HTEC81A.F06
Fall Quarter 2007
De Anza College
Clinical Urinalysis Lecture
HTEC 81A
Instructor Debbie Wagner, MS, MT(ASCP), CLS
1.50 unit
This is a 12-week course: September 28, 2007 - December 14, 2007
Meeting Time: FRIDAY, 8:30 a.m. - 9:50 a.m.
Course Description: This lecture teaches the student the various properties and constituents of
urine, as well as kidney physiology and body fluid analysis. Emphasis is placed on the
laboratory interpretation of urinalysis test results including microscopic and visual evaluation of
normal and abnormal conditions. The students will be taught to examine urine physically,
chemically, and microscopically and compare clinical values as related to the physiology of the
urinary system in health and disease. Examination of body fluids, i.e. spinal, synovial, serous
fluids (pleural, peritoneal) and semen and amniotic analysis in clinical diagnosis with expected
microscopic findings will be taught. Successful completion of this course (HTEC 81A), HTEC
81, HTEC 82, and HTEC 82A, are required to enroll in Clinical
Hematology/Urinalysis/Coagulation Practicum.
Co-requisite: HTEC 81 (Clinical Urinalysis Lab)
Text: Brunzel, Nancy A. Fundamentals of Urine and Body Fluid Analysis Second Edition.
Philadelphia, PA: Saunders 2004.
Medical Terminology text: Brooks, Myrna LaFleur. Exploring Medical Language, 6th edition
(5th edition is OK too). Copies are available for loan at the Allied Health Resource Center: S82.
Instructor Information:
Office hours:
Friday 12PM-1PM or by appt.
Phone/Voicemail:
408-864-8790
Fax Telephone:
408-864-5444
Office Location:
S75A
E-mail address:
wagnerdebbie@fhda.edu
D.Wagner
HTEC81A.F06
Affective Objectives of De Anza College’s MLT Program:
Listed below are acceptable behaviors, attitudes, and responsibilities for De Anza College MLT
students. These acceptable behaviors may be expanded upon in certain courses or during the
clinical rotation courses. Repeated failures to comply with these professional behaviors will
result in written comments on grade forms, student counseling documented on Student Contact
form that become part of a student’s record.
The professional behaviors and responsibilities of students are:
1. Adapt easily to various situations.
2. Interact cooperatively with other students and instructors.
3. Demonstrate an interest in learning by:
a. attending all lectures, discussions and lab sessions scheduled
b. arriving on time for the beginning of class and when returning from breaks
c. coming prepared for all lectures and labs
d. listening attentively to lectures and lab instructions
e. showing enthusiasm in all activities
4. Ask questions to clarify and aid in understanding.
5. Be self reliant, yet recognize limitations and ask for guidance when necessary.
6. Accept responsibility for own behavior.
7. Admit mistakes and take necessary steps to correct them.
8. Accept instruction and constructive criticism maturely.
9. Be regular and punctual in attendance.
10. Follow appropriate policy for reporting absences.
11. Present a neat, clean appearance.
12. Comply with the stated dress codes.
13. Perform work in student and clinical labs as assigned following lab methods and
procedures as taught.
14. Organize one’s work load around the need to share equipment, reagents and
supplies as necessary.
15. Use all instruments and equipment with care and respect.
16. Clean and maintain instruments, equipment, and microscopes appropriately.
17. Leave the work area clean, orderly, and restocked when work is completed.
18. Follow safety procedures.
19. Submit all assigned work reports by the specified date and time they are due.
Late material will be accepted only at the instructor’s discretion and points may
be deducted as appropriate.
20. Be responsible for all material presented in lectures, handouts, and in the assigned
readings.
21. Take exams on the scheduled date and at the scheduled time unless prior
notification has been given to the instructor and arrangements made.
22. Maintain confidentiality of patient information in accordance with medical
professional ethics.
23. Show appropriate respect for other students, instructors and patients.
24. Is courteous and respectful to patient when obtaining specimens or in
communication with them.
D.Wagner
HTEC81A.F06
HTEC 81A – Clinical Urinalysis I Lecture: Cognitive Objectives
After attending the Clinical Urinalysis lectures, reading the assigned chapters and completing the
homework, the student will:
HTEC 81A – Clinical Urinalysis – Course Introduction:
1. State the number of exams given throughout this course and the required % score
needed to pass this class
2. Locate in the course syllabus the “important dates to note” section
Introduction to Urinalysis:
1. List the three major organic and three major inorganic chemical constituents of urine.
2. Recognize normal an abnormal daily urine volumes.
3. Correlate the type of urine specimen (random, first morning, fasting, 2 hr
postprandial, 24 hr, catheterized, midstream clean catch, suprapubic aspiration and
three-glass collection with their testing purpose.
4. Describe the requirements for urine containers used for urinalysis specimen
collection.
5. Describe the correct methodology for labeling urine specimens.
6. Predict observed changes and mechanism of change in improperly stored urine
specimens (urines that remain at room temperature for more than 2 hours).
7. Correlate the preferred type of urine specimen with its testing purpose.
7. Given urinalysis results, differentiate between diabetes mellitus and diabetes insipidus
Quality Assurance and Quality Control
1. List the information that must be included for each procedure in a clinical laboratory
procedure manual.
2. Match quality control/quality assurance acronyms with their definitions.
3. Categorize clinical laboratory factors as preanalytical, analytical or post-analytical.
4. Outline the 7 main areas of laboratory testing affected by CLIA ’88 stipulations or
regulations.
5. Discuss the importance of continuous quality improvement (CQI) and total quality
management (TQM) including the recommendations of the Joint Commission on
Accreditation of Healthcare Organizations
Renal Anatomy and Physiology
1. Identify the components of the nephron, kidney and excretory system.
2. Diagram the formation of urine by tracing its formation through the kidney.
3. Compare and contrast major physiologic functions the kidney employs during urine
formation.
4. Identify the laboratory procedures used to evaluate glomerular filtration, tubular
reabsorption and secretion and renal blood flow.
5. Discuss the advantages and disadvantages is using urea, insulin, creatinine, beta
microglobulin, and radionucleotides to measure glomerular filtration.
D.Wagner
HTEC81A.F06
6. Given laboratory data, calculate a creatinine clearance and determine if the result is
within the normal range.
Renal Diseases
1. Differentiate among renal diseases of glomerular, tubular, interstitial, and vascular
origin.
2. Describe the process by which immunologic damage is produced to the
glomerular membrane.
3. For each disease discussed in lecture, correlate the clinical course and significant
laboratory results.
4. Given characteristic clinical symptoms, etiology and urinalysis findings, correctly
diagnose the renal disease.
Urine Screening for Metabolic Disorders
1. Explain the abnormal accumulation of metabolites in the urine in terms of
overflow and renal disorders.
2. Summarize each disease discussed in lecture including distinguishing
characteristics, clinical manifestations, laboratory findings, pathology and
treatment.
3. Given laboratory results, interpret the Guthrie Bacterial Inhibition test.
4. Given a set of laboratory data and patient history, correctly diagnose the
metabolic disorder.
Body Fluids:
1. State the three major functions of cerebrospinal fluid (CSF)
2. Differentiate between CSF specimens caused by intracranial hemorrhage and a
traumatic tap.
3. Given fasting plasma glucose level of a specimen, calculate the expected fasting
CSF glucose level.
4. Evaluate presented CSF leukocyte content to correctly diagnose a suspected case
of bacterial, viral, tubercular and fungal meningitis.
5. Describe the normal appearance of semen and three abnormalities in appearance.
6. Describe the appearance of normal sperm, including structures and their
functions.
7. Describe the formation and function of synovial fluid
8. Relate laboratory test results to the four common classifications of joint disorders
9. Given synovial fluid crystal results, correctly diagnose gout or pseudogout.
10. Describe the normal formation of serous fluid.
11. Differentiate between a transudate and an exudate, including etiology,
appearance, and laboratory tests.
12. Given the type of WBC’s seen in pleural fluid, predict the clinical significance of
such findings.
D.Wagner
HTEC81A.F06
13. Given laboratory testing results in peritoneal fluid, predict the clinical
significance of such findings.
14. State the function of amniotic fluid.
15. Describe the specimen handling and processing procedures for testing of amniotic
fluid for bilirubin, fetal lung maturity (FLM), and Cytogenetic analysis.
16. Given L/S results of amniotic fluid, predict the clinical significance of such
findings.
17. State the clinical significance of a black, red or green stool.
18. Given laboratory fecal findings, correlate these results with disease states.
19. Instruct a patient in the proper collection of specimens for occult blood, including
providing and explanation of dietary restrictions.
20. Explain the principle of the guiac test for occult blood and the reasons that guiac
is the reagent of choice.
Automation:
1. Name the basic functions of “strip readers”
2. Compare and contrast features, benefits and methodologies of instrumentation
used in clinical urinalysis testing including semiautomated, automated, automated
microscopy and workstations.
D.Wagner
HTEC81A.F06
Student Responsibilities:
 Be prepared to spend 5-7 hours per week using and studying course material.
 Attend all classes.
 Complete all reading assignments.
 Complete all lecture homework assignments.

Participate in online assignments.
 Successfully complete quizzes, tests, and exams including the final exam
Attendance:
 Attendance in this course is mandatory. The ability to make-up a missed lecture
session is up to the discretion of the instructor and will be dealt with on an individual
basis. The student must initiate make-up sessions.
 Any unexcused absence results in an automatic drop from the course. Student will
also be dropped from HTEC 81 (Clinical Urinalysis Laboratory).
Grades:
Midterm
Cumulative Final
Quizzes
Student Project
Total
100 points
250 points
100 points
50 points
500 points
Student Project: This will be a critical thinking exercise on a research paper or in-depth case study presented to the
class and evaluated for detailed review, analysis and presentation.
90 - 100%
80 - 89%
75 - 79%
65 - 74%
64% and below
D.Wagner
A
B
C
D
F
HTEC81A.F06
Dates to note:
Oct. 5, 2007– last day to drop for a refund
Oct 12, 2007– last day to drop with no grade record (No Refund)
Nov 16, 2007 – last day to drop with a “Withdraw”
Dec 14, 2007 – Final exam
Student Accountability: “There is a zero tolerance policy for any cheating, plagiarism, or behavior
that would lead a reasonable person to assume that these actions have taken place. Anyone observing
such behavior should report it to a faculty member at once. Anyone found by a faculty member to have
committed plagiarism or to have cheated (or given the appearance of having done either), will be
dropped from the course and given an F by the faculty member.”
“BHS Division Student Handbook, De Anza College, p.6
You may access your final grades through the Star System (408-777-9394 or 650-917-0509) or via the
Internet at:( http://www.deanza.fhda.edu/DA_grades.shtml).
Medical Terminology Course Work:
Reading: Chapter 1
This will be an independent study assignment. Tests are to be taken in the Allied Health
Resource Center (S-82). Points will be included as part of the final exam.
D.Wagner
HTEC81A.F06
Class Schedule
HTEC 81A Clinical Urinalysis Lecture
Good General Website: wikipedia
No Class on November 9th and November 23rd.
Case Studies
Lecture
Session
1
Course Introduction
9/28/07 Introduction to Urinalysis – QC/QA
Reading Assignment
Chapter 2: Quality Assurance &
Safety
Chapter 3: Urine Specimen Types,
Collection, and Preservation
2
3
10/5/07 The Kidney, Anatomy & Physiology
10/12/07 Renal Function
Chapter 4: The Kidney
Chapter5 : Renal Function
4
5
6
7
8
9
10
Date
Topic
Exam I
10/19/07 Renal Disease
Review of Exam I
10/26/07 Metabolic Disease
Fecal Analysis & Seminal Fluid
11/2/07 Analysis
CSF, Amniotic, Synovial, Pleural,
11/16/07 Pericardial & Peritoneal
11/30/07 Student Project Presentations
Project Presentations (cont’)
Automation in Urinalysis
12/7/07 Review
12/14/07 Final Exam (Cumulative)
D.Wagner
Online Reading assignment
Case Study 2-1, pg 40
www.labtestsonline.org
 Urinalysis
www.medtraining.org
 Urinalysis (Intro & Kidney
Structure & Formation
www.howstuffworks.com/kidney
Case Study 5-1 & 5-2
www.msud-support.org
 Introduction
 Overview
www.labtestsonline.org
Kidney Disorders/Diseases
Chapter 9:pgs. 243-262
Case Studies 9-1 – 9-6
Chapters 9: pgs. 263-270
Case Study 10-1, 11-1
Chapter 10 & 11
Chapter 12,13, 14, 15
Case Study 12-1, 131&2, 14-1, 15-1
http://www.ericblumrich.com/
portfolio/bayer.html