Page 1Page 2Page 3Page 4Page 5Page 6Page 7Page 81MLAB 1311Urinalysis PreTestThe Complete Urinalysis Instructor: Ragland MLAB 1311 Pre-Test Revised Fall 2010 Name_______________________________ Date_____________________/ 10 pointsINSTRUCTIONS: Unless otherwise indicated, each question is worth one point. Answer the questions onthis paper as appropriate.1. List the three (3) routine procedures which constitute a “complete UA”.1.2.3.2. What observations are part of the physical analysis of the routine UA?(5 points total)3. List the tests that are included in the Chemstrip 7 urine dipstick (put these answers in #1 - #7). In # 8through 10, state what urine chemistry tests are not included on the Chemstrip 7.1. 6.2. 7.3. 8.4. 9.5. 10.(2 points total)4. Complete the following table to list the Urine Backup tests and indicate the test or substance for which theyare testing.Name of BackUp test Which dipstick test or substance it is testing.1.2.3.4. 5. The Clinitest is most often used to test what substance & in what population?EXERCISE 4: The Complete Urinalysis (Chemstrip 7) Urinalysis2 ! MLAB 1311 ! Body Fluids/Urinalysis2The Complete UrinalysisPoints:Points are awarded for Pre-test, Skills, including general lab requirements, as well assuccessful and timely completion of Study Questions. The Skills portion of this exercise will berepeated for additional points.Objectives:According to the standards set by the instructor, the student will: 1. perform complete routine urinalysis on five specimens within the following stated level ofaccuracy. To meet this objective, the student must:a. obtain dipstick results ± one color square of the instructor’s resultsb. be able to identify RBCs, W BCs, squam ous and renal epithelial cells as well as normal acidand alkaline crystals, mucous threads, bacteria and yeast at least 4 out of 5 times. At theinstructor’s discretion, microphotographs or electronic pictures may be used to aid inevaluation. In the evaluation of quantity, the student’s results must match that of theinstructor’s ± reporting unit. (Using the quantitation of amorphous urates as and example,if the instructor reviews a representative area and determines the report value as 2+, thestudent’s value can be as low as 1+ or as high as 3+ to be acceptable.)2. bring to the instructor’s attention any abnormal / unexpected results including dipstick results thatare > 1 square above the negative or normal, and if the following microscopic structures aresuspected: fatty, cellular, or waxy casts, abnormal crystalline structures, oval fat bodies, fatglobules, trichomonas, etc. 3. use appropriate recording format to report results as established in previous UA labs.4. use quality control results to determine the acceptability of test results.5. answer all pre-test and study questions using related information found in the textbook, lectureguide, and this lab procedure and submit the results to the instructor by the due date.Equipment:1. Centrifuge 4. Test tubes, racks, marking pencils, Kim-wipes2. Microscope 5. Color charts for Multistix, Acetest and Ictotest3. AO TS Meter 6. Color pictures of urinary sedimentSupplies:1. Five (5) urine specimens 5. 3% sulfosalicylic acid2. Centrifuge tubes 6. Acetest tablets3. Microscope slides and coverslips 7. Ictotest tablets and absorbent pads4. Multistix 10 SG reagent strips References:Same as for previous UA Lab Exercises.Preparation:1. Review of techniques from UA Lab Exercises 2 and 3. Students should review previous UA lab exercises, textbook and lecture materials when preparingPre-Test and Study Question answers.2. Review all materials within this lab.Agenda:1. Classroom discussion. Turn in lab pre-test.2. Perform complete urinalysis on five (5) specimens including color, transparency, specific gravityby TS Meter or Multistix.3. Centrifuge each specimen and perform a microscopic examination of the sediment.4. Perform a minimum of 3 SSA, and one each Ictotest, Acetest, and Clinitest tablet backup tests. Principles &Related info:By definition, a complete urinalysis test would include the recording of:Physical properties of: color and transparency / clarity; Using the Chemstrip 7 urine dipstick, the following chemical (semi-quantitative) tests are: pH,glucose, ketones, leukocyte esterase, nitrite, protein, and blood. ( the liver tests - bilirubin andurobilinogen as well as dipstick specific gravity are not on the Chemstrip 7 dipstick) Microscopic evaluation for: red and white blood cells, casts, bacteria and other parasites such asyeast or trichomonas, epithelial cells, crystals and other microscopic structures of interest.EXERCISE 4: The Complete Urinalysis (Chemstrip 7) UrinalysisBody Fluids/Urinalysis! MLAB 1311 ! 33Recording of the urine specific gravity is also part of the routine UA. This may be done either by therefractometer, by harmonic oscillation densitometery or as part of the urine dipstick.In performing the complete UA , it may be necessary to perform one or more of the ‘back up’ tests if /when warranted. As a student you will be asked perform the backup tests regularly to obtaincompetency. (Acetest for positive ketones; Ictotest for positive bilirubin, SSA for positive protein, andClinitest for glucose and other reducing substances.) In the clinical world, the back-up tests are far morerarely done. Review the principles and other information on the backup tests in the Macroscopic Lab.As a quality control measure, always correlate microscopic results with physical and chemical properties.For example, a pink, cloudy sample with positive blood should demonstrate the presence of RBCs. Correlatingresults:W hen the microscopic is performed, its results should be correlated with the findings of the physical/chemical testing results. Example correlations between physical/chemical analysis and microscopic:1. Urine that is red in color - hazy to cloudy - has positive blood should demonstrate the presenceof RBCs under the microscope.2. Urine that is hazy to cloudy - has positive protein, leukocytes and nitrite should be carefullyexamined for WBC and bacteria.3. Increased turbidity in a refrigerated urine sample often means the presence of crystals.More information on correlation of physical / chemical results with expected microscopic analysis canbe found in your course textbook. Additionally information on urinary casts and crystals is available there.Trouble -shootingdiscrepanciesThere are many possible