Urinalysis Quiz 2

How often should you QC dipstick

beginning of each shift

Most frequently tested analyte in the lab

glucose

Renal threshold of glucose in the blood before the net breaks

160-180 mg/dL

Reaction for Glucose Testing

glucose oxidation

Tests to correlate pos Glucose with

ketones, protein

Confirmatory test for pos Glucose

Clinitest, copper reduction

What sugar is utilized for Clinitest

galactose

Application of Clinitest

newborn screening

Reaction for Bilirubin testing

diazo

Test to correlate pos Bilirubin with

urobilinogen

What can bilirubin be influenced by

urine color

Confirmatory test for Bilirubin

Ictotest

Principle of Ictotest

pad with tablet

Why are Ketones volatile

broken down to co2

Reaction for Ketone testing

sodium nitroprusside

Test to correlate pos Ketone with

glucose

Confirmatory test for Ketones

acetest tablet

Normal range of Specific Gravity

0-30

Reaction for Specific Gravity testing

change in pKa

What testing methodology for Blood in urine is most accurate

chemical

Reaction for Blood testing

pseudoperoxidase

Test to correlate pos Blood with

protein, microscopic

Most common cause of false Blood positive

menses

3 categories of Blood in urine

hematuria, hemoglobinuria, myoglobinuria

Normal range of pH in urine

4.5-8.0

Reaction for pH testing

double indicator system

Major type of disease associated with proteinuria

renal

Most common protein found in urine

albumin

Reaction for Protein testing

protein error of indicators

Test to correlate pos Protein with

blood, nitrite, LE, microscopic

Categories of Proteinuria clinical significance

prerenal, renal, postrenal

Confirmatory test for pos Protein

sulfosalicylic acid precipitation

Reaction for Urobilinogen Testing

Erlich’s aldehyde

Test to correlate pos Urobilinogen with

bilirubin

Reaction for Nitrite Testing

Greiss

Tests to correlate pos Nitrite with

LE, protein, microscopic

Reaction for LE testing

hydrolysis of acid ester

Tests to correlate pos LE with

nitrite, protein, microscopic

Applications of Phase-contrast microscope

low refractive casts, mucous

Applications of Polarizing scope

crystals, lipids

Applications of Dark field scope

syphilis

Applications of Fluorescence scope

intracellular bacteria, viruses

Volume needed for microscopic

10-15 mls

Volume dispensed onto glass slide for microscopic

20 ul

Purpose of Commercial systems in urinalysis

standardization

Applications of Sternheimer-Malbin stain

WBCs, epis, casts

Applications of 5% Toluidine Blue stain

differentiate WBCs w/ RTE

Applications of 2% Acetic Acid stain

lyses RBCs, enhances WBC nuclei

Applications of Sudan III/Oil Red O stain

trigs and fats

Application of Hansel stain

eosinophilic granules

Application of Prussian Blue stain

iron

What is the largest and most common epithelial cell found microscopically

squamous

What does high epithelial cells in urine indicate

skin contamination

What shapes can transitional epithelial cells come in

spherical, polyhedral, caudate

Most clinically significant epithelial cell

renal tubular

Most common cause of oval fat bodies

nephrotic syndrome

How to differentiate bacteria from debris

motility

How to differentiate RBCs from yeast

budding, 2% acetic acid

Criteria for Trichomonas diagnosis

motile

Dipstick result correlated w/ spermatozoa

protein

What protein is associated w/ casts

uromodulin

Which objective is used to quantify casts

10x

Which objective is used to identify casts

40x

Disease associated w/ Fatty casts

nephrotic syndrome

When are waxy casts seen

extreme urinary stasis

What casts is referred to as the renal failure cast

broad cast

Most common types of broad casts

waxy, granular

Dipstick test used to differentiate urinary crystals

pH

Appearance of amorphous urates

yellow brown granules

Appearance of uric acid crystals

rhombus

Condition associated w/ dihydrate Calcium oxalate crystals

kidney stones

Appearance of Calcium oxalate crystals

diamond or oval

Condition associated with Monohydrate calcium oxalate

ethylene glycol poisoning

Appearance of amorphaous phosphates

white granules

Appearance of triple phosphate crystal

coffin lid

Appearance of Calcium carbonate crystal

dumbbell or spherical

Appearance of Ammonium biurate

yellow-brown thorny apples

What type of urine are abnormal crystals found in

acidic

Appearance of Cystine crystals

hexagons

Appearance of Cholesterol crystals

notch

How to differentiate Tyrosine from ammonium biurate crystals

pH

Appearance of Tyrosine crystals

brown shards

Appearance of Leucine crystals

wagon wheel

Purpose of microscopic examination of urine

detect/ID insoluble materials