Urine Analysis Quiz

Clinical Microscopy Intensive Exam - Study Notes

• Pictogram Identification: Triple Phosphate is a pictogram in the exam provided.
• Alkali Chemical Exposure: Irrigate affected skin with water for 15 minutes. Report to supervisor.
• Inorganic Compounds in Urine (Daily): Normally, the amount of inorganic compounds in urine per day is 25 g.
• Urinary Crystal Formation: Protein concentration does not contribute to urinary crystal formation. Factors like pH, temperature, and solute concentration do.
• Soluble Calcium Oxalate Crystals: Dilute HCl dissolves uncommon forms of calcium oxalate crystals.
• Pink Precipitate in Refrigerated Urine: Microscopy of clear, pink-precipitating refrigerated urine indicates amorphous urates.
• Urine Sample Rejection Criteria: A urine sample with a temperature of 95°F after collection is a reason for rejection when drug screening is required.
• Urine Drug Testing Temperature: The correct temperature range for urine drug testing is 32.5°C to 35.5°C.
• Urine Controls for Reagent Strips: Run daily positive and negative controls on reagent strips to ensure accuracy and precision.
• Urine Drug Testing Requirements: When performing drug tests, the collector must perform these actions: inspect specimen color, fill out a chain-of-custody form, and read specimen temperature. Testing with reagent strips is also a part of this step.
• Renal Calculi Formation: Renal calculi do not form in the medulla.
• Specimen Types for Testing:
  • Routine screening: random specimen
  • Glucose determination: fasting or first morning specimen
  • Bacterial culture: random specimen
  • Prostatic infection: first morning specimen
• Urine Specimen Labeling: Attach labels to the container itself, not the lid or bottom.
• Struvite Crystals: Struvite crystals are associated with magnesium ammonium phosphate.
• Urine Sediment Preservation: Toluene is the best preservative for urine sediment.
• Urine Specimen Labeling Method: Labels should be attached directly to the specimen containers, not the lids.
• Urine Characteristics Affecting RBCs: In dilute urine, RBCs swell.
• Clinically Significant Epithelial Cells in Urine: Transitional cells are the most clinically significant epithelial cells often found in urine.
• Cast Degradation Order: Hyaline casts degrade to granular casts and then to waxy casts, often in order of their presence in clinical samples.
• Sternheimer-Malbin Stain: This stain uses Methylene blue and eosin Y.
• Glitter Cells Staining: Glitter cells appear a light blue color when stained.
• Highly Refractive Urine Contaminants: Air bubbles are a highly refractile contaminant in urine samples.
• Oval Fat Bodies: An oval fat body that produces a Maltese cross in polarized light and doesn't stain with Sudan III contains no cholesterol.
• RTE Reporting: Use the terms few, moderate, many, or abundant per high power field (HPF).
• Urine Microscopic Centrifugation: The centrifugation for urine microscopic reaction should be 400 RCF for 5 minutes.
• Microscope Total Magnification: A 10x objective and 4x ocular lens combination results in a 40x total magnification.
• Microscope Image Sharpness: The fine adjustment knob sharpens the quality of the image in a microscope.
• Concentration Tests: Specific gravity is a concentration test. Osmolality & specific gravity are also good indicators relating to renal concentration ability.
• Urine Specific Gravity Correction: The correct specific gravity is 1.026 when considering the temperature being 26C and that the chemical test showed 2g/dL protein.
• Reagent Strip Chemical Reactions: Excess urine on the reagent strip after application can alter the color and potentially cause run-over, reducing precision.
• Reagent Strip pH Reaction: The pH reagent strip determines pH via dissociation of a polyelectrolyte.
• False-Negative Glucose Reagent Strip Reactions: Detergent, ascorbic acid, unpreserved samples, and low temperature can cause false-negative glucose reagent strips.
• Negative Copper Reduction Test Result: A dark green, orange-red, or yellow color result implies a negative copper reduction test.
• Clinitest vs. Reagent Strip Glucose: Reagent strip tests are more sensitive and precise than Clinitest for glucose, particularly for lower concentrations.
• Clinitest Purpose: Clinitest is primarily used to confirm positive glucose findings from reagent strips.
• Ketone Origin: Ketones are byproducts of fat metabolism.
• Lange Test Reagents: Sodium nitroprusside, glacial acetic acid, ammonia, and copper sulfate (CuSO4) are among the reagents for ketones.
• Specific Gravity Reaction Substances: Chloride reacts in the reagent strip for specific gravity tests.
• Urine pH of 9.0: A pH of 9.0 in urine suggests a need for recollecting the sample and/or a possible condition.
• Post-Standing Urine pH Increase: Post-standing urine pH increase can occur due to bacterial urease production, which increases alkalinity but not directly nitrite itself.
• Protein in Normal Urine: Normal urine typically contains 30 mg/dL of protein.
• Bence Jones Protein Levels: Elevated Bence Jones protein levels may indicate different types of proteinuria (pre-renal, renal glomerular, renal tubular, post-renal).
• Protein Reagent Strip Discrepancy (SSA Test): A discrepancy between a negative reagent strip protein result and a positive SSA result signifies the presence of proteins other than albumin or other interferences.
• Orthostatic Proteinuria Classification: Orthostatic proteinuria involves identifying a discrepancy between afternoon and morning protein readings, not a consistent positive reading.
• Detecting Hemoglobin vs. Myoglobin: Sodium dithionite reduces hemoglobin in a method for identifying the two in urine.
• Ictotest Interference Removal: Add water to the mat, rather than directly adding urine, to remove interference.
• Watson-Schwartz Test Substances: In this test, porphobilinogen, urobilinogen, and other ehrlich-reactive substances will not be extracted into butanol.
• Tests Requiring Special Diets: Certain tests (e.g., for bilirubin) may require the patient to be on an appropriate diet beforehand, such as avoiding green vegetables.
• Leukocyte Esterase Reaction Components: The test detects neutrophils (and sometimes eosinophils) but not lymphocytes or basophils in urine.
• Normal Urobilinogen Concentration: Normal urine urobilinogen level is 1 Ehrlich unit or 2 Ehrlich Units, not 1 g/dL or 2 g/dL
• Reagent Strip Test Insignificance: Creatinine, in small amounts, has no significance in reagent strip tests
• Urine Specimen Sterility: Catheterized specimens are usually the most sterile.
• Orange Urine Color Change: Change in urine color from orange to colorless with changes in urine pH relates to specific drugs and/or diseases.
• Melanuria Cause: A metabolic disease, alkaptonuria can cause urine to turn black upon standing.
• Phenylketonuria Cause: A deficiency in phenylalanine hydroxylase causes phenylketonuria.
• Diurnal Variation in Urine Solutes: Creatinine levels in urine may vary throughout different times of the day. Corticoids and 17-hydroxysteroid levels are other examples of urine solutes with diurnal variation.
• ADH Release Stimuli: ADH release is stimulated by changes in plasma osmolality, not low arterial pressure.
• Renal Tubular Acidosis Cause: Renal tubular acidosis results from the inability of the tubules to secrete hydrogen ions and produce acidic urine.
• Dehydration and ADH: Dehydration leads to increased ADH production, ultimately reducing urine volume.
• Normal CSF Protein Values: Normal CSF protein ranges from 15 to 45 mg/dL, not 6 to 8 d/dL.
• Increased Urine Volume and Specific Gravity: Low specific gravity (SG 1.002-1.003) and constant urine production are signs of diabetes insipidus.
• MDRD eGFR Calculation Formula: Serum creatinine, age, gender, and race are used in the MDRD formula for estimating glomerular filtration rate (eGFR).
• Sperm Cell Concerns: Round cells like leukocytes, RBCs, and spermatids must be checked for in sperm samples, to ensure the sample's integrity.
• Seminal Fluid Viscosity: A viscosity rating of 0 indicates a watery fluid, and 4, suggests a gel-like consistency.
• Sperm Count Calculation: Determine sperm count by the following formula (sperm counted in RBC squares * 20).
• Normal Sperm Motility: Normal sperm motility is 50–60%.
• Causes of Decreased Amniotic Fluid: Increased fetal swallowing, membrane leakage, and urinary tract defects can cause reduced amniotic fluid.
• Peritoneal Fluid Classification: Use the serum-ascites albumin gradient (SAAG) to distinguish between transudate and exudate types of fluid. A SAAG is typically higher than 1.1 g/dL.
• Amniotic Fluid vs. Urine Differentiation: Differentiate amniotic fluid from urine using glucose and creatinine.
• Synovial Fluid Tests: Total protein is often tested.
• Synovial Fluid Functions: Synovial fluid aids in lubricating, removing cartilage debris, and providing nutrients for joints.
• Pseudogout Crystals: Pseudogout is related to calcium pyrophosphate dihydrate (CPPD) crystals, not monosodium urate crystals.
• Nonbacterial Increased WBC Counts: Rheumatoid arthritis, systemic lupus erythematosus, and some urinary tract infections, are examples of conditions that can lead to nonbacterial causes to an elevated WBC count.
• Stool Specimen Appearance: Ribbon-like stool appearance is often indicative of conditions affecting intestinal constriction and/or motility.
• Normal Stool Composition: Electrolytes, water, and bacteria are found in normal stool composition.Blood is not.
• Fecal Analysis: The most frequently performed fecal analysis is occult blood testing.
• Personal Protective Equipment (PPE): Disinfectants are not considered PPE to be used regularly to protect oneself. Gloves, lab coats, and goggles are.

Test your knowledge on urine analysis, focusing on topics such as reagent test strips, controls, and urine characteristics. This quiz covers key aspects of urine testing, including temperature, pH values, and specific gravity. Challenge yourself with questions about renal calculi and urinary precipitates.