UA rotation final

Who wrote the first known treatise devoted entirely to the subject of urine? What was the name of this book?

Theophilus Protospatharius wrote De Urinis

According to the Modern-Day Urine Wheel, what are some causes of pink-red urine?

full or lysed rbc, porphyria, myoglbinuria, ingestion of red foods

According to the Modern-Day Urine Wheel, which of the following is a cause of orange urine? 

billirubin

The nephron is the "functional" part of the kidney. Approximately how many of these does each adult kidney contain

.4-1.2 million

what component of the nephron filters blood

glomerulus

At what rate does a healthy glomerulus filter blood? Will this rate be increased or decreased in different kidney related disease states?

125mL/ min decreased

The filtrate is being reabsorbed as it travels through the nephron. After the filtrate travels through the loop of Henle and enters the collecting duct, most of the filtrate has been reabsorbed. The non-absorbed filtrate (now called urine) is excreted.

What percent of filtrate is reabsorbed? What % the filtrate is excreted (urine)?

90 reabsorebed 10 excreted

What are the cells that line the renal tubules in a nephron called? Hint: A high number of these cells found in the urine indicates intrinsic renal disease.

renal tubular epi cells

What are the cells that line the exit pathway of urine (the pelvis, ureters, bladder, and urethra) called? Hint: A high number of these cells is common after catheterization.

transitional epi

what are cells found on the outer layer of skin that may contaminate urine during collextion epically in women called

squamous epi

what are the 4 physical and chemical characteristics of urine

color clarity odor specific gravity

Beckman Coulter’s iQ200 auto particle recognition algorithm categorize particles by analyzing size, shape, texture, and contrast. How many photos does the digital microscope take?

500

What is the average daily urinary output?

1200mL

What are the three main organic (carbon-containing) compounds found in normal urine?

Urea, creatinine, and uric acid

what is oliguria

decrease in urine excretion

what is ployuria

increase urine excretion

what is anuria

cessation of urine excretion

what is nocturia

increase in night time excretion

what causes oliguria

dehydration

what cuases polyuria

diabetes or diuretics

what cause anuria

serious kidney damage

what causes nocturia

bladder obstruction

what is the ideal volume requestd for microscopic analysis of urine

12mL

What temperature range should urine specimens that are not to be analyzed immediately (i.e. within 2 hours of collection) be held at?

refidge 2-8c

Which of the following statements regarding collection of urine specimens is true? 

The first morning specimen preferred over random specimens because it is more concentrated, leading to better detection of chemicals and other formed elements.

24-hour collections account for diurnal variations in analyte concentrations that may occur due to daily activities such as exercise, meals, and body metabolism.  

true

What is the most common collection method used to obtain sterile specimens for bacterial culture and routine urinalysis (it is the least traumatic and simplest)? 

midstream clean catch

What legally required procedure involves documenting all individuals who come in contact with urine specimens being processed for potential drugs of abuse

chain of custody

what is the pigment responsible for the yellow color of urine

urochrome (urobiliin)

what causes colorless urine

recent fluid consumption

what causes pale yellow urine

polyuria diabetes

what causes dark yellow to amber

concentrated b vitamin dehydration billirubin certain antibiotics

what causes green urine

pseudomonas infection asparagus consumption

what causes blue green urine

certain medications

what causes turbid and red urine

intact rbc

what causes clear and red urine

hgb (lysed rbc)

if a bloody urine specimen sits at room temp for several hours what color will it become and why

Hemoglobin will oxidize into methemoglobin causing the urine to become brown.

what is hemoglobinurea

free hemoglobin in urine (from rbc lysiing)

what is myoglobinuria

myoglobin in urine (from muscle damage)

what is hematuria

intact rbc in urine

what does the urine look like in hemoglobinurea

res and clear urine red serum/pasma

what does the urine look like in myoglobinurea

red and clear urine normal serum/plasma

what does the urine look like in hematuria

red turbid urine normal serum/plasma

what are the pathological cuases of urine turbidity

rbc ,yeast ,abnormal crystal ,bacteria, wbc, trichomonas, non squamos epi

what physical propeties of urine ensures the specimen is concentrated enough to produce accurate chemical results?

specific gravity

what is/are a better indicator of renal concentrating ability than specific gravity because it is not affected by the molecular weight or density of the particles present. This reduces the bias seen in specific gravity from non-significant molecules such as urea.

osmolality

what causes foul smelling urine

bacteria

what causes dweet fruity smell

ketones

what causes maple syrup odor

maple syrup urine disease

what causes a bleach odor

contamination

chemistry strip test are what kind of analysis

semiquant

what is rhe normal pH of urine specimens

4.5-8

if a specimen is received in the lab is found to have a pH of 9, what is the likely cause? How should a tech handle this situation

Overly alkaline pH is indicative of an improperly preserved specimen. Neither the dipstick or microscopic analysis should be completed. A new specimen should be requested.

what can cause proteinuria

diabetes, nephrotic syndrome, glomerulonephtis, renal (kidney) failure

what category of proteinuria is this scenerio:

Protein added to urine in the lower urinary tract often by microorganisms such as bacteria, fungus, and sperm

post renal

what category of proteinuria is this scenerio:

Protein not being filtered properly due to conditions that have directly damaged parts of the kidney either transiently (exercise, dehydration, hypertension, preeclampsia (high blood pressure from pregnancy) fevers), or chronically (renal disease).

renal

what category of proteinuria is this scenerio:

Protein added to urine from blood due to conditions affecting blood protein levels such as inflammation (transient) or multiple myeloma (chronic).

pre renal

t/f

based on the principle of dipstick protein measurements an improperly preserved specimen would give a flase neg protein level

false

What is the major protein found in and associated with the urine of a patient with a compromised kidney (i.e. nephrotic syndrome)?

albumin

what urine dipstick test are positive w/ ketones during ketoacidosis

glucose

a dipstick result of highly positive protein and negative is indicative of

nephrotic syndrome

a dipstock result of midly positive protrin and positive blood is indicative of

glomerulonephritis

what major organ may be compromised if bilirubin is detectable on urine (bilirubinuria)

liver

what rbc component is converted to bilirubin?

protoporphyrin

What protein binds to bilirubin to transport it from the blood stream to the liver for further metabolism?

albumin

What does bilirubin become conjugated with to make it water-soluble?

glucuronic acid

When bilirubin finally makes it to the intestine, what two products is it broken down into? 

urobilinogen and stercobilinogen

a urine dipstick thats negative bilirubin increase urobilinogen is indicative of

hemolytic disease

a urine dipstick thats positive bilirubin normal or decreased urobilinogen is indicative of

bile duct obstruction

a urine dipstick thats positive bilirubin increase urobilinogen is indicative of

liver disease

Which two chemical tests are the most relevant for rapid detection of UTIs?

nitrite and leukocyte esterase

t/f

A Staphylococcus saprophyticus UTI will cause a positive leukocyte esterase and nitrite result. 

false staph aureus lack nitrate reductase

t/f if there is too much bacteria thry may further reduce all the nitrite to oxygen leading to a neg nitrite result

true

what cell will NOT produce a positive leukocyte esterase test

lymphocytes

What technique may be used to dissolve nonpathological crystals that may obscure microscopic fields?

warming specimen to 37

What is a frequently used (ideal) specimen volume should be spun down for standardized microscopic urinalysis? 

12ml

Microscopic examination should be performed in a consistent manner and include observation of a minimum of ____ fields under both low (______ objective) and high (______objective) power.

10, 10x, 40x

what would u use brightfield microscopy for

routine ua

what would u use phase contrast microscopy for

id of cast mucous ans some parasites

what would u use polarizing microscopy for

id of some crystals cholestrol and fatty cast

t/f rbc are easier to id than wbc

false

t/f squamous epi are (mostly) non pathological and are seen in higher numbers in female patients

true

What is the term for a squamous epithelial cells covered at least 70% with bacteria (Gardnerella vaginalis). 

clue cell

what is a squamous epi and clinical significance

largest type of epi w/ a sheet like appreance, non pathological

what transitional epi and clinical significance

spherical polyhedral or caudate w/ central nucelus, representive of catherization when seen in clumps

what is renal cell and clinical significance

round cubodal or columnar w/ eccentric nucleus, tubular necrosis

what is a clue cell and clinical significance

squamous w/ >70% of it covered in bacteria, gardnerella infection

what is an oval fat body and clinical significance

rte containing lipid droplets, nephrotic syndrome

What stain can be used to confirm the presence of oval fat bodies?

sudan 3

what charateristics can be seen in cholesterol droplets undder polarized light

maltese cross

To be considered significant for UTI (as opposed to a contaminant), bacteria should be accompanied by ________ . Observing bacteria for _______________ is also useful in differentiating them from amorphous crystals. The bacteria associated with UTI most frequently are of the ___________________ family, which are gram-______________, however cocci-shaped, gram-positive Staphylococcus and Enterococcus are also capable of causing UTI.

WBCs, motility, Enterobacteriaceae, negative

What is the most common parasite encountered in urine? This parasite has flagella and undulating membranes that should be moving (fresh specimen required to capture this) to differentiate it from WBCs, transitional, or RTE cells.

trichomonas vaginalis

What chemistry strip result may be positive when increased amounts of spermatozoa are present?

protein

t/f

Observation of mucous strands in a urine sample is a clinically significant finding. 

false

From which organ do casts originate (their shape is indicative of their origin)?

kidney (tubules)

What is the most common type of cast seen in urine?

hyaline

Oval fat bodies are RTEs containing lipids. Fatty casts are casts containing lipids. What is the main cause of their presence in urine (choose one)?

nephrotic syndrome

Compared to other casts, granular casts are quite common and can be non-pathological. When they are pathological, they are usually representative of degradation of cellular casts or protein aggregates in the glomerulus. If only a few granules are seen in a cast, should it be considered hyaline or granular? 

hyaline

Waxy casts are easily identified due to their high refractive index (they are shiny). This is believed to be because they are deprived of any cellular elements or protein granules, since these would have degenerated during the prolonged amount of time they spend sitting in the tubules during urine stasis. What clinical condition is extreme urine stasis representative of?

chronic renal failure

Bile is a greenish-brown fluid that aids digestion and is secreted by the liver. What is the specific cause of tubular necrosis when broad, bile-stained (greenish) waxy casts are seen in urine? 

hep c