MLT 120 - Urinalysis

1. Describe required specimens and special handling when specific urinalysis and body fluid procedures are requested and discuss quality control measures in the urinalysis laboratory
2. Describe the anatomy and physiology of the urinary system and other body systems as they relate to urinary and body fluid findings and describe the laboratory tests used to evaluate them
3. Demonstrate the proper technique for analyses of urine and body fluid specimens
4. Relate laboratory findings in urinalysis and body fluid results to disease processes and recognize discrepancies between results
5. Demonstrate professionalism by following written and verbal instruction, responding positively to suggestions, working well with peers and instructors, and developing a commitment to quality work by repeating assignments if necessary

Unit Objectives:

Unit 1: Introduction to urinalysis, kidney function, diseases, and physical examination of urine

1. List major normal chemical constituents of urine
2. Recognize terminology and volumes associated with normal and abnormal urine output
3. Describe the characteristics of appropriate urine specimen containers, labeling, and rejection criterion
4. Describe proper collection and use of types of urine specimens
5. Describe advantages and disadvantages of urine preservatives currently in use and changes that occur in unpreserved urine
6. Describe appropriate handling of biological hazards in the clinical laboratory
7. Discuss handling of other types of hazards
8. Describe the four physiologic mechanisms of the urinary system
9. Identify laboratory procedures used to evaluate renal functions and the normal ranges associated with the procedures
10. Distinguish between the cause of abnormal and normal urine colors
11. Correctly identify the appearance of urine sample unknowns according to four classifications
12. Define the principle used to determine urinary specific gravity by three different methods
13. Calculate urinary specific gravity readings by urinometer using correction factors for temperature, glucose, and protein

Unit 2: Chemical Examination of Urine

1. Demonstrate proper technique to determine chemical analyses of urine samples using chemical test strips
2. State the principle used to determine urinary pH by chemstrip
3. Summarize the clinical significance of urinary pH values
4. State the principle used to determine urinary protein by chemstrip
5. Describe the pathologic causes of proteinuria
6. Compare protein determination by chemstrip and precipitation methods
7. Compare the glucose oxidase and copper reduction test used to detect glucose and reducing substances in urine
8. List the three ketone bodies that may be found in urine and those that will react on the chemstrip
9. Summarize the clinical significance of the presence of ketones detected by chemstrip or tablet reactions
10. Describe the chemical principle involved in a positive reaction on the chemical strip for the detection of blood
11. Differentiate between reactions due to RBC’s, hemoglobin, and myoglobin
12. Describe the degradation of hemoglobin to bilirubin, urobilinogen and urobilin, and the conjugation of bilirubin
13. Describe the chemical principle used to detect urinary bilirubin
14. Summarize clinical conditions of urine bilirubin as determined by the diazo reaction
15. Describe the physiologic conditions that result in either an absence or increase in urinary urobilinogen
16. State the chemical principles utilized in testing for urobilinogen in urine specimens
17. State clinical conditions that may result in a positive urinary nitrite test
18. Describe the chemical principle used to detect nitrite in urine
19. Describe the chemical principle used to detect leukocytes in urine
20. Summarize the clinical significance of a positive urinary leukocyte esterase test
21. State the chemical principle incorporated in chemstrip testing for urinary specific gravity

Unit 3: Microscopic Examination of Urinary Sediment and Special Screening Procedures

1. Describe standard steps for preforming the microscopic urinalysis of a urine samples
2. Identify cellular elements in the urine sediment and relate their appearance to clinical conditions
3. Identify crystals found in urine and correlate their appearance with pathologic and nonpathologic conditions
4. Describe conditions necessary for urinary cast formation
5. Explain the significance of casts observed in the sediment of a urine sample
6. Differentiate between miscellaneous artifacts, cellular elements, formed elements, and parasites in the sediment
7. Describe techniques used to confirm the identity of elements in urinary sediment
8. Describe scales used to quantitate results of urinary sediment
9. Differentiate between overflow and renal diseases that result in the abnormal accumulation of metabolites in urine
10. Summarize the disorders of Phenylalanine-Tyrosine pathway
11. List the tests for detection of disorders in the Phenylalanine-Tyrosine pathway
12. Describe branched-chain amino acid disorders and the test results associated with them
13. Describe disorders with tryptophan metabolites and the test results associated with them
14. Differentiate between disorders of cysteine metabolism that result in cystinuria, cystinosis, and homocystinuria
15. Describe porphyrin disorders resulting from disruptions in the pathway of heme formation
16. Discuss other urine diseases

Unit 4: Body Fluid Analysis Performed in the Laboratory

1. List three major functions of spinal fluid
2. Distribute tubes 1, 2, and 3 of CSF to the appropriate lab department
3. Describe the significance of the appearance of CSF resulting from traumatic tap vs. cerebral hemorrhage and other conditions
4. Identify and state the significance of abnormal cells in CSF
5. State normal values for CSF chemistry tests
6. List pathologic conditions associated with abnormal CSF chemistry findings
7. Discuss diagnostic value of bacterial and antigen tests performed on CSF in the microbiology department
8. Discuss the composition and proper collection of seminal fluid
9. List normal values associated with semen
10. Describe the methods used to evaluate sperm motility, morphology, and additional tests performed
11. Discuss the appearance, function, composition, and collection of normal synovial fluid
12. Correlate abnormal values obtained on synovial fluids with classifications of joint disorders
13. Discuss the use of polarized and compensated polarized light in crystal identification
14. Describe the formation and collection of serous fluids
15. List laboratory test results used to differentiate between transudates and exudates
16. Correlate laboratory tests on pleural fluid with pathologic conditions
17. Correlate laboratory tests on peritoneal fluid with pathologic conditions
18. Perform and interpret miscellaneous body fluid tests