Urinalysis

Question 1

What equipment is needed?

Answer 1

Gloves
Apron
Urine dipstick
Urine sample
Paper towels

Question 2

Inspection

Answer 2

Colour

Clarity

Question 3

Normal colour of urine

Answer 3

straw

Question 4

Dark concentrated urine suggests…

Answer 4

dehydration

Question 5

red urine

Answer 5

haematuria, rifampicin, porphyria, beetroot

Question 6

Brown urine

Answer 6

anti-malarials, bile pigments, myoglobin

Question 7

Cloudy urine

Answer 7

Infection (UTI)

Question 8

Frothy urine

Answer 8

nephrotic syndrome

Question 9

Describe procedure (9)

Answer 9

1. Check urine dipsticks’ expiry date
2. Remove a testing strip from the container
3. Insert test strip into urine sample (ensuring all test zones are immersed)
4. Remove the strip, ensuring to tap off residual urine before removing from the sample bottle
5. Ensure test strip remains in a horizontal orientation (to avoid cross contamination of testing zones)
6. Use the dipstick analysis guide on the side of the testing strip container to interpret the findings
7. Different tests on the strip are required to be read at different times, so ensure you interpret the appropriate test at the correct time interval – e.g. 60 seconds for protein
8. Once you have interpreted all of the tests, discard the strip into the clinical waste bin along with your gloves and apron
9. Wash hands

Question 10

Suggestion for further examination

Answer 10

If raised WCC > send urine for culture

Raised glucose > check blood glucose levels

Question 11

Specific gravity

Answer 11

indicates how much solute is dissolved in urine (decreased in DI)

Question 12

protein in urine suggests…

Answer 12

nephrotic syndrome

Question 13

Leukocyte esterase

Answer 13

enzyme produced by neutrophils (WCC in urine) – ↑ in UTI

Question 14

Nitrites in urine

Answer 14

breakdown products caused by Gram -ve organisms – Gram -ve UTI e.g. Ecoli

Question 15

Ketones in urine

Answer 15

breakdown product of fatty acid metabolism – ↑ starvation / ↑DKA

Question 16

Glucose in urine

Answer 16

↑ hyperglycaemia e.g. poorly controlled diabetes

Question 17

Bilirubin

Answer 17

Indicates ↑ conjugated bilirubin (water soluble) – ↑ biliary tract obstruction

Question 18

Urobilinogen

Answer 18

if raised indicates ↑ bilirubin turnover – ↑malaria / ↑haemolytic anaemia