of the following statements regarding the test for nitrite in urine is true? 

It is nitrite + aromatic amine reagent = diazonium salt compound, diazonium salt compound + 3 hydroxy 1,2,3,4 tetrahydrobenzquinolin= pink color 

Nondiabetic ketonuria can occur in all of the following except: 

Renal failure

In addition to ascorbate, the glucose oxidase reaction may be inhibited by which substance? 

High SG, high ketones, old specimens, bleach, peroxide, oxidizing detergents. AAA acetoacetic acid 

If this urine specimen was stored uncapped at 5°C without preservation and retested at 2 P.M., which of the following test results would be changed due to these conditions? 

Explain your answer: (+ 3 for the correct answer and explanation) 

It is uncapped so ketones will evaporate, but refrigerated so nitrites will stay the same as bacteria will not reproduce and glucose will stay the same because it wont be metabolized. 

The pH of a urine specimen measures the: 

How acidic or alkaline it is, the free hydrogen 

The principle of the reagent strip test for urine protein depends on: 

Protein error of indicators 

Which of the following reagents is used to react with ketones in the urine? 

Acetoacetate (ketone) + sodium nitroprusside 

All casts typically contain what kind of protein? 

Tamm-Horsfall mucoprotein  

 Myoglobinuria is MOST likely to be noted in urine specimens from patients with which of the following disorders? 

 Rhabdomyolysis, destruction of muscles, crush injuries 

Normal variations of urine can be caused by: 

Diet, medications, hydration levels