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Urinalysis > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

two dominant manifestations of acute glomerulonephritis

A

Proteinuria and hematuria

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2
Q

causes of acute glomerulonephritis

A

immune complex disease, hereditary, metabolic disorder

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3
Q

clinical manifestations of acute tubular necrosis

A

decreased urine flow, inability to concentrate urine, and loss of many tubular epithelial cells into urine

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4
Q

what is acute tubular necrosis associated with

A

reduced blood supply to renal tubules

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5
Q

three manifestations of nephrotic syndrome

A

proteinuria, hypoproteinemia, and edema

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6
Q

common causes of urinary obstruction

A

congenital malformation, stricture from infection, tumors, and calculi

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7
Q

explain pyelonephritis

A

infection of kidney and renal pelvis which initially affects renal interstitial but progresses into renal tubules

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8
Q

two main clinical findings in urine that may indicate diabetes mellitus

A

glycosuria and ketonuria

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9
Q

what would you expect to see in regards to volume and SG in diabetes mellitus

A

increased SG and increased volume

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10
Q

what is unconjugated bilirubin

A

linked loosely to albumin, insoluble in water so not found in urine

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11
Q

what is conjugated bilirubin

A

unconjugated bilirubin that has been conjugated by esterification by glucuronic acid in the liver, now water soluble

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12
Q

what is urobilinogen

A

conjugated bilirubin that is reduced by the intestinal flora of the small intestine

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13
Q

What is PKU

A

patient lacks phenylalanine hydroxylase for the conversion of phenylalanine to tyrosine

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14
Q

how would PKU be detected

A

the metabolite phenylpyruvic acid appears in the urine; diagnosed by phentest which uses ferric ions: dk green to blue green

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15
Q

what is alkaptonuria

A

patient lacks homogentistic acid oxidase

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16
Q

how is alkaptonuria detected

A

homogentistic acid accumulates in the blood, body fluids, and urine; gives orange color with Clinitest tablet

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17
Q

what is maple syrup disease

A

patient lacks enzyme needed in branched-chain amino acid metabolism

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18
Q

how is maple syrup disease detected

A

accumulation of leucine, isoleucine, keto, and hydroxy acid in urine, blood, and CSF; maple syrup odor; gives purple color with Acetest tablet

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19
Q

what is Fanconi’s syndrome

A

the proximal convoluted tubule function of the kidney is impaired

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20
Q

how is Fanconi’s syndrome detected

A

produces a deficiency of blood phosphates, aminoaciduria, and glycosuria

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21
Q

what is cystinuria

A

urinary excretion of large amounts of the amino acid cystine, as well as arginine, lysine, and ornithine

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22
Q

how is cystinuria detected

A

cystine calculi are produced due to the ability of cystine to readily precipitate in acid pH

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23
Q

what is galactosemia

A

patient is able to break down lactose to glucose and galactose, but lack the enzyme to convert galactose to glucose causing galactose to accumulate

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24
Q

how is galactosemia detected

A

detected in infancy as diarrhea, vomiting, and failure to thrive; neg on dipstick and pos on Clinitest

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25
Q

what is hematuria

A

presence of abnormal number of RBCs accompanied by urinary system disease

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26
Q

causes of hematuria

A

glomerular disease, tubular disease, interstitial disease, vascular disease, lower UT infection, tumors, and calculi

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27
Q

urine culture container and specimen

A

sterile with clean catch midstream

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28
Q

overall patient health urine sample

A

random specimen in a clean, dry, clear disposable plastic container with lid; 50-100 mL capacity

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29
Q

Addis count specimen and container

A

large container for 12 hour specimen; approx 3000 mL

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30
Q

postprandial urine specimen

A

2-3 hours after meal

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31
Q

protein urine specimen

A

first morning in regular container or 24 hours

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32
Q

glomerular filtration rate or renal clearance specimen

A

24 hour large container

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33
Q

quantitative glucose specimen

A

24 hour specimen

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34
Q

chemical changes in urine at room temp

A

pH increases, glucose decreases, ketones decrease, bilirubin decreases, urobilinogen decreases, nitrite increases

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35
Q

physical changes in urine at room temp

A

color darkens, clarity decreases

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36
Q

cellular changes in urine at room temp

A

blood cells decrease, casts decrease, bacteria increase, trichomonads decrease

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37
Q

time limit for examination of urine held at room temp

A

one hour

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38
Q

what is Addis count used for

A

follows progress of renal disease; 12 hour period overnight

39
Q

what should the status of pH and concentration for an Addis count

A

low pH and high concentration

40
Q

what is catheterization

A

insertion of sterile catheterization into the bladder

41
Q

when should catheterization be used

A

patients with urinary tract infections or if they are unable to pass urine due to obesity or severe illness

42
Q

what is suprapubic aspiration

A

puncturing the abdominal wall and distended bladder with needle and syringe

43
Q

when should suprapubic aspiration be used

A

bacterial cultures of anaerobes and in infants where contamination is unavoidable

44
Q

three characteristics of urine routinely recorded in physical examination

A

color, odor, and clarity

45
Q

what preservative gives false positive result for albumin in protein precipitation test

A

Thymol

46
Q

what urine preservative for the preservation of bacteria

A

refrigeration

47
Q

what urine preservative preserves cellular elements

A

formalin

48
Q

which reactions are not time critical on Multistix

A

pH and protein

49
Q

total time to read a Multistix

A

two minutes

50
Q

ten Multistix tests

A

pH, protein, glucose, ketones, blood, leukocytes, specific gravity, bilirubin, nitrite, urobilinogen

51
Q

abnormal colors for urine

A

red, dark brown to black, green

52
Q

cause for red urine

A

RBCs and hemoglobin

53
Q

cause for dark brown to black urine

A

due to melanin, associated with malignant melanoma

54
Q

cause for green urine

A

Pseudomonas UTI, small intestine infection

55
Q

what causes urine to be cloudy

A

crystals, epithelial cells, fat, microbes, white blood cells, radiographic contrast media

56
Q

what causes large amounts of white foam

A

protein

57
Q

what causes large amounts of yellow foam

A

bilirubin

58
Q

what causes a pungent odor

A

UTI

59
Q

what causes a sweet or fruity smell

A

increased ketones, diabetes mellitus, starvation

60
Q

what causes a mousy odor

A

phenylketonura

61
Q

what causes a maple syrup odor

A

maple syrup urine disease

62
Q

what is the specific gravity range of normal urine

A

1.002 - 1.030

63
Q

three substances that may cause high SG readings

A

glucose, protein, radioactive dye

64
Q

what is refractive index

A

ratio of velocity of light in air to velocity in the solute

65
Q

what is osmolality

A

expression of concentration in terms of the number of solute present (no dependent on the size of solutes)

66
Q

what is specific gravity

A

ratio of density of an equal volume of pure water (dependent on the number and size of solutes)

67
Q

two constituents of urine that contribute most to SG

A

NaCl and urea

68
Q

one condition may be responsible for abnormally low SG

A

diabetes insipidus

69
Q

what is oliguria

A

decreased urine excretion (<400 mL/day); elevated SG and decreased volume

70
Q

cause of oliguria

A

dehydration, urinary tract obstruction, nephrotic syndrome

71
Q

what is anuria

A

complete lack of urine excretion, potentially fatal

72
Q

what causes anuria

A

major hemolytic transfusion reaction, acute renal failure, urinary tract obstruction

73
Q

what is hyposthenuria

A

low SG, lack of ADH

74
Q

what causes hyposthenuria

A

diabetes insipidus

75
Q

what is polyuria

A

excessive excretion (>3 L/day) aka diuresis

76
Q

what causes polyuria

A

diabetes mellitus

77
Q

what is nocturia

A

increased urine excretion at night (>500 mL), form of polyuria

78
Q

what causes nocturia

A

kidney disease, diabetes mellitus, diabetes insipidus

79
Q

what is isosthenuria

A

fixed specific gravity around 1.010

80
Q

what causes isosthenuria

A

chronic renal disorder where kidneys cannot concentrate or dilute

81
Q

what is hypersthenuria

A

high specific gravity

82
Q

what causes hypersthenuria

A

radiographic dye, nephrotic syndrome with proteinuria, diabetes mellitus with glycosuria, dehydration

83
Q

what causes refrigerated urine to become cloudy

A

increased amorphous

84
Q

what properties are used in the determination of urine osmolality

A

freezing point depression

85
Q

average normal urine output for average adult

A

1200 - 1500 mL/day

86
Q

what happens to urobilinogen

A

99% excreted as feces and some reabsorbed by intestinal mucosa and then travels back to liver

87
Q

brown/amber color urine cause

A

bilirubin

88
Q

pink color urine cause

A

blood

89
Q

what causes rancid odor

A

tyrosonemia

90
Q

what causes phenolic odor

A

disinfectant like lysol

91
Q

normal urine excretion

A

600-1800 mL/day with <400 mL at night

92
Q

what can cause urine to be concentrated

A

dehydration, low fluid intake, first morning

93
Q

what can cause urine to be diluted

A

increased intake and or excretion

Urinalysis (5 decks)

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