Urinalysis Practical

Criteria for Clear urine clarity

no visible particulates

Criteria for Hazy urine clarity

few particulates, print easily seen

Criteria for Cloudy urine clarity

many particulates, print blurred

Criteria for Turbid urine clarity

print cannot be seen

Shades of yellow that can be reported

pale, yellow, dark

Specimen color that requires microscopic analysis

orange

Specimen clarity that would require microscopic analysis

cloudy or turbid

Positive analytes that require microscopic analysis

blood, protein, nitrate, LE, glucose

WBC

WBC

WBC

eosinophil

RBC

RBC

SEC

SEC

Transitional epithelial cell

transitional epithelial cell

RTE

RTE

What condition are RTEs seen

tubular necrosis

bacteria

mucus

What is positive on the dipstick if mucus is present

protein

mucus

yeast

yeast

What can be positive on the dipstick if yeast is present

glucose, LE

Populations more protein to yeast in urine

diabetes, immunocompromised

Trichomonas

Identifying features of trichomonas

undulating membrane, flagella, motility

sperm

What can be positive on the dipstick if sperm is present

protein

hyaline cast

hyaline cast

Possible positive on the dipstick if hyaline casts are present

protein

granular cast

granular cast

waxy cast

waxy cast

Condition associated w/ waxy cast

urinary stasis

Disease state associated w/ waxy cast

chronic renal failure

Broad cast

broad

Condition associated w/ broad cast

extreme urinary stasis

Disease state associated w/ broad cast

renal failure

Amorphous

Amorphous crystals in acidic pH

urates

Amorphous crystals in alkaline pH

phosphates

Color of amorphous urate sediment

pink

Color of amorphous phosphate sediment

white

uric acid

Conditions associated w/ uric acid crystals that aren’t gout

chemo, lesch-nyhan

Calcium oxalate

Calcium oxalate

Pathological cause of monohydrate calcium oxalate

ethylene glycol poisoning

triple phosphate

ammonium biurate

calcium carbonate

cystine

Disease state associated with Cystine crystals

cystinuria

leucine

tyrosine

Diseases associated w/ tyrosine crystals

tyrosinemia, liver disease

bilirubin

Principle of spectrophotometry

light reflection decreases in proportion to intensity of color

How does the spectrophotometer work

monochromatic light reflected to photodetector, instrument compares light to stored knowns

4 goals of automation for urinalysis

improve reproducibility, color discrimination, productivity, reporting standardization

Sources of variance in urinalysis

testing personnel, timing, color interpretation