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Bladder Information and Courses from MediaLab, Inc.

These are the MediaLab courses that cover Bladder and links to relevant pages within the course.

Learn more about laboratory continuing education for medical technologists to earn CE credit for AMT, ASCP, NCA, and state license renewal and recertification. Or get information about laboratory safety and compliance courses that deliver cost-effective OSHA safety training and continuing education to your laboratory's employees.



Basic Tissue Orientation and Paraffin Embedding Technique
On all of the following specimens, the histologist is given the embedding orientation instructions to "embed on edge." For which specimen is this orientation NOT appropriate?View Page

Chemical Screening of Urine by Reagent Strip
Urine Analysis for Nitrites

The nitrites portion of the chemical reagent strip provides a rapid screening test for the presence of gram-negative bacteria that are often responsible for urinary tract infections. Urine cultures are still needed to confirm the diagnosis and monitor any urinary tract or kidney infection. 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.

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Nitrites and Bladder Infections

Bladder infections are usually caused by gram-negative bacteria. These bacteria reduce nitrates to nitrites when urine remains in the bladder three to four hours. 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.

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False Positive and Negative Results

False Positives:A false positive nitrite test result may occur when a urine specimen has remained at room temperature for an extended period of time, allowing bacterial contaminants to multiply and produce measurable levels of nitrites. Interference from some medications that cause the urine to become red or orange may lead to an incorrect reading of positive for nitrite. False Negatives:False negative results may occur in urine specimens that did not remain in the bladder for the sufficient length of time needed 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 a 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.

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Clinical Significance of Nitrites in Urine

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.

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Nitrates in urine are reduce to nitrites by:View Page
The nitrite portion of the test strip can be used to: (Choose ALL correct answers)View Page

Chemical Screening of Urine by Reagent Strip (retired March 2012)
A patient suspected of a urinary tract infection has a negative nitrite test, but bacteria is present upon microscopic examination. What may have caused this discrepant 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.

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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.

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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.

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Match the following:View Page
The nitrite portion of the test strip can be used to: (Choose ALL of the correct answers)View Page

Chemistry / Urinalysis Question Bank - Review Mode (no CE)
Bacterial contamination of a urine specimen from a normal healthy individual could originate from all of the following except:View Page

Department of Transportation (DOT) Federally Regulated Urine Specimen Collection Training
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.

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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.

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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.

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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.

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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.

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General Laboratory Question Bank - Review Mode (no CE)
What is the primary functional unit of the kidney :View Page

Histology Special Stains: Carbohydrates
PAS: Diagnostic Applications

The PAS staining procedure is most commonly used in the clinical histology laboratory to demonstrate glycogen deposits in the liver. Glycogen granules may also be visible in tumors of the bladder, kidney, ovary, pancreas, and lung. Basement membranes, which are present in various tissues in the body, may also be visualized through the PAS staining procedure. Several disorders can be identified through the demonstration of abnormal basement membranes. The PAS staining procedure can also demonstrate fungi in tissue samples due to the high carbohydrate content of the organisms cellular walls. Neutral mucins in the gastrointestinal tract and some epithelial mucins will also give a PAS-positive staining reaction.

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Parasitology Question Bank - Review Mode (no CE)
The adult worms of which of the following parasites reside in human intestine?View Page

Semen Analysis
Which of the following organs are normally involved in the production of semen?View Page

The Urine Microscopic: Microscopic Analysis of Urine Sediment
Which of the following findings may correlate with the presence of a yeast infection?View Page
Crystals in Normal Alkaline Urine

Crystals found in normal alkaline urine include triple phosphate, ammonium biurate, calcium carbonate, and amorphous phosphates. 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.

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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.

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