Case 1: Urine Lab Values Flashcards
Urine that smells like strong, sweet acetone indicates what?
Ketoacidosis
Urine with fecal odor might indicate what?
enterobladder fistula
Urine with foul odor might indicate what?
UTI
In patients with renal tubular acidosis, the blood is ______ and the urine is ______.
Acidic; alkaline
Except for renal tubular acidosis, acidemia tends to be accompanied by _____ urine.
acidic (same for alkalemia, associated with alkalotic urine)
Proteinuria is an indicator of ______ ________.
Renal disease (glomerular filtration is injured (and spaces therefore too large), allowing protein (usually albumin) to seep out.
High specific gravity indicates what?
Concentrated urine (dehydration)
Low specific gravity indicates what?
Dilute urine (often caused by chronic renal diseases that diminish ability of kidneys to concentrate urine)
What does positive leukocyte esterase in urine indicate?
UTI
What do positive nitrites in urine suggest?
UTI
What do ketones in urine indicate?
Massive fatty acid catabolism (usually caused by poorly controlled diabetes and hyperglycemia, alcoholism, high-protein diets, or starvation)
What does bilirubin/urobilinogen in urine suggest?
Disease affecting bilirubin metabolism after conjugation or defects in excretion of conjugated bilirubin (such as gall stones)
Why will unconjugated bilirubin not be excreted in urine?
It is not water soluble
What do crystals found in urinary sediment indicate?
That renal stone formation is imminent, if not already present.
Casts are usually associated with some form of ______ and ____ within the renal tubules.
Proteinuria; stasis
What are the two types of casts that can form in urine?
Hyaline and cellular
What are hyaline casts indicative of?
Proteinuria
What are the types of cellular casts that can be found in urine?
Granular, fatty, waxy, epithelial, WBCs and casts, and RBCs and casts.
HPF in microscopic analysis of urine means what?
high powered field
What are cellular casts in urine?
Conglomerations of degenerated cells
What are granular casts?
Conglomerations of WBC or epithelial cells; found after exercise and in various renal diseases
What can fatty casts indicate?
glomerular disease or nephrotic syndrome (causing desquamation of epithelial cells into the renal tubule and coalescence of fatty deposits from those cells); can also be indicative of fatty emboli (occur in patients with bone fractures).
What causes waxy casts?
Diminished urine flow through the renal tubule, allowing time for granular casts to degenerate; associated with chronic renal disease/failure, diabetic neuropathy, malignant hypertension, and glomerulonephritis.
Low amounts of epithelial casts in urine are ______________, but high amounts may indicate what?
Unremarkable; not clean catch, renal tubular disease, or toxicity. *Epithelial casts are a sign that the urine was not clean catch
For what type of infections will WBC casts in urine most often be found?
Kidney infections
