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Urinalysis Test Prep
Test practice for urinalysis test in Clinical Chemistry at Del-Tech Owens Campus
| Question | Answer |
|---|---|
| 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 |
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IsaacJ
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