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GU > deck 4 > Flashcards

deck 4 Flashcards

1
Q

what casts are assciated w/ nephrotic syndrome?

A

fatty casts

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2
Q

what does high specific gravity indicate?

A

dehydration and shock

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3
Q

what do transitional epithelial cells (urothelial cells) indicate?

A

possible neoplasm

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4
Q

what are the types of crystals?

A

uric acid, calcium phosphate, cystine, struvite

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5
Q

what do eosinophils indicate?

A

allergy

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6
Q

what does dipstick test for blood?

A

erythrocytes, free hemoglobin, and myoglobin

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7
Q

best ua sample

A

clean catch, midstream, 1st morning void

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8
Q

what do casts often suggest?

A

renal parenchymal disease

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9
Q

what do crenated RBCs indicate (shrunken/scalloped)?

A

concentrated urine

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10
Q

what casts are indicative of tubules that have become dilated and atrophic due to chronic parenchymal disease and end stage renal disease?

A

broad casts

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11
Q

what do squamous epithelial cells indicate?

A

contamination >10/HPF repeat collecting

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12
Q

what does protein in urine indicate?

A

often first indication of renal disease, most sensitive to albumin

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13
Q

what doest conjugated bilirubin suggest?

A

hepatocellular disease

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14
Q

specific gravity show what?

A

hydration status and concentration ability of kidney, correlates well with urine osmolality

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15
Q

what are struvite crystals?

A

infection stones, need urease producing organisma such as proteus or klebsiella

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16
Q

what appears as a pear shaped, flagellated organism?

A

trichomonas

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17
Q

what do you need to do to get microscopic urinanalysis?

A

request micro, and examined at 10 high powered views

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18
Q

what is nitrite?

A

gram negative bacteria convert nitrate to nitrite, positive indicated bacterial infection, but negative does not rule out

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19
Q

what do dysmorphic RBCs (irregular) indicate?

A

nephritic syndrome

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20
Q

what are ketones used for?

A

screen for ketosis, diabetic ketoacidosis, can be elevated in starvation/fasting/carb free diet, post exercise, pregnancy

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21
Q

where does urine acidify?

A

DCT and collecting duct

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22
Q

what number of erythrocytes is concerning on microscopy?

A

> 3 RBCs per HPF, rule out menstruation

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23
Q

false pos and negative for blood?

A

false pos: menses

false neg: high ascorbic acid intake

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24
Q

what do neutrophils indicate?

A

bacterial infection

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25
Q

when is BUN decreased?

A

liver disease, less ammmonia converted to urea

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26
Q

what casts are characteristic of acute pyelonephritis?

A

WBCs

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27
Q

when is BUN usually elevated?

A

chronic or acute renal failure, urinary obstuction, dehydration

28
Q

what does pyuria indicate overall?

A

urinary tract injury, may or may not be related to infection

29
Q

what does an increase in urobilinogen indicate?

A

hemolysis and hepatocellular disease (hepatitis and cirrhosis)

30
Q

what do renal tubular epithelial cells indicate?

A

diagnostic for ischemic or nephrotoxic acute tubular necrosis

31
Q

what casts suggest severe renal stasis and are seen in chronic renal failure?

A

waxy casts

32
Q

what is serum creatinine?

A

means of estimating GFR

33
Q

when is a BUN: creatinine ratio decreased?

A

intrinsic renal disease

34
Q

what is the most important parameter of renal function?

A

GFR

35
Q

in actue renal failure, if the FEna is >1%? what does that suggest?

A

INTRINSIC RENAL DISEASE: the kidney is losing sodium inappropriately

36
Q

when is BUN usually elevated?

A

chronic or acute renal failure, urinary obstruction, dehydration (reduced renal perfusion)

37
Q

what is leukocyte esterase?

A

produced by neutrophils, when positive indicated WBC in urine

38
Q

what are the two main mechanisms that control GFR?

A

blood flow in and out of glomerulus, and control of glomerular surface area

39
Q

what casts are characterisiticallly sen in acute tubular necrosis?

A

renal tubular epithelial cell casts, and granular “muddy brown” casts

40
Q

what is GFR?

A

amount of filtrate formed by both kidneys per minute

41
Q

what are you supposed to do if you see bacteria in a uncontaminated specimen?

A

get it cultured

42
Q

nitrite false positive?

A

gross hematuria, contamination

43
Q

what do you do if dpstick is positive for blood?

A

confirm w/ microscopic evaluation

44
Q

what does lower values of specific gravity indicate?

A

overhydration or impaired ability to concentrate urine

45
Q

what is considered a positive culture?

A

100,000 colony forming units

46
Q

what are cystine crystals?

A

hereditary cystinuria

47
Q

when is BUN: creatinine ratio elevated?

A

pre-renal and post renal azotemia (build up of waste)

48
Q

what are the hallmarks of glomerulonephritis?

A

red cell casts, bleeding from glomeruli or renal tubules)

49
Q

hyaline casts suggest what?

A

nothing, they are not specific for any renal disease

50
Q

in acute renal failure, if the kidney FEna <1% what does that suggest?

A

DECREASED PERFUSION: hypovolemia or dehydration and the kidney is retaing Na to increase intravascular volume

51
Q

how many leukocytes are concerning on microscopy?

A

> 5 leukocytes/HPF considered pyuria

52
Q

fals pos and negative for leukocyte esterase?

A

false pos: specimen contamination

false neg: not waiting long enough prior to testing

53
Q

tools to calculate GFR?

A

cockroft gault, modification of diet in renal disease

54
Q

how long to use urine sample?

A

w/in 1 hour or refrigerate

55
Q

when is serum creatinine elevated?

A

acute or chronic renal failure, urinary tract obstruction

56
Q

when is fractional excretion of sodium FE na used?

A

acute renal failure, most accurate when the patient is oliguric

57
Q

what do round/ normal RBCs indicate?

A

disease along epithelial lining

58
Q

where are casts formed?

A

DCTs and collecting ducts

59
Q

what is the MC way of measuring GFR?

A

creatinine clearance

60
Q

what do cell ghosts RBCs (swollen) indicate?

A

dilute urine

61
Q

what drugs make the urine color orange?

A

phenazopyridine, nitrofurantoin, rifampin, metronidazole

62
Q

if you see transitional epthelial cells (urothelial cells) what do you need to do?

A

confirm w/ urinary cytology

63
Q

what makes the urine cloudy?

A

pyuria (pus in urine) or suspended crystals

64
Q

what is the gold standard for measring GFR?

A

clearance of injected carb. (inulin)

65
Q

benign glycosuria can be secondary to what?

A

heavy metal

GU (19 decks)

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