Exam 2 Flashcards
What gives urine its yellow color
urochrome
What causes urine to become orange-brown, what causes it if its normal
urobilin
conversion of urobilinogen to urobilin over time,
What causes urine to become pink, assuming its normal
uroerythrin,
What can turn urine green?
biliverdin, improper storage, oxidizes
What turns urine black?
homogentistic acid, associated with malignant melanoma
What turns urine blue or green
drugs, bacteria like pseudomonas, mouthwash, some antidepressants
What turns urine blue or green
drugs, bacteria like pseudomonas, mouthwash, some antidepressants
What turns urine brown
myoglobin blood drugs
Match the drug to the reaction that causes the color change in urine: Rhabdomyolysis, metronidazole, methemoglobin
oxidized hemoglobin
treatment for trichomoniasis
myoglobin in urine
methemoglobin- oxidized hemoglobin
metronidazole-treatment for trichomoniasis
rhabdomyolysis-myoglobin in urine
What turns urine red-purple
oxidation of porphyrinogen and porphobilinogen to color,
can be caused by porphyrias or improper handling of specimen
What turns urine very bright yellow
riboflavin from, B complex vitamins
What turns urine orange
food and drugs
anticoagulants, tuberculosis treatment, urinary analgesic, certain fruits with carotene
What turns urine yellow-brown
antibiotics
What turns urine pink
could be blood from a UTI, porphyria due to porphobilin
What turns urine red?
blood in urine, hemoglobin or eating too many beets
What can urine foam indicate?
dont report it out
could be due to too much protein, bilirubin if foam is yellow
List the term that matches the description
visible particles, can read through it
no visible particles
many particles, print is blurred or hard to read
can’t read through it
slightly cloudy
clear
cloudy
turbid
What can urine odor tell us
dont report it,
could be due to urea being converted to ammonia by bacteria
certain foods
metabolic disorders- cause sweet smell if diabetes
bleach smell- adulteries drug specimen
pungeant smell- UTI
What is the normal concentration of urine
94% water
6% solutes
What two tests are used to measure urine concentration
specific gravity-mass of solutes in urine compared to water- faster
osmolality- number of particles in a solution- more specific
What is the possible physiological range for specific gravity
1.002 to 1.040
The greater the urine density the ____ the SG value
greater
Match the method to the test: reagent strip, urinometry, harmonic oscilation, refractometry
- measures charged ions, indirect measure of density
- uses molecular size and structure
- measure of density, inaccurate
- measure of density, very accurate
reagent strip-measures charged ions, indirect measure of density
refractometry-uses molecular size and structure
urinometry-measure of density, inaccurate
harmonic oscilation denistometry-measure of density, very accurate
What is nocturia
when you pee too much over 500mL at night
What is isothenuria
when the kidneys cant alter specific gravity of ultrafiltrate, specific gravity is really low
What is polyuria
more than 3L of water a day
What is diuresis
increase in urine excretion more than 1800 mL per day
What is oliguria
decrease in urine less than 400
what is anuria
no urine excretion
What could cause a specific gravity result to be more than 1.040
could have radiographic contrast
What could cause a specific gravity result to be less than 0.005
could be due to the presence of some nonionic solute
What is the normal range for serum osmo? and urine?
serum: 275-300
urine: 275-900
What is the normal daily volume of urine
600-1800
How much does adding mole of solute particles to 1kg of pure water cause the freezing point to change? increase or decrease?
decrease by 1.86C
What are the normal ranges of specific gravity, what are the terms if too low or too high
1.010 to 1.025
hyposthenuric too low
hypersthenuric too high
What is the normal range for the urine pH
4.5 to 8.0
What is a normal daily protein amount
more than 150mg/day
What proteins originate from the urinary tract
uromodulin, urokinase, secretory immunoglobulin A
What is the term for increased protein in urine, what causes it? what are the 3 types
proteinuria- increase in plasma proteins that are filtered or reduction in the reabsorptive ability of the tubules
pre-renal, renal and post-renal
What are these conditions related to: septicemia, hemoglobinuria, myoglobinuria, multiple myeloma and macroglobulinemia
pre renal proteinuria
What are bence jones proteins
immunoglobulin light chains found in urine
Match the condition to the description
glomerular proteinuria
tubular proteinuria
capacity for reabsorption Tm is exceeded
reabsorptive function is altered or impaired
glomerular proteinuria: capacity for reabsorption Tm is exceeded
tubular proteinuria: reabsorptive function is altered or impaired
What type of proteinuria is the most common and the most serous
glomerular proteinuria
How does proteinuria affect the daily excretion of urine
glomerular- more than 2.5 a day
tubular-less than 2.5 a day
An inflammatory response in the urinary tract can be a result of what type of proteinuria
post renal
Leakage of blood products into the urinary tract can be a result of
postrenal proteinuria
If a specimen is contaminated with vaginal secretions or seminal fluid what test on the reagent strip is affected
protein is false positive
Match the reagent strip test to the principle
sg, pH, protein, blood leukocyte, nitrite, glucose, ketones, bilirubin, ascorbic acid
- measures ionically charged solutes
-double indicator with bromothymol blue and methyl red
- the protein error of indicators
- pseudoperoxidase activity
- diazotization reaction of nitrite with aromatic amine, creates diazonium salt
-sequential enzyme reaction that detects only glucose
- nitroprusside reaction
- reaction of diazonium salt and bilirubin in an acid medium
– ascorbic acid reduces a dye in the reagent
Specific gravity- measures ionically charged solutes
pH-double indicator with bromothymol blue and methyl red
protein- the protein error of indicators
blood leukocyte esterase- pseudoperoxidase activity
nitrite- diazotization reaction of nitrite with aromatic amine, creates diazonium salt
glucose-sequential enzyme reaction that detects only glucose
ketones- nitroprusside reaction
bilirubin- reaction of diazonium salt and bilirubin in an acid medium
ascorbic acid – ascorbic acid reduces a dye in the reagent
What dipstick test is SSA related to, what does positive look like
protein, looks really milky gets more turbid
What reagent strip test is clinitest related to, what does positive look like
glucose, reagent strip color change
What reagent strip test is acetest related to
ketones, purple
What reagent strip test is the ictotest related to
bilirubin, blue or purple
What is the sensitive albumin related to and what does a positive result look like
albumin, strip test
What are the limitations of the protein strip test
most sensitive to albumin, does not detect other proteins
What is hematuria and hemoglobinuria, what causes them
too many RBCs-kidney disease
too much hemoglobin-hemolysis intravascularly
in urine
How does the test strip find blood
looks for heme moiety
What is myoglobinuria and what causes it
muscle trauma,
What will intravascular hemolysis lead to in urine usually
hemosiderin
How can you distinguish hemoglobinuria from myoglobinuria
hem- plasma has hemolysis
myo-plasma looks normal
How can you distinguish hematuria from hemoglobinuria
hematuria- cloudy
hemoglobinura-clear
What is the normal range for leukocyte esterase
up to 10WBCs, if too many could imply inflammation
WBCs are susceptible to lysis in ____ and ____ urine
hypotonic and alkaline
What WBC does leukocyte esterase not detect
lymphs
Nitrite is an important tool to identify a ____, the most common organism that causes this is ____
a UTI, E coli
What is glucosuria vs glycosuria
glucosuria- glucose in urine
glycosuria- non glucose sugars like fructose, sucrose and lactose
If blood glucose levels exceeds ____, the glucose in the ___ exceeds reabsorptive abilities and results in ____
160-180
ultrafiltrate
glucouria
What is the most common disease that causes glucosuria
diabetes
True or False: hyperglycemia can occur without glucosuria
True, can cause bp to go down and glucose gets reabsorbs through glomerulus
What causes galactosemia lactose fructose pentoses maltose and glucose in urine
galactosemia- metabolic issues lactose- could be pregnant or infant fructose- too much fruit or honey pentoses- too much fruit or genetics maltose and glucose in urine- diabetes
Of the sugars that can be present in the urine, only ____ or ____ signify pathologic condictions
glucose or galactose
What is the principle of the copper reduction clinitest
reduces substrates to convert cupric sulfate to cuprous oxide
When are clinitests used
screen for reducing substances in children less than 2 years old
What are the 3 products used to ID ketone bodies
acetoacetate, Beta hyrdroxybutyrate, acetone
T or F, no levels of ketones are normal
T
What do ketones mean clincally, what is the most common reason ketones are elevated
issues with diabetes, excessive diets, frequent vomiting, diabetes
Explain which ketone can convert into the other two
acetate can become acetoacetate or beta hydroxy
List which ketones are most to least abundant
most- beta hydroxy
acetoacetate
acetone-least
Which ketone is the first one to form in the liver, which is the most enzymatically reduced
acetoacetate- first
beta hydroxy- most reduced
Which ketone has no method of detection
beta hydroxy
What is bilirubin vs urobilinogen
bilirubin- breakdown of hemoglobin
urobilingen- if billirubin is exposed to bacteria in the intestines- it becomes urobilinogen
What is the normal range for bilirubin in urine
any amount is significant
What tell tale sign is there of posthepatic altered bilirubin metabolism
white poop
What test uses ehrlich’s reaction
urobilinogen
What is ascorbic acid, what can it interfere with?
vitamin C,
blood, bilirubin, glucose and nitrite
causes false negatives
Name the normal ranges for RBCs WBCs Casts Epethelial cells squamous cells transitional renal bacteria and yeast abnormal crystals
RBCs : 0-3 WBCs: 0-8 Casts: 0-2 only hyaline squamous cells: few transitional : few renal: few bacteria and yeast: none abnormal crystals: none
What do eosinophils in urine indicate, how are they stained
acute intersitial nephritis, Hansel stain
ID: smooth, biconcave disk with no nucelus,
RBCs
ID: spherical, granular cytoplasm, lobed nuclei, glitter cells
WBCs
What do lymphs in urine indicate
renal transplant rejection
ID: spherical, large, granular, filled with debris
monocyte
Refractile monocyte with lipoproteins and fat inside
oval fat body
large, thin, irregular shapes, central nucleus, lots of cyotplasm
squamous epethelial
round or pear shape, borders appear firm, clublike, round oval nucleus off center sometimes
transitional epithelial cell
Small, cuboidal, columnar, off center nucleus
renal epithelial cells
acid pH, increased solutes, urine stasis, increased plasma
casts
How are casts formed
in distal and collecting ducts out of uromodulin, Tamm Horsfall
What conditions cause casts to disintegrate
hypotonic and alkaline
What type of casts can be in healthy indv
hyaline or finely granular
What are casts made of
uromodulin/ tamm horsefall protein
What type of casts are usually present
granular or waxy
The most clinically significant crystals are found in ____ urine
acid
What stains are used to see urine?
sternheimer-malbin
sudan, gram stain, prussian blue, hansel
thin, irregularly angles with a centrally located nucleus. Can be found in increased numbers if collection technique was poor.
squamous cells
What crystals are found in acidic urine
amorphous, acid urate, monosodium, uric acid and calcium oxalate
What crystals are in alkaline urine
amorphous phosphate, calclium phosphate, ammonium biurate, calcium carbonate
What crystals are of metabolic origin
bilirubin, cystine, tyrosine, cholesteriol
looks like brick dust, common, uroerythrin deposits of crystal making it look pink orange, refrigeration enhances precipitation
amorphous urate
envelope or dumbbell shape, usually small, possible under any pH
calclium oxalate
looks like grains of sand, white or grey precipitate, soluble in acid, no clinical significance
amorphous phosphate
looks like coffin, soluble in acetic acid, can be in healthy patients
triple phosphate
throny apple, irreglular with striations. Indicates dehydration, can cause renal tubular damage
ammonium biurate
notched corners, could mean lipiduria and proteinuria
cholesterol
