Random Routine screening First morning Routine screening, Pregnancy tests, Orthostatic protein Fasting (Second morning) Diabetic screening/monitoring 2-hour postprandial Diabetic monitoring Glucose tolerance test Optional with blood samples in GTT 24-h (or timed) Quantitative chemical tests Catheterized Bacterial culture Midstream clean-catch Routine screening/ Bacterial culture Suprapubic aspiration Bladder urine for bacterial culture and cytology Random Urine Specimen most commonly received Ease of collection Convenience for the patient may be collected at any time and without prior patient preparation useful for routine screening test affected by dietary intake or physical activity, or excessive fluid intake Random Clean Catch Urine ideal for cytology studies w/ prior hydration instruct: 24-32 oz of water each hour for 2 hours Cytologic protocols: for 3-5 consecutive days First morning urine/ 8-hour specimen ideal screening specimen concentrated specimen ideal to test subs. that require concentration or incubation for detection prevents false-negative pregnancy tests evaluating orthostatic proteinuria Instructions: the patient voids before going to bed Immediately on rising: collect urine specimen Delivered and tested within 2 hours Fasting (Second Morning) Urine double-voided urine Instructions: The first morning specimen is discarded (first void) Urine is collected after half an hour without eating anything (second void) will not contain any metabolites from food ingested before the beginning of the fasting period 2-hr postprandial urine Instructions: Empty the bladder Consume a routine meal: 100 g carbohydrates 2 hours after meal completion: collect urine specimen Ideally: a blood sample should also be drawn Glucose tolerance urine specimen collected to correspond with the blood samples drawn during a GTT fasting, half-hour after ingestion, 1-hour, 2-hour, 3-hour, 4-hour, 5-hour, 6-hour tested for glucose and ketones results are interpreted along with the blood test results aid in interpreting the ability to metabolize a measured amount of glucose correlated with the renal threshold for glucose 24-hr (timed) urine produce accurate quantitative results many solutes exhibit diurnal variations E.g. catecholamines, 17-hydroxysteroids, and electrolytes lowest concentration: early morning highest concentration: afternoon 24-hr urine Instructions: Day 1: 7 am: Patient voids and discards specimen, collects all urine for the next 24hours Day 2: 7 am: Patient voids and add urine to the previously collected urine 24-hr urine Urea Nitrogen by-product of protein metabolism indicator of kidney function Urine electrolytes Ca, Cl, K, Na part of clinical work-up for suspected endocrine disorders or hormonal imbalances or kidney dysfunction Urine Ca: recurring kidney stone formation 17-hydroxysteroids suspicion of Addisons disease 24-hr urine Catecholamines Breakdown products: Homovanillic acid (HVA), Vanillylmandelic acid (VMA), normetanephrine, and metanephrine adrenal gland tumor (pheochromocytoma) is suspected symptomatic hypertension Urine total protein indicator of kidney damage 5-hydroxyindoleacetic acid (5-HIAA) carcinoid tumor of the digestive tract metabolite of serotonin 24-hr urine Urine creatinine breakdown product of creatine phosphate cleared from the body exclusively by the kidneys to screen for kidney dysfunction creatinine clearance test Catheterized urine urine is collected by inserting a hollow tube (catheter) through the urethra into the bladder bacterial culture UTIs are common in catheterized patients Catheter threaded up the urethra, through the bladder and into each ureter to determine: one or both of the kidneys are involved in the disease process Suprapubic aspirate puncturing of the abdominal wall and the distended bladder needle and syringe principally for bacterial cultures under normal conditions: bladder is sterile completely free of extraneous contamination anaerobic microbes infants specimen contamination is often unavoidable Mid-stream clean catch urine Routine UA and Urine culture Instructions: Cleanse the urethral opening and surrounding area with soap and water Void into the toilet and continue to void, but interrupt the urine stream Collect at least 30mL into a clean, dry, sterile, and leak-proof container Finish voiding into the toilet Label the specimen container with the following information: Patients name, age, gender Type of specimen Date and time of collection