1
Q
What is the average daily urine output for an adult?
A
1200–1500 mL/day
2
Q
What test confirms urine vs other body fluids?
A
Creatinine or Urea testing
3
Q
Define oliguria.
A
<400 mL urine/day
4
Q
Define anuria.
A
<50–100 mL urine/day
5
Q
Define nocturia.
A
Excessive urination at night
6
Q
Define polyuria.
A
> 2000–2500 mL urine/day
7
Q
Proper 24-hour urine collection rule?
A
Discard first morning urine, collect all urine for 24 hours
8
Q
Confirmatory test for protein in urine?
A
Sulfosalicylic acid (SSA) test
9
Q
Confirmatory test for ketones?
A
Acetest (nitroprusside reaction)
10
Q
Confirmatory test for glucose?
A
Clinitest (copper reduction)
11
Q
Confirmatory test for bilirubin?
A
Ictotest
12
Q
Normal urine specific gravity range?
A
1.003–1.035
13
Q
Diabetes mellitus effect on SG?
A
Increased SG
14
Q
Diabetes insipidus effect on SG?
A
Decreased SG
15
Q
what is the creat cl formula?
A
C=UV/P
16
Q
when a urine is cloudy red what does that indicate?
A
whole RBC’s
17
Q
clear red urine indicates what?
A
rbc’s have lysed; hemoglobin or myoglobin
18
Q
what is the pigment that causes the yellow color in urine called?
A
urochrome
19
Q
what is a normal color urine?
A
pale yellow, yellow, dark yellow
20
Q
pink pigment in urine; attaches to amorphous urates formed in refrigerated specimens (normal turbidity)
A
uroerythrin
21
Q
orange brown color in older urine specimens; oxidation of normal constituent
A
urobilin
22
Q
what are abnormal colors of urine?
A
red, pink, brown, black, brown, blue, or green
23
Q
dark yellow or amber colored urine indicate what?
A
bilirubin in urine
24
Q
if yellow foam is produced when shaken in a amber colored urine what does that indicate?
A
billirubin
25
photooxidation of large amount of urobilliogen produces what color urine
yellow-orange
26
photooxidation of bilirubin to biliverdin produces what color urine?
yellow green
27
AZO used for UTI infections can cause urine to turn what color
greasy/dark orange
28
what is the most common cause of a red urine
blood
29
brown urine color may indicate what
oxidation of Hgb to MetHgb
30
when RBC's remain in acid urine this produces what
MetHgb
31
fresh brown specimen can indicate what?
glomerular bleeding
32
the oxidation of porphobilinogen to porphyrias will make urine what color
port wine
33
when a urine is brown/black that may indicate what?
melanin-excess malignant melanoma; homogeneistic acid
34
what are normal acid crystals in urine?
amorphous urates, uric acid, calcium oxalate dehydrate, sodium urates
35
what are normal alkaline crystals in urine?
amorphous phosphates, triple phos, ammonium bitrate, calcium phos, calcium carbonates
36
abnormal crystal shaped like a bumble bee and is seen in cystinuria
cystine crystals
37
this abnormal crystal is seen in nephrotic syndrome it has rectangular plate with notched corners and normally seen with fatty casts
cholesterol crystals
38
this abnormal crystal is associated with liver disease has spheres with co eccentric circles and radial striations and is normally accompanied by tyrosine crystals
leucine
39
abnormal crystal that looks like yellow needles with clumps and rosettes, associated with liver disease
tyrosine
40
this abnormal crystals is usually seen in an amber colored urine, people with viral hep or tubular damage, looks like clumped needles or granules
bilirubin crystals
41
this abnormal crystal is seen in dehydration, looks like colorless needles "sheaves of wheat"
sulfonamide crystal
42
this abnormal crystal is caused from having intravenous radiographic dye contrast, its colorless resembles elongated plates, sometimes with corner notches ; can resemble cholesterol crystals
radiographic dye crystals
43
this abnormal crystals looks like colorless clusters of long needles
ampicillin crystals
44
acid precipitation confirmatory test for protein
SSA- sulfosalicylic acid
45
sodium nitroprusside reaction, confirmatory test for ketones
acetest
46
confirmation test for bilirubin
ictotest
47
principle: copper reduction, non specific confirmatory test that detects glucose, lactose, maltose, fructose, and galactose
clinitest
48
SG of 1.010 is called what?
Isosthenuric
49
SG<1.010 is called what?
hyposthenuric
50
SG>1.010 is called what?
hypersthenuric
51
what is the SG ref range for a urine
1.003-1.035
52
when do you perform QC on a urine reagent strips?
QC is normally run at the beginning of the shift but may need additional QC when a new Lot # of strips is opened (or new shipment of same lot#), When results are questionable, When there are concerns over strip integrity
53
what is the pH ref range on urine?
4.5-8.0
54
when to re collect a specimen due to pH problems?
when pH is higher than 8.5, specimen could have been preserved improperly
55
Double indicator System
(Methyl red & Bromothymol
blue); measures free H ions
reaction principle for pH
56
this reaction principle uses Protein error of indicators
protein
57
reaction principle: Peroxidase / Oxidase method Double sequential enzyme
reaction principle for glucose
58
reaction principle: Sodium nitroprusside
reaction principle for ketones
59
reaction principle: Pseudo-oxidase activity of Hgb
reaction principle for blood
60
reaction principle: Diazo reaction
reaction principle for bilirubin
61
reaction principle: Ehrlich’s reaction / Diazo reaction
reaction principle for urobilinogen
62
reaction principle: Greiss reaction Diazo compound + Hydroxy- 1,2,3,4 tetrahydrobenz-h-quinolin
principle reaction for nitrate
63
principle reaction: LE reaction (Leukocyte esterase)
principle reaction for leukocytes
64
principle reaction: pKa change of polyelectrolyte
principle reaction of SG
65
what can cause a false positive in protein?
increased pH, highly alkaline urine
66
what can cause a false positive in glucose?
bleach
67
what can cause a false negative in glucose?
ascorbic acid(vit c)
68
what can cause a false pos in ketones?
highly pigmented urine
69
what can cause a false negative in ketones?
improper storage
70
what can cause a false pos in blood?
bleach
71
what can cause a false negative in blood?
ascorbic acid(vit c)
72
what can cause a false pos in bilirubin?
medication color
73
what can cause a false negative in bilirubin?
ascorbic acid(vit c)
74
what can cause a false pos in urobilinogen?
highly pigmented urine, some meds
75
what can cause a false negative in urobilinogen?
nitrate
76
what can cause a false pos in nitrate?
medication color
77
what can cause a false neg in nitrate?
ascorbic acid
78
what can cause a false pos in leukocytes?
bleach
79
what can cause a false neg in leukocytes
ascorbic acid
80
what can cause a false pos in SG
protein
81
what can cause a false neg in SG
alkaline urine (>6.5)
82
What are the 3 types of ketones formed from the breakdown of fats stores in the body?
Beta-Hydroxybutyrate (BHB), Acetoacetate (AcAc), and Acetone
83
which type of ketone is measured on the chemstrip?
Acetoacetate (AcAc)
84
what type of urine is ghost cells found in?
hypotonic urine or alkaline urine (dilute) Low SG <1.010
85
what type of urine are crenated RBC's found in?
high SG >1.025
86
epithelial cells from distal urethra vagina, usually contamination
SEC
87
epithelial cell from the bladder, uterus, or renal pelvis; increased in catheterization, infection, or inflammation
transitional epis
88
epithelial cells from renal tubules and are significant bc they indicate tubular damage, necrosis, drug toxicity, or hepatitis
renal tubular epi
89
Galactose in the urine of a newborn signifies what?
"in born error of metabolism"
90
what does glactosuria results look like on a chemstrip vs clinitest
negative for glucose on a chemstrip but pos for a clinitest bc strip does not test for galactose
91
galactosuria is mostly seen in what age group?
new borns
92
what is the tube order when collecting a CSF tubes?
chemistry, micro, hematology, send out test/ cytology viral studies
93
Traumatic tap vs. hemorrhage — what clears in later tubes?
traumatic tap
94
Xanthochromia present in what?
hemmorage
95
Clot formation in CSF is seen in what?
traumatic tap
96
normal to decrease glucose and increased lymphs in CSF may indicate what?
Viral/fungal meningitis
97
decreased glucose with increased lymphs in CSF may indicate what?
tubercular meningitis
98
Markedly decreased glucose with increased neutrophils in CSF may indicate what?
bacterial meningitis
99
Yellow discoloration of CSF supernatant after centrifugation, indicates older hemorrhage
xanthochromia
100
Yellow CSF (xanthochromia) indicates what?
Breakdown of hemoglobin (old hemorrhage, elevated protein, or bilirubin)
101
What is the normal color of CSF?
colorless or clear
102
Normal CSF glucose range?
45–80 mg/dL
103
Normal CSF protein range?
15–45 mg/dL.
104
Normal CSF WBC count?
0–5/µL
105
Normal CSF RBC count?
negative
106
what organism is detected with India ink stain?
Cryptococcus neoformans
107
what is the normal liquification time for semen?
30-60 min
108
how can delay of testing of semen can effect results
sperm motility and concentration
109
what is Eosin-nigrosine Stain used for in semen testing?
used to detect living and dead semen; RED=DEAD; BLUE=ALIVE
110
What is the normal % of motile sperm?
50%
111
what is the difference of hematuria and hemoglobinuria ?
hematuria: intact RBC
hemoglobinuria: broken down RBC in urine
112
When performing a chemstrip analysis for hematuria and hemoglobinuria what would be pos on a strip?
blood
113
in a microscopic examination when there is >3-5/HPF RBC's this indicates what?
hematuria
114
when performing a microscopic examination, the dipstick was pos for blood but there is < 3 RBC/HPF what does this indicate?
hemoglobinuria
115
what is the normal appearance of synovial fluid?
clear, pale yellow, viscous
116
when a patient is diagnosed with gout, their serum uric acid levels look like what?
increased significantly
117
What are the 2 primary crystals in synovial fluid?
MSU (monosodium urate)
CPPD (calcium pyrophosphate dihydrate)
118
crystals found in synovial fluid that are needle-shaped, negatively birefringent; indicates gout
MSU (monosodium urate)
119
crystals that are found in synovial fluid that are rhomboid, positively birefringent; indicate Pseudogout
CPPD (calcium pyrophosphate dihydrate)
120
What is the Mucin Clot Test called, and why is it performed?
the rope test, measures hyaluronic acid quality (viscosity)
121
Excess fluid in a joint cavity.
effusion
122
low protein, low cells; systemic cause
transudate
123
high protein, high cells; inflammatory/infectious cause.
exudate
124
what is tumor marker CEA used for?
GI cancers
125
what is tumor marker CA 125 used for?
ovarian cancers
126
Protects fetus, allows movement, lung development, temperature regulation.
amniotic fluid
127
When/why does amniotic fluid normally increase?
2nd–3rd trimester due to fetal urine production.
128
How to preserve bilirubin in amniotic fluid?
protect from light
129
Why run creatinine on amniotic fluid?
to determine fetal age/maturity
130
Decreased amniotic fluid volume
oligohydramnios.
131
Increased amniotic fluid volume.
polyhydramnios
132
green amniotic fluid means what?
meconium
133
yellow amniotic fluid means what?
bilirubin (HDN)
134
red amniotic fluid means what?
blood contamination
135
dark red brown amniotic fluid means what?
fetal death
136
Maternal IgG antibodies cross placenta and destroy fetal RBCs (usually Rh or ABO incompatibility).
HDN
137
What is measured with spectrophotometer & Liley graph?
Bilirubin ΔOD450 in amniotic fluid to determine HDN severity.
138
What is the concern with underdevelopment in premature labor?
respiratory distress syndrome
139
What do lamellar bodies measure?
Surfactant storage granules
140
What does the L/S ratio test for?
surfactant maturity
141
Detects amniotic fluid using ferning crystallization pattern (ruptured membranes)
fern test
142
Reagent in Hemoccult test?
Guaiac + hydrogen peroxide.
BLUE=POS
143
Foods causing false positives in FOBT?
Red meat, horseradish, turnips, iron, aspirin.
144
Standard test for occult blood?
FOBT
145
what type of specimen is collected for quantitative fecal fat test?
72 hour specimen
146
What is steatorrhea?
excess fat in stools
147
“Occult” means what?
Hidden (not visible) blood.
148
How many days to collect stool samples for FOBT?
3 days/ 3 different specimens
149
Normal brown stool color due to what pigment?
urobilin
150
Black/tarry stool means what?
Upper GI bleed (melena).
151
Red stool means what?
Lower GI bleed.
152
Clay/gray stool means what?
Bile duct obstruction.
153
Green stool means what?
Rapid transit or antibiotic use
154
Yellow stool means what?
Fat malabsorption
155
Increased neutrophils in feces indicate what?
Bacterial infection or inflammation.
156
Stain with Sudan III (most common) or IV, oil red O is used for what in stool examination
microscopic screening for steatorrhea(fats in stool)
157
normal vaginal fluid appearance?
clear/white, low viscosity.
158
abnormal vaginal fluid appearance?
Yellow-green (Trichomonas)
Gray/white thin (BV)
Thick curdy white (Candida)
159
What are clue cells and what do they indicate?
Epithelial cells coated with bacteria → Gardnerella vaginalis (BV)
160
What is normal vaginal flora?
Lactobacillus (produces lactic acid, keeps pH low)
161
Why use KOH prep?
Dissolves epithelial cells to enhance yeast visibility.
162
What is the whiff test?
KOH added → fishy odor → positive for BV.
163
an instrument that measures velocity of light in air versus velocity of light in a solution (SG)
Refractometer
164
what solution is used to calibrate the refractometer?
Distilled water, should read 1.000; 5% NaCl should read 1.022 ± 0.001
* 9% sucrose should read 1.034 ± 0.001
165
What urine specimen should not be run on a refractometer?
do not use for patients with x-ray dye contrast
166
How do you get rid of Amorphous Urate crystals?
dissolving by warming specimen (RT)
167
How to get rid of Amorphous Phosphate crystals?
Dissolve by acidifying specimen- add acetic acid
168
this gives urine its normal yellow color
urochrome
169
This gives stool its normal brown color
urobilin
170
Increase Fat metabolism (such as in KETO diet) increases what in the urine
chemistry
ketones
171
How much urine is desired for Routine UA; how much for microscopic examination
after decanting supernatant
0.5-1.0
172
What objective on microscope do you start with; what to try to focus on first; what to scan around edges to look for?
10x/LPF to look for epis; scan edges to look for casts
173
What objective on microscope do you use to perform identification of sediment
40x
174
Renal Glycosuria is characterized by what?
glucose in urine
175
Diabetes mellitus vs. Diabetes insipidus
DM: high blood sugar due to insulin issues
DI: fluid imbalance causing excessive urination, thirst, with normal blood sugar
176
What are kidney stones predominantly made of?
calcium oxalate
177
When is a ‘chain of custody’ needed?
Legal/forensic or drug testing cases
178
what time of collection is best for UA?
first morning urine (more concentrated)
179
what are the dimensions of a hemacytometer
3 × 3 × 0.1 mm
180
what protein makes up casts in urine?
uromodulin (Tam-Horsefall protein)
181
what condition causes casts to form in urine?
proteinuria
182
what disorder is associated with fatty casts?
nephrotic syndrom- seen with oval fat bodies
183
RBC casts is seen when?
glomerular damage
184
WBC casts is seen when?
pyelonephritis
185
Waxy casts are seen when?
end stage renal disease
186
oval fat bodies are seen when?
nephrotic syndrome or heavy proteinuria (RTE containing fat droplets)
187
body fluids
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