2: Renal Diagnostics Flashcards
What can cause ketonuria (4)?
Stress
Sickness
Dehydration
Diabetic ketoacidosis
Protein readings that are elevated in the presence of specific gravity _____ than 1.015 are concerning. Protein readings that are elevated in the presence of specific gravity _____ than 1.015 need to be checked again.
greater
less
Where do casts form?
Distal convoluted tubule and collecting ducts of nephrons
Cast formed during extremely low urine flow states (renal failure).
Waxy cast
Fine or course cast that is usually indicative of CKD but can be seen after intense exercise.
Granular cast
When the body burns through its own sugars _____ are present in the urine.
ketones
Normal urine pH.
5-8
Most accurately measured by pH meter, but many rely on dipstick.
Murkiness is an example of very _____ urine.
Murkiness is an example of very turbid urine.
What sediment might you find in urine that is abnormal?
Casts
Crystals
_____ casts are always pathologic.
RBC
Normal urine epithelial cells.
<10
Cast caused by dehydration or vigorous exercise.
Hyaline cast (most common)
T/F UA specific gravity can be affected by elements such as protein and glucose.
True
Epithelial casts are usually seen in _____ and _____.
Acute tubular necrosis
Ingestion of nephrotoxic drugs
Cast associated with high urinary protein nephrotic syndrome.
Fatty cast
Kidneys may excrete glucose in periods of _____ or _____.
stress
fever
Cast indicative of infection/inflammation.
WBC cast
Glucosuria can indicate _____ and _____.
kidney issues
diabetes
WBC casts are most commonly seen in _____.
pyelonephritis
What is the gold standard for screening for renal problems and UTI?
Spun urine (not dipstick). In reality, you will see the dipstick overused.
_____ should always be interpreted in consideration of specific gravity.
Protein
WBCs >10 could indicate what (5)?
UTI Sterile pyuria Kawasaki's Urolithiasis Contamination
When are pigment casts seen (3)?
Hemolytic anemia
Rhabdomyolysis (Statins!)
Drug pigments
Cylindrical structures produced by the kidney that are present in the urine in certain disease states.
Casts
Normal urine specific gravity.
- 003-1.030
1. 005-1.025 more standard
Normal urine RBCs.
<5
Shape is also important.
Cast strongly indicative of glomerular damage.
RBC cast
UA pH can be falsely _____ if specimen is not fresh.
alkaline
Causes of RBC casts (3).
Glomerulonephritis (Goodpasture’s syndrome after strep)
SLE
Vasculitis
Casts named for discoloration.
Pigment casts
