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Boards.CP.Chemistry > Body Fluids: Urine > Flashcards

Body Fluids: Urine Flashcards

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1
Q

Red Urine is seen in what conditions? (3)

*Urine dipstick results

A
  • Hematuria (RBCs)
  • Hemoglobinuria (Free Hgb)
  • Myoglobinuria

*All 3 will produce a positive hemoglobin result on dipstick

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2
Q

Red urine with Negative Hemoglobin on dipstick causes? (5)

A
  • Porphyria
  • Rifampin
  • Pyridium
  • L-Dopa (aldomet)
  • Beets
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3
Q

What conditions produce a Brownish/Black urine? (2)

A
  • Alkaptonuria

- Methemoglobinuria

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4
Q

What causes Blue/Green Urine?

A

Pseudomonas infection

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5
Q

Glycosuria with normal renal function:

  • “Renal Threshold”
  • Pregnancy
A

180 mg/dL serum glucose (“Renal Threshold”)

-Pregnancy Lower the threshold

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6
Q

Glycosuria with renal tubular dysfunction:

  • Caused by
  • Serum glucose
A

Impaired Reabsorption

-Serum glucose may be normal

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7
Q

The presence of what, inhibits several dipstick tests?

-Test (5)

A

Ascorbate Inhibits Dipstick tests for:

  • Glucose
  • Hemoglobin
  • Bilirubin
  • Nitrite
  • Leukocyte esterase
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8
Q

What is the normal urine protein amount?

-predominantly what protein?

A

150 mg/day

-Tamm-Horsfall (Tubular) protein

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9
Q

T/F: Vigorous excercise, dehydration and fever may cause increased urine protein.

A

True

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10
Q

The urine dipstick is sensitive mainly to what protein?

A

Albumin

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11
Q

What are the 3 major ketones in blood and urine?

A
  • Acetone
  • Acetoacetic Acid
  • B-Hydroxybutyrate
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12
Q

What ketone is the urine dipstick mainly sensitive to?

*what other urine test is the same

A

Acetoacetic Acid

*Tablet Test (Acetest)

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13
Q

Hematuria - Microscopic findings.

A

Erythrocytes in urine

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14
Q

Hemoglobinuria - Microscopic findings.

-Stain

A

Hemosiderin-laden macrophages/monocytes

-Prussian Blue stain

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15
Q

How is Myoglobinuria distinguished from Hematuria and Hemoglobinuria? (3)

A
  • Clinical History
  • Creatine Kinase
  • Normal Haptoglobin
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16
Q

Urinary Bilirubin is indicative of what?

A

Conjugated Hyperbiliriubinemia

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17
Q

What type of bilirubin does NOT pass through the Glomerulus?

A

Unconjugated bilirubin

*Urinary Bilirubin is indicative of Conjugated Hyperbilirubinemia

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18
Q

Urobilinogen is the product of what?

A

Hydrolysis of bilirubin by Intestinal Bacteria

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19
Q

Urine Bilirubin Interpretation - Normal:

  • Urine Bilirubin
  • Urine Urobilinogen
A

Urine Bilirubin Interpretation - Normal:

  • Urine Bilirubin - (Neg)
  • Urine Urobilinogen - (+/-)
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20
Q

Urine Bilirubin Interpretation - Unconjugated Bilirubinemia:

  • Urine Bilirubin
  • Urine Urobilinogen
A

Unconjugated Bilirubinemia:

  • Urine Bilirubin - (Neg)
  • Urine Urobilinogen - (Neg)
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21
Q

Urine Bilirubin Interpretation - Conjugated Bilirubinemia:

  • Urine Bilirubin
  • Urine Urobilinogen
A

Conjugated Bilirubinemia:

  • Urine Bilirubin - (Pos/+)
  • Urine Urobilinogen - (Pos/+++)
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22
Q

The presence of urine Nitrate indicates what?

A

Presence of Nitrite producing organisms

-E. coli

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23
Q

What are Nitrite Negative Agents of UTIs? (3)

A
  • Enterococci
  • N. gonorrhoea
  • M. tuberculosis
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24
Q

What urine test is a reflection of the number of urinary neutrophils?

A

Leukocyte Esterase

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25
Q

What are possible sources of a False-Positive Urine Leukocyte Esterase? (2)

A
  • Trichomonads

- Eosinophils

26
Q

The urine specific gravity is _______ when the urine is concentrated

A

Increased

*The urine specific gravity is Increased when the urine is concentrated

27
Q

What is isothenuria?

  • Specific Gravity
  • Cause/Result
A

Specific Gravity is fixed at 1.010

-Tubular Damage results in the urine specific gravity equaling the glomerular filtrate

28
Q

What is the normal Urine pH?

A

Urine pH = 6.0

-mildly acidic

29
Q

In general, patients with Acidosis (metabolic or respiratory) should be producing urine with a pH of __, whiles those with Alkalosis (metabolic or respiratory) should produce urine with pH of __.

A
  • pH = 6.0

- pH = >6.0

30
Q

What happens to urine pH in Renal Tubular Acidosis (RTA)? (2)

A
  • Urine is inappropriately Alkaline relative to blood pH

- Kidneys cannot acidify the urine beyond pH 6.5

31
Q

Urine Crystal Morphology:

-Calcium oxalate

A

“Envelopes”

32
Q

Urine Crystal Morphology/Polarization:

-Uric Acid

A
  • Pleomorphic (Diamond, Square, Rod-shaped)

- Polarize in a variety of colors

33
Q

Urine Crystals - Triple Phosphate:

  • Composition (2)
  • Morphology
  • Complication
A

Magnesium Ammonium Phosphate/Struvite

  • “Coffin Lids”
  • “Staghorn Calculi” (75% are Struvite)
34
Q

Urine Crystals - Triple Phosphate:

-When do they form? (2)

A
  • Alkaline pH

- Urea-splitting organisms (P. mirabilis)

35
Q

What organisms is capable of urea-splitting and can cause Staghorn Calculi?

A

Proteus mirabilis

36
Q

Urine Crystals with “Thorn Apples” morphology.

A

Ammonium burate

37
Q

Urine Crystals - Morphology:
-Cystine

*related to what?

A

Hexagonal cystals

*related to cystinuria

38
Q

Urine Crystals - Morphology:

-Tyrosine (2)

A

-“Silky”
or
-“Sheaves of Wheat”

39
Q

Urine Crystals - Morphology:

-Cholesterol

A

“Broken Panes of Glass”

40
Q

Urine Crystals - Morphology:

-Sulfa

A

“Fans”

41
Q

Urine Crystals - Morphology:

-Bilirubin

A

Yellow-Brown Needles

42
Q

The majority of kidney stone are composed of what?

  • 2nd
  • 3rd
A

Calcium Oxalate (70%)

  • Calcium Phosphate
  • Struvite (magnesium ammonium phosphate or triple phosphate stones)
43
Q

What promotes the formation of Calcium Oxalate crystals? (4)

A
  • Low Urine Volume (ALL stone types)
  • Low Urinary Citrate
  • Hypercalciuria
  • Oxaluria
44
Q

What causes Increased Oxaluria? (2)

A
  • Crohn’s Dz (s/p sm. bowel resection)

- Ingestion of Rubarbs, Spinach, Nuts

45
Q

T/F: Urinary pH has little effect on calcium oxalate cyrstallization

A

True

46
Q

What promotes the formation of Calcium Phosphate stones? (3)

A
  • Low Urine Volume
  • Hypercalciuria
  • Elevated (Alkaline) pH
47
Q

What promotes the formation of Urate stones? (2)

A
  • Acidic pH

- Hyperuricosuria

48
Q

What are the microscopic findings in Glomerular Bleeding? (3)

A
  • Polymorphous RBCs
  • RBC casts
  • Erythrophagocytosis
49
Q

What are the microscopic findings in Non-Glomerular Bleeding? (3)

A
  • Uniform RBCs
  • NO RBC casts
  • NO erythrophagocytosis
50
Q

Red Cell Casts:

  • Specific for?
  • Morphology (2)
A

Glomerulonephritis

  • Lumpy edges
  • Anucleate, slight reddish, pale discs
51
Q

White Cell Casts:

  • Found in what condition?
  • Morphology
A

Tubulointerstitial Nephritis/Pyelonephritis

-Nucleate cells w/ typical lobated nuclei of neutrophils

52
Q

Tubular Casts:

  • Indication of what?
  • Composed of?
  • Morphology
A
  • Acute Tubular Necrosis
  • Renal Tubular Cells
  • Mononuclear, cuboidal cells
53
Q

Granular Casts:

  • Nonspecific but typically present when?
  • Morphology
  • Often found with what other Cast
A

Significant Renal Disease

  • Acellular
  • Rough, Granular (fine or coarse) surface
  • Hyaline casts
54
Q

Granular and Hyaline casts can been seen in what conditions? (4)

A
  • Vigorous exercise
  • Dehydration
  • Heat-related Trauma
  • Renal disease
55
Q

Waxy Casts:

  • Indicative of what?
  • Morphology (4)
A

Severe Renal Disease

  • Acellular
  • Blunt Ends
  • Pale Yellow color
  • Cracks along their lenght
56
Q

How do you distinguise Waxy casts from that of Nonspecific Casts (Granular/Hyaline)?

A

Diameter is >2X that of nonspecific casts

57
Q

Broad Casts:

  • Indicate
  • Morphology
  • Correspond to what?
A
  • Endstage Renal Disease
  • Unusually broad (waxy,hyaline,or granular casts)
  • Widely dilated collecting ducts seen in advance atrophy
58
Q

Fatty Casts:

  • Indicative of
  • Common feature
  • Morphoology
  • Polarized light
A

Nephrotic syndrome

  • Lipiduria is common feature
  • Cellular casts in which lipid droplets are absorbed
  • Maltese Cross appearance w/polarized light
59
Q

Urine Microscopy in Acute Renal Failure - Acute Tubular Necrosis (ATN):

  • RBCs
  • Casts
  • Erythrophagocytosis (+/-)
  • Granulocytes (+/-)
A

Acute Tubular Necrosis (ATN):

  • RBCs - normal numbers (nonglomerular)
  • Casts - Tubular
  • Erythrophagocytosis - NO
  • Granulocytes - Scant
60
Q

Urine Microscopy in Acute Renal Failure - Rapidly Progressive Glomerulonephritis (RPGN):

  • RBCs
  • Casts
  • Erythrophagocytosis (+/-)
  • Granulocytes (+/-)
A

Rapidly Progressive Glomerulonephritis (RPGN):

  • RBCs - Increased (Glomerular)
  • Casts - Red Cell
  • Erythrophagocytosis - PRESENT
  • Granulocytes - Scant
61
Q

Urine Microscopy in Acute Renal Failure - Acute Interstitial Nephritis (AIN):

  • RBCs
  • Casts
  • Erythrophagocytosis (+/-)
  • Granulocytes (+/-)
A

Acute Interstitial Nephritis (AIN):

  • RBCs - Normal numbers (nonglomerular)
  • Casts - Tubular Casts
  • Erythrophagocytosis - NO
  • Granulocytes - Numerous (neuts/eosinophils)

Boards.CP.Chemistry (17 decks)

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