MLS 4510 Urinalysis and Body Fluids Midterm Lecture Exam

three-glass method

What method of urine collection is used for suspected prostate infections

random urine (dirty urine)

What type of urine specimen is required for STI testing?

postprandial

What urine specimen is collected 2-3 hours after eating?

Boric acid

What preservative for urine comes in a gray top evacuated tube similar to that of a blood collection tube.

-inhibits bacterial growth
-preserves aldosterone

What are the two uses of chloroform for urine specimens?

causes changes in the characteristics of cellular sediment

What is the downside to chloroform as a preservative of urine?

urochrome

What is the pigment that gives urine its characteristic color?

amorphous phosphate crystals

white precipitate in cloudy alkaline urine is the result of....

amorphous urate crystals

Pink precipitate in cloudy acidic urine is the result of.....

chyle

emulsified fat and lymph fluid

pyridium

What treatment of UTIs causes a bright orange color to urine?

1.003-1.035

What is the normal range for specific gravity of urine?

15 mL

What is the typical amount of urine needed for routine testing?

clean catch [midstream]

What type of urine collection is required for culture?

First morning void

What is the best specimen for urine analysis?

postprandial

What type of urine specimen is collected for screening of carbohydrate metabolism disorders?

refrigeration

What is the best preservation method for urine?

48

Urine testing should be performed within ______ hours after collection.

one hour

How long should urine samples remain at room temperature before refrigeration?

Boric Acid

What preservative preserves formed elements in urine but interferes with the pH?

refractometer

how is specific gravity measured

specific gravity

what urine measurement is used to measure the concentrating and diluting ability of the kidney?

specific gravity

What is measured on a urine reagent strip by measuring the pKa change of polyelectrolytes in relation to ionic concentration; as the value increases the reagent pad becomes more acidic.

Osmolality is concerned only with the number of particles in solution, while specific gravity depends on the number and weight of the solutes.

what is the difference between specific gravity and osmolality?

-kidneys
-ureters
-bladder
-urethra

What are the four components of the urinary system?

renal medulla

what are the arrows pointing to?

renal column

What is "H" pointing to?

renal cortex

what is the arrow pointing to?

minor calyx of kidney

what are the blue arrows pointing to?

major calyx of kidney

what is the arrow pointing to?

renal pelvis

what is the arrow pointing to?

nephron

what is the main functional unit of the kidney

glomerulus

renal corpuscle AKA

within the renal cortex

where are cortical nephrons located

nephrons that extend deep into the medulla

what are juxtamedullary nephrons?

-descending loop of henle
-dista; convoluted tubule
-collecting duct

Where in the nephron is water reabsorbed?

-ascending loop of henle

where in the nephron is sodium reabsorbed?

20-25%

How much of the blood pushed from the left ventricle of the heart enters the kidneys?

True

Blood passes through the kidneys at a rate of 1,200 mL/min (600 mL/min/kidney) True/False

the capsule that surrounds the glomerulus

Define Bowman's capsule

podocytes

what are the specialized cells within the glomerulus that adhere to the basement membrane?

-shield of negativity (- charge)
-podocytes

What helps keep plasma proteins from entering the filtrate in the glomerulus?

peritubular capillaries

A secondary capillary network (from the efferent arteriole) which surround the renal tubules and reabsorb substances from the ultrafiltrate from the glomerulus.

120 mL/min

How much plasma is filtered through the glomeruli as ultrafiltrate (per minute)?

GFR

what value is used to monitor kidney function and kidney disease progression?

non-protein nitrogen (NPNs)

What group of analytes are measured to assess kidney function?

proximal convuluted tubule (PCT)

what part of the nephron reabsorbs 80% of the filtrate?

True

Proteins and glucose is almost completely reabsorbed in the proximal convoluted tubules. True/False

carbonic anhydrase

Microvilli on epithelial cells that line the proximal tubule carry what enzyme to help in absorption transfer?

When plasma concentration exceeds 160-180 mg/dL

When will glucose appear in the urine?

Countercurrent mechanism

The mechanism that provides for the absorption of water from the descending loop, and the resorption of solute without water in the ascending limb

90%

How much of the glomerular filtrate is reabsorbed by the time it reaches the distal tubule?

hypertonic

The interstitium of the vasa recta is meant to retain a hypertonic/hypotonic state?

secretion

What process sends molecules from the blood into the tubular filtrate

- removes unwanted wastes (medications, toxins)
- removal of hydrogen and other ions to retain acid-base and electrolyte balance

What are the two functions of secretion into the renal tubules?

-hydrogen ions exchanged for sodium and bicarbonate
-ammonia diffuses into the tubule and sodium is reabsorbed

In acidic blood conditions, what are two ways that secretion helps correct the balance? (specific exchanges)

juxtaglomerular cells

What cells produce renin?

angiotensinogen (to produce angiotensin I)

What does renin react with?

ACE

What converts angiotensin I to angiotensin II?

lungs

Where is ACE produced?

-triggers aldosterone release
-triggers ADH release
-dilates afferent arterioles
-constricts efferent arterioles
-stimulates Na2+ reabsorption in proximal tubule

What are the roles of angiotensin II? (5)

ADH

What hormone regulates water absorption in the distal portion of the nephron?

Diabetes insipidus

What disease results from insufficient ADH?

Kova slide

What is this called

10x

What magnification should be used to enumerate casts?

After initial enumeration of urine elements, add a drop of acetic acid or KOH to the slide and allow it to diffuse. This will lyse the RBCs.

Yeasts or WBCs may resemble RBCs on a slide. What can you add to the slide to counteract this problem?

1-2 per HPF

What is considered a normal amount of RBCs on a urine slide?

protein

Besides the blood reagent pad and hemoglobin pad, what other portion of the reagent strip will most likely be positive on the reagent strip if blood is present in the urine?

True

The number of WBCs in an alkaline and hypotonic urine decreases by 50% within 1 hour after collection if the specimen is kept at room temp. True/False

When WBCs expand in hypotonic solution the granules may demonstrate Brownian movement

What is a glitter cell?

False. Only in granulocytes, not lymphocytes.

Leukocyte esterase is contained within all WBCs. True/False

Renal

What epithelial cells originate in the convoluted tubules

Transitional

What epithelial cells originate from the renal pelvis to the upper urethra

Squamous

What epithelial cells originate from lower urethra or are vaginal contamination

transitional epithelial cells

What type of cells are these? (Urine sample)

squamous epithelial cell

What type of cell is this (urine)?

renal epithelial cells

what type of cells are these (urine)

renal (tubular) epithelial cells

What type of epithelial cells may be found in urine in cases of pyelonephritis, acute tubular necrosis, salicylate intoxication, and kidney transplant rejection.

Oval fat bodies

Renal tubular epithelial cells or leukocytes that contain refractile fat droplets

oval fat bodies

What may be found in the urine in the following conditions:

•Chronic glomerulomephritis

•Diabetes mellitus

•Eclampsia

•Lipid nephrosis

•Nephrotic syndrome

•Toxic renal poisoning

oval fat body

What is that

maltese cross

What conformation do oval fat bodies take under polarized light

transitional epithelial cells

What cells are 2-4 times the size of WBCs, swell easily in hypotonic solution, and may be present in higher numbers after catheterization of cystitis?

yeast

What may be found in urine of diabetic patients or patients on high dose antibiotic regimens?

False. Can only be reported if it is motile because of its ability to be mistaken for other cellular elements.

Trichomonas vaginalis must be reported if seen on a wet mount. True/False

Enterobius vermicularis (pinworm) egg

What is this

acidic

pathologic crystals are found in acidic/alkaline urine?

-appearance
-pH dependency
-solubility characteristics

How are crystals identified? (3)

-cysteine
-leucine

What crystals are found in inherited metabolic conditions?

uric acid

what is this crystal? Found in pH < 6.0

gout (uric acid)

What disease may be associated with this crystal, if levels are also increased in the serum?

Cysteine crystals are clear

How can uric acid crystals be differentiated from cysteine crystals?

-rhombus (football)
-lemon shapes/rosettes
-barrel shaped

What are the three formations that uric acid crystals can take?

Yes

Does Uric acid polarize light?

sodium urates

What are these crystals?

amorphous urates

What is this in urine

True. Most common in acidic, though

Calcium oxalate can be found in acidic, neutral, or alkaline urines. True/False

Calcium oxalate

What crystals may be present in urine with ingestion of increased amount of spinach, rhubarb, or antifreeze poisoning?

calcium oxalate

Name the crystals

calcium oxalate

What crystal has an "envelope" form?