02 - renal fx (urinalysis)

Question 1

(colors!)

1. red/brown = ?
2. dark brown/black = ?
3. green = ?

Answer 1

1. RBC, hemoglobin, myoglobin
2. conversion of hemoglobin to methemoglobin
3. pseudomonas infection or oxidation of bilirubin to biliverdin

Question 2

(appearance)

1. usually clear but cloudy 20% of time
2. what causes cloudiness?
3. which animal has typically cloudy urine?

Answer 2

2. ^ cells, crystals, mucus, casts
3. horse (cause of mucus)

Question 3

(USG)

1. dipstrip good? what better?

Answer 3

1. no; refractometry

Question 4

(pH)

1. carnivores have acidic urine, herbivores have basic
2. what causes acidic?
3. what causes basic?

Answer 4

2. meat, acidosis, paradoxical aciduria in metabolic alkalosis w/ potassium and chloride depletion
3. plants, UTI by urease organisms, alkalosis

Question 5

(protein)

1. trace to 1+ protein normal in high USG
2. dipstick more sens to albumin or globulins?
3. proteinuria can be caused by what 5 things?
4. persistent moderate or heavy proteinuria is absence of sediment abnormalities suggests what?
5. active sediment with mild/mod proteinuria suggests what?

Answer 5

2. albumins
3. ^ GFR filtration of protein, failure of tubular reabsorption, tubular secretion of protein, leakage from damaged tubular cells, renal parenchymal inflammation
4. glomerular dz
5. inflammatory renal dz or LUT disease

Question 6

(glucose)

1. normally present in dog/cat urine?
2. most common cause of presence?
3. possible cause in cat?

Answer 6

1. no
2. DM (180 in dog, 300 in cat)
3. stress or excitement

Question 7

(ketones)

1. not normally present
2. what can lead to ketone production?
3. most common cause?
4. other causes?

Answer 7

2. inadequate consumption/utilization of carbs
3. diabetic ketoacidosis
4. starvation, glycogen storage dz, low carb high fat diet, persistent hypoglycemia (↓ insulin -> ketone formation)

Question 8

(bilirubin)

1. small amounts can be normal in cat or dog?
2. causes?

Answer 8

1. dog
2. hemolysis, liver dz, extrahepatic biliary obstruction, fever, starvation

Question 9

(blood)

1. dipsticks don’t diff intact RBC’s from hemoglobin
2. name 4 causes of hemolysis

Answer 9

2. transfusion rxn, IMHA, DIC, zinc tox

Question 10

(sediment - RBCs)

1. occasional normal
2. name 6 causes?

Answer 10

2. trauma, urolithiasis, neoplasia, UTI, FLUTD, kidney stuff

Question 11

(sediment - WBC)

1. occasional are normal
2. excessive (pyuria) indicates what?
3. clumped WBCs are typically due to what?

Answer 11

2. inflam somewhere in UT or contamination from genital tract
3. infectious organisms

Question 12

(sedmiment - epi cells)

1. squamous -> common in voided or catheterized samples
2. Transitional epi cells -> small # normal, ^ when?
3. renal epi

normal? indicates?

Answer 12

2. infection, irritation, neoplasia (rafts)
3. never; ischemic/toxic/degen renal dz

Question 13

(Casts)

1. hyaline?

Answer 13

1. pure protein, low signif

Question 14

(casts - cellular)

1. white cell casts suggest what?
2. red cell casts
3. what are hemoglobin casts?
4. renal epi casts occur when? suggest what?

Answer 14

1. pyelonephritis (other kidney infection)
2. rarely found; acute gn, renal trauma
3. casts where hemoglobin color is retained
4. severe tubular injury, acute tubular necrosis or pyelonephritis

Question 15

(casts - granular)

1. represent what?
2. what type of granular cast may be seen in nephrotic syndrome or DM?

Answer 15

1. the degeneration of cells or precipitation of filtered plasma proteins
2. fatty casts

Question 16

(casts - waxy casts)

1. represent what?

Answer 16

1. final stage of degeneration of granular casts -> suggest chornic intrarenal stasis

Question 17

(organisms)

1. normal urine is sterile
2. bacteria w/pyuria suggests UTI
3. the absence of bacteria doesn’t rule out UTI
4. yeast an fungal hyphae are usually contaminants

Question 18

(sediment - crystals)

1. often an artifact of storage/refridgeration
2. alkaline: struvite, calcium phosphate/carbonate, phosphate, ammonium biurate
3. calcium oxalate, cystine in acidic
4. what crystals assoc w/ dalmations?
5. what crystals assoc w/ liver dz and shunt

Answer 18

4. uric acid
5. urate crystals