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Urinalysis

CMA

TermDefinition
Urinalysis (UA) The physical, chemical, and microscopic examination of urine.
Dissolved Solids
Physical Examination Concerns the observation of urine. Usually includes color, odor, and transparency. May include specific gravity if not done chemically.
Specific Gravity Measures the weight of a solution as compared to the weight of an equal volume of water.
Chemical Examination Using reagent strips that cause a color change in the presence of the substance being tests for.
Qualitative Test Detects the presence or absence of an analyte, e.g. negative, positive.
Quantitative Test Measures a precise amount of an analyte, e.g. 10 mg.dl.
Semiquantitative Test Measures approximate ranges of an analyte, trace, small, moderate, large; 1+, 2+, 3+
pH Measures the percent hydrogen ion concentration that determines the acidity (sourness) or alkalinity (bitterness) of urine.
Protein Is a significant for renal diseases.
Nitrite A normal component of urine, suggests possible UTI. e.g. E. coli. Correlated with positive leukocyte esterase
Leukocyte Esterase Measures the presence of an enzyme commonly found in WBCs. The presence of leukocyte esterase suggests the presence of WBCs which may in turn implicate the presence of bacteria found in UTI. Correlated with positive nitrite.
Glucose
Ketones Are the by product of incomplete fat metabolism commonly seen in diabetes mellitus and starvation where the body, lacking a glucose source, must resort to breaking down fat for energy.
Bilirubin A byproduct of RBC destruction, it is a component of bile, a substance that aids in the digestion of fats that is ultimately excreted in feces.
Urobilinogen Is the result of the reduction of bilirubin in the intestine and will be seen in most conditions causing bilirubinuria including hemolytic anemia, pernicious anemia, and malaria.
Erythrocytes 0-2 RBCs per high power field (HPF). More than that indicates hematuria. Small, clear biconcave to spherical-shaped cells. Highly correlated to positive blood.
Leukocytes 0-5 WBCs/HPF. More than that suggests inflammation, pyuria, or infection. About 2-3 times the size of RBC, they are round with a grainy appearance. Highly correlated to Positive leukoesterase, and positive nitrite.
Bacteria A few may be seen/HPF. More than that usually indicates UTI. Cocci appear as tiny grains. Bacilli (rods) appear similar to tiny hair slivers.
Yeast A few/HPF. More than that indicates a yeast infection (C. albicans). Appear as oval to round, clear bodies often confused with RBCs. There is often considerable size variation with buds or hyphae.
Mucus Primarily Tamm-Horsfall protein. Produced by epithelial cells and glands. Appear as wavy thread-like structures in the background. Generally of no clinical significance.
Trichomonas vaginalis A sexually transmitted parasite. Normal: None/HPF. One or more indicates vaginal infection. Appear similar to a large WBC with a flagella (whipping tail).
Casts Structures that are formed within the tubules of the nephron indicating a temporary blockage. The material that forms the cast solidifies in the tubule and may include WBCs, RBCs, epithelial cells, fat globules, and bacteria.
Amorphous Commonly causes turbidity; appears similar to amorphous urates
Triple Phosphate Have a coffin-lid shape
Calcium Phosphate Appear as flat plates or rosettes
Cholesterol Large, flat, hexagonal plates with one or more notched corners often associated with fatty casts
Artifact Structures or contaminants that have no clinical significance.
Blood The distinction between hemoglobin, myoglobin and intact RBCs is of high diagnostic value.
Calcium Oxalate Look similar to square crystals containing a refractive X shape. Common constituent of kidney stones.
Clean Catch Specimen Used for urine culture. Collect in a sterile container using the midstream approach.
MidStream Specimen Used for routine Urinalysis (UA) and usually collected randomly as requested. Begin passing the first portion in the toilet, collect the mid-portion in a clean, dry container, and pass the remaining portion in the toilet.
Uric Acid Morphology is variable, but typically appear lemon-shaped, barrel-shaped, and rosette-shaped.
Created by: itsdelis