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MTAP 1 > AUBF > Flashcards

AUBF Flashcards

1
Q

What is urine?

A

A liquid tissue biopsy of the urinary tract containing waste products excreted by the kidneys

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2
Q

What percentage of urine is composed of water?

A

Approximately 95%

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3
Q

What is the major inorganic component of urine?

A

Chloride

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4
Q

List other inorganic components of urine.

A
  • Sodium
  • Potassium
  • Sulfate
  • Phosphate
  • Ammonium
  • Magnesium
  • Calcium
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5
Q

What is the major organic component of urine?

A

Urea

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6
Q

List other organic components found in urine.

A
  • Creatinine
  • Uric acid
  • Hippuric acid
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7
Q

What is the normal daily urine excretion volume?

A

Approximately 0.6-2 liters (or 0.5-1.8L)

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8
Q

What does polyuria refer to?

A

Increased urine output

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9
Q

What does oliguria refer to?

A

Decreased urine output

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10
Q

What does anuria refer to?

A

Complete cessation of urine flow

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11
Q

What does dysuria refer to?

A

Painful urination

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12
Q

What does nocturia refer to?

A

Increased excretion of urine at night

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13
Q

What is the normal day to night urine ratio?

A

2:1 to 3:1

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14
Q

Describe the appearance of normal urine.

A

Clear, with color ranging from straw (pale yellow) to amber

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15
Q

What causes the yellow color of urine?

A

Presence of the pigment urochrome

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16
Q

When is urochrome excretion increased?

A

During fever, thyrotoxicosis, and starvation

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17
Q

What pigment can cause pink coloration in urine?

A

Uroerythrin

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18
Q

What is urobilinogen?

A

An oxidation product of the normal urinary constituent that imparts an orange-brown color to non-fresh urine

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19
Q

What does urine color indicate?

A

Hydration level and urine concentration

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20
Q

What color of urine is associated with lead porphyrinuria?

A

Yellow

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21
Q

What causes red-orange urine in patients undergoing tuberculosis treatment?

A

Intake of Rifampin

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22
Q

What color is associated with very dilute urine?

A

Colorless

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23
Q

What could cause very dilute urine?

A

Recent fluid consumption, polyuria (DI or DM)

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24
Q

What is indicated by a concentrated urine specimen?

A

Excess urobilin

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25
Q

What substances can lead to yellow-orange urine?

A
  • Bilirubin
  • Acriflavine
  • Phenazopyridine (Pyridium)
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26
Q

What causes green or blue-green urine?

A

Bilirubin oxidized to biliverdin

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27
Q

What infections can cause colored urine?

A

Pseudomonas infection

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28
Q

What substances can lead to reddish urine?

A
  • RBCs
  • Hemoglobin
  • Myoglobin
  • Porphyrins
  • Beets
  • Rifampin
  • Menstrual contamination
  • Fuscin
  • Aniline dye
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29
Q

What might cause brown or black urine?

A
  • Methemoglobin
  • Homogentisic acid
  • Melanin or melanogen
  • Phenol derivatives
  • Argyrols
  • Methyldopa or Levodopa
  • Metronidazole
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30
Q

What is the recommended time frame for testing urine specimens after collection?

A

Within 2 hours

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31
Q

What happens to the color of unpreserved urine?

A

Darkened

Due to modified oxidation or reduction of metabolites.

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32
Q

How does the clarity of unpreserved urine change?

A

Decreased

This is often due to bacterial growth and precipitation of amorphous material.

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33
Q

What is the change in odor of unpreserved urine?

A

Increased

Caused by bacterial multiplication and breakdown of urea into ammonia.

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34
Q

What is the typical change in pH for unpreserved urine?

A

Increased

Resulting from the breakdown of urea into ammonia by urease-producing bacteria.

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35
Q

What happens to glucose levels in unpreserved urine?

A

Decreased

Due to conversion to acids and alcohols by bacteria and yeast.

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36
Q

What is the change in ketones in unpreserved urine?

A

Decreased

Caused by glycolysis and bacterial usage.

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37
Q

How does bilirubin change in unpreserved urine?

A

Decreased

Due to decreased exposure to light and photo-oxidation to biliverdin.

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38
Q

What happens to urobilinogen levels in unpreserved urine?

A

Decreased

Resulting from volatilization and bacterial metabolism.

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39
Q

What is the change in nitrite levels in unpreserved urine?

A

Increased

Multiplication of nitrate-reducing bacteria leads to this increase.

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40
Q

What is the effect on RBCs, WBCs, and casts in unpreserved urine?

A

Positive

This indicates disintegration in dilute and alkaline urine.

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41
Q

What happens to trichomonas if unpreserved for a longer period?

A

Decreased

Loss of motility and death occur over time.

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42
Q

What is the effect of bacterial growth on urine clarity?

A

Decreased

Caused by the precipitation of amorphous material.

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43
Q

Fill in the blank: The _______ of unpreserved urine increases due to bacterial breakdown of urea.

A

pH

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44
Q

True or False: The odor of unpreserved urine typically decreases.

A

False

The odor increases due to ammonia production.

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45
Q

What is the normal range for renal plasma flow in ml/min?

A

600-700 ml/min

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46
Q

What is the renal blood flow rate for a normal adult in L/min?

A

1.2 L/min

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47
Q

What percentage of cardiac output do the kidneys receive?

A

Approximately 20-25%

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48
Q

What are the three mechanisms involved in urine formation?

A
  1. Renal blood flow
  2. Glomerular filtration
  3. Tubular reabsorption & secretion
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49
Q

What is the functional unit of the kidney?

A

Nephrons

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50
Q

Which components make up the renal/excretory system?

A
  • Kidneys
  • Ureters
  • Urinary bladder
  • Urethra
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51
Q

What are the arterioles formed from the renal artery that carry blood towards the nephrons called?

A

Afferent arterioles

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52
Q

What is the filtering apparatus of the nephrons known as?

A

Glomerulus

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53
Q

What is the pH of urine formation in the nephrons?

A

7.4

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54
Q

What is the osmolality of urine compared to plasma?

A

Similar to plasma

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55
Q

Which parts of the renal tubules are responsible for concentrating and diluting urine?

A

PCT, LH, DCT, and CD

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56
Q

Where does the majority of reabsorption (65-80%) occur in the nephron?

A

Proximal Convoluted Tubule (PCT)

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57
Q

What substances are primarily reabsorbed in the Proximal Convoluted Tubule (PCT)?

A
  • Water
  • Amino acids
  • Glucose
  • Electrolytes
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58
Q

What is the role of Antidiuretic Hormone (ADH) in the nephron?

A

Promotes water reabsorption

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59
Q

Which part of the nephron is permeable to water but impermeable to salt?

A

Descending Limb of the Loop of Henle (DLH)

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60
Q

Which part of the nephron is permeable to salt but impermeable to water?

A

Ascending Limb of the Loop of Henle (ALH)

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61
Q

Fill in the blank: The renal tubules include the ______, Loop of Henle, Distal Convoluted Tubule, and Collecting Duct.

A

Proximal Convoluted Tubule (PCT)

62
Q

What is the mechanism of the Loop of Henle?

A

Countercurrent mechanism

63
Q

True or False: The Distal Convoluted Tubule (DCT) is primarily involved in reabsorbing glucose.

64
Q

What is the term for the fluid that is filtered through the glomerulus?

65
Q

What are the primary wastes removed from the body during urine formation?

A
  • Nitrogenous wastes
  • Toxins
66
Q

Fill in the blank: The _______ is the part of the nephron that aids in the reabsorption of electrolytes.

A

Distal Convoluted Tubule (DCT)

67
Q

What size of particles are allowed to pass through the glomerulus?

A

<70 kilo daltons

68
Q

Fill in the blank: The glomerulus is _______-charged.

A

Negatively

69
Q

In which part of the nephron does casts form?

A

DCT & Collecting Duct

70
Q

How are protein charges described?

A

Amphoteric; can be positive or negative

71
Q

How does blood pH affect the protein charge?

A

Low pH = positive
High pH = negative

72
Q

True or false: Protein charge is normally negative

73
Q

What is the Urea Clearance Test used for?

A

It is a test that was used to assess glomerular filtration but is no longer used due to dietary effects and 40% reabsorption in tubules.

Urea clearance is affected by protein intake and other dietary factors.

74
Q

What is the gold standard for assessing glomerular filtration rate (GFR)?

A

Inulin Clearance Test

The Inulin Clearance Test measures a substance filtered by the glomerulus that is neither reabsorbed nor secreted by the tubules.

75
Q

What substance is used in the Inulin Clearance Test?

A

Inulin, a polymer of fructose.

Inulin is an exogenous substance that helps measure GFR effectively.

76
Q

Which clearance test is most commonly used to assess GFR?

A

Creatinine Clearance Test

Creatinine clearance is favored due to the almost complete filtration and lack of reabsorption of creatinine.

77
Q

What type of specimen is needed for the Creatinine Clearance Test?

A

24-hour urine and serum/plasma.

This dual specimen collection allows for accurate GFR assessment.

78
Q

How is Creatinine Clearance calculated?

A

Using the formula: urine creatinine x urine volume in mL per min / plasma creatinine.

This formula provides a measure of kidney function based on creatinine levels.

79
Q

What is the urine volume collected over 24 hours in the sample provided?

A

2,880 mL

This volume is necessary for calculating creatinine clearance.

80
Q

Fill in the blank: The _______ Clearance Test is no longer used because it is affected by diet.

A

Urea

Urea clearance is influenced by dietary protein intake.

81
Q

True or False: Almost 100% of creatinine is reabsorbed by the kidneys.

A

False

Almost 100% of creatinine passes through the glomerulus and is not reabsorbed.

82
Q

Greatest source of error in renal function test

A

Improperly collected urine specimen

83
Q

What colligative properties increaes when the osmolality of urine increases?

A
  • Boiling point
  • Osmotic pressure
84
Q

Tests that assess tubular reabsorption

A

Fishberg Concentration test
Mosenthal Test
Specific Gravity
Osmolality/osmolarity

85
Q

Normal value of urine SG

A

1.002–1.035

86
Q

Osmolality formula

A

Osm=1.86Na + (Glu/18) + (BUN/2.8) + 9

Or

Osm=2Na + (Glu/20) + (BUN/3) + 9

87
Q

What is the principal contributor of osmolality?

A

Sodium (Na)

88
Q

Normal pH value of urine

89
Q

What is the principle of pH in the reagent strip method? What is/are the reagent/s?

A

Double indicator system using methyl red and bromthymol blue

90
Q

What is the confirmatory test for protein in the urine?

A

3% Sulfosalicylic acid

91
Q

What is the sensitivity range of the reagent strip method of glucose?

A

75-125 mg/dL

92
Q

What does the copper reduction test detect?

A

All reducing sugars

93
Q

Which reagent strip parameter uses sodium nitroprusside as he reagent?

94
Q

How does lactose affect the acetest tablet test for ketones?

A

It enhances the color differentiation

95
Q

Ketones may be positive in patients that have:

A

DM, Vomiting, & Starvation

96
Q

What type of ketone do we have in the body?

A

B-hydroxybutyric acid

97
Q

This ketone consists 20% in the body

A

Acetoacetic acid

98
Q

Modified true or false: Sodium nitroprusside can only detect acetone used in the urine reagent strip

A

False; detects acetoacetic acid

99
Q

Which parameter in the reagent strip method uses tetramethyl benzidine?

100
Q

Speckled pattern in the blood pad indicates __________.

101
Q

Ehrlich reaction uses what reagent for detecting urobilinogen?

A

para-dimethyl aminobenzaldehyde

102
Q

Which test for bilirubin is more sensitive?

A

Ictotest tablet

103
Q

Which parameter of the reagent strip method is considered as a screening for UTI?

104
Q

Nitrite is based on what principle?

A

Greiss reaction

105
Q

What are the possible causes for a negative nitrite infection, despite the patient having a bacterial infection?

A

Non-reductase bacteria present
Insufficient contact time between bacteria and nitrite
large quantitites of bacteria
Presence of antibiotics

106
Q

Which parameter in the reagent strip method has the longest reading time?

A

Leukocyte esterase

107
Q

What is the principle of detecting the Specific gravity of a urine sample?

A

Change in the pKa of a polyelectrolyte

108
Q

RBCs in hypotonic urine are known as ______.

A

Ghost cells

109
Q

Dysmorphic RBCs in the urine may indicate what?

A

Glomerular damage

110
Q

What is the predominant WBC in the urine?

A

Neutrophil

111
Q

In a hypotonic urine, WBCs are called ________ because of what?

A

Glitter cells; it shows false motility (Brownian movement)

112
Q

What stain is used in detecting eosinophils in the urine?

A

Hansel stain

113
Q

What disease is associated with the appearance of eosinophils in the urine?

A

Drug-induced interstitial nephritis

114
Q

What is indicative of vaginal infection caused by Gardnerella vaginalis?

A

Clue cells

115
Q

What type of epithelial cell is considered to be the most clinically significant?

A

Renal Tubular Epithelial Cells

116
Q

Lipid-containing RTE cells are most often found in patients with _______.

A

Nephrotic syndrome

117
Q

What is added on to the urine to differetiate yeasts from RBCs?

A

2-5% Acetic acid

118
Q

Mucus threads are usually made up of what?

A

Tamm-Horsfall Protein

119
Q

Casts are formed in _____ and _____.

A

Distal Convoluted Tubule (DCT) & Collecting Ducts (CD)

120
Q

What is the difference between casts and cylindroids?

A

Casts: formed in the DCT & CD; uniform in shape
Cylindroids: formed in the ALH & DCT; tapered end

121
Q

What cast is considered normal when found in low numbers in the urine?

A

Hyaline cast

122
Q

What casts is considered normal when found in low numbers in the urine?

A

Hyaline cast

123
Q

The appearance of _______ can distinguish cystits from pyelonephritis.

124
Q

What is considered ass the renal failure cast?

A

Broad cast

125
Q

Which cast is the final degenerative form of all casts?

126
Q

75% of renal calculi found in the urine are ________.

A

Calcium Oxalate (CaOX)

127
Q

Opposite pH agents added in the urine would ______ crystals.

128
Q

What are the other names of triple phosphate crystal?

A

Struvite; Ammonium Magnesium Phosphate; Coffin-lid crystal

129
Q

What are the crystals found in liver diseases?

A

Bilirubin, Leucine, & Tyrosine crystals

130
Q

This crystal may be confused with a parasitic ova

A

Leucine crystal

131
Q

Cystine crystals are often found in patients with ________ syndrome.

132
Q

Cystine crystals are sometimes mistaken as _______.

A

Uric acid crystal

133
Q

Described as fine colorless to yellow needles the frequently form clumps or rosettes.

A

Tyrosine crystals

134
Q

Also known as staircase crystals

A

Cholesterol crystals

135
Q

Crystal found in patients with nephrotic syndrome

A

Cholesterol crystals

136
Q

Plate-shaped crystals found in patients with history of taking meglumine diatrizoate

A

Radiographic contrast media crystals

137
Q

What is the primary cause of the appearance of sulfonamide crystals?

A

inadequate patient hydration

138
Q

Crystal that forms bundles when refrigerated, and is found in an acidic urine.

A

Ampicillin crystal

139
Q

The cerebrospinal fluid is found in ______.

A

Subarachnoid space

140
Q

What are the functions of the CSF?

A
  • Supplies nutrients to the nervous tissue
  • Remove metabolic wastes
  • Acts as a cusion for the brain and the spinal cord
141
Q

Modified true or false: The CSF is an ultrafiltrate of the blood.

A

False; not an ultrafiltrate

142
Q

What is the normal CSF volume for adults and neonates?

A

Adults: 90-150 mL
Neonates: 10-60 mL

143
Q

Modified true or false: 20mL of CSF is produced by the body every hour

144
Q

70% of the CSF is produced in the __________.

A

Choroid plexuses

145
Q

If CSF is constantly produced, how doesn’t it build-up inside the body?

A

It drains via the arachnoid granulations or villi

146
Q

The position of the patient during the collection of CSF

A

Fetal position

147
Q

During the lumbar puncture, CSF is collected in which part of the body?

A

Between the 3rd and 4th or 4th and 5th lumbar vertebrae

148
Q

When 3 tubes are successfully collected during the spinal tap, what is the proper order in submitting the tubes?

A

Tube 1: Clinical Chemistry and Serology
Tube 2: Microbiology
Tube 3: Hematology

149
Q

If only a single tube is collected for CSF, what is the order of draw?

A

Microbiology -> Hematology -> CC & Serology

150
Q

High opening pressure during the collection of CSF are seen in patients with _________.

A

meningitis

151
Q

Modified true or false: Organisms that causes meningitis are not always encapsulated such as the N. gonorrhoeae

A

False; always encapsulated

152
Q

Why is the CSF sample for hematology refrigerated for storage?

A

To preserve cells

MTAP 1 (3 decks)

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