Bladder Information and Courses from MediaLab, Inc.
These are the MediaLab courses that cover Bladder and links to relevant pages within the course.
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| A patient suspected of a urinary tract infection has a negative nitrite test, but bacteria is present upon microscopic examination. What may have caused a false-negative result? (Choose ALL of the correct answers) | View Page |
| Nitrite Test The nitrites portion of the reagent strip provides a rapid screening test for the presence of gram-negative bacteria that are often responsible for urinary tract infections. Although urine cultures are still needed to confirm the diagnosis and monitor any urinary tract or kidney infection, the need for a culture may not be obvious because in some cases of early bladder infection, the symptoms may be vague or the patient may be asymptomatic. Diagnosis and treatment of cystitis (bladder infection) is important because if left untreated it may result in kidney damage, impairment of renal function, hypertension and/or septicemia. | View Page |
| Bladder Infections Bladder infections are usually caused by gram-negative bacteria. These bacteria reduce nitrates derived from food to nitrites when urine remains in the bladder three to four hours, sufficient time for this reaction to occur. Nitrite is not present in urine under normal circumstances. When present, nitrites react with p-arsanilic acid to produce a diazonium compound. The diazonium compound in turn couples with 3-hydroxy-1,2,3,4 tetrahydrobenzo-(h)-quinolin to produce a pink color. A first morning, clean, voided midstream specimen is optimal for detecting nitrites in urine. | View Page |
| False Negative Results False negative results may occur in urine specimens that did not remain in the bladder a sufficient length of time for the bacteria to reduce a measurable quantity of nitrate to nitrite. Other reasons for false negative results include high specific gravity, ascorbic acid levels above 25mg/dL or low pH (<6). Less frequently, the cause may be due to a lack of sufficient nitrate in the diet (green vegetables) or further reduction of nitrite to nitrogen when large numbers of bacteria are present. In patients receiving antibiotics, the metabolism of the bacteria may be inhibited which would also produce a false negative reaction. | View Page |
| Clinical Significance Early detection of bacteria is important in order to prevent cystitis from developing into inflammation or infection involving the kidney and renal pelvis. The nitrite portion of the test strip can be used to screen individuals who are at risk for developing urinary tract infections, such as diabetics, persons with recurrent infections, or pregnant women. The test is also useful in evaluating the success of antibiotic therapy that is used to treat a bladder infection. | View Page |
| Match the following: | View Page |
| The nitrite portion of the test strip can be used to: (Choose ALL of the correct answers) | View Page |
| Bacterial contamination of a urine specimen from a normal healthy individual could originate from all of the following except: | View Page |
| What is the primary functional unit of the kidney : | View Page |
| Situations not considered as refusal If a donor for pre-employment testing fails to appear, does not provide a urine specimen, or leaves the collection site before the collection process begins (e.g. before being given a collection cup), this is not considered a refusal to test.If a donor refuses to sign the donor certification on the pink copy of the CCF or to initial the security strips, this is not considered a refusal to test.If a donor refuses to provide an ID or Social Security Number, this is not considered a refusal to test.If a donor during the three (3) hour waiting period for a "shy bladder" refuses to drink any liquids, this is not considered a refusal to test. | View Page |
| Shy bladder The term "shy bladder" refers to a situation where the donor is unable to provide the sufficient amount of urine required for a drug screen.If the donor indicates upon arrival at the collection site that he or she cannot provide a specimen, the collector should begin the collection process anyway and have the donor make an attempt to provide a specimen. If after an attempt the donor cannot provide a specimen or can only provide a specimen of insufficient volume, the donor must be instructed not to leave the collection site and to do so will be considered a refusal to test. The donor should be monitored either by the collector or by another member of the collection site staff. The donor should be encouraged to drink up to 40 ounces of fluid reasonably distributed over a period of up to three (3) hours, or until the donor can provide a sufficient amount of urine, which ever comes first. If no specimen is provided on the first attempt, the same collection container may be used for the next attempt. The donor may keep possession of the container during the waiting period. The same CCF is used. | View Page |
| Shy bladder If the donor provides an initial insufficient specimen, the collector discards the insufficient specimen and notes in the Remarks section of the CCF when the donor provided the insufficient specimen. If in an insufficient specimen there is enough urine to activate the temperature strip, and the specimen is out of temperature range, the collector will initiate the next collection under direct observation.The "shy bladder" procedure also goes into effect if from an earlier collection it was determined that an observed collection must be made and the donor is unable to provide a specimen.If the donor is unable after three hours to provide a specimen, the collector must discontinue the collection and note that no specimen was obtained in the "check" box and in the Remarks section of the CCF. Notation should also be made as to the quantity of specimen that was collected, if any, and amount of fluids the donor was given to drink. The collector must immediately notify the DER. | View Page |
| Shy bladder If no specimen is obtained or an insufficient specimen is obtained at the end of three hours, the control form should be distributed as follows in order to alert the MRO and employer of the problem:The collector must fax or send these copies to the MRO and DER within 24 hours or the next business day. | View Page |
| Accidental Spills If a donor or the collector accidentally spills a specimen before it is sealed, the collector should instruct the donor to provide another specimen. The same CCF may be used. The collector should note in the "Remarks" section that the first specimen was accidentally spilled and the specimen submitted is a second attempt. If the donor can not immediately provide a specimen, follow the procedure outlined in the "Shy Bladder" procedure. | View Page |
| Which of the following organs are normally involved in the production of semen? | View Page |
| The patient was a female and the examination was completed within two hours of collection. Which of the following findings correlate with the presence of a yeast infection of the bladder? | View Page |
| Crystals in Normal Alkaline Urine Crystals found in normal alkaline urine include triple phosphate, ammonium biurate, calcium carbonate, amorphous phosphates, and calcium oxalate. This slide shows an example of triple phosphate crystals. These may appear as four to six sided prisms resembling coffin lids. They indicate either stasis of the bladder or a stale sample. | View Page |
| Schistosoma Haematobium Ova The third parasite which may be seen is the Schistosoma haematobium ovum. This parasite is considered an important factor in the etiology of carcinoma of the bladder. The ova are elongated and are 60 X 160 microns. They are a yellowish color, slightly transparent, and possess a delicate terminal spine. | View Page |