1 Flashcards
Microalbumin
Used to evaluate kidney damage
Indicates kidneys leaking protein
Common in diabetic patients and HTN
Components of urinalysis
– specific gravity, glucose, blood, protein, nitrites, pH, ketones, leuk estrace
Nitrites
produced as bacteria replicate in urinary tract. However negative nitrites do not rule out infection
XRay
Evaluates solid structures
Does NOT evaluate soft structures such as tendons and ligaments
CT scan is advanced x-ray; mammogram
MRI
Noninvasive diagnostic scanning. No radiation exposure
Metal implants, pins for reductions, pacemaker, aneurysm clips are disqualifying
Used for central nervous system, neck and back, bones and joints, heart, and breasts
Evaluates softer structures such as tendons and ligaments
Pulmonary Function Tests
Evaluate lungs and pulmonary reserve
Evaluation response of bronchodilator therapy
Differentiate between restrictive and obstructive forms of COPD
Chloride, blood
- Does not provide much information alone
- Can help identify acid-case imbalance and hydration when used in combination with other electrolytes
Creatinine
- Diagnoses impaired renal function
- Used to estimate GFR
- Can become elevated with use of ACEI, aminoglycosides, certain chemotherapy agents, NSAIDs
Creatinine clearance
- Used to measure GFR of kidney
- CrCl not affected if only 1 functioning kidney
- Decreases with age
Estimated GFR
- Used to determine stage of kidney disease
- Utilizes creatinine, age, gender, and body size to calculate
- eGFR <60 for 3 months or more indicates chronic kidney disease
Prostate-specific antigen (PSA)
-Screening method for prostate cancer
-PSA elevated in cancer, infection, BPH
– UTI and prostatitis can cause elevations for up to 6 weeks
- Secreted in ALL males
Sodium, blood
- Monitor fluid and electrolytes
- Part of BMP/CMP
-Increased sodium due to:
increased sodium intake
Cushing syndrome
Excessive free water loss
-Decreased sodium due to:
Addisons, hypoaldosteronism. GI loss, excessive sweating, overhydration, burns, DI, renal insufficiency, diuretic
BUN
-rough measurement of renal function and GFR
- Dietary protein can affect BUN
- Almost all renal diseases cause inadequate excretion of urea
- can be affected by hepatic function
Uric Acid
- Diagnose gout and monitor treatment
- Gout is common metabolic disorder caused by chronic hyperuricemia
- Can be used to evaluate kidney stones
- Uric acid is excreted primarily by the kidney and a lesser amount by the intestinal tract
Urodynamic Studies (Manometric)
- Used to identify problems with bladder function
- Includes urine flow studies, post-void residual, and cystometrogram
- Performed in combination with cystoscopy
Chloride, urine
- electrolyte or acid-base imbalance
- 24 hour urine
Substance abuse testing
- Metabolites of illegal drugs
- used for drug screens in pre-employment, narcotic agreements
Toxicology
- Drugs of abuse, overdose, poisoning
- Often used in emergency department when clearing patient for psych delegate
Osmolality
- Fluid and electrolyte imbalance
- Used to evaluate diabetes insipidus and SIADH
Potassium, Urine
- Major cation of the cell
- Acid-base balance, electrolytes
- Renal and adrenal disease
Sodium, Urine
- Evaluate fluid and electrolyte imbalances
- Monitor sodium therapy
- Volume depletion, acute renal failure, adrenal disturbances
Uric Acid (urine)
-Useful for assessing uric acid metabolism in gout and renal calculi
Urinalysis
- Kidney function and metabolic processes
- UTI – leuk estrace, nitrates
- Kidney stone – blood, proteinuria
- Diabetes - glucosuria
Urine Stones
- Identify composition of kidney stones
- Calcium oxalate and calcium phosphate make up most stones
- Stones <5mm generally will pass; stones >7mm almost always require intervention to pass