Medical Assessment Quiz

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Questions and Answers

What is the main component of urine composition?

Electrolytes

Water (correct)

Urea

Proteins

How much solid content is typically found in urine over a 24-hour period?

60 grams (correct)

120 grams

30 grams

150 grams

What is the purpose of the three-glass technique in urinalysis?

To assess urine volume

To identify kidney stones

To measure urine pH

To isolate prostatic infection (correct)

What does the PAH (p-aminohippuric acid) test assess?

Tubular secretion dynamics Signup and view all the answers

During the three-glass technique, which specimen is analyzed after prostatic massage?

First portion of urine voided Signup and view all the answers

What component makes up approximately 3-5% of urine?

Solids Signup and view all the answers

What is one characteristic of a sterile specimen obtained for urinalysis?

It is usually collected through catheterization Signup and view all the answers

Which test is also known as Diodrast test?

PAH test Signup and view all the answers

Which test involves depriving a patient of fluid for 24 hours?

Fishberg test Signup and view all the answers

What minimum specific gravity (SG) value is considered normal during fasting?

1.026 Signup and view all the answers

What is evaluated in the Mosenthal test?

Urine volume and specific gravity Signup and view all the answers

Which parameter in urine is influenced by the number and density of particles?

Specific gravity Signup and view all the answers

In the context of glucose tolerance testing, what is typically collected along with blood samples?

At least 2 voided urine collections Signup and view all the answers

What type of specimen is used for routine screening and bacterial culture?

Random urine sample Signup and view all the answers

What does osmolarity in a solution indicate?

Concentration of solutes in solution Signup and view all the answers

What is required for conducting a glucose tolerance test?

Blood and urine samples Signup and view all the answers

What factors are considered in the evaluation mentioned?

Ethnicity, BUN, Serum Albumin Signup and view all the answers

What is the implication of a patient with low Serum Albumin?

It indicates liver dysfunction or nephrotic syndrome Signup and view all the answers

Which of the following tests primarily evaluates tubular reabsorption?

Urine concentration tests Signup and view all the answers

When evaluating a patient, which lab values might be significantly altered if tubular reabsorption is impaired?

Serum Electrolytes and Urine Osmolality Signup and view all the answers

Why is ethnicity mentioned in the context of evaluation?

It may influence the prevalence of certain conditions Signup and view all the answers

What is the main purpose of assessing BUN levels in patients?

To evaluate kidney function Signup and view all the answers

In the context provided, what does low Albumin suggest about a patient's health?

Possible kidney or liver disease Signup and view all the answers

Which condition could lead to reduced Serum Albumin levels?

Nephrotic syndrome Signup and view all the answers

What compound is produced when urobilinogen reacts with hydrogen peroxide and a chromogen?

Oxidized chromogen Signup and view all the answers

What color change indicates a positive result for urobilinogen?

Red to yellow Signup and view all the answers

Which bilirubin type is indicated as being water soluble?

Conjugated bilirubin Signup and view all the answers

Which conditions are associated with elevated levels of conjugated bilirubin?

Hepatitis and biliary obstruction Signup and view all the answers

What is the primary purpose of the chain of custody in drug specimen collection?

To document proper sample identification Signup and view all the answers

What color of urine is often associated with an early indication of liver disease due to high conjugated bilirubin levels?

Tea-colored or amber Signup and view all the answers

Which temperature range is recommended for urine specimen preservation within 4 minutes of collection?

0-5°C Signup and view all the answers

Which of the following reagents is specific for urobilinogen?

4-methoxybenzene-diazonium-tetrafluoroborate Signup and view all the answers

What is the function of formalin as a urine preservative?

Preserves sediment and casts Signup and view all the answers

What could potentially cause a false negative result in a bilirubin test?

Old specimen or preservation in formalin Signup and view all the answers

What is the required urine volume for specimen collection in a 60 ml container?

60 ml Signup and view all the answers

What is the significance of a positive test for urobilinogen?

Suggests liver dysfunction or hemolysis Signup and view all the answers

What is the ideal time frame for testing urine specimens after collection?

Within 2 hours Signup and view all the answers

Which statement accurately describes bilirubin testing limitations?

Old specimens may yield inaccurate results. Signup and view all the answers

Which preservative is noted for preventing bacterial growth up to 24 hours?

Refrigeration Signup and view all the answers

What condition is commonly ruled out if there is a significant increase in conjugated bilirubin?

Hemolytic anemia Signup and view all the answers

Which component is added to the toilet water reservoir to prevent specimen adulteration?

Chemical dye Signup and view all the answers

What does the term 'Addis count' refer to in urine analysis?

Count of cells and casts in urine Signup and view all the answers

What is the main consequence of delayed testing of unpreserved urine samples?

Alteration in chemical composition Signup and view all the answers

Which of the following is NOT a function of urine preservatives?

Shorten testing time Signup and view all the answers

Study Notes

Tubular Reabsorption and Tests

Tubular reabsorption tests evaluate how effectively kidneys reabsorb substances.
Common tests include:
- Fishberg test: measures urine specific gravity after 24 hours of fluid deprivation (SG should be ≥ 1.026).
- Mosenthal test: compares day vs. night urine volume and specific gravity.
- Fasting urine test: involves collecting urine after a period of fasting for glucose determination.
- 2-hour postprandial test: used for diabetic screening and monitoring.
- Glucose tolerance test: may include blood samples for confirmation.

Urinalysis Composition

Normal urine composition consists of 95-97% water and 3-5% solids (approximately 60 grams in 24 hours).
Specific gravity (SG) indicates the concentration of particles in urine, while osmolarity assesses the number of solute particles.

Bile Pigments and Indicators

Urobilinogen (from hemoglobin degradation) indicates liver function; normal value is (+).
Conjugated bilirubin (water-soluble) is an early indicator of liver disease, associated with conditions like hepatitis and biliary obstruction.
Tea-colored or amber urine suggests possible liver disorders.

Drug Specimen Collection Procedures

Chain of custody ensures proper identification of samples from collection to laboratory results.
Required urine volume is typically 60 ml for testing.

Urine Preservation and Testing Integrity

Specimens should be refrigerated to maintain integrity and prevent bacterial growth (up to 24 hours).
Urine preservatives are utilized to prevent contamination and degradation, with formaldehyde acting as a sediment preservative.
Urine should be tested within a specific timeframe after collection for accurate results.

Interferences in Urinalysis

Certain chemicals can lead to false-positive or false-negative results, requiring careful consideration of the specimen's handling and storage conditions.
Common interferences come from substances (e.g., Ehrlich-reactive compounds in bilirubin tests) and environmental conditions during specimen collection.

Additional Collection Techniques

The three-glass technique is useful for diagnosing prostatic infections by comparing urine from different stages of voiding.
Pediatric specimens often use soft adhesive bags to collect samples non-invasively.

Microscopic Examination of Urine

Microscopic analysis includes examining cellular material such as casts and cells, which can reveal additional insights into renal health.
Sample integrity is crucial to obtaining reliable microscopic results, necessitating prompt delivery to the laboratory after collection.

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Description

Test your understanding of medical assessment procedures with this quiz. It focuses on various patient evaluation techniques and their implications for treatment. Ideal for medical students and professionals.