Urinalysis and CLIA-Waived Laboratory Testing Flashcards
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Which type of urine specimen is considered the MOST concentrated and is preferred for routine urinalysis?
Answer: First morning void
The first morning void is the most concentrated urine specimen because solutes accumulate overnight. It provides the most reliable results for detecting abnormalities like protein, glucose, and formed elements such as casts.
A urine dipstick test shows a positive result for nitrites. This finding MOST suggests:
Answer: A urinary tract infection caused by gram-negative bacteria
Nitrites on a dipstick indicate that bacteria (typically gram-negative organisms such as E. coli) have converted urinary nitrates to nitrites. This finding, especially combined with leukocyte esterase, is strongly suggestive of a UTI.
Under CLIA regulations, a 'CLIA-waived' test is defined as one that:
Answer: Is cleared by the FDA as simple with minimal risk of error
CLIA-waived tests are FDA-cleared tests deemed simple enough that the risk of error is negligible. Offices performing only waived tests must obtain a Certificate of Waiver and follow manufacturer instructions but face minimal regulatory oversight.
A midstream clean-catch urine specimen is ordered. In what order should the medical assistant instruct the female patient to perform the collection?
Answer: Cleanse, begin urinating, catch midstream in cup, finish urinating into toilet
The correct sequence for a midstream clean-catch is: cleanse the urethral area front to back, begin voiding into the toilet to flush out urethral contaminants, then catch the midstream portion in the sterile container, and finish voiding into the toilet. This minimizes contamination.
Urine dipstick results show a specific gravity of 1.001. This MOST likely indicates:
Answer: Very dilute urine
Urine specific gravity ranges from approximately 1.001 to 1.035. A value near 1.001 indicates highly dilute urine, suggesting overhydration or possible diabetes insipidus. Normal specific gravity is roughly 1.010–1.025.
When using a urine dipstick, which step is CRITICAL to ensure accurate results?
Answer: Compare pads to the color chart at the manufacturer-specified times for each analyte
Each analyte pad on a dipstick has its own specific reading time specified by the manufacturer (e.g., leukocytes at 2 minutes, glucose at 30 seconds). Reading all pads at the same time or too early/late leads to inaccurate results.