Instructions for Collecting a Clean Catch Urine Sample
1. Wash hands with soap and warm water.
2. Spread the labia (folds of skin) apart with one hand and wipe with the towelette provided.
Wipe from front to back.
3. Continue holding the labia apart. As you start to urinate, allow a small amount of urine
to fall into the toilet bowl. (This clears the urethra of contaminants) Do not touch the
inside of the cup.
4. After the urine stream is well established, urinate into the cup. Once an adequate amount
of urine fills the cup (the cup only needs to be half-full), remove the cup from the urine
stream.
5. Pass the remaining urine into the toilet.
6. Screw the lid on the cup tightly (do not touch the inside of the cup or lid). Give the
cup to the Customer Service Tech.
INSTRUCTIONS FOR MALES
1. Wash hands with soap and warm water.
2. If uncircumcised, retract foreskin.
3. Wipe the end of penis with towelette provided. As you start to urinate, allow a small
amount of urine to fall into the toilet bowl. (This clears the urethra of contaminants)
Do not touch the inside of the cup.
4. After the urine stream is well established, urinate into the cup. Once an adequate amount
of urine fills the cup (the cup only needs to be half-full), remove the cup from the urine
stream.
5. Pass the remaining urine into the toilet.
6. Screw the lid on the cup tightly (do not touch the inside of the cup or lid). Give the
cup to the Customer Service Tec
10 Panel drug screen Urinalysis test
DRUGS OF DETECTION
Cocaine (COC)
Marijuana (THC)
Opiates (OPI, including heroin)
Amphetamines (AMP)
Methamphetamines (mAMP)
Oxycodone (OXY)
Propoxyphene (PPX)
Benzodiazepines (BZO)
Barbiturates (BAR)
Ecstasy (MDMA)
Plasma
The liquid component of blood is called plasma, a mixture of water, sugar, fat, protein, and salts. The main job of the plasma is to transport blood cells throughout your body along with nutrients, waste products, antibodies, clotting proteins, chemical messengers such as hormones, and proteins that help maintain the body’s fluid balance.
Red Blood Cells (also called erythrocytes or RBCs)
Known for their bright red color, red cells are the most abundant cell in the blood, accounting for about 40-45 percent of its volume. The shape of a red blood cell is a biconcave disk with a flattened center – in other words, both faces of the disc have shallow bowl-like indentations (a red blood cell looks like a donut).
Production of red blood cells is controlled by erythropoietin, a hormone produced primarily by the kidneys. Red blood cells start as immature cells in the bone marrow and after approximately seven days of maturation are released into the bloodstream. Unlike many other cells, red blood cells have no nucleus and can easily change shape, helping them fit through the various blood vessels in your body. However, while the lack of a nucleus makes a red blood cell more flexible, it also limits the life of the cell as it travels through the smallest blood vessels, damaging the cell’s membranes and depleting its energy supplies. The red blood cell survives on average only 120 days.
Red cells contain a special protein called hemoglobin, which helps carry oxygen from the lungs to the rest of the body and then returns carbon dioxide from the body to the lungs so it can be exhaled. Blood appears red because of the large number of red blood cells, which get their color from the hemoglobin. The percentage of whole blood volume that is made up of red blood cells is called the hematocrit and is a common measure of red blood cell levels.
White Blood Cells (also called leukocytes)
White blood cells protect the body from infection. They are much fewer in number than red blood cells, accounting for about 1 percent of your blood.
The most common type of white blood cell is the neutrophil, which is the “immediate response” cell and accounts for 55 to 70 percent of the total white blood cell count. Each neutrophil lives less than a day, so your bone marrow must constantly make new neutrophils to maintain protection against infection. Transfusion of neutrophils is generally not effective since they do not remain in the body for very long.
The other major type of white blood cell is a lymphocyte. There are two main populations of these cells. T lymphocytes help regulate the function of other immune cells and directly attack various infected cells and tumors. B lymphocytes make antibodies, which are proteins that specifically target bacteria, viruses, and other foreign materials.
Platelets (also called thrombocytes)
Unlike red and white blood cells, platelets are not actually cells but rather small fragments of cells. Platelets help the blood clotting process (or coagulation) by gathering at the site of an injury, sticking to the lining of the injured blood vessel, and forming a platform on which blood coagulation can occur. This results in the formation of a fibrin clot, which covers the wound and prevents blood from leaking out. Fibrin also forms the initial scaffolding upon which new tissue forms, thus promoting healing.
A higher than normal number of platelets can cause unnecessary clotting, which can lead to strokes and heart attacks; however, thanks to advances made in antiplatelet therapies, there are treatments available to help prevent these potentially fatal events. Conversely, lower than normal counts can lead to extensive bleeding.
Complete Blood Count (CBC)
A complete blood count (CBC) test gives your doctor important information about the types and numbers of cells in your blood, especially the red blood cells and their percentage (hematocrit) or protein content (hemoglobin), white blood cells, and platelets. The results of a CBC may diagnose conditions like anemia, infection, and other disorders. The platelet count and plasma clotting tests (prothombin time, partial thromboplastin time, and thrombin time) may be used to evaluate bleeding and clotting disorders.
Your doctor may also perform a blood smear, which is a way of looking at your blood cells under the microscope. In a normal blood smear, red blood cells will appear as regular, round cells with a pale center. Variations in the size or shape of these cells may suggest a blood disorder.
Normal blood smear. The four larger cells shown are called granulocytes, a type of white blood cell.
Abnormal blood smear with variation in the size and color of the red blood cells.
Where Do Blood Cells Come From?
Blood cells develop from hematopoietic stem cells and are formed in the bone marrow through the highly regulated process of hematopoiesis. Hematopoietic stem cells are capable of transforming into red blood cells, white blood cells, and platelets. These stem cells can be found circulating in the blood and bone marrow in people of all ages, as well as in the umbilical cords of newborn babies. Stem cells from all three sources may be used to treat a variety of diseases, including leukemia, lymphoma, bone marrow failure, and various immune disorders.
Hypochromic anemia is a generic term for any type of anemia in which the red blood cells (erythrocytes) are paler than normal. (Hypo- refers to less, and chromic means color.) A normal red blood cell will have an area of pallor in the center of it; in hypochromic cells, this area of central pallor is increased. This decrease in redness is due to a disproportionate reduction of red cell hemoglobin (the pigment that imparts the red color) in proportion to the volume of the cell. In many cases, the red blood cells will also be small (microcytic), leading to substantial overlap with the category of microcytic anemia. The most common causes of this kind of anemia are iron deficiency and thalassemia.
Hypochromic anemia was historically known as chlorosis or green sickness for the distinct skin tinge sometimes present in patients, in addition to more general symptoms such as a lack of energy, shortness of breath, dyspepsia, headaches, a capricious or scanty appetite and amenorrhea.
Urinalysis can reveal diseases that have gone unnoticed because they do not produce striking signs or symptoms. Examples include diabetes mellitus, various forms of glomerulonephritis, and chronic urinary tract infections.
The most cost-effective device used to screen urine is a paper or plastic dipstick. This microchemistry system has been available for many years and allows qualitative and semi-quantitative analysis within one minute by simple but careful observation. The color change occurring on each segment of the strip is compared to a color chart to obtain results. However, a careless doctor, nurse, or assistant is entirely capable of misreading or misinterpreting the results. Microscopic urinalysis requires only a relatively inexpensive light microscope.
MACROSCOPIC URINALYSIS
The first part of a urinalysis is direct visual observation. Normal, fresh urine is pale to dark yellow or amber in color and clear. Normal urine volume is 750 to 2000 ml/24hr.
Turbidity or cloudiness may be caused by excessive cellular material or protein in the urine or may develop from crystallization or precipitation of salts upon standing at room temperature or in the refrigerator. Clearing of the specimen after addition of a small amount of acid indicates that precipitation of salts is the probable cause of tubidity.
A red or red-brown (abnormal) color could be from a food dye, eating fresh beets, a drug, or the presence of either hemoglobin or myoglobin. If the sample contained many red blood cells, it would be cloudy as well as red.
Examples of appearances of urine
URINE DIPSTICK CHEMICAL ANALYSIS
pH
The glomerular filtrate of blood plasma is usually acidified by renal tubules and collecting ducts from a pH of 7.4 to about 6 in the final urine. However, depending on the acid-base status, urinary pH may range from as low as 4.5 to as high as 8.0. The change to the acid side of 7.4 is accomplished in the distal convoluted tubule and the collecting duct.
Specific Gravity (sp gr)
Specific gravity (which is directly proportional to urine osmolality which measures solute concentration) measures urine density, or the ability of the kidney to concentrate or dilute the urine over that of plasma. Dipsticks are available that also measure specific gravity in approximations. Most laboratories measure specific gravity with a refractometer.
Specific gravity between 1.002 and 1.035 on a random sample should be considered normal if kidney function is normal. Since the sp gr of the glomerular filtrate in Bowman’s space ranges from 1.007 to 1.010, any measurement below this range indicates hydration and any measurement above it indicates relative dehydration.
If sp gr is not > 1.022 after a 12 hour period without food or water, renal concentrating ability is impaired and the patient either has generalized renal impairment or nephrogenic diabetes insipidus. In end-stage renal disease, sp gr tends to become 1.007 to 1.010.
Any urine having a specific gravity over 1.035 is either contaminated, contains very high levels of glucose, or the patient may have recently received high density radiopaque dyes intravenously for radiographic studies or low molecular weight dextran solutions. Subtract 0.004 for every 1% glucose to determine non-glucose solute concentration.
Protein
Dipstick screening for protein is done on whole urine, but semi-quantitative tests for urine protein should be performed on the supernatant of centrifuged urine since the cells suspended in normal urine can produce a falsely high estimation of protein. Normally, only small plasma proteins filtered at the glomerulus are reabsorbed by the renal tubule. However, a small amount of filtered plasma proteins and protein secreted by the nephron (Tamm-Horsfall protein) can be found in normal urine. Normal total protein excretion does not usually exceed 150 mg/24 hours or 10 mg/100 ml in any single specimen. More than 150 mg/day is defined as proteinuria. Proteinuria > 3.5 gm/24 hours is severe and known as nephrotic syndrome.
Dipsticks detect protein by production of color with an indicator dye, Bromphenol blue, which is most sensitive to albumin but detects globulins and Bence-Jones protein poorly. Precipitation by heat is a better semiquantitative method, but overall, it is not a highly sensitive test. The sulfosalicylic acid test is a more sensitive precipitation test. It can detect albumin, globulins, and Bence-Jones protein at low concentrations.
In rough terms, trace positive results (which represent a slightly hazy appearance in urine) are equivalent to 10 mg/100 ml or about 150 mg/24 hours (the upper limit of normal). 1+ corresponds to about 200-500 mg/24 hours, a 2+ to 0.5-1.5 gm/24 hours, a 3+ to 2-5 gm/24 hours, and a 4+ represents 7 gm/24 hours or greater.
Glucose
Less than 0.1% of glucose normally filtered by the glomerulus appears in urine (< 130 mg/24 hr). Glycosuria (excess sugar in urine) generally means diabetes mellitus. Dipsticks employing the glucose oxidase reaction for screening are specific for glucos glucose but can miss other reducing sugars such as galactose and fructose. For this reason, most newborn and infant urines are routinely screened for reducing sugars by methods other than glucose oxidase (such as the Clinitest, a modified Benedict’s copper reduction test).
Ketones
Ketones (acetone, aceotacetic acid, beta-hydroxybutyric acid) resulting from either diabetic ketosis or some other form of calorie deprivation (starvation), are easily detected using either dipsticks or test tablets containing sodium nitroprusside.
Nitrite
A positive nitrite test indicates that bacteria may be present in significant numbers in urine. Gram negative rods such as E. coli are more likely to give a positive test.
Leukocyte Esterase
A positive leukocyte esterase test results from the presence of white blood cells either as whole cells or as lysed cells. Pyuria can be detected even if the urine sample contains damaged or lysed WBC’s. A negative leukocyte esterase test means that an infection is unlikely and that, without additional evidence of urinary tract infection, microscopic exam and/or urine culture need not be done to rule out significant bacteriuria.
MICROSCOPIC URINALYSIS
Methodology
A sample of well-mixed urine (usually 10-15 ml) is centrifuged in a test tube at relatively low speed (about 2-3,000 rpm) for 5-10 minutes until a moderately cohesive button is produced at the bottom of the tube. The supernate is decanted and a volume of 0.2 to 0.5 ml is left inside the tube. The sediment is resuspended in the remaining supernate by flicking the bottom of the tube several times. A drop of resuspended sediment is poured onto a glass slide and coverslipped.
Examination
The sediment is first examined under low power to identify most crystals, casts, squamous cells, and other large objects. The numbers of casts seen are usually reported as number of each type found per low power field (LPF). Example: 5-10 hyaline casts/L casts/LPF. Since the number of elements found in each field may vary considerably from one field to another, several fields are averaged. Next, examination is carried out at high power to identify crystals, cells, and bacteria. The various types of cells are usually described as the number of each type found per average high power field (HPF). Example: 1-5 WBC/HPF.
Red Blood Cells
Hematuria is the presence of abnormal numbers of red cells in urine due to: glomerular damage, tumors which erode the urinary tract anywhere along its length, kidney trauma, urinary tract stones, renal infarcts, acute tubular necrosis, upper and lower uri urinary tract infections, nephrotoxins, and physical stress. Red cells may also contaminate the urine from the vagina in menstruating women or from trauma produced by bladder catherization. Theoretically, no red cells should be found, but some find their way into the urine even in very healthy individuals. However, if one or more red cells can be found in every high power field, and if contamination can be ruled out, the specimen is probably abnormal.
RBC’s may appear normally shaped, swollen by dilute urine (in fact, only cell ghosts and free hemoglobin may remain), or crenated by concentrated urine. Both swollen, partly hemolyzed RBC’s and crenated RBC’s are sometimes difficult to distinguish from WBC’s in the urine. In addition, red cell ghosts may simulate yeast. The presence of dysmorphic RBC’s in urine suggests a glomerular disease such as a glomerulonephritis. Dysmorphic RBC’s have odd shapes as a consequence of being distorted via passage through the abnormal glomerular structure.
Red blood cells in urine
Dysmorphic red blood cells in urine
White Blood Cells
Pyuria refers to the presence of abnormal numbers of leukocytes that may appear with infection in either the upper or lower urinary tract or with acute glomerulonephritis. Usually, the WBC’s are granulocytes. White cells from the vagina, especially in the presence of vaginal and cervical infections, or the external urethral meatus in men and women may contaminate the urine.
If two or more leukocytes per each high power field appear in non-contaminated urine, the specimen is probably abnormal. Leukocytes have lobed nuclei and granular cytoplasm.
White blood cells in urine
Epithelial Cells
Renal tubular epithelial cells, usually larger than granulocytes, contain a large round or oval nucleus and normally slough into the urine in small numbers. However, with nephrotic syndrome and in conditions leading to tubular degeneration, the number sloughed is increased.
When lipiduria occurs, these cells contain endogenous fats. When filled with numerous fat droplets, such cells are called oval fat bodies. Oval fat bodies exhibit a “Maltese cross” configuration by polarized light microscopy.
Oval fat bodies in urine
Oval fat bodies in urine, with polarized light
Transitional epithelial cells from the renal pelvis, ureter, or bladder have more regular cell borders, larger nuclei, and smaller overall size than squamous epithelium. Renal tubular epithelial cells are smaller and rounder than transitional epithelium, and their nucleus occupies more of the total cell volume.
Squamous epithelial cells from the skin surface or from the outer urethra can appear in urine.
Their significance is that they represent possible contamination of the specimen with skin flora.
Squamous epithelial cells in urine
Casts
Urinary casts are formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron). The proximal convoluted tubule (PCT) and loop of Henle are not locations for cast formation. Hyaline casts are composed primarily of a mucoprotein (Tamm-Horsfall protein) secreted by tubule cells. The Tamm-Horsfall protein secretion (green dots) is illustrated in the diagram below, forming a hyaline cast in the collecting duct:
Even with glomerular injury causing increased glomerular permeability to plasma proteins with resulting proteinuria, most matrix or “glue” that cements urinary casts together is Tamm-Horsfall mucoprotein, although albumin and some globulins are also incorporated. An example of glomerular inflammation with leakage of RBC’s to produce a red blood cell cast is shown in the diagram below:
The factors which favor protein cast formation are low flow rate, high salt concentration, and low pH, all of which favor protein denaturation and precipitation, particularly that of the Tamm-Horsfall protein. Protein casts with long, thin tails formed at the junction of Henle’s loop and the distal convoluted tubule are called cylindroids. Hyaline casts can be seen even in healthy patients.
Red blood cells may stick together and form red blood cell casts. Such casts are indicative of glomerulonephritis, with leakage of RBC’s from glomeruli, or severe tubular damage.
White blood cell casts are most typical for acute pyelonephritis, but they may also be present with glomerulonephritis. Their presence indicates inflammation of the kidney, because such casts will not form except in the kidney.
When cellular casts remain in the nephron for some time before they are flushed into the bladder urine, the cells may degenerate to become a coarsely granular cast, later a finely granular cast, and ultimately, a waxy cast. Granular and waxy casts are be believed to derive from renal tubular cell casts. Broad casts are believed to emanate from damaged and dilated tubules and are therefore seen in end-stage chronic renal disease.
The so-called telescoped urinary sediment is one in which red cells, white cells, oval fat bodies, and all types of casts are found in more or less equal profusion. The conditions which may lead to a telescoped sediment are: 1) lupus nephritis 2) malignant hypertension 3) diabetic glomerulosclerosis, and 4) rapidly progressive glomerulonephritis.
In end-stage kidney disease of any cause, the urinary sediment often becomes very scant because few remaining nephrons produce dilute urine.
Hyaline casts in urine
Red blood cell casts forming in tubules
Red blood cell cast in urine
White blood cell cast in urine
Renal tubular cell cast in urine
Granular casts in urine
Granular cast in urine
Waxy cast in urine
Bile stained hyaline casts in renal tubules
Bacteria
Bacteria are common in urine specimens because of the abundant normal microbial flora of the vagina or external urethral meatus and because of their ability to rapidly multiply in urine standing at room temperature. Therefore, microbial organisms found in all but the most scrupulously collected urines should be interpreted in view of clinical symptoms.
Diagnosis of bacteriuria in a case of suspected urinary tract infection requires culture. A colony count may also be done to see if significant numbers of bacteria are present. Generally, more than 100,000/ml of one organism reflects significant bacteriuria. Multiple organisms reflect contamination. However, the presence of any organism in catheterized or suprapubic tap specimens should be considered significant.
Yeast
Yeast cells may be contaminants or represent a true yeast infection. They are often difficult to distinguish from red cells and amorphous crystals but are distinguished by their tendency to bud. Most often they are Candida, which may colonize bladder, urethra, or vagina.
Crystals
Common crystals seen even in healthy patients include calcium oxalate, triple phosphate crystals and amorphous phosphates.
Very uncommon crystals include: cystine crystals in urine of neonates with congenital cystinuria or severe liver disease, tyrosine crystals with congenital tyrosinosis or marked liver impairment, or leucine crystals in patients with severe liver disease or with maple syrup urine disease.
Oxalate crystals in urine
Triple phosphate crystals in urine
Cystine crystals in urine
Miscellaneous
General “crud” or unidentifiable objects may find their way into a specimen, particularly those that patients bring from home.
Spermatozoa can sometimes be seen. Rarely, pinworm ova may contaminate the urine. In Egypt, ova from bladder infestations with schistosomiasis may be seen.
METHODS OF URINE COLLECTION
Random collection taken at any time of day with no precautions regarding contamination. The sample may be dilute, isotonic, or hypertonic and may contain white cells, bacteria, and squamous epithelium as contaminants. In females, the specimen may cont contain vaginal contaminants such as trichomonads, yeast, and during menses, red cells.
Early morning collection of the sample before ingestion of any fluid. This is usually hypertonic and reflects the ability of the kidney to concentrate urine during dehydration which occurs overnight. If all fluid ingestion has been avoided since 6 p.m. the previous day, the specific gravity usually exceeds 1.022 in healthy individuals.
Clean-catch, midstream urine specimen collected after cleansing the external urethral meatus. A cotton sponge soaked with benzalkonium hydrochloride is useful and non-irritating for this purpose. A midstream urine is one in which the first half of the bladder urine is discarded and the collection vessel is introduced into the urinary stream to catch the last half. The first half of the stream serves to flush contaminating cells and microbes from the outer urethra prior to collection. This sounds easy, but it isn’t (try it yourself before criticizing the patient).
Catherization of the bladder through the urethra for urine collection is carried out only in special circumstances, i.e., in a comatose or confused patient. This procedure risks introducing infection and traumatizing the urethra and bladder, thus producing iatrogenic infection or hematuria.
Suprapubic transabdominal needle aspiration of the bladder. When done under ideal conditions, this provides the purest sampling of bladder urine. This is a good method for infants and small children.
Summary
To summarize, a properly collected clean-catch, midstream urine after cleansing of the urethral meatus is adequate for complete urinalysis. In fact, these specimens generally suffice even for urine culture. A period of dehydration may precede urine collection if testing of renal concentration is desired, but any specific gravity > 1.022 measured in a randomly collected specimen denotes adequate renal concentration so long as there are no abnormal solutes in the urine.
Another important factor is the interval of time which elapses from collection to examination in the laboratory. Changes which occur with time after collection include: 1) decreased clarity due to crystallization of solutes, 2) rising pH, 3) loss of ketone bodies, 4) loss of bilirubin, 5) dissolution of cells and casts, and 6) overgrowth of contaminating microorganisms. Generally, urinalysis may not reflect the findings of absolutely fresh urine if the sample is > 1 hour old. Therefore, get the urine to the laboratory as quickly as possible.
The color of urine can vary from almost colorless to black. Normal urine may show color variation ranging from pale yellow to deep amber. Urine color is typically a result of the degradation of the heme molecule into a urinary pigment called urochrome. Two other pigments contributing to the color of urine are uroerythrin and urobilin. Uroerythrin is usually associatied with amorphous urates in a refrigerated sample causing the sample to exhibit a pink coloration. Urobilin is produced from the oxidation of urobilinogen and results in an orange-brown color to urine that is not fresh. Dietary pigments, drugs, and their metabolites and various other abnormal substances may also contribute to the coloration of the urine sample.
Correlation of Urine Color
Color or Appearance Possible Cause
Colorless Highly dilute, recent fluid consumption
Pale yellow Normal
Yellow Normal
Amber Normal, concentrated urine
Deep yellow Concentrated sample, riboflavin, dehydration
Orange Antibiotic, pyridium, bilirubin, anticoagulant
Pink Porphyrin, myoglobin, hemoglobin, beet pigment, rhubarb
Red Porphyrin, myoglobin, hemoglobin, beet pigment, uroerythrin
Green Oxidized bilirubin (biliverdin), clorets, pseudomonas infections
Blue Diagnex, methylene blue, indicant
Brown Bilirubin, hematin, methemoglobin
Gray Furazolidone, nitrofurantoin
Black Melanin, homogenistic acid
Clinical Laboratory Assistant Quiz 1
- List at least 4 different chemicals found in the lab?
Ethanol, methanol, Boric Acid, Sulfuric Acid, HCL, Normal Saline, Na2Co3 (sodium bicarb), Methylene blue, K2MgPO4 (Potassium Permanganate)
2. What happens when you mix a base and a acid?
When you mix a strong base and a strong acid you get a salt and a water.
NaOH (base) + HCL (acid) —————> NaCl (salt) + H2O (water)
3. List the lab tests that are in the lipid profile?
Total Cholesterol, Triglycerides, LDL (Low density lippoproteins) , HDL (High Density Lippoproteins)
4. Put the following chemicals in order of greatest flammability.
Crude oil, methanol, ethanol
#1 Methanol CH4 #2. Ethanol #3 Crude Oil
5. Give a brief explanation of the duties of a laboratory assistant?
A lab assistant helps the Medical Laboratory Technologists prepare solutions, keep the lab clean, perform quality assurance control tests on the machines, perform urineanalysis tests, point of care finger sticks, and keeps records of controls, expiration dates.
6. What type of education does a clinical laboratory technician have? 4 year BS degree
7. Sulfur is a chemical that can be very dangerous? Why?
Sulfur paralyzes the olfactory senses of smell and can cause the person to no longer smell the dangerous chemical thereby poisoning them.
8. Why are quality control logs necessary?
To be sure that the tests are working properly and that they are within their expiration date.
9. When performing an HIV test on a client, what must you be aware of, and what steps must you follow?
To be sure to adhere to all infection control procedures, donning PPE, goggles, and medical asepsis.
10.The 10 panel drug screen tests for what drugs?
Benzodiazapines, Methamphetamine’s, Barbituates, Cocaine, Ecstasy, THC, Opiates,
- List the different divisions of the laboratory.
- Why wouldn’t you clean the alcohol breathalyzer with alcohol pads?
- Explain how you would clean up an acid spill that is 1 oz?
- Explain how you would clean up an acid spill that is 1 gallon?
- What happens to the atmosphere when ethanol is spilled in large quantities?
- List the data that is normally required for a quality control log?
- Why do you add saline to the HIV test card prior to adding the blood?
- Why are quality controls necessary?
- Why is it important to check the temperature in the refrigerator?
- List the tests included in a chemistry profile?
- Why is it important to measure blood gases? What are the bodies blood gases?
- (22 points) List the 10 components in a U/A test and give a brief explanation of each of the components as to the reason they may be elevated.
- Explain how to obtain a clean catch urine.
- Upon applying the chemical reagent to the stool card, what color will it turn if the stool is positive for blood?
- Factor V, IX, X are blood tests that look for specific clotting abnormalities.
What color tube will these test be done in?
What special preparation is needed?
- You patient has a PT/INR of 3.8, Choose the best explanation below.
- This is considered above the normal range and the Doctor must be called. It indicates that the patient ‘s blood is taking too long to clot.
- This is considered below normal range and the Doctor must be called. It indicates that the blood is clotting normally and not therapeutically.
- State the reasoning that we use sterile normal saline as a reagent for the HIV test.
- What would you think the significance of pale red blood cells indicate?
- Your patient has a white cell count of 40,000, explain this result?
- List the White Blood Cells of the Body
Clinical Laboratory Assistant Quiz 1
- 1. List at least 4 different chemicals found in the lab?
- NaOH, KOH, NaCO3, HCL, K2MnPO4, H2SO4, Ethanol, Methanol, H2O2,
- 2. What happens when you mix a base and an acid?
- A slat and a water, ie, NaOH (strong base) + HCl (strong acid)———— NaCl (salt) + HOH(water)
- 3. List the lab tests that are in the lipid profile?
- Triglycerides, Total cholesterol, HDL (High Density Lipoprotein’s) , LDL (Low Densisty Lipoproteins’s)
- 4. Put the following chemicals in order of greatest flammability.
- Crude oil, methanol, ethanol
- Methanol, ethanol, crude oil
- 5. Give a brief explanation of the duties of a laboratory assistant?
- Assistant to the Laboratory Technician, prepare Quality control reports, do point of care testing, prepare and clean up.
- 6 . What type of education does a clinical laboratory technician have?
- BS in Medical science, Medical Technology
- 7. Sulfur is a chemical that can be very dangerous? Why?
- Paralyzes the olfactory senses, and makes the person unaware that they are in danger
- 8. Why are quality control logs necessary?
- To be sure that the test machines are working properly and are calibrated to keep tests accurate.
- 9. When performing an HIV test on a client, what must you be aware of, and what steps must you follow?
- Use of therapeutic communication, proper isolation techniques.
- 10. The 10 panel drug screen tests for what drugs?
- cocaine
- amphetamines
- methamphetamines
- tetrahydrocannabinol (marijuana)
- methadone
- opiates
- phencyclidine
- barbiturates
- benzodiazepines
- tricyclic antidepressants
- 11. List the different divisions of the laboratory.
- Hematology, Microbiology, Blood Bank, Cytology, Histology, Toxicology, Serum Chemistry
- 12. Why wouldn’t you clean the alcohol breathalyzer with alcohol pads?
- It would cause the patient to have a false positive
- 13. Explain how you would clean up an acid spill that is 1 oz?
- Sand or NaCO3 Sodium Bicarbonate
- 14. Explain how you would clean up an acid spill that is 1 gallon?
- Immediately evacuate area of all personnel, and call hazardous materials cleanup crew.
- 15. What happens to the atmosphere when ethanol is spilled in large quantities?
- Because ethanol is heavier than air, it displaces oxygen and causes a area that is immediately dangerous to life and health, by displacing oxygen, especially in lower levels. (get out of the room and evacuate everyone, go to higher ground and well ventilated area)
- 16. List the data that is normally required for a quality control log?
- Time, temperature, expiration date, control value
- 17. Why do you add saline to the HIV test card prior to adding the blood?
- To act as a medium to transport the blood upwards on the strip.
- 18. Why is it important to check the temperature in the refrigerator?
- The temperature control needs to be at 38 deg F to make sure that the specimens and tests quality is preserved.
- 19.List the tests included in a chemistry profile?
- Glucose, Albumin, SGOT also called (AST), SGPT also called (ALT), Direct Bilirubin, Alk PHos, K, Na, Cl, CO2, BUN/CREAT, Ca,
- 20.Why is it important to measure blood gases? What are the body’s blood gases?
- To make sure that the bodies pH is balanced. pH, PCO2, PO2, HCO3
- 21. (22 points) List the 10 components in a U/A test and give a brief explanation of each of the components as to the reason they may be elevated.
- Explain how to obtain a clean catch urine.
- Instructions for Collecting a Clean Catch Urine Sample
- INSTRUCTIONS FOR FEMALES
- 1. Wash hands with soap and warm water.
- 2. Spread the labia (folds of skin) apart with one hand and wipe with the towelette provided.
- Wipe from front to back.
- 3. Continue holding the labia apart. As you start to urinate, allow a small amount of urine
- to fall into the toilet bowl. (This clears the urethra of contaminants) Do not touch the
- inside of the cup.
- 4. After the urine stream is well established, urinate into the cup. Once an adequate amount
- of urine fills the cup (the cup only needs to be half-full), remove the cup from the urine
- stream.
- 5. Pass the remaining urine into the toilet.
- 6. Screw the lid on the cup tightly (do not touch the inside of the cup or lid). Give the
- cup to the Customer Service Tech.
- INSTRUCTIONS FOR MALES
- 1. Wash hands with soap and warm water.
- 2. If uncircumcised, retract foreskin.
- 3. Wipe the end of penis with towelette provided. As you start to urinate, allow a small
- amount of urine to fall into the toilet bowl. (This clears the urethra of contaminants)
- Do not touch the inside of the cup.
- 4. After the urine stream is well established, urinate into the cup. Once an adequate amount
- of urine fills the cup (the cup only needs to be half-full), remove the cup from the urine
- stream.
- 5. Pass the remaining urine into the toilet.
- 6. Screw the lid on the cup tightly (do not touch the inside of the cup or lid). Give the
- cup to the Customer Service Tec
- 22. Upon applying the chemical reagent to the stool card, what color will it turn if the stool is positive for blood?
- Blue
- 23. Factor V, IX, X are blood tests that look for specific clotting abnormalities.
- What color tube will these test be done in? light blue
- What special preparation is needed? Fill the tube completely, freeze immediately
- 24. You patient has a PT/INR of 3.8, Choose the best explanation below.
- This is considered above the normal range and the Doctor must be called. It indicates that the patient ‘s blood is taking too long to clot. (correct answer)
- This is considered below normal range and the Doctor must be called. It indicates that the blood is clotting normally and not therapeutically.
- 25.What would you think the significance of pale red blood cells indicate?
- Anemia
- 26. Your patient has a white cell count of 40,000, explain this result?
- Increase, sign of infection
- 27. List the White Blood Cells of the Body
- Lymphocytes, eosinophils, basophils, neutrophils, monocytes
