Change Flashcards
What governs the labs utilized by chiropractors
CLIA (clinical laboratory improvement amendments)
A patient with a UTI may have a subluxation where
Lumbar region
Liver disease may present with subluxations where
T5-T9
What are the s/s to order a UA
LBP, painful urination (dysuria), hematuria, suprapubic pain, urethral or vaginal discharge, frequent urination, inability, polydipsia, polyphagia
What is the functional unit of the kidney
Nephron
When is the best time to collect the specimen
Early morning, most concentrated
Hydration and concentration is roughly indicated by what in urine
Color
Red or dark brown urine is seen when
Excessive hemoglobin, RBS, myoglobin. lots of diseases associated with these s/s
Yellow urine + Red blood = ?
Smoky urine
What color urine is found with dehydration from fever,
vomiting, certain foods (rhubarb, Vit C, carrots),
medications
Orange
What color urine is found to be bright yellow
Excessive B Vitamins
What color urine is found with alkaptonuria, melanin problems like
malignant melanoma
Black
What color urine is found with diabetes insipidus or
over hydration associated with low SpG; diabetes
insipidus associated with decrease pituitary ADH (eg.,
head trauma)
Colorless
What color urine is found with liver
problems check bilirubin and urobilinogen
may also be referred to as dark yellow
may see jaundice of skin and sclera and other
findings possible for hepatitis/liver disease
(SGOT,SGPT, RUQ pain)
Brownish yellow/green
What color urine is found associated with hyperlipidemia (risk
factor for heart disease)
Milky
Hazy or cloudy urine is usually due to what
Infection
Frothy urine is associated with what
Protein
What does specific gravity measure
Kidneys ability to concentrate the urine (inability is a sign of early renal disease)
Isosthenuria, fixed SpG at 1.010, the same as protein free plasma, signifies what
End stage renal failure
Increased SpG has more “stuff” in it
Decreased SpG is more dilute urine
What is the normal pH range
4.5-7.5. Acidic <7, Alkaline >7
What conditions are associated with acidic pH’s
Respiratory acidosis (emphysema), metabolic acidosis, diabetic ketoacidosis, diabetes mellitus, lots of meats and cranberries
What conditions are associated with alkaline pH’s
Respiratory alkalosis (hyperventilation), metabolic alkalosis, UTI, E. coli, bacillus proteus (inc blue/cranberry juices), high veggies and citrus
What is proteinuria used synonymously with
Albuminuria
What normally prevents protein from entering the glomerular filtrate
Glomerulus
Why must you always investigate proteinuria
Primary indicator of renal disease
What does a positive dipstick need to be confirmed with
Sulfosalicylic acidic precipitation (detects all proteins)
Strenuous exercise, exposure to cold, large abdomen, pregnancy, dehydration and febrile illness all increase the risk of
Proteinuria
What is massive proteinuria
Nephrotic Syndrome
How may the urine appear in nephrotic syndrome
frothy
Severe edema can be seen where in nephrotic syndrome
around the eyes
Nephrotic syndrome is associated with what
toxins, bee stings, severe infections, and polycystic kidney
What test should be run on all patient’s with a 4+ protein
Bence Jones test
What condition and xray sign may be a strong indicator for Bence Jones test
Multiple myeloma and Rain drop skull
What is multiple myeloma
Malignant proliferation of plasma cells (produce antibodies)
What urine protein is the bence jones protein
light chain
What tests are used for finding a monoclonal immunoglobulin in urine
Urine protein electrophoresis and urine immunofixation
T/F: A routine UA will detect Bence Jones proteins
FALSE, it will not
What are the definitive tests for immunoglobulins in urine
Electrophoresis and immunoelectrophoresis
If labs look like lytic mets what is the protocol
Bone scan, MRI, Biopsy
If labs look like Multiple Myeloma, what is the protocol
PEP (urine and blood), skeletal survey, MRI, Biopsy
What is usually ordered when the protein electrophoresis test shows the presence of an abnormal protein band that may be an immunoglobulin
Immunofixation electrophoresis
When may glucosuria be seen
Immediately after eating a high carb meal, also with kidney disease
Hyperglycemia and Glucosuria are classically seen in what condition
Diabetes mellitus
When are ketones produced
Lack of available sugar getting to the cells due to lack of insulin
what are ketones produced as a byproduct to
Fat metabolism
Unconjugated bilirubin cannot pass what
glomerular filter
What does a positive test for urine bilirubin confirm
That any raised plasma levels are from conjugated hyperbilirubinemia
What kind of bilirubin is prehepatic
Unconjugated
What are the main cause of biliary obstruction (cholecystitis)
Gallstones (wait and see)
What typically results from m. trauma due to crushing inj or MI. Occult blood w/o elevated RBC’s
Myoglobinuria
If there are increased RBCs what is is called
Yellow: Microhematuria
Red/pink/smoky: Hematuria
TNTC
Too numerous to count
