Case 1: Urine Lab Values

Question 1

Urine that smells like strong, sweet acetone indicates what?

Answer 1

Ketoacidosis

Question 2

Urine with fecal odor might indicate what?

Answer 2

enterobladder fistula

Question 3

Urine with foul odor might indicate what?

Answer 3

UTI

Question 4

In patients with renal tubular acidosis, the blood is ______ and the urine is ______.

Answer 4

Acidic; alkaline

Question 5

Except for renal tubular acidosis, acidemia tends to be accompanied by _____ urine.

Answer 5

acidic (same for alkalemia, associated with alkalotic urine)

Question 6

Proteinuria is an indicator of ______ ________.

Answer 6

Renal disease (glomerular filtration is injured (and spaces therefore too large), allowing protein (usually albumin) to seep out.

Question 7

High specific gravity indicates what?

Answer 7

Concentrated urine (dehydration)

Question 8

Low specific gravity indicates what?

Answer 8

Dilute urine (often caused by chronic renal diseases that diminish ability of kidneys to concentrate urine)

Question 9

What does positive leukocyte esterase in urine indicate?

Answer 9

UTI

Question 10

What do positive nitrites in urine suggest?

Answer 10

UTI

Question 11

What do ketones in urine indicate?

Answer 11

Massive fatty acid catabolism (usually caused by poorly controlled diabetes and hyperglycemia, alcoholism, high-protein diets, or starvation)

Question 12

What does bilirubin/urobilinogen in urine suggest?

Answer 12

Disease affecting bilirubin metabolism after conjugation or defects in excretion of conjugated bilirubin (such as gall stones)

Question 13

Why will unconjugated bilirubin not be excreted in urine?

Answer 13

It is not water soluble

Question 14

What do crystals found in urinary sediment indicate?

Answer 14

That renal stone formation is imminent, if not already present.

Question 15

Casts are usually associated with some form of ______ and ____ within the renal tubules.

Answer 15

Proteinuria; stasis

Question 16

What are the two types of casts that can form in urine?

Answer 16

Hyaline and cellular

Question 17

What are hyaline casts indicative of?

Answer 17

Proteinuria

Question 18

What are the types of cellular casts that can be found in urine?

Answer 18

Granular, fatty, waxy, epithelial, WBCs and casts, and RBCs and casts.

Question 19

HPF in microscopic analysis of urine means what?

Answer 19

high powered field

Question 20

What are cellular casts in urine?

Answer 20

Conglomerations of degenerated cells

Question 21

What are granular casts?

Answer 21

Conglomerations of WBC or epithelial cells; found after exercise and in various renal diseases

Question 22

What can fatty casts indicate?

Answer 22

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).

Question 23

What causes waxy casts?

Answer 23

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.

Question 24

Low amounts of epithelial casts in urine are ______________, but high amounts may indicate what?

Answer 24

Unremarkable; not clean catch, renal tubular disease, or toxicity. *Epithelial casts are a sign that the urine was not clean catch

Question 25

For what type of infections will WBC casts in urine most often be found?

Answer 25

Kidney infections