Body Fluids Exam 2 Flashcards

1
Q

This renal disease is caused by Group A Strep

A

Acute Glomerulonephritis

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2
Q

In what renal disease are RBC casts a “defining” finding?

A

Acute Glomerulonephritis

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3
Q

What is shown in these photos? What disease correlates with finding these in the sediment?

A
  • RBC casts
  • Acute Glomerulonephritis
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4
Q

How do RBCs differ from yeast in appearance?

A

Yeast typically has buds

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5
Q

Fatty urine is a sign of what renal disease?

A

Nephrotic syndrome

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6
Q

This renal disease is a complication of other renal diseases or systemic shock

A

Nephrotic syndrome

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7
Q

In Nephrotic Syndrome, a loss in _____ ______ triggers fat production and fats then leak through and end up in the urine.

A

Serum protein

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8
Q

A diabetic patient is admitted with oliguria and swelling of the hands and ankles.
Their urine is yellow, turbid, and foamy.
Dipstick results are as follows: Protein is 4+, Blood is Moderate, Trace Glucose, Moderate LE.
Microscopic reveals 20-30 RBC/hpf, 25-30 WBC/hpf, Many RTEs, 0-2 fatty casts/lpf, and few oval fat bodies.

What is probable diagnosis?

A

Nephrotic syndrome

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9
Q

What crystals might you see in a patient with nephrotic syndrome?

A

Cholesteral crystals

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10
Q

This renal disease is typicall due to severe infection but can also result because of shock or toxins.

A

Acute tubular necrosis

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11
Q

In what renal disease might you see RTE casts?

A

Acute tubular necrosis

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12
Q

This urinary tract infection my have WBC casts seen in the microscopic. Dipstick results would include LE+ and Nitrite +/-.

A

Pyelonephritis

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13
Q

This UTI is considered a lower UTI. You will NOT see WBC casts. LE+, Nitrite +/-, bacteria, protein and some blood are all possibilities.

A

Cystitis

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14
Q

This renal disease can be either acute or chronic. Possible casts seen in microscopic include: RTE, granular, waxy, and broad. Symptoms include: acid-base imbalances, increased urea (possible cause of psychosis), and decreased erythropoietin (causing anemia).

A

Renal failure

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15
Q

If the kidneys are unable to excrete acids, this can occur.

A

Renal tubular acidosis

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16
Q

In renal tubular acidosis, _______ pH is low while _______ pH is high.

A

Blood pH is low while urine pH is high

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17
Q

What is performed on infants 3-5 days after birth?

A

Newborn Screening Tests

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18
Q

What are the newborn screening tests looking for?

A
  • Errors in metabolism
  • Endocrinopathies
  • Cystic fibrosis
  • Hemoglobinopathies
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19
Q

What microorganism is sometimes the cause of glomerulonephritis in children?

A

Group A strep

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20
Q

When red cells are allowed to sit in a hypotonic environment, what can happen to them?

A

Ghost cells

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21
Q

If red cells are allowed to sit in a hypertonic environment, what can happen to them?

A

Crenation

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22
Q

Normal range for RBCs in a urine microscopic

A

< 2/hpf

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23
Q

Normal range of WBCs in a urine microscopic

A

0-5/hpf

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24
Q

What is the typical WBC seen in urine?

A

Segmented neutrophils

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25
Q

When are lymphocytes seen in urine?

A

Inflammation due to kidney rejection

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26
Q

Term for presence of WBCs in urine

A

Pyuria

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27
Q

Term for inflammation of the bladder

A

Cystitis

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28
Q

Term for inflammation of the urethra

A

Urethritis

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29
Q

Term for kidney infection

A

Pyelonephritis

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30
Q

When WBCs are allowed to sit in a hypotonic environment, what can happen?

A

Glitter cells

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31
Q

What would you expect the pH to be (acidic or alkaline) if both bacteria and WBCs are present in the urine?

A

Alkaline

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32
Q

These are considered a vaginal contaminant and typically indicative of bacterial vaginosis due to Gardnerella vaginalis

A

Clue cells

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33
Q

These epithelial cells are associated with the lower urinary tract

A

Squamous epithelial

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34
Q

What epithelial cells are associated with bladder and ureters?

A

Transitional epithelials

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35
Q

These epithelials are typically seen with bladder infections and catheterized urine.

A

Transitional epithelials

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36
Q

These epithelials are associated with the kidneys. Seeing >2/hpf is considered significant

A

Renal tubular epithelials

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37
Q

What phenomenon occurs when WBCs are allowed to sit in a hypotonic urine?

A

Glitter cells

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38
Q

These epithelials typically have a central nucleus and may be pear shaped or caudated

A

Transitional epithelials

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39
Q

What renal disease are oval fat bodies typically associated with?

A

Nephrotic syndrome

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40
Q

What stains are used for oval fat bodies?

A

Sudan or Oil Red O

41
Q

What could cause a positive nitrite with negative LE?

A

Improper specimen storage

42
Q

What would cause a positive nitrite and positive LE?

A

Infection

43
Q

What is the protein matrix made up of in casts?

A

Tamm-Horsfall

44
Q

This type of cast can be caused due to dehydration, exercise, stress, or fever. It is the least significant cast.

A

Hyaline cast

45
Q

This cast is always significant when seen and may be seen because of infections, malignancies, HUS, or SLE.

A

Red blood cell cast

46
Q

This cast type is seen with lower UTIs and pyelonephritis.

A

White blood cell cast

47
Q

This cast is a sign of advanced tubular necrosis.

A

Epithelial cell cast

48
Q

This cast occurs due to nephrotic syndrome, crush injuries, or diabetes. You may see oval fat bodies and cholesterol crystals with it.

A

Fatty cast

49
Q

This cast is seen with exercise, stress, fever, or dehydration. It is caused by a variety of renal diseases.

A

Granular cast

50
Q

What cast indicates extreme urine stasis, renal failure, or chronic renal disease?

A

Waxy cast

51
Q

What cast forms in the collecting ducts?

A

Broad cast

52
Q

What are the normal crystals found in acidic urine?

A
  • Amorphous urates
  • Uric acid
  • Calcium oxalate
53
Q

These crystals precipitate upon cooling and dissolve by warming

A

Amorphous urates

54
Q

This crystal type is seen in patients with gout or chemotherapy patients

A

Uric acid

55
Q

Crystals:

Small square envelopes

A

Calcium oxalate

56
Q

The oval form of this crystal is found in patients with ethylene glycol poisoning

A

Calcium oxalate monohydrate

57
Q

What are the normal crystals found in alkaline urine?

(5)

A
  • Amorphous phosphate
  • Triple phosphate
  • Calcium phosphate
  • Ammonium biurate
  • Calcium carbonate
58
Q

These crystals are found in alkaline urine and will not dissolve upon warming.

A

Amorphous phosphates

59
Q

Crystals:

Look like coffin lids and are often seen in UTIs

A

Triple phosphates

60
Q

Crystals:

Prisms or rosettes

“Shards of glass”

A

Calcium phosphates

61
Q

Crystals:

“Thorny apples” found in old urine or UTIs that are brownish in color

A

Ammonium biurate

62
Q

Crystals:

Small dumbells found in alkaline urine

A

Calcium carbonate

63
Q

What are the abnormal crystals found in urine?

(7)

A
  • Cystine
  • Tyrosine
  • Leucine
  • Bilirubin
  • Cholesterol
  • Radiographic dye
  • Drugs
64
Q

Crystals:

  • “Stop signs”
  • Due to a reabsorption defect
  • Causes kidney stones at a young age
A

Cystine

65
Q

Crystals:

  • Brown to black fine needles
  • Caused by severe liver disease in adults
  • Caused by impaired amino acid metabolism in children
A

Tyrosine

66
Q

Crystals:

  • “Wagon wheel”
  • Due to sever liver disease in adults
  • Maple syrup urine disease in children
A

Leucine

67
Q

Crystals:

-Icteric needles caused by hepatitis and other liver diseases

A

Bilirubin crystals

68
Q

Crystals:

  • Notched corners
  • Seen with nephrotic syndrome
A

Cholesterol crystals

69
Q

Crystals:

  • Resemble tyrosine crystals but are thicker.
  • Concerned with dehydration
A

Radiographic dye crystals

70
Q

Crystals:

  • Can be caused by antibiotics or sulfa drugs
  • Can damage tubules
  • Check patient hydration
A

-Drug crystals

71
Q

Crystals:

  • pH of 5.5
  • Dissolved after being warmed
A

Amorphous urates

72
Q

Crystals:

  • acidic pH
  • Gout and chemo patients
A

Uric acid

73
Q

Crystals:

-acidic to neutral pH

A

Calcium oxalate

74
Q

Crystals:

-Ethylene glycol poisoning

A

Calcium oxalate monohydrate

75
Q

Crystals:

  • Alkaline pH
  • Remains after warming sample
A

Amorphous phosphates

76
Q

Crystals:

  • Often seen in UTIs
  • Alkaline pH
A

Triple phosphates

77
Q

Crystals:

“Shards of glass”

-Prisms or rosettes

A

Calcium phosphates

78
Q

Crystals:

“thorny apples”

seen in old urine and UTIs

A

Ammonium biurate

79
Q

Crystals:

-Small dumbbells

A

Calcium carbonate

80
Q

Crystals:

-Can cause kidney stones at a young age

A

Cystine

81
Q

Crystals:

  • Severe liver disease in adults
  • Impaired amino acid metabolism in chilren
A

Tyrosine

82
Q

Crystals:

  • Maple syrup disease in children
  • Severe liver disease in adults
A

Leucine

83
Q

Crystals:

Dipstick: bilirubin +

A

Bilirubin crystals

84
Q

Crystals:

  • Nephrotic syndrome
  • notched corners
A

Cholesterol crystals

85
Q

Crystals:

  • Concerned for patient dehydration
  • High SG with refractometer
A

Radiographic dye crystals

86
Q

Crystals:

  • Antibiotics or sulfa drugs
  • Can damage tubules
A

Drug crystals

87
Q

Term:

Decreased urination

A

Oliguria

88
Q

Term:

Increased urination

A

Polyuria

89
Q

Term:

No urination

A

Anuria

90
Q

Term:

Increased urination at night

A

Nocturia

91
Q

Term:

Painful urination

A

Dysuria

92
Q

Term:

WBCs in urine

A

Pyuria

93
Q

With diabetes insipidus, _______ causes an increase in plasma osmolality.

A

Sodium

94
Q

With diabetes mellitus, _______ is causing an increase in plasma osmolality.

A

Glucose

95
Q

In diabetes mellitus, there is a decreased production or function of what?

A

Insulin

96
Q

In diabetes insipidus, there is a decreased production or function of what?

A

Anti-diuretic Hormone

aka

Vasopressin

97
Q

SG Diabetes:

Diabetes insipidus has a _____ SG, Diabetes mellitus has a _____ SG.

A

Insipidus: Low SG

Mellitus: High SG

98
Q
A