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Visceral Disorders COPY (Frontier) > Exam 1 - Urine Part 1 > Flashcards

Exam 1 - Urine Part 1 Flashcards

1
Q

What condition is most likely present when the clavicles are underdeveloped or absent on a film?

A

Cleidocranial dysplasia

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2
Q

What lab test should be ordered if your patient presents with signs and symptoms of anemia?

A

Complete blood count (CBC)

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3
Q

What imaging should be ordered if you see an abdominal aortic aneurysm on X-ray?

A

Abdominal CT (size-depending)

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4
Q

What imaging should be done if a patient has a congenital absence of the posterior arch?

A

Flexion/extension

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5
Q

When OPLL is seen on X-ray, what does the patient then need?

A

CT/MRI and a neuro/ortho consult

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6
Q

What test should be ordered for a patient with DISH?

A

Fasting blood sugar (possible diabetic)

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7
Q

What test is needed for a patient with a kidney stone?

A

Urine analysis

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8
Q

Increased levels of what enzyme in the blood are indicative of probable prostate cancer?

A

Alkaline phosphatase

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9
Q

What kind of X-ray finding could appear on the vertebral bodies in a patient with increased levels of alkaline phosphatase?

A

Hemispherical sclerosis (blastic metastasis)

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10
Q

What imaging does a patient with signs and symptoms of pneumonia need?

A

Chest film

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11
Q

What kind of test does a patient with burning urination and flank pain need?

A

Urine analysis

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12
Q

What kind of test does a patient with pain in the right upper quadrant of the abdomen need?

A

Liver function tests (check enzymes)

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13
Q

What are the federal regulatory standards that apply to all clinical laboratory testing performed on humans in the United States, except clinical trials and basic research?

A

CLIA (clinical laboratory improvement amendements)

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14
Q

If a chiropractor chooses to do his lab work in his office, what standards must be met for legalities?

A

CLIA and OSHA standards

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15
Q

What percentage of cardiac output perfuse the kidneys every minute?

A

25% (a lot, guys)

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16
Q

What is the name of the hormone produced in the kidneys that stimulates RBC and renin production?

A

Erythropoitin

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17
Q

What are the 3 properties that make up a routine UA?

A

1 physical 2 chemical 3 microscopic

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18
Q

What is the functional unit of the kidney?

A

Nephron

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19
Q

How many nephrons (approx.) are in 1 kidney?

A

1 million

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20
Q

What anatomy makes up a nephron?

A

Glomerulus, capillary network, proximal convoluted tubule, loops of Henle, distal tubule, collecting duct

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21
Q

What is the oldest clinical lab procedure?

A

UA

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22
Q

What is the nickname for the ancient Sumarian, Babylonian, and Egyptian physicians that were highly skilled in urine examinations (aka urine gazers)?

A

Pisse-prophets

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23
Q

The glomerular filtrate becomes urine after leaving what specific part of the nephron?

A

Distal convoluted tubule

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24
Q

What are the principle solutes of urine?

A

Urea, sodium, chloride, potassium, creatinine, uric acid, and ammonia

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25
The body excretes approximately how many grams of dissolved material in 24 hours? Half of it is what substance?
60 grams; 50% = urea
26
What percentage of urine is water?
95% (rest are dissolved solids)
27
What is the normal range for daily volume of urine?
600-2000ml/day (average if 1200-1500ml/day)
28
What is the term for urine output of greater than 2000ml/day?
Polyuria
29
What are some potential causes of polyuria?
Diabetes mellitus, diabetes insipidus, large fluid intake, diuretics
30
What is the term for urine output that is less than 500ml/day?
Oliguria
31
What are some potential causes for oliguria?
Renal tubule dysfunction, end stage renal disease, obstruction, edema, dehydration, diarrhea, vomiting, shock
32
What is the term for an absence of urine?
Anuria
33
What can cause anuria?
Renal failure, obstruction, heart attack
34
What is the term for excessive water intake?
Polydipsia
35
At what time of the day is the best urine analysis specimen usually retrieved and why?
Early morning (urine has been in the bladder for hours and is the most concentrated)
36
After what amount of time does decomposition of urine begin?
Within 30 minutes at room temperature and 4 hours if refrigerated
37
How does the color of urine change when unpreserved?
Gets darker
38
How does the turbidity of urine change when unpreserved?
Increases
39
How does the odor of urine change when unpreserved?
More foul smelling
40
How does the pH of urine change when unpreserved?
Increases
41
How do the levels of glucose, ketones, bilirubin, and urobilinogen change in urine when unpreserved?
Decrease
42
How do the levels the nitrites and bacteria of urine change when unpreserved?
Increased
43
What happens to RBCs in unpreserved urine?
Lysis
44
What happens to WBCs and casts in unpreserved urine?
Disintegrate
45
What color urine is seen with dehydration from fever, vomiting, and certain foods like rhubarb?
Orange
46
Excess of what nutrient can cause BRIGHT yellow urine?
B vitamins
47
What can cause black urine?
Alkaptonuria, melanin problems like malignant melanoma
48
What can cause colorless urine?
Diabetes insipidus, over hydration
49
What would brownish yellow/green urine indicate?
Liver problems (so check bilirubin an urobilinogen
50
Milky urine is associated with what overlying condition?
Hyperlipidemia (risk factor for heart disease)
51
Is slightly hazy urine considered normal?
Yeah
52
What does cloudy urine usually indicate?
Pus, bacteria, RBCs, spermatozoa
53
What does frothy urine indicate?
Proteins
54
What color froth would be associated with levels of bilirubin?
Yellow
55
What color froth would be associated with levels of proteins?
White
56
What is the purpose of measuring for specific gravity?
Evaluates the kidneys' ability to concentrate urine
57
What is the normal range for specific gravity of urine?
1.015-1.035
58
What is the specific gravity, technically?
The weight of the urine compared to distilled water (SpG of water = 1.000)
59
What is the term for low or high specific gravity of urine?
High = hypersthenuria; Low = hyposthenuria
60
What is the term for a fixed SpG of urine at 1.010?
Isosthenuria
61
What does isosthenuria indicate?
Protein free plasma and the end stage of renal failure
62
What can cause increased urine specific gravity?
Proteinuria or glucosuria (due to heavy molecules), dehydration, decreased renal blood flow
63
What can cause decreased urine specific gravity?
Over hydration, glomerulonephritis, pyelonephritis, DI, renal failure
64
A foul or fishy urine smell usually indicates what?
UTI
65
A fruity or sweet urine smell usually indicates what?
Diabetes mellitus/ketosis
66
A feces odor of urine usually indicates what?
Asparagus, enterobladder fistula
67
What is the normal pH range of urine?
4.5-7.5 (slightly acidic)
68
What causes the pH of urine to increase and become alkaline as it sits?
Bacterial growth and breakdown of urea
69
Diets high in what foods lead to urine that is typically acidic in nature?
Animal products
70
Diets high in what foods lead to urine that is typically alkaline in nature?
Citrus fruits and vegetables
71
What can cause urine to be more acidic?
Respiratory acidosis (emphysema), metabolic acidosis, DM, large amounts of meat and cranberries
72
What can cause urine to be more alkaline?
Respiratory alkalosis (hyperventilation), metabolic alkalosis (common with UTI), diets high in veggies and citrus fruits
73
Should a patient with a UTI with a urine pH of 5 drink heavy amounts of cranberry juice to combat the balance?
NO; urine is already acidic (increase fluids, adjust, and monitor)
74
What type of UTI (upper or lower) needs a consult right away?
UPPER
75
Should acidic urine with xanthine, cysteine, and/or uric acid stones be kept acidic or alkaline?
Alkaline
76
Should alkaline urine with calcium carbonate and/or calcium and magnesium phosphate stones be kept acidic or alkaline?
Acidic
77
Which protein is the dipstick most sensitive to?
Albumin
78
What is a synonym for proteinuria?
Albuminuria
79
Is it normal to release protein in the urine?
Only in trace amounts... (150mg/day aka non measurable)
80
Does protein in the urine indicate an upper or lower UTI?
Upper
81
Why is it important to always analyze for proteinuria?
Primary indicator for renal disease
82
What part of the nephron is damaged when proteinuria is seen?
Glomerular filter
83
What does a positive dipstick for proteinuria need to be confirmed with?
Sulfosalicylic Acid Precipitation Test (SSA)
84
What can cause proteinuria?
Diabetes, glomerulonephritis, nephrotic syndrome, preeclampsia, trauma, exposure to cold, pregnancy increasing abdominal pressure
85
What is the term for when a patient presents with normal urine when supine and displays proteinuria when standing?
Orthostatic proteinuria
86
Orthostatic proteinuria is associated with what spinal change?
Exaggerated lumbar lordosis
87
How can nephrotic syndrome affect the urine?
Massive proteinuria (+4), frothy in appearance
88
What extra test should be run on all patients with a 4+ protein level?
Bence Jones test (PEP)
89
What is the #1 radiographic feature for Multiple Myeloma?
Rain drop skull
90
What are the 3 probable causes of pathological fracture in order from most common to least common?
1 osteoporosis 2 lytic metastasis 3 multiple myeloma
91
What is another name for MM?
Kahler's disease
92
What is MM?
Malignant proliferation of plasma cells
93
What do plasma cells do?
Produce antibodies
94
What is the light chain part of the immunoglobulin sometimes excreted into the urine in patients with MM?
Bence-Jones protein
95
What is the test used for finding a monoclonal immunoglobulin in urine (aka looking for Bence-Jones proteins for a patient with suspected MM)?
Protein electrophoresis (urine immunofixation)
96
Which will detect Bence Jones proteins: routine UA or PEP?
PEP (NOT UA!!!)
97
Why won't a routine urine analysis detect Bence Jones proteins?
Dipsticks are sensitive to albumin
98
What is the procedure used to measure the exact amount of Bence Jones proteins?
Immunoelectrophoresis
99
What other coexisting condition is commonly seen with those with MM?
Anemia
100
Why is anemia commonly seen in MM patients?
Cloned immunoglobulins are being made more than RBCs
101
What kind of sickness is a common complication in patients with MM?
Respiratory infections

Visceral Disorders COPY (Frontier) (10 decks)

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