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CLS 1521 URINE AND BODY FLUID ANALYSIS
(THEORETICAL)
The student, at the completion of the classroom component of this course, will
be responsible for meeting the following cognitive objectives. The student will
be responsible for achieving a cumulative score of 70% or better on all problem
sets, study questions, case studies, and written examinations.
COGNITIVE OBJECTIVES
The student, upon completion of the classroom
component, will be responsible to successfully meet these objectives for the
cerebrospinal fluid section:
01 describe how cerebrospinal fluid is formed, where it
circulates and
where it is reabsorbed.
02 identify the three covering membranes of the brain
and spinal cord.
03 list several medical justifications for collecting a
spinal fluid specimen.
04 describe how spinal fluid is obtained for a
laboratory examination.
05 list several medical justifications for NOT
collecting a spinal fluid specimen.
06 describe how the lab differentiates and tests the
different tubes of spinal
fluid.
07 explain the importance of immediate testing of
spinal fluid.
08 explain the use of the term “xanthochromia” in
describing spinal fluid
and how to determine if the CSF is
from a patient who has had a recent
or old cerebral hemorrhage..
09 explain why a physician would request checking the
spinal fluid for
spontaneous clotting.
10 explain the importance of the pellicle
11 describe how to perform a spinal fluid count
using a hemocytometer
12 calculate the true WBC count when a traumatic
tap has occurred when
given a set of lab values.
13 define the term “pleocytosis and it clinical
significance.
14 explain why the laboratory would perform a RBC
count on spinal fluid
and it clinical significance.
15 describe why a CSF leukocyte count is
clinically significant.
16 describe how to decontaminate a hemocytometer.
17 when given selected CSF constituents, cite the
normal values.
18 explain why a cytofuge is an advantage in the
clinical laboratory.
19 describe how a lab could set up a CSF
differential with a standard
clinical centrifuge.
20 differentiate between “shift-to-the-right” and
“shift-to-the-left”.
21 describe the macrophage in CSF and their
clinical significance.
22 describe the ependymal cell and why it may not
be clinically significant.
23 explain how to recognize reactive lymphocytes
in CSF.
24 list several morphological features that may
be used to identify a
neoplastic cell.
25 explain the purpose of the following stains in
CSF testing:
A. Wright’s stain
B. Gram stain
C. Lactophenol
cotton blue stain.
D. Ziehl-Neelsen
Acid-Fast stain
26 explain why a physician would request the
“India-ink” prep.
27 state why a calcium test on CSF is not likely to be
ordered by a physician.
28 explain why the protein testing is the most
requested chemical test for CSF.
29 explain why a physician would order an CSF IgG test.
30 summarize why electrophoresis is an important
testing parameter for CSF.
31 review why a physician would order a CSF IgG index.
32 when given appropriate data, calculate the CSF/IgG
index.
33 describe why a physician would order a CSF/Albumin
index.
34 when given appropriate data, calculate the CSF/Albumin
index.
35 appraise why the myelin-basic protein may or may not
be a clinically
useful test.
36 communicate why a physician would request a CSF
glucose test.
37 list the normal CSF glucose ranges for selected age
groups.
38 summarize why the CSF glutamine would be a
clinically significant test.
39 review why a physician would request a CSF lactate
test.
40 review why a physician would request a CSF lactic
acid dehydrogenase
test.
41 generalize why CSF chloride testing would or would
not be clinically
useful.
42 appraise why the C-Reactive Protein test would be
important in
CSF testing.
43 list several common bacteria known to cause spinal
meningitis.
44 list a few anaerobic bacteria that would be most
likely to be found
in CSF.
45 list several laboratory tests and their expected
results that would be
helpful in identifying bacterial
meningitis.
46 list three virus groups that are most often involved
in viral meningitis
and state the prognosis when this
infection is diagnosed.
47 list several lab tests that are helpful in
diagnosing viral meningitis and
cite the expected lab findings.
48 describe fungal meningitis and list several fungal
organisms known to
cause such infections and the
importance of a biological cabinet.
49 list several lab tests that are helpful in
diagnosing fungal meningitis and
cite the expected findings.
50 summarize tubercular meningitis and cite why its
diagnosis is important.
51 list several lab tests that are helpful in
diagnosing tubercular meningitis
and cite the expected lab findings.
52 summarize amoebic meningoencephalitis.
53 read this historical interest item – Limulus Lysate Test,
not a test item.
The student, upon completion of the classroom
component, will be responsible to successfully meet these objectives for the
seminal fluid section:
01 list synonyms for seminal fluid and define this body
fluid.
02 list and describe the various fractions of seminal
fluid.
03 describe the correct collection technique and
transportation criteria for semen.
04 list three medical justifications for evaluating
semen.
05 summarize the coagulation and liquefaction
phenomenon of semen.
06 describe the physical appearance of semen as part of
the lab assessment process.
07 define the following terms:
Azoospermia
Cells of Leydig Coagulum
Epididymus
Liquefaction Oligospermia
Prostate Gland
Seminal Fluid Seminal
Vesicles
Seminiferous Tubules
Serotoli Cells Spermatid
Spermatozoa
Viability
Vicosity
08 summarize seminal fluid viscosity and how to
evaluate it.
09 state the normal seminal fluid volume range.
10 describe the normal seminal fluid pH range and the
effects of pH shifts on the health of seminal fluid.
11 discuss the clinical importance of seminal fluid
odor.
12 explain how to prepare a seminal fluid wet mount and
describe what information can be obtained by this testing technique.
13 describe sperm motility and summarize how to
interpret, grade, and report motility values.
14 review the revitalization check for spermatozoa.
15 explain how to differentiate between dead and living
sperm.
16 differentiate between normal and abnormal sperm
morphology and identify twelve types of abnormal spermatozoa.
17 describe the following sediment elements that may be
found in seminal fluid:
epithelial cells
sertoli cells
macrophages
erythrocytes
leukocytes
lecithin granules
corpora amylacea
spermine hydrochloride crystals
18 explain how to perform a sperm count using a
hemocytometer and when given data, calculate a sperm count.
19 summarize a vasectomy, its purpose, and how to
confirm azoospermia.
20 state the normal values for a sperm count.
21 describe sperm antibodies and how one might detect
their presence in a ‘wet mount”.
22 list methods as to how a clinical laboratory can
assay sperm antibodies.
23 summarize the gelatin agglutination test for sperm.
24 list the following biochemicals found in sperm and
state their significance:
fructose
citric acid spermine
acid phosphatase
zinc
glycerylphosphoryl choline
The student, upon completion of the classroom
component, will be responsible to successfully meet these objectives for the
synovial fluid section:
01 List synonyms for synoval fluid.
02 define the following terms:
arthritis
arthrocentesis gout
hyaluronic acid
ochronosis synovial fluid
synoviocyte
synovitis
xanthochromic
03 summarize synovial fluid and its function, where it
is found and formed.
04 explain how synovial fluid is collected for
laboratory testing.
05 explain why certain anticoagulants are not
recommended for use with
synovial fluid.
06 appraise the volume characteristics of synovial
fluid.
07 discuss how transparency is a characteristic feature
of synovial fluid.
08 explain how color is a reporting characteristic for
synovial fluid.
09 describe the viscosity characteristics of synovial
fluid.
10 review the Rope’s test and explain how it is
interpreted.
11 summarize the procedure for RBC or WBC counts on
synovial fluid.
12 list the normal values for the following
constituents of synovial fluid.
WBC assay
WBC differential RBC count
fibrin clot
viscosity
protein
glucose
13 describe how to prepare a slide for synovial fluid
differential cell count.
14 list and describe the following that have been observed
in synovial fluid:
LE cell
Reiter cell Cartilage cell
Hemosiderin
Ragocytes Fat droplets
Rice bodies
15 summarize the procedure for evaluating crystals in
synovial fluid.
16 describe and/or illustrate the following crystals in
synovial fluid:
cholesterol
monosodium urate
calcium pyrophosphate
dihydrate hydroxyapatite
corticosteroid crystals
17 other than those identified in objective 16, list
several elements that
may be observed in synovial
fluid.
18 describe betamethosone acetate and its relationship
to synovial fluid.
19 review the polarizing microscope and how it may be
used in synovial
fluid testing.
20 state the value of chemical testing for synovial
fluid.
21 discuss the importance of testing for glucose in
synovial fluid.
22 discuss the importance of testing for protein in
synovial fluid
23 discuss the importance of testing for lactate in
synovial fluid.
24 explain why a physician would order uric acid tests
for synovial fluid.
25 summarize why the Gram stain can be an important lab
technique for
synovial fluid.
26 state the expected lab findings for the group I,
non-inflammatory joint
disorder.
27 state the expected lab findings for the group II,
inflammatory joint
disorder.
28 state the expected lab findings for the group III,
septic joint disorder.
29 state the expected lab findings for the group IV,
hemorrhagic joint
disorder.
30 state the expected lab findings for a
crystal-induced joint disorder.
The student, upon completion of the classroom
component, will be responsible to successfully meet these objectives for the
amniotic fluid section:
01 define amniotic fluid.
02 list six funcitons of amniotic fluid.
03 list the composition and normal values of amniotic
fluid.
04 state the origin of the types of cells that may be
found in amniotic fluid.
05 state the normal range of the volume of amniotic
fluid in milliliters.
06 explain how amniotic fluid is formed.
07 describe the aminocentesis procedure and state when
it can be
performed and list reasons for
performing this procedure.
08 describe the normal color of amniotic fluid and cite
the significance
of other colors.
09 explain why amniotic fluid is normally turbid.
10 list steps and findings that will help to identify
amniotic fluid.
11 summarize the ‘fern’ test.
12 describe meconium.
13 summarize the Kelihauer - Betke stain and it
purpose.
14 explain why a physician would order fetal lung
maturity testing.
15 summarize the collection, handling, and transport of
amniotic fluid for
the laboratory.
16 discuss the importance of bilirubin testing in
amniotic fluid and explain
how the manual spectrophotometer may
be used to evaluate bilirubin
concentration.
17 when given lab data, use Freda’s classification to
interpret the bilirubin
curve.
18 identify lecithin and sphingomyelin and explain the
significance of
calculating the lecithin/sphingomyelin
ratio in amniotic fluid.
19 discuss why a physician would order the alpha-fetal
protein test in
amniotic fluid.
20 identify phosphatidyl glycerol and state why a
physician would request
the lab to test for this chemical component
in amniotic fluid.
21 discuss the term “fetal distress.”
22 describe the foam stability shake test and how it
should be interpreted.
23 summarize why a physician would order a creatinine
test on amniotic
fluid.
24 define microvicosity and explain it clinical
significance in amniotic
fluid testing.
The student, upon completion of the classroom
component, will be responsible to successfully meet these objectives for the
serous fluid section:
01 summarize serous fluids and differentiate where they
are found.
02 define the following terms:
ascites
anascarca
chylous
edema
effusion
exudate
fibrinous
milky
paracentesis
pseudochylous
purulent
sanguineous
serous fluid
shimmering transudate
03 list the required minimum volumes for the following
lab evaluations of serous fluid:
color
clarity cell
count
cell differential
cytology Gram stain
glucose
protein pH
04 summarize transudates.
05 summarize exudates
06 differentiate between exudates and transudates.
07 explain why a differential cell evaluation is
important for serous fluid testing.
08 identify the most important test to differentiate
between exudates and transudates.
09 explain how to calculate a protein ration and state
its clinical importance.
10 describe how to calculate the LD ratio and state its
clinical significance for serous fluid testing.
11 explain why a physician would order a serous fluid
glucose test and state its clinical significance.
12 explain why a physician would order a serous fluid
amylase test and state its clinical significance.
13 explain why a physician would order a serous fluid
triglyceride test and state its clinical significance.
14 explain why a physician would order a serous fluid
pH test and state its clinical significance.
15 when given laboratory data, identify a fluid as
being a transudate or exudate.
The student, upon completion of the classroom component, will be responsible
to successfully meet these objectives for the fecal section:
01 describe the normal composition of feces.
02 summarize the correct collection procedure for fecal
material.
03 identify the fecal contaminants that should be
avoided in the collection process.
04 describe the consistency characteristics of fecal
material using the following terms:
scybalous
formed
soft
mushy
loose
diarrheic
watery
05 list a possible cause when the following colors are
observed in feces:
black
dark brown
brown
pale brown
yellow
gray
green
clay
red
06 define the following terms:
acholic
constipation diarrhea
malabsorption
melena
occult blood
steatorrhea
urobilin
urobilinogen
07 describe how stools may be classified using the
following terms:
fibrous
colloidal mucoid
bloody
pus
watery
08 summarize odor in feces, differentiating between
normal and abnomal
odors.
09 explain why the presence of leukocytes in stools may
be clinically
significant.
10 explain why the presence of fat in stools is clinically
significant.
11 describe how to test a stool specimen for the
presence of fat.
12 explain why a physician would ask the laboratory to
examine a stool
specimen for the presence of muscle
fibers.
13 summarize the clinical significance of occult blood
in feces.
14 explain why a laboratory would use gum guaiac for
the testing of occult
blood instead of ortho-toluidine.
15 list those constitutents that are known to cause
false-positive
or false-negative test results in occult
blood testing.
16 explain why hemoglobin causes a positive occult
blood test.
17 describe the Apt test and explain why it is
clinically significant.
18 summarize how the Clinitest tablet can be used to
detect fecal
carbohydrate intolerance problems.
The student, upon completion of the classroom
component, will be responsible to successfully meet these objectives for the
sweat section:
01 summarize the composition of sweat, where it is
formed, how much is formed daily.
02 explain why a physician would request a sweat test.
03 define cystic fibrosis.
04 describe the essential criteria that is necessary to
diagnose cystic fibrosis.
05 summarize the pilocarpine iontoporesis procedure for
the sweat test.
06 cite the reference ranges for sodium and chloride in
healthy children and those diagnosed with cystic fibrosis.
07 summarize seven precautions that must be observed when
performing the sweat test.
08 describe three procedures for testing sweat
chlorides.
09 discuss borderline values for the sweat chlorides
and the recommended course of action when the lab reports these values.
The student, upon completion of the classroom
component, will be responsible to successfully meet these objectives for the
gastric fluid section:
01 summarize the composition of gastric fluid, where it
is formed and how much is produced daily.
02 explain why a physician request a gastric fluid
analysis.
03 describe how gastric fluid is collected for the clinical
laboratory.
04 define gastrin and explain why it is clinically
significant in gastric analysis.
05 summarize gastric analysis and differentiate between
BAO and MAO.
06 define the following terms:
achlorhydria
anacidity basal
acid output (BAO)
combined gastric acids
free hydrochloric acid hypochlorhydria
titration
total acidity
maximal acid output (MAO)
07 discuss the clinical significance of color in
gastric analysis.
08 explain why it can be clinically significant to
measure the volume of gastric fluid.
09 describe the behavior of gastric fluid when it is allowed
to stand in a graduated cylinder.
10 explain why pH can be clinically significant in
gastric fluid analysis.
11 explain why odor can be clinically significant in
gastric fluid analysis.
12 summarize the following stimulants used in gastric
fluid testing.
pentagastrin
histamine
histalog
13 describe Zollinger-Ellison syndrome.
14 review this historical interest item: Töffer’reagent.
15 review this historical interest item and chemistry
titration technique: titrating the acidity of gastric fluid.
The student, upon completion of the classroom component, will be responsible to
successfully meet these objectives for the sputum section:
01 summarize sputum and its composition.
02 describe how to differentiate between sputum
and saliva.
03 summarize the collection criteria for collecting
sputum.
04 explain why measuring sputum volume can be clinically
significant.
05 summarize the clinical significance of color in
sputum.
06 describe the clinical significance of sputum
consistency for each of the following terms:
serous
mucoid purulent
mucopurulent
tenacious blood
caseous
07 explain how the odor of sputum can be clinically
significant.
08 describe how to prepare a “wet mount” of sputum for
a microscopic examination.
The student, upon completion of the
urinalysis classroom
component, will be responsible to successfully meet these objectives for the
following three urinalysis sections:
Lecture Unit I – Objectives 01 through 93.
01 summarize a brief history of urinalysis.
02 explain why urine testing is medically important.
03 when given or shown an illustration or a model of a
cross-section of a
kidney, identify its anatomical parts.
04 cite or write the correct progression of renal
vessels as they progress
from the renal artery to the renal vein.
05 state the rate of blood flow per minute through the
vessels of the kidney.
06 list and describe the following regions of the
kidney:
cortex
medulla
renal pelvis
07 list and discuss the following parts of the basic
functional unit of the kidney:
renal tubule
nephron
juxta-glomerular complex
glomerulus
Bowman’s capsule
proximal convoluted tubule
loop of Henle
distal convoluted tubule
collecting tubule
08 summarize the renin-angiotensin mechanism.
09 explain how aldosterone interacts with the urinary
system.
10 list several functions of the kidney
11 describe how the glomerulus functions in the
formation of urine.
12 summarize the following filtration factors that
affect glomerular function
and filtration and when given filtration
factor data, calculate the filtration
pressure.
glomerular hydrostatic pressure
capsular hydrostatic pressure
plasma oncotic pressure
ultra-filtrate oncotic pressure
filtration pressure
13 quote or write how many milliliters (or liters) of
glomerular filtrate is
formed, absorbed, and the residue
that is excreted as urine per 24 hours.
14 identify the peritubular capillaries on an
illustration, state their purpose,
and/or describe their location.
15 identify the vasa recta capillaries on an
illustration, their purpose, and
location.
16 summarize the concept of ‘tubular secretion’.
17 identify the loop of Henle and describe its physiological
role in the
formation of urine.
18 identify the ureter in an illustration and describe
it function.
19 identify the bladder in an illustration and describe
its function.
20 identify the urethra in an illustration and describe
it function.
21 summarize the concepts of ‘threshold substances’ and
differentiate
between high and low threshold substances.
22 differentiate between ‘active’ and ‘passive’
transport in the nephron.
List examples of substances transported by these two
mechanisms.
23 recognize and define the following terms:
acidosis
alkalosis
anuria
azotemia
catheter
diuresis
diuretic dysuria
enuresis
glycosuria hematuria
urolith
hypersthenuira
hypertonic hyposthenuria
hypotonic
interstitial fluid
isosthenuria ketonuria
nephritis
nephropathy
nocturia
olilguria urocyanin
phosphaturia
pyelonephritis pyuria
renal failure
renal insufficiency
trichomonas vaginalis
urates
uicaciduria
uricosuria urochrome
uropathy
uropenia
uropsammus uroscopy
glomerular filtrate
nephrotic syndrome
24 recognize and define the following abbreviations:
amt
bili JP
CaOx
epi
GU IVP
ket
KT
KUB LE
mod
nitr
OFB pro
QNS
RTEC
refr SE
SSA
TEC
TNTC UA
UI
UO
URO urob
UTI
25 summarize and/or illustrate the following mechanisms
in the kidney
hydrogen ion excretion and phosphate
formation
hydrogen ion excretion and ammonia
formation
hydrogen ion excretion and
bicarbonate ion conservation
26 list nine things necessary for a successful
urinalysis test.
27 summarize a method for appraising a randomly
collected urine for
contamination.
28 explain the importance of centrifuging urine.
29 list a minimum of four components that are foreign
to the renal system.
30 describe errors that can occur when examining urine
with the glass slide
and coverslip technique.
31 list three sources of urine contamination associated
with the human
body and state the consequences of such
contamination.
32 describe how to handle a mislabled urine specimen.
33 summarize the conditions in which a urine specimen
may be rejected
and recommend a corrective course of
action.
34 list the criteria for an appropriate urine
container.
35 list the information that may be placed on a label
of a fluid specimen
and designate which of the
information items are essential and
non-essential.
36 list and describe seven types of urine specimens and
summarize the
advantages and disadvantages of each type.
37 list several methods for preserving urine samples
and cite the advantages
of each.
38 summarize the more common sources of error that are
known to occur
with urine collection and specimens.
39 summarize who a laboratory can verify an unknown
fluid specimen as
being either urine, spinal fluid,
amniotic fluid, or blood serum.
40 summarize ten chemical constituents found in both
urine and blood plasma,
citing the normal values of each.
41 describe how to measure the urine volume, the
clinical importance of
reporting urine volumes, and cite the
normal values for a 24 hour
specimen for six age groups.
42 list six factors that affect the volume of urine
that is formed by the body.
43 summarize several causes for polyuria and cite one
or more examples in
which it is not true polyuria.
44 list several causes for oliguria.
45 explain how reporting the odor of a urine specimen
can be clinically
informative.
46 summarize the clinical value of reporting color when
assessing a urine
specimen.
47 explain the concept of ‘appearance’ in the physical
assessment of
urine and summarize it importance in
urine testing.
48 explain how reporting ‘foam’ in the physical
assessment of urine can
be clinically helpful.
49 summarize ‘specific gravity’ of urine, list the
normal values, and cite
causes for increases and decrease in
urine specific gravity.
50 explain how color of urine and specific gravity
values may be correleated.
51 list several drugs/medications that can be excreted
by the kidney and
describe the color that is imparted to the
urine by these chemicals.
52 summarize several common causes of cloudiness in
urine.
53 summarize how to measure specific gravity with a
urometer.
54 summarize how to measure specific gravity with a
refractometer.
55 discuss how to calculate and correct specific
gravity readings when
glucose and/or protein and/or
temperature changes are present.
56 describe the operating principle of the
refractometer.
57 describe and/or illustrate how to read a urometer
scale to report a
specific gravity value.
58 explain how the specific gravity reading is
chemically derived with
the reagent strip test.
59 summarize the concept of ‘harmonic oscillation
desniometry.
60 summarize the concept of ‘osmolarity’ and explain
why it is used in the
clinical laboratory for testing urine
and other fluids.
61 summarize the concept of ‘osmolarity’ and
differentiate between
‘freezing point” osmolarity and ‘vapor
pressure’ osmolarity.
62 calculate the osmolarity of a urine specimen when
given data
63 summarize the concept of ‘free water clearance’ and
state how it test
results can be clinically useful.
64 when given data, the student can calculate the free
water clearance and
interpret it results.
65 describe how to correctly use an urinalysis reagent
test strip.
66 explain why it is important to remove excess urine
from the test strip.
67 discuss QC in the care and storage of reagent test
strips.
68 discuss QC in the use of reagent test strips.
69 summarize pH in urine testing and cite it normal
values.
70 describe the clinical importance of pH testing of
urine.
71 summarize causes for acidic and alkaline urine.
72 explain the clinical validity of an urine specimen
with a pH of 9.0.
73 list the known substances that will interfere with
pH testing.
74 explain the chemical reaction phenomenon that takes
place in the urine
pH reagent test pad.
75 explain the chemical reaction phenomenon that takes
place in the urine
glucose reagent test pad.
76 distinguish between a false-positive and
false-negative test result in urine
testing.
77 list several sources for false-positive and
false-negative test results for
urine glucose testing using the
reagent test strip.
78 summarize the principle for glucose testing using
the Clinitest reagent
tablet.
79 explain what is meant by ‘non-specific’ test results
and illustrate the
explanation using the Clinitest
tablet copper sulfate reduction test principle.
80 discuss the ‘pass-through’ phenomenon associated
with the Clinitest
tablet reagent test and cite a method
for correcting the testing procedure.
81 explain why children under two years of age should
have their urine
specimens tested with the Clinitest
reagent tablet.
82 explain why a physician would request a clinical
laboratory to perform a
galactose test on the urine of an
infant.
83 compare and interpret the test results of the
Clinitest tablet test and the
glucose reagent test pad.
84 list several causes for a false negative or a false
positive test result when
using the the Clinitest tablet.
85 list limitations that the clinical laboratory must
be aware of when testing
an urine specimen.
86 list several advantages for the physician when
he/she orders urine
glucose testing.
87 summarize the diasaccharide ‘lactose’, why it can
appear in urine, and
its clinical significance.
88 discuss ‘ketones’ and ‘ketosis’, summarizing the
formation of these
intermediates, and why they appear in
urine.
89 explain why a physician would order a urine ketone
test.
90 cite several causes for the presence of ketones in
urine.
91 summarize the ketone testing principle in the
‘Acetest’ tablet and the
ketone reagent strip pad.
92 cite several causes for false-negative and
false-positive ketone test
results.
93 compare and interpret the test results of the ketone
reagent test pad
and the glucose reagent test pad.
Lecture Unit II – Objectives 94 through 199
94 discuss the types of proteins found in urine.
95 summarize the clinical significance of
proteins found in urine.
96 discuss orthostatic proteinuria.
97 discuss overflow proteinuira
98 discuss glomerular proteinuria.
99 summarize the concept of selective proteinuria.
100 summarize tubular proteinuria and its types.
101 summarize post-renal proteinuria.
102 explain why a physician would request a test for
microalbuminuria.
103 summarize two commercial testing methods for
microabluminuria.
104 describe Bence-Jones protein and explain why it appear
in urine.
105 describe the classical heat screening technique for
Bence-Jones protein
and identify the best testing
method for this protein.
106 summarize the chemical reaction mechanism for
albumin in the protein
reagent test pad.
107 list several causes for false-negative and
false-positive test results with
the protein reagent test pad.
108 summarize the Kingsbury–Clark Sulfosalicylic acid
semi-quantitative
turbidity procedure when
testing for urine proteins.
109 list several causes for false-negative and
false-positive test results with
the Kingsbury–Clark
Sulfosalicylic acid semi-quantitative turbidity
procedure.
110 compare and interpret the test results of the
protein reagent test pad
and the Kingsbury–Clark
Sulfosalicylic acid semi-quantitative turbidity
test procedure.
111 identify and list those urinary tests that can be
correlated to urinary
protein testing.
112 summarize the importance of testing for bilirubin
in urine.
113 summarize the catabolism of hemoglobin and its
conversion to
urobilinogen.
114 explain the difference between conjugated and
non-conjugated bilirubin
and summarize it clinical
significance in urine testing.
115 explain the chemical reaction of the chemicals in
the bilirubin reagent
strip test pad.
116 describe the Ictotest procedure and list how to perform
this test.
117 list several causes for false - positive and false
- negative test results in
bilirubin testing.
118 describe how to perform the “foam” test and summarize its
clinical
significance.
119 list those UA tests that can be correlated to the
bilirubin test.
120 describe or list a minimum of three characteristics
each for free and
conjugated bilirubin.
121 explain why urobilinogen testing is important.
122 explain the reaction process for the urobilinogen
reagent strip test.
123 list causes for false-positive and false-negative
test results for UA tests
that employ
para-dimethylaminobenzaldehyde as a reagent.
124 describe a way that will allow the laboratory to
test for the absence
of urobilinogen.
125 list several disorders in which urobilinogen may be
elevated or absent.
126 list the intermediates in heme synthesis and
summarize the molecule
porphobilinogen and why it is
considered clinically significant.
127 summarize the difference between acquired and
hereditary porphyrias.
128 explain how to perform the Hoesh test.
129 summarize why the Hoesh test is a good screening
test for
porphobilinogen.
130 summarize the Watson-Schwartz differentiation
test ane how it is used
to identify
Ehrlich-reactive substances, porphobilinogen, and
urobilinogen.
131 list several Ehrlich reactive substances.
132 explain the importance of testing for urobilin in
urine.
133 differentiate between the terms “hematuria” and “hemoglobinuria”.
134 summarize the importance of testing for blood in the
urine.
135 explain how myoglobin can appear in the blood and
state why it
presence is significant.
136 describe how myoglobin can be identified and its
presence in urine
confirmed.
137 explain how the reactions occur in the reagent
strip test for blood.
138 when given data, differentiate between the presence
of RBC’s,
hemoglobin, and myoglobin in
urine.
139 list several substances that causes false-negative
and/or false-positive
tests in urine.
140 list other UA tests/findings that can be correlated to a
positive blood test.
141 explain why testing for the presence of nitrates in
urine is clinically useful.
142 explain how the reactions occur in the reagent
strip test for nitrates.
143 list several substances that can cause a
false-negative and/or false-positive
nitrate test.
144 list other UA tests/findings that correlate to the
nitrate test.
145 summarize why testing for the presence of leukocyte
esterase is clincially
useful.
146 discuss the clinical significance of the presence
of leukocytes in urine.
147 explain how the reactions occur in the reagent
strip test for leukocyte
esterase.
148 list other UA tests/findings that correlate to the
leukocyte esterase test.
149 list several substances that can cause a false-negative
and/or false-positive
leukocyte esterase test.
150 explain how the reactions occur in the reagent strip
test for pH and
correlate the pH results to
that obtained using the refractometer.
151 list several substances that will cause either decreases
or increases in the
reagent strip test for specific
gravity or might obscure the test pad color
and affect interpreting the
test.
152 summarize how ascorbic acid can affect the reagent
strip test chemical
reactants.
153 describe how a dilute acetic acid solution can
affect urinary sediment.
154 list quality control steps for the examining urine
sediment microscopically
that assure an accurate
interpretation.
155 identify several sources of error that can impact
upon the examination of
urine sediment.
156 write or describe the correct procedure for
reporting urinary sediment
and when given data correctly
complete a urinary report.
157 list several artifacts found in urine and either
illustrate or describe them.
158 list the expected coloration of formed elements in
urine when using
Sternheimer-Malbin stain.
159 When given data, calculate the number of formed elements
in a milliliter
of urine.
160 define a supervital stain, list a minimum of two such
stains, explain how
they work, list disadvantages
to using such stains, and describe how to
apply these stains.
161 summarize how the laboratory can demonstrate the
presence of fats/lipids
in urine.
162 explain why a physician would order a gram stain on
a urinary specimen.
163 explain why and when the laboratory would use Hansel’s
stain on urinary
sediment.
164 explain why a physician would order the lab to
perform a Prussian blue
stain.
165 describe and/or illustrate the appearance of
erythrocytes in different
osmotic concentrations of
urine.
166 identify several erythrocyte “look-a-likes” and how
the differentiate
between each.
167 describe the dysmorphic erythrocyte and explain why
they appear in
urine.
168 list other UA tests/findings that correlate to the
finding of RBC’s in urine.
169 describe how RBC’s might appear in a non-glomerular
bleeding event.
170 summarize the clinical significance of finding
RBC’s in urine.
171 describe the types of leukocytes and other
phagocytes that may be
found in urine.
172 explain why the neutropil has been described as the
typical leukocyte
found in urine.
173 list other UA test findings that can correlate to the
presence of
leukocytes in urine sediment.
174 describe and discuss the squamous epithelial cell found
in urine.
175 describe and discuss the transitional epithelial
cell found in urine.
176 summarize the clinical significance of transitional
cells in urine.
177 describe a “decoy” cell and state its clinical
significance.
178 describe a “multi-nucleated giant” cell and state
its clinical significance.
179 describe the histocyte and state its clinical
significance.
180 discuss the “clue” cell and state its clinical
significance.
181 describe the “umbrella” cell and state its clinical
significance.
182 describe renal tubular epithelial cells (RETC) and
state their clinical
significance.
183 describe and differentiate between the epithelial
cells of the proximal
and distal convoluted tubules
and also those of the collecting tubules.
184 discuss the clinical significance of RETC’s when
observed in increasing
numbers.
185 describe an appropriate course of action when a
laboratorian observes
columnar tubular cells are
observed in the urinary sediment.
186 describe the oval fat body and state its clinical
significance.
187 summarize the significance of observing inclusion
bodies in RTEC’s.
188 describe and/or illustrate a cast and summarize how
they are formed.
189 explain the role of pH, solute concentration, and
urinary stasis in the
formation of casts.
190 summarize how casts can be classified.
191 describe the false cast and explain how to
recognize them.
192 differentiate between ‘narrow’ and ‘broad’ casts
and state the
significance of finding each
one in the urinary sediment.
193 describe the hyaline cast, state how to recognize it,
and summarize
its clinical significance.
194 describe cylindroids and state their significance.
195 review the stability and solubility characteristics
of casts.
196 describe the RBC cast, state how to recognize it,
and summarize its
clinical significance.
197 describe the WBC cast, state how to recognize it,
and summarize its
clinical significance.
198 discuss the RETC cast, state how to recognize it, and
summarize its
clinical significance.
199 discuss the hemoglobin cast, state how to recognize
it, and summarize
its clinical significance.
Lecture Unit III: Objective 200 through 303.
200 discuss the granular cast, state how to recognize
it, and summarize its
clinical significance.
201 discuss the fatty cast, state how to recognize it,
and summarize its
clinical significance.
202 discuss the waxy cast, state how to recognize it,
and summarize its
clinical significance.
203 describe the “mixed” cast, how to recognize them,
and summarize any
clinical significance.
204 discuss the bacterial cast, how to recognize it,
and summarize its
clinical significance.
205 discuss the pigmented cast, how to recognize it,
and summarize its
clinical significance.
206 explain the meaning of the term “telescoped” urine.
207 explain the condition, “athletic pseudo–nephritis.
208 discuss the broad cast, how to recognize it, and
summarize its clinical
significance.
209 discuss the crystal cast, how to recognize it, and
summarize its clinical
significance.
210 explain how mucus is found in urine and summarize
it clinical
significance.
211 summarize the finding and presence of yeast in
urine and state the
clinical significance.
212 describe the potassium hydroxide preparation, how
to use it, and
why it is used in urine
testing.
213 explain why spermatozoa may be found in urine and
state the clinical
significance of such
findings in urine.
214 cite or list what parasites may be found in urine,
which are true urinary
parasites, and state
their clinical significance.
215 explain how fecal contamination may occur in urine.
216 explain why bacteria may be found in urine and
state why their
presence is clinically
significant.
217 describe how crystals may form in urine and state
why their presence
may or may not be clinically
significant.
218 describe the types of amorphous sediment in urine and
state the
clinical significance.
219 list the normally occurring urinary crystals and
state the pH at which
they are formed.
220 discuss the calcium oxalate crystal, how to
recognize it, and state it
clinical significance.
221 discuss the uric acid crystal, how to recognize it,
and state its clinical
significance.
222 discuss the sodium urate crystal, how to recognize
it, and state its
clinical significance.
223 discuss the triple phosphate crystal, how to
recognize it, and state
its clinical significance.
224 discuss the dicalcium phosphate crystal, how to
recognize it, and state
its clinical significance.
225 discuss the calcium phosphate crystal, how to
recognize it, and state
its clinical significance.
226 discuss the calcium carbonate crystal, how to
recognize it, and state
its clinical significance.
227 discuss the ammonium biurate crystal, how to
recognize it, and state
its clinical significance.
228 discuss the calcium sulfate, how to recognize it,
and state it clinical
significance.
229 list the abnormal crystals that are found in urine
that are of metabolic
origin.
230 discuss the hippuric acid crystal, how to recognize
it, and state it
clinical significance.
231 discuss the cystine crystal, how to recognize it,
and state it clinical
significance.
232 discuss the tyrosine crystal, how to recognize it,
and state it clinical
significance.
233 discuss the leucine crystal, how to recognize it,
and state it clinical
significance.
234 discuss the cholesterol crystal, how to recognize
it, and state it
clinical significance.
235 discuss the bilirubin crystal, how to recognize it, and
state it
clinical significance.
236 discuss the hemosiderin crystal, how to recognize
it, and state it
clinical significance.
237 list the abnormal crystals that are found in urine
that are of iatrogenic
or drug origin.
238 discuss the sulfonamide crystals, how to recognize
them, and state their
clinical significance
239 discuss the penicillin crystal, how to recognize it, and
state it
clinical significance
240 discuss the acyclovir crystal, how to recognize it,
and state it
clinical significance
241 discuss the radiographic dye crystals, how to
recognize them, and
state their clinical
significance
242 explain the meaning of the term “iatrogenic”
origin.
243 discuss the concept and importance of ‘quality
assurance’.
244 discuss and define the term ‘quality control’ and
state why it is
important in clinical
laboratory activities.
245 explain how the concepts of reliability, accuracy,
precision, and
variance are an intergral part
of quality control.
246 discuss how ‘control specimens’ contribute to
clinical laboratory
quality control.
247 list or cite several factors that may cause a test
result to be considered
unacceptable.
248 explain how quality control is used as part of specimen
test result
validation.
249 list or cite several errors that can occur in urine
testing if quality
assurance principles are
ignored.
250 when given a list of equipment items for the urinary
lab, state how
frequently certification
performance tests should be performed.
251 using quality assurance concepts, describe the
appropriate procedure
for handling non-labeled and
mislabeled urine specimens.
252 summarize the disorder glomerulonephritis.
253 discuss the clinical features of acute
glomerulonephritis.
254 summarize the clinical features of
post-streptococcal glomerulonephritis
and cite its typical laboratory
findings.
255 summarize the clinical features of
non-streptococcal glomerulonephritis
and cite its typical laboratory
findings.
256 summarize the clinical features of acute
glomerulonephritis (associated
with multi-system disease) and
cite its typical laboratory findings.
257 summarize the clinical features of membrane
proliferative
glomerulonephritis and cite its
typical laboratory findings.
258 summarize the clinical features of Berger’s disease
and cite its typical
laboratory findings.
259 describe serum sickness and state it relationship
to glomerulonephritis.
260 summarize the clinical features of progressive and
cite its typical
laboratory findings.
261 summarize the clinical features of focal
glomerulonephritis and cite
typical laboratory findings.
262 summarize the clinical features of chronic
glomerulonephritis and
cite typical laboratory
findings.
263 summarize the clinical features of nephrotic
syndrome and cite its
typical laboratory findings.
264 summarize the clinical features of minimal change
disease and cite its
typical laboratory findings.
265
266 summarize the clinical features of a lower tract
urinary tract infection
and cite its typical laboratory
findings.
267 summarize the clinical features of cystitis and
cite its typical
laboratory findings.
268 summarize the clinical features of a upper urinary
tract infection and
cite its typical laboratory
findings.
269 summarize the clinical features of chronic
pyelonephritis and cite its
typical laboratory findings.
270 summarize the concepts of renal tubulointerstitial
pathologies and
their clinical laboratory
findings.
271 describe how uric acid acts as a metabolic toxin
and cite the expected
laboratory findings.
272 summarize the concepts of renal failure and cite
the expected laboratory
findings.
273 summarize the clinical features of chronic renal
failure and cite its
typical laboratory findings.
274 review the occurrence of renal allograph rejection
and cite its typical
laboratory findings.
275 define a renal function test.
276 summarize what information a renal function test is
suppose to provide
for the client.
277 define the glomerular filtration rate (GFR).
278 list or cite several factors that affect the GFR.
279 list or cite several advantages or disadvantages
for using creatinine as
a renal function test.
280 summarize what is required for the creatinine
clearance test, state the
normal range for adult males
and females, and cite the formula for this
testing procedure.
281 describe a nomogram and explain how to use it.
282 when given data, calculate a creatinine clearance
test, and interpret
the results.
283 list or cite several sources of error when
performing the creatinine
clearance test.
284 summarize the concept of tubular secretion testing
and state why a
physician might order it.
285 summarize the PAH test
286 summarize the phenylsulfophthalein test and state
why a physician
would not order it.
287 summarize the concept of aminoaciduria and cite the
three types.
288 summarize the disorders of Fanconi’s syndrome,
Cystinosis, Wilson’s
disease, and Galactosemia and
cite their relationship to defective
tubular reabsorption
mechanisms.
289 summarize phenylketonuria and describe how the
clinical lab might
screen for it presence.
290 summarize the ferric chloride test and list it
advantages and
disadvantages.
291 summarize the Guthrie test.
292 summarize the clinical need for newborn screening
of inherited
disorders (based on a national
perspective.
293 summarize the importance of considering uric acid
in urine testing.
294 summarize homocystinuria and state how the
laboratory can screen
for this disorder.
295 summarize cystinosis and state how the laboratory can
screen for
this disorder.
296 summarize 5-hydroxyindoleacetic acid (5-HIAA) and state
how the
laboratory can screen for this
disorder.
297 summarize melanuria and state how the laboratory can
screen for
this disorder.
298 summarize tyrosyluria and state how the laboratory can
screen for
this disorder.
299 summarize indicanuria and state how the laboratory can
screen for
this disorder.
300 summarize alkaptonuria and state how the laboratory
can screen for
this disorder.
301 summarize mucopolysaccharidosis and state how the
laboratory can
screen for this disorder.
302 summarize cystinuria and state how the laboratory
can screen for this
disorder.
303 summarize maple syrup urine disease (MSUD) and
state how the
laboratory can screen for this
disorder. |
