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Urinalysis Test Prep

Test practice for urinalysis test in Clinical Chemistry at Del-Tech Owens Campus

How many nephrons are in each kidney? 1 to 1.5 million
What are the 4 functions of the kidney nephrons? 1. Renal blood flow 2. glomerular filtration 3. tubular reabsorption 4. tubular secretion
What is the average surface area of a human body? 1.73m2
What is the rate of renal blood flow in the average human body? 1200 mL/min
What is the average renal plasma flow in the average human body? 600-700 mL/min
Where salt goes, __ follows. water
The Renin-Angiotensin-Aldosterone System (RAAS) regulates what? blood flow
The macula densa initiates RAAS in response to __ __ changes. blood pressure
Angiotensin II dilates the __ arteriole while constricting the __ arteriole. afferent, efferent (a before e)
Normal flow of glomerular filtrate is about __ mL/min. 120
About __ liters of plasma get turned into filtrate every day in a normal human body. 172.8
If blood sugar is normal but urine glucose is high, what is wrong with the patient? tubular damage
Normal blood pH is ? 7.4
What 4 things do renal function tests check for? 1. Glomerular filtration 2. tubular reabsorption 3. tubular secretion 4. renal blood flow
You would not choose __ or __ to measure in a clearance test. sodium or water
Clearance tests are usually done over what length of time? 24 hours
Clearance tests measure the rate the kidneys can remove a filterable substance from the __. blood
To run a proper clearance test, you must measure a substance that cannot be __ or __. reabsorbed or secreted
Many clearance tests require an accurately __ urine collection. timed
Name 2 advantages to measuring creatinine when running a clearance test? 1. Waste product of muscle destruction is pretty constant 2. Chemical tests are automated
If you eat a lot of meat during a creatinine clearance test, creatinine levels could go __ and mess up the test results. up
Strenuous __ can also alter the results of a creatinine clearance test. exercise
What is the greatest cause of errors during a creatinine clearance test? Improperly timed urine specimen
The principle behind the creatinine clearance test is to measure the glomerular __ __. filtration rate
The glomerular filtration rate (GFR) is the amount of creatinine completely removed from the plasma in __ minute. one
Creatinine is produced as a result of muscle __. destruction
Normal values of creatinine for men are ? 107-139 mL/min
Normal values of creatinine for women are ? 87-107 mL/min
Nephrons can __ their work capacity if needed, as is the case with someone who only has one kidney. double
Creatinine clearance tests allow us to monitor the extent of known __ __. renal disease
Creatinine clearance testing cannot be used to detect __ renal disease. early
Crearinine clearance tests can help doctors decide if it's safe to administer __ that may build up to toxic levels. medications
A small protein that dissociates from human leukocyte antigens at a constant rate, while also measured to test for renal disease, is called ? Beta2 microglobulin
Tubular reabsorption tests are a good indicator of early __ __. renal disease
Tubular reabsorption tests are a good measure of renal __ ability. concentrating
The baseline for determining concentration is a specific gravity of __ of the original ultrafiltrate. 1.010
In order to get accurate results with a tubular reabsorption test, control of __ __ is necessary. fluid intake
What test has replaced specific gravity as the test to assess renal concentration? osmolarity
While a measure of specific gravity includes the size and number of molecules present, osmularity only measures the number of __ __. small molecules
Osmolarity tests can be used to monitor the course of __ __. renal disease
Osmolarity tests can evaluate the secretion and response to __. ADH
What is the composition of urine? 95% water, 5% solutes
Urine solutes can vary depending on 5 factors? 1. diet 2. activity 3. metabolism 4. endocrine 5. body position
The largest portion of urine solutes is __. urea
Aside from urea and water, what are 2 other major components of urine that are byproducts of protein metabolism? creatinine and uric acid
Formed elements like yeast and RBCs in the urine indicate a __. disease
Urine volume is determined by the body's state of __. hydration
The usual daily volume of urine is ? 1200-1500 mL
The normal range for how much urine can be excreted in a single day by a normal, healthy person is ? 600-2000 mL
Adults who produce less than 500 mL per day or urine are experiencing ? oliguria
Cessation of all urine excretion is called ? anuria
If you excrete 2-3 times more urine at night than you do during the day, you have ? nocturia
Excreting more than 2.5 Liters or urine per day is called ? polyuria
Patients who drink and urinate a lot have a condition called ? polydypsia
What condition causes increased urine production due to the need to excrete excess glucose? Diabetes mellitus
Patients with diabetes mellitus often excrete dilute urine with a high __ __. specific gravity
What condition causes decreased production of ADH and decreased reabsorption of water? Diabetes insipidus
Minimal amount of urine needed for testing is about __ mL. 10
Unless it has been refrigerated, urine must arrive at the lab within __ hours of collection. 2
What 6 things will increase in a urine sample the longer it has been left at room temperature? 1. color 2. turbidity 3. pH 4. nitrite 5. bacteria 6. odor
What 7 things will decrease in a urine sample the longer it has been left at room temperature? 1. glucose 2. ketones 3. bilirubin 4. urobilinogen 5. RBCs 6. WBCs 7. casts
All urine specimens should be tested at what temperature? room temperature
What is the ideal screening specimen for urinalysis? morning specimen
A fasting specimen for urinalysis is the __ specimen to be voided. 2nd
Chain of __ is very important when collecting a specimen for drug testing. custody
What kind of strips are used to perform routine chemical tests on urine? reagent strips
The presence of what 10 things are typically tested/detected on a reagent strip? 1. pH 2. Protein 3. glucose 4. ketones 5. blood 6. bilirubin 7. urobilinogen 8. nitrite 9. leukocyte esterase 10. specific gravity
When using a reagent strip to test urine, how should the excess urine be removed from the strip? By touching the edge of the strip to the container as the strip is withdrawn.
How should you hold a test strip when comparing colors? Horizontally
If the urine specimen is unmixed, RBCs and WBCs will do what? sink to the bottom
What must be kept away from reagent strips if they're to remain accurate? moisture
Do not use __ __ as a negative control for urinalysis. distilled water
What kind of test accurately checks for the presence of protein in urine? sulfosalycilic acid test
Which kind of test accurately checks for the presence of galactose in urine? clinitest
Aside from a reagent strip, which other kind of test checks for ketones in urine? Acetest
What kind of test accurately checks for the presence of bilirubin in urine? Ictotest
When testing for pH levels in urine, remember that the first morning excretion is __. acidic (ph or 5 or 6)
When testing pH levels of urine, remember that specimens taken after a meal (postprandial) are more __. alkaline
What is the normal pH range for urine? 4.5 - 8
Fresh urine cannot reach a pH of __ without contamination. 9
Eating lots of meat will do what to the acidity of urine? increase it
When eaten, most vegetables will make urine more __. alkaline
What is most indicative of renal disease when reading a reagent strip? protein (more than a trace amount)
The main protein of concern when testing urine is __. albumin
What protein, when found in the urine, indicates multiple myeloma? Bence Jones Protein
Bence Jones proteins coagulate between __-__ Celcius and dissolve at __ degrees. 40-60, 100
A disorder of the kidney tubes where substances normally absorbed into the bloodstream are instead released into the urine is called? Fanconi syndrome
Fanconi syndrome affects the __ tubules in the kidneys. proximal
Albumun binds to blue latex particles with antihuman albumin antibody: This describes which test? Immunodip Test
The renal threshold for glucose is between ? 160-180 mg/dL
When placental hormones block action of insulin, this is called ? gestational diabetes
If blood sugar is higher than 180 mg/dL, this is called ? glycosuria
This hormone raises blood glucose by releasing sugar stored in the pancreas into the blood stream. glucagon
This hormone lowers blood glucose by sending it into cells of the liver, skeletal muscles, and fat tissues. insulin
Renal glycosuria is a sign of end-stage renal disease, lowering of renal threshold during pregnancy, and __ __. Faconi's syndrome
If a patient's urine is glucose positive on a reagent strip, what test should you use to confirm that the results are accurate? Clinitest
When running clinitest, the color of the tablet changes rapidly from blue to red-black to green-brown. What is this called? pass through
What are the 3 primary causes of ketones being found in the urine? 1. diabetes mellitus 2. vomiting 3. starvation or malabsorption
Ketonuria (ketones in the urine) indicates inadequate __. insulin
What kind of test is better at finding the presence of blood in the urine that microscopic examination? reagent strip
When intact RBCs are found in the cloudy urine, this is called ? hematuria
Name one drug that can cause hematuria. Coumadin
When RBCs are found in clear, red urine, this is called ? hemoglobinuria
Hemoglobinuria is a sign of what type of coagulation problem? DIC/hemolytic anemia
Myoglobinuria causes an increase in what kind of enzyme? creatinine kinase
Bilirubin or urobilinogen found in the urine is early indicator of __ disease. liver
An ictotest is confirmatory for the presence of __. bilirubin
Negative bilirubin and strongly positive urobilinogen are seen in __ __. hemolytic disorders
Reagent strips DO NOT give a __ reading for urobilinogen in urine. negative
No urobilinogen in urine indicates what kind of obstruction? bile duct
What kind of test can differentiate between urobilinogen, porphobilinogen, and Ehrlich reactive compounds? Ehrlich Tube Test
To check for cystitis, you would test for ? nitrite
What is the most common reason for nitrites in a urine specimen? bacteria
Why does a positive leukocyte esterase reading mean? Leukocytes present in specimen, double-check with microscope
What 3 things should you check for while physically examining a urine sample? 1. color 2. clarity 3. specific gravity
A sample from a patient with DIC or hemolysis (hemoglobin or myoglobin in urine), will look ? clear red
A sample with actual blood or RBCs in it will look ? cloudy red
Color of urine samples ranges from clear to __. black
What pigment is the cause of urine's yellow color? Urochrome
If a urine sample is colorless, you should check its __ __. specific gravity
Besides urochrome, what are 2 more pigments that can be found in urine? uroerythrin, urobilin
Dark yellow or amber urine is usually due to ? concentrated urine or bilirubin present
The presence of bilirubin in a urine sample suggests the patient may have ? hepatitis virus
If bilirubin is present in a urine sample, shaking it will produce what color foam? yellow
What drugs meant for urinary tract infections can produce a thick orange pigment and yellow foam? Phenazopyridine, azo-gantrisin
If a sample is still red in color after it's been spun down, the patient may have ? DIC
Patient's with malignant melanoma may excrete urine specimens that are __ in color. black
What is the most likely reason for a blue/green urine sample? Urinary and intestinal bacterial infection
If a sample is green due to bacteria, it's probably a __ infection. urinary (Pseudomonas infection)
If a sample is blue due to bacteria, it's probably an __ infection intestinal
Clorets gum can turn urine __ in color. green
Elavil, Robaxin, and methylene blue can all turn a urine sample __ in color. blue
The 5 descriptors for urine clarity, from highest to lowest, are ? 1. clear 2. hazy 3. cloudy 4. turbid 5. milky/opaque
You can only be sure that you have find yeast in a urine sample if you see __. budding
Specific gravity is the density of a solution compared with the density of an equal volume of __ __ at same temperature. distilled water
Normally, specific gravity should be __ or higher. 1.010
A __ is a direct method of measure urine's specific gravity. urinometer or HOD
A refractometer or reagent strip is an __ method of measuring the specific gravity of urine. indirect
A refractometer measures velocity of light in air versus velocity of light in a __. solution
Refractometer readings are less affected by __ __ than reagent strips. particle size
Distilled water should read __ on a refractometer. 1.000
Three substances that can be used to calibrate a refractomer are ? 1. distilled water 2. 5% sodium chloride 3. 9% sucrose
A specific gravity of 1.010 is called ? isosthenuric
A specific gravity lower than 1.010 is called ? hyposthenuric
A specific gravity greater than 1.010 is called ? hypersthenuric
If specific gravity of urine is less than 1.003, then the sample may ? not be urine or diluted
If specific gravity is too high, you can __ it to get an accurate reading. dilute
A 1:2 dilution with a reading of 1.040 will be recorded with a specific gravity of ? 1.080
When urine smells of ammonia, the sample is probably __. old
If urine has a "mousy" smell, this could be due to ? phenylketonuria
Urine samples from a patient with maple syrup urine disease will smell like ? maple syrup
Fruity or sweet smelling urine probably has __ in it. ketones
Why would urine smell like bleach? Someone added bleach to it
To screen for urinary tract infections leukocyte esterase should be coupled with ? nitrite, pH, protein
Name 2 causes of a falsely negative reaction when testing for urobilinogen with a reagent strip. 1. Urine specimen exposed to light for too long 2. Specimen remaining at room temp for too long BONUS ANSWER 3: Can also happen if formalin is present
In hemolytic disease, the urine bilirubin test result is negative and the urine urobilinogen test result is ? Increased
Excessive carbohydrate loss that may occur due to vomiting or rapid weight loss may cause what substance to be found in urine that should not be there? ketones
Sulfosalicylic acid can be used to confirm the result of which test on a urine reagent strip? protein
What 2 things can cause a false negative for bilirubin on a urine reagent strip? 1. nitrites 2. light exposure
Urobilinogen is excreted in the urine in increased amounts in csses of ? 1. cirrhosis 2. hemolytic disorders 3. hepatitis
Creatinine excretion correlates best with ? muscle mass
Diets high in meats, and extreme exercise will cause a significant increase in __ excretion. creatinine
Creatinine clearance testing can used to measure what rate? glomerular filtration rate
The primary chemical affected by the renin-angiotensin-aldosterone system is ? sodium
Colorless urine could be due to recent __ consumption. fluid
If urine is pale yellow with a high specific gravity and positive for glucose, what is wrong with the patient? Diabetes mellitus
A patient's urine is dark yellow. He has just taken a jog around the block. What fits? Concentrated specimen
A patient is suffering from burns and has amber colored urine. Why is his urine amber? Burns
A patient's urine is amber with no other symptoms. Why is his urine amber? Dehydration
A sample is orange and produces yellow foam when shaken. What does he have? Bilirubin in urine
A sample is yellow-green or yellow-brown and has colored foam. His urine is acidic, but testing negative for bilirubin. What is wrong? Bilirubin has oxidized into biliverdin
A patient has orange urine that has green fluorescence and tests negative for bile. Why? Acriflavine
A sample is green. Why? Pseudomonas infection
A patient has orange urine after receiving treatment for a urinary tract infection. Why? Phenazopyridine/Pyridium or Nitrofurantoin treatment for UTI is orange
A patient suffering from depression has blue-green urine. Why? Ellavil/amitriptyline (2 names for one drug that treats depression) can turn urine blue-green
What can turn a patient's urine orange that isn't due to bilirubin, acriflavine, or medications for UTI? Phenindione (an anticoagulant)
Methylene blue, a treatment for fistulas, can turn urine what color? blue-green
Clear red urine that's positive for blood and has hemoglobin in it could be due to ? intravascular hemolysis
Clear red urine that's positive for blood and has myoglobin in it could be due to ? muscle damage
Who might excrete red urine that is alkaline after eating beets? Someone genetically susceptible to this condition
Red urine from someone with tuberculosis could be due to ? Rifampin treatment for TB
A cloudy red specimen with RBCs, mucous, and clots could be due to ? menstrual contamination
What kind of muscle relaxant can turn urine blue-green or green-brown? Methocarbamol (Robaxin)
What treatment for bacterial infections can turn urine blue-green? Indican
What drug can turn urine blue-green once oxidized? Phenol
Brown/black urine can be due exposure to what kind of antiseptic? Argyrol
Antihypertensives that can turn urine brown-black are called ? Methyldopa or levodopa
Urine that darkens to a brown or black on standing that reacts with nitroprusside and ferric chloride may be due to ? Melanin or melanogen
Alkaline urine that darkens to a brown or black after standing could be due to ? Homogentistic acid (alkapatonuria)
Pink/red urine that is negative for blood might have ? porphyrins in it
Transparent urine with no visible particulates is called ? clear
Urine that isn't quite clear but where print can easily be seen through is called ? hazy
Urine that makes print look blurry would be called ? cloudy
Urine where print cannot be seen through, but isn't milky, would be called ? turbid
The least or lowest level of urine clarity is called ? milky
Urine from a patient who is starving himself or vomiting a lot may have a __ smell. fruity
What would give urine a fruity smell that isn't due to starvation, malabsorption, or vomiting? Diabeted mellitus
Phenylketonuria can give urine a __ smell. mousy
Tyrosinemia gives urine a __ smell. rancid, like rotting meat
Isoveleric acidemia makes urine smell like ? sweaty feet
Urine that smells like cabbage is probably due to ? Methionine malabsorption
Urine with a foul ammonia smell is probably due to ? UTI or bacterial decomposition
True or false: Urine that turns black after standing may have Homogenistic acid. True
Alkaline urine, even if freshly voided, may have white tubidity due to ? amorphous phosphates and carbonates
True or false: Urine's specific gravity is equally affected by glucose, urea, and sodium. False
Created by: IsaacJ