2: Renal Diagnostics

Question 1

What can cause ketonuria (4)?

Answer 1

Stress
Sickness
Dehydration
Diabetic ketoacidosis

Question 2

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.

Answer 2

greater

less

Question 3

Where do casts form?

Answer 3

Distal convoluted tubule and collecting ducts of nephrons

Question 4

Cast formed during extremely low urine flow states (renal failure).

Answer 4

Waxy cast

Question 5

Fine or course cast that is usually indicative of CKD but can be seen after intense exercise.

Answer 5

Granular cast

Question 6

When the body burns through its own sugars _____ are present in the urine.

Answer 6

ketones

Question 7

Normal urine pH.

Answer 7

5-8

Most accurately measured by pH meter, but many rely on dipstick.

Question 8

Murkiness is an example of very _____ urine.

Answer 8

Murkiness is an example of very turbid urine.

Question 9

What sediment might you find in urine that is abnormal?

Answer 9

Casts

Crystals

Question 10

_____ casts are always pathologic.

Answer 10

RBC

Question 11

Normal urine epithelial cells.

Answer 11

<10

Question 12

Cast caused by dehydration or vigorous exercise.

Answer 12

Hyaline cast (most common)

Question 13

T/F UA specific gravity can be affected by elements such as protein and glucose.

Answer 13

True

Question 14

Epithelial casts are usually seen in _____ and _____.

Answer 14

Acute tubular necrosis

Ingestion of nephrotoxic drugs

Question 15

Cast associated with high urinary protein nephrotic syndrome.

Answer 15

Fatty cast

Question 16

Kidneys may excrete glucose in periods of _____ or _____.

Answer 16

stress

fever

Question 17

Cast indicative of infection/inflammation.

Answer 17

WBC cast

Question 18

Glucosuria can indicate _____ and _____.

Answer 18

kidney issues

diabetes

Question 19

WBC casts are most commonly seen in _____.

Answer 19

pyelonephritis

Question 20

What is the gold standard for screening for renal problems and UTI?

Answer 20

Spun urine (not dipstick). In reality, you will see the dipstick overused.

Question 21

_____ should always be interpreted in consideration of specific gravity.

Answer 21

Protein

Question 22

WBCs >10 could indicate what (5)?

Answer 22

UTI
Sterile pyuria
Kawasaki's
Urolithiasis
Contamination

Question 23

When are pigment casts seen (3)?

Answer 23

Hemolytic anemia
Rhabdomyolysis (Statins!)
Drug pigments

Question 24

Cylindrical structures produced by the kidney that are present in the urine in certain disease states.

Answer 24

Casts

Question 25

Normal urine specific gravity.

Answer 25

1. 003-1.030

1. 005-1.025 more standard

Question 26

Normal urine RBCs.

Answer 26

<5

Shape is also important.

Question 27

Cast strongly indicative of glomerular damage.

Answer 27

RBC cast

Question 28

UA pH can be falsely _____ if specimen is not fresh.

Answer 28

alkaline

Question 29

Causes of RBC casts (3).

Answer 29

Glomerulonephritis (Goodpasture’s syndrome after strep)
SLE
Vasculitis

Question 30

Casts named for discoloration.

Answer 30

Pigment casts