PREPARED BY: E.

Cabural
Introduction to Urinalysis • Uric acid
• Chloride
HISTORY AND IMPORTANCE
th
• Sodium
1. In 5 century BCE, who wrote a book about
• Potassium
“Uroscopy”?
• Phosphate
Hippocrates
• Ammonium
2. In 1694, who discovered albuminuria by boiling
• Calcium
urine?
4. What are the factors that influence urine
Frederik Dekkers
composition?
3. Term for individuals without medical credentials
*Remember DiPaBEB*
that began offering predictions to public for
healthy fee. • Dietary intake
Charlatans • Physical activity
4. Charlatans are called “_______”. • Body metabolism
Pisse Prophets • Endocrine functions
5. Who wrote a book whose subject are the “pisse • Body position
prophets”, which inspired the passing of the first 5. How can you identify that the particular fluid is a
medical licensure laws in England in 1627? urine?
Thomas Bryant The specimen is tested for its UREA and
6. Who developed methods for quantitating CREATININE, these substances are present in
microscopic sediment? much higher concentrations in urine than other
Thomas Addis body fluids. The test is called Urine-Creatinine
7. He introduced concept of urinalysis as part of a Test.
doctor’s routine patient examination in 1827. 6. What is the major body constituent?
Richard Bright Water
8. What are the reasons for performing Urinalysis 7. It is the primary organic component and the
as identified by CLSI? product of protein and amino acid metabolism.
*Remember A-S-M* Urea
• Aiding in the diagnosis of disease 8. It is the product of creatinine metabolism by
• Screening asymptomatic populations muscles.
for undetected disorders Creatinine
• Monitoring the progress of disease and 9. It is the product of nucleic acid breakdown in
effectiveness of therapy food and cells.
9. According to CLSI, it is “the testing of urine with Uric acid
procedures commonly performed in an 10. Primary/ Major inorganic component and is
expeditious, reliable, accurate, safe, and cost- found in combination with Na (table salt) and
effective manner”. many other inorganic substances.
Urinalysis Chloride
URINE 11. It is primarily from salt and varies by intake.
1. The ultrafiltrate of plasma. Sodium
Urine 12. It is combined with chloride and other salts.
2. What is the average daily urine output? Potassium
1200-1500 mL 13. It is combined with sodium to buffer the blood.
3. What are the primary components of urine? Phosphate
*Remember WUCUC-SPPAC* 14. It regulates blood and tissues fluid acidity
• Water Ammonium
15. It combines with chloride, sulfate, and
• Urea
phosphate.
• Creatinine
Calcium
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16. Decrease in urine output, commonly seen when • Squamous epithelial cells
the body enters the state of dehydration • Urothelial (transitional) epithelial cells
(vomiting, diarrhea, perspiration, severe burns). • Renal tubular epithelial cells
Oliguria 28. These cells line the urethra and vagina of female
17. Cessation of urine flow result from any serious and distal portion of urethra of males.
damage to kidneys or from decrease in flow of Squamous epithelial cell
blood to kidneys. (<100mL/24hrs in 3 29. These cells are most common, and the largest
consecutive days) no. of the cells seen in urine and is due to vaginal
Anuria contamination.
18. Increase in nocturnal excretion of urine Squamous epithelial cell
Nocturia 30. These cells line the renal calyces, renal pelvis,
19. An increase in daily urine volume (>2.5L/day in ureters, bladder, in male, in the urethra.
adults and 2.5-3 mL/kg/day in children) Urothelial cells
associated with diabetes mellitus and diabetes 31. These cells are seen in normal patients or after
insipidus. catheterization.
Polyuria Transitional cell
20. Involuntary voiding of urine at night 32. An increased no. of urothelial cells is seen in
Enuresis what certain conditions?
21. Indicates lipid droplets contained in the cell. • Urinary Tract Infection
Maltese cross • Transitional cell carcinoma
22. Caused by defect either in pancreatic production 33. What are the epithelial cells that lines each part
of insulin or function of insulin, results in of renal tubule?
increased blood glucose concentration. Renal tubular epithelial cells
Diabetes mellitus 34. Inflammation of the bladder.
23. What is the indication that a patient has Diabetes Cystitis
mellitus? 35. Inflammation of the kidney and can be present
Urine has high specific gravity because of with bacterial infection or without infection.
increased glucose content Nephritis
24. Results from decrease in production or function 36. Nephritis with infection.
of ADH, water necessary for hydration is not Pyelonephritis
reabsorbed from plasma filtrate. 37. Nephritis without infection
Diabetes insipidus Glomerulonephritis
25. What is the indication that a patient has Diabetes 38. The degeneration of kidney w/out inflammation.
insipidus? Nephrosis (Nephrotic syndrome)
Urine is truly dilute and has low specific gravity. 39. Secreted by adrenal cortex and increase the
26. What are other structures found in urine of reabsorption of Na.
which some are considered normal, while others Aldosterone
are seen on renal and metabolic disorders? 40. Secreted by posterior pituitary gland and
*Remember CC-BEMB* regulates reabsorption of water in distal tubules,
• Casts deficiency results in diabetes mellitus.
• Crystals Antidiuretic Hormone or Vasopressin
• Blood cells 41. Secreted by kidneys and stimulates production
• Epithelial cells of erythrocytes.
• Mucus Erythropoietin
• Bacteria 42. The concentration of urine is (directly or
27. What are the three categories of EPITHELIAL inversely) proportional to its SG.
CELLS found in urine? Directly
*Remember SURe* 43. Factors affecting urine volume:
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*Remember FFVN* 2. Following collection, specimens should be
• Fluid intake delivered to laboratory promptly and tested
• Fluid loss from non-renal sources within ______.
• Variations in secretion of ADH 2 hrs.
• Necessity to excrete increased amount 3. A specimen that cannot be delivered within 2
of dissolved solids. hrs. should be _____.
44. What is the volume of filtered plasma on Refrigerated or have an appropriate chemical
glomerulus which produces 1mL/min finally preservative.
excreted as urine? 4. What is the most routinely used method of
120mL/min preservation that decreases bacterial growth
45. Normal reaction of urine and metabolism?
Acidic pH 4-6 Refrigeration at 2℃ - 8℃
46. Ammonia odor results after urine is exposed to 5. An ideal preservative should be?
bacteria which converts UREA into ____. However, ideal preservative does not exist,
Ammonia thus, the best suits the needs of required
47. Color of urine is influenced by ____ analysis should be chosen.
Diet and Drugs • Bactericidal
48. Acidity of urine is influenced by ____ • Inhibit urease
Nature of the diet • Preserve formed elements in the
49. Vegetable and fruits produce ___ urine sediment
Alkaline urine • Preservative should not interfere with
50. Meat and high protein produce ___ urine chemical tests
Acidic urine 6. A specimen that may be collected anytime;
51. SG of urine actual time of voiding should be recorded on
1.015-1.025 container.
52. Presence of glucose in urine Random specimen
Glycosuria/glucosuria 7. Essential for preventing false-negative
53. Presence of blood in urine pregnancy tests and for evaluating orthostatic
Hematuria proteinuria.
54. Stone formation in kidneys. First morning specimen
Nephrolithiasis 8. A concentrated specimen, assuring detection of
55. Stone formation in ureters chemicals and formed elements.
Ureterolithiasis First morning specimen
56. Stone formation in urinary bladder 9. Sometimes collected to correspond with blood
Cystolithiasis samples drawn during GTT.
57. Indicate the condition: Glucose tolerance specimens
a. >2500mL/24 hrs. 10. Collected under sterile conditions by passing a
Polyuria hollow tube (Catheter) through the urethra into
b. <500mL/24 hrs. the bladder.
Oliguria Catheterized specimen
c. <100mL/24 hrs. for 3 consecutive days 11. Most commonly requested test on a catharized
Anuria specimen.
SPECIMEN COLLECTION Bacterial culture
1. What is the recommended capacity of the urine 12. Provides a safer, less traumatic method for
container? obtaining urine for bacterial culture and routine
50 mL urinalysis, less contaminated by epithelial cells
and bacteria.
Midstream Clean-catch specimen
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13. Collected by external introduction of a needle
through the abdomen into the bladder.
Suprapubic Aspiration