AUBF LAB PT-Module 2

Gauze-pad method

Method of urine collection used for infants

Infant urine bags; hypoallergenic

It has a ______ stick on sticker where the genital of baby is attached

5mL

Maximum voided urine for gauze-pad method

60mL

Ideal amount of urine for gauze-pad method

Catheterization

Uses a a lubricated catheter (thin rubber tube) is inserted through the urethra (tube-like structure in which urine is expelled from the bladder) into the bladder. This avoids contamination from the urethra or external genitalia

Urethral catheter

catheter is inserted in the urethra & urine is obtained from the bladder

Ureteral catheter

catheter is inserted in the urethra & urine is obtained from the ureter

suprapubic aspiration

urine is collected by external introduction of needle through the abdomen into the bladder.

Suprapubic aspiration

Can be used for cytologic examination.

Suprapubic Aspiration

It involves putting a needle through the skin just above the pubic bone into the bladder.

Suprapubic aspiration

It is typically used as a method to collect urine in child less than 2 years of age who is not yet toilet trained in an effort to diagnose a urinary tract infection.

less than 2 year old

Suprapubic aspiration is typically used in what age?

20 degrees

At what angle should the needle for suprapubic aspiration be introduced to the patient?

Midstream Clean Catch Method

Most common and widely used to detect infection, do cell counts and culture & sensitivity

Midstream clean-catch specimen

Provides specimen that is less contaminated by epithelial cells and bacteria and therefore is more representative of the actual urine than the routinely voided specimen.

Random specimen

Most common specimen submitted and examine in the laboratory when urine is collected any time

First Morning Specimen

Most concentrated and preferred type of specimen which is the first urine voided after sleep (6 to 8 hours)

First morning specimen

Used for Routine screening; good recovery of cells and casts, and to confirm postural or orthostatic proteinuria

First morning specimen

Ideal screening specimen essential for preventing false-negative pregnancy tests

Second Morning Specimen

Specimen collected after a period of overnight fasting and is suitable for glucose monitoring

24 hour urine specimen

Suitable for testing metabolites with diurnal variation and hormones such as catecholamines, 17-hydroxysteroids, and electrolytes

24-hour or Timed Specimen

When the concentration of the substance to be measured changes with diranal variations and with daily activities such as exercise, meal, and body metabolism

2-3 Hours Postprandial Specimen

Urine sample taken after eating

Catheterized Specimen

Collected under sterile conditions by passing a hollow tube through the urethra into the bladder and is utilized in female patient to avoid vaginal contamination during menstruation

Bacterial culture

The test requested most commonly on a catheterized specimen is a ________.

Suprapubic aspiration

Urine sample that is collected and used for cytological examination

Three-glass collection

Main method in determining prostate infection where all portions, beginning, middle, and final portion of the voided are collected in three separate containers.

1st urine voided

The 1st glass for 3-glass collection method includes _______

Midstream catch

The 2nd glass for 3-glass collection method includes _______

Prostate

What is stimulated or massaged for the third glass during three-glass collection?

Refrigeration

Most effective and most commonly used and precipitates amorphous phosphates & urates

Addition of chemical preservatives

Method of urine preservation used for further testing

clean, dry, leakproof, with flat bottom, transparent or translucent disposable glass or plastic container that can hold 50-100mL of urine

Recommended urine container

12mL

How much of urine is need for microscopic analysis?

Full Name of the Patient, Date and Time of Collection

Important information to be reflected in urine container

2 hours

After collection, specimens should be delivered to the laboratory promptly and tested within _____.

Refrigerate or add preservative

What should you do after 2 hours when urine is not yet preserved?

ammonium carbonate

After 1-2 hours when urine is not examined, urea is converted to ________ by urea splitting organisms, thus urine becomes alkaline.

yeast or bacteria

After 2 hours when urine is not yet preserved, glucose is destroyed by ______.

acetone

After 2 hours when urine is not yet preserved, diacetic acid is converted to ______.

biliverdin

After 2 hours when urine is not yet preserved, bilirubin is converted to ________

urobilin

After 2 hours when urine is not yet preserved, urobilinogen is oxidized to _______

2°C to 8°C

Refrigeration of urine is at what temperature?

Refrigeration

Does not interfere with chemical test and prevents bacterial growth up to 24 hours

Refrigeration

Precipitates amorphous phosphates and urates

Thymol

Preserves glucose and sediments well and at the same time, interferes with acid precipitation tests for protein, but it does not interfere with reagent strip test for protein.

Boric Acid

Preserves protein and sediments well; keeps pH at about 6.0 and does not interfere with routine urinalysis, except for pH

Boric acid

Bacteriostatic (not bactericidal) at 18 g/L

Formaldehyde/Formalin

Excellent sediment preservative (1 drop/30 ml urine) but too large concentration will precipitate protein and will give false positive test for reducing tests such as glucose, blood, leukocyte esterase, and copper reduction

Toluene

Does not interfere with routine urinalysis and floats on surface of specimens and clings to

pipettes and testing materials.

Toluene

At 2ml/100 mL urine, it preserves ketones, protein, and reducing substances.

Sodium fluoride

Prevents glycolysis, good preservative for drug analyses but Inhibits reagent strip test for glucose, blood and leukocytes

Phenol

Does not interfere with routine test, causes an odor change and uses 1 drop per ounce/ml of specimen

Chloroform

Inhibit bacterial growth but not recommended for routine specimen, causes change in the characteristics of the cellular sediment.

Chlorhexidine

Prevents bacterial growth and is useful as glucose preservative

6N hydrochloric acid

For Vanillyl Mandelic Acid/VMA

Sulfuric acid

For cathecholamines

Usage of Gray C&S Tube

Sample stable at RT for 48 hrs. Preserves bacteria. Decreases pH.

Usage of Yellow Plain Tube

Use on Automated instruments. Refrigerate w/in 2 hours.

Usage of Cherry Red Tube

Stable for 72 hours at RT. Preservative is sodium propionate.

Random, first morning, midstream clean-catch

Types of urine specimens used for routine screening

First morning

Specimen for pregnancy test

First morning

Specimen for orthostatic protein

24 hour or timed specimen

Urine specimen for quantitative chemical tests

Catheterized, midstream clean-catch, suprapubic aspiration

Specimens used for bacterial C&S

24hour or timed

Specimen used for quantitative chemical tests

Suprapubic aspiration

Specimen used for cytology

Three-glass collection, four-glass collection

Specimens used for prostatic infection

Color

What analyte is modified/darkened because of oxidation or reduction of metabolites

Clarity

What analyte is decreased because of bacterial growth and precipitation of amorphous material?

Odor

What has an increaed ammonia smell because of bacterial multiplication causing breakdown of urea to ammonia?

pH

What analyte is increased because of the breakdown of urea to ammonia by urease-producing bacteria/loss of CO2?

glucose

What analyte is decreased because of glycolysis and bacterial use?

ketones

What analyte is decreased because of volatilization and bacterial metabolism?

Bilirubin

What analyte is decreased because of exposyre to light or photo oxidation to biliverdin?

Urobilinogen

What analyte is decreased becaused of the oxidation to urobilin?

nitrite

What analyte is increased because of the multiplication of nitrate-reducing bacteria?

red and white blood cells and casts

What analyte is decreased because of the disintegration/lyse in dilute alkaline urine?

bacteria

What analyte is increased because of their multiplication?

Trichomonas

What analyte is decreased because of loss of motility or death?

30-45mL

During drug specimen collection, a same-gender collector will observe the collection of how much urine?

4 minutes

During drug specimen collection, how many minutes should the sample be taken?

32.5°C to 37.7°C

The temperature of urine should read within the range of ____ for drug collected urine.

pH of 9; less than 1.005

To ensure unadulterated urine, the pH should read _____ and the SG should read ______.

2H Post Prandial Collection

Recommended for diabetic patients and are collected shortly before consuming a meal and after 2 hour after

2H Postprandial

Recommended collection for diabetic patients

Early afternoon specimen

For urobilinogen determination from 2-4pm where bilirubin levels are high

urochrome, uroerythrin, urobilin

three pigments responsible for urine’s normal color

Pseudomonas aeruginosa

Main bacteria responsible for green or blue-green urine coloration

Uroerythrin

most evident in specimens that have been refrigerated, resulting in the precipitation of amorphous urates in an acidic urine

orange-brown

Urobilin is an oxi- dation product of the normal urinary constituent urobilinogen, imparts an _______ to urine that is not fresh.

conjugated biluribin (B2)

In the case of liver disease or bilirubinuria, what type of bilirubin is present?

pyoverdin, pyocyanine

What pigments does P. aeruginosa produce which produces the blue-green color in urine?

phenazopyridine and Nitrofurantoin

UTI medications that may cause yellow foam formation and will show negative to reagent strip

porphobilinogen

Porphyrins come from the oxidation of _______ and are derived from the lack of enzymes in making heme.

Homogentisic acid; alkaptonuria

A metabolite of phenylalanine, imparts a black color to alkaline urine from patients with the inborn error of metabolism, called ________

melanogen

Melanin is an oxidation product of the colorless pigment _______, which is produced in excess when a malignant melanoma is present

hematuria

When intact RBCs (________) are present, the urine is red and cloudy

hemoglobin or myoglobin

If the urine has _____ or ____, the specimen is clear and red