Exam 1 Flashcards
Turbid urine may be due to
crystal precipitaion bacteria, yeast WBC, RBC Mucus, squamous epithilial cells (normal) Sperm, prostatic fluid, lipids
Urine appearance: Color
Normal: pale straw colored or dark amber
Abnormal
Red or red brown - blood or hemoglobinuria
R/O menstrual contamination, food dyes, myoglobin beets.
Dark brown to black - BILE OR BILIRUBIN, melanoma
fruity odor is a sign of
Abnormal odors are due to
Ketone bodies/DM
UTI, cigarrettes, AA disorders
Urine Dipstick checks for
pH, Spec gravity, glucose, ketones (fruity), protein (turbid smell), blood (red), Nitrite and Leukocyte estrase = UTI, Bilirubin and Urobilinogen = liver dz
- Normal pH is
2. pH > 8 is a sign of
- 4.5-8.0
2. of urine sitting too long and bacterial overgrowth (contaminated due to long processing time)
Specific Gravity of H2O is 1, everything else is substance wgt
Normal SG si
1.003 - 1.035
- SG reflects the ability of kidneys to
2. With kidney dz, the SG is fixed at
concentrate the urine
1.010 (same as filtrate due to inability to concentrate urine)
When renal threshhold of glucose >150 is exceeded, the glucose is spilled into urine.
In some types of kidney defects, the renal threshold for glucose is
lower
Urine Glucose False Negative can be due to
Vit C
Aspirin
Ketones are a result of low carb diet (rapid wgt loss, starvation, DKA diabetic ketoacidosis, pregs)
Presence of ketones in urine represents
Acidosis
Normal protein in urine is < 150
30% albumin
30% globulin
40% Tamm-Horsfall protein (A mucoprotein secreted ONLY by renal tubular cells)
High SG - may give higher protein level
lower SG - may give lower protein level
Tomm Horsfall protein is
a mucoprotein that is secreted ONLY by renal tubular cells
Falsely positive for protein if
High alkaline urine
Hematuria (blood picked up as protein)
Pyridium present (analgesic for UTIs in addn to ABs)
High SG
Microalbuminuria
excretion of albumin BELOW dection level of 300, but ABOVE normal:
EARLY sign of diabetic neuropathy
urine dipstick doesn’t detect < 300
other causes: excercise, fever, cystitis (UTI) and CHF
Glomerulonephritis (and vasculitis) has was type of casts
Red cell casts
Acute pyelonephritis has which casts
White cell casts
(infection, fever, low back pain + White casts)
kidney inf not bladder
Granular cells are
from renal tubular cell casts (injury to epithilium)
old epithilium sloughing off
rectangular shape
Distended tubules, kidney dz
waxy casts:
broad, sharp edges with crackles
Urine culture is most relaible to dx infections
range indicative of inf is
> 100,000 colonies
hyaline casts are
and made of
very pale and made of Tamm-Horsefall mucoprotein secreted by tubule cells only
High number of epithilial cells in UA is a sign of
contamination
oval cell bodies consist of
degenerated tubular cells that contain high amounts of lipid,
maltese cross on microscope
Large amount of renal tubular and transit epithilial cell are a sign of
tubular degeneration
Normal WBC in urine is
0-5
10-20 suspect UTI
>20 = UTI
If sediment is red after centerfuging
Its hematuria
If supernatent (top part) is RED after centerfuging
Do a dipstick for HEME,
If HEME is neg - it’s beets
if HEME is pos - its either Myoglobin (clear plasma) or Hemoglobin (red plasma)
Abnormal range for RBCs in urine
> 3
Causes of RBCs in urine
kidney stones, renal and urinary tract trauma glomerular damage tumors UTI menstrual contamination
Bilirubin and Urobilinogen in urine is a sign of
LIVER dz
Proteinuria is a sign of
KIDNEY dz
due to endothelial dysfx
(in blood vessels, endothelial dyxfx results in atherosclerosis)
Tx of proteinuria
Decrease BP
ACE inhibitor
Low protein diet
Microalbuminuria is a
early sign of diabetic neuropathy
other: excercise, fever, cystitis (UTI), CHF
use 24 hr urine or alb to creat ration (first am void)
<30 is normal
