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Urinalysis and Body Fluids 4214 > Exam 2: Review > Flashcards

Exam 2: Review Flashcards

1
Q

pH will _________ in the presence of bacteria.

A

increase

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2
Q

If the Urine is left at room temperature too long, it will give an ammonia smell produced by the bacteria which will decompose the _____.

A

urea

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3
Q

Urine creatinine concentrations are _____ times higher than plasma.

A

50

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4
Q

What three things are higher in urine that in other body fluids?

A

Urea, sodium, chloride

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5
Q

What is the physiologic SG urine range?
pH?

A

1.002 to 1.035

4.0 to 8.0

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6
Q

Urine from a healthy person contains no _______ or ________, where other body fluids do.

A

protein, glucose

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7
Q

Unpreserved urine color darkens due to _________.

A

oxidation

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8
Q

What causes decreased clarity of unpreserved urine?

A

Bacterial growth and precipitation of amorphous material.

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9
Q

What causes increased odor in unpreserved urine?

A

Bacterial multiplication causing breakdown of urea to ammonia

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10
Q

What causes increased pH in unpreserved urine?

A

Breakdown of urea to ammonia by urease-producing bacteria/loss of CO2

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11
Q

What causes decreased glucose in unpreserved urine?

A

Glycolysis

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12
Q

What are the normal pigments found in urine?

A

Uroerythrin and Urobilin

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13
Q

When is uroerythrin most evident?

A

when deposited on amorphous crystals in a stored urine specimen, causing a pink color or “brick dust” sediment

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14
Q

What are two possible causes of abnormally dark yellow urine?

A

-May be dehydrated
-May have high conversion of urobilinogen → urobilin

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15
Q

What are possible causes of amber/orange urine?

A

-RBC breakdown in alkaline urine
-May have bilirubin (shake and look at foam)
-Formation of urobilinogen - normal component to urine but photo oxidized and turns yellow orange. No yellow foam
-Patient maybe taking phenazopyridine to relieve symptoms of urinary tract infection

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16
Q

What can the foam of a urine sample indicate?

A

-yellow foam = may be bilirubin

-white foam = formation of urobilinogen (normal component of urine but photo oxidizes and turns yellow/orange)

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17
Q

What drug that is used to relieve symptoms of urinary tract infection can cause an abnormal amber/orange urine color?

A

phenazopyridine

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18
Q

What are two possible causes of pink colored urine?

A

-Oxidized porphobilinogen in patient with porphyria if specimen has set out too long
-Amorphous crystal formation causes a light pink color to form

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19
Q

What can cause a red color of urine?

A

RBCs, hemoglobin, beets

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20
Q

Three possible causes of brown/black urine?

A

-Myoglobin; muscle breakdown, too much is damaging to the kidney
-Oxidized melanogen in patient with malignant melanoma if specimen is set out too long
-Could also be blood or Hgb

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21
Q

Three possible causes of blue/green urine?

A

-Biliverdin
-Pseudomonas
-Propofol

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22
Q

What is common cause of urine color changes?

A

numerous drugs

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23
Q

What is the clinical significance of foam in urine?

A

-Not normally included on report forms
-Normal urine when shaken will produce white foam then rapidly dissipate
-Stable white foam indicated large amounts of albumin in urine
-Yellow foam caused by increased bilirubin

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24
Q

What genetic disorder can caue a Mousy odor?

A

PKU

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25
Q

What can cause a rancid odor?

A

Tyrosinemia

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26
Q

What can cause a sweaty feet odor?

A

isovaleric acidemia

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27
Q

What can cause a cabbage odor?

A

Methionine malabsorption

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28
Q

What can cause a bleach odor?

A

contamination

29
Q

The density of a solution compared with the density of an equal volume of distilled water at the same temperature

A

Specific gravity

30
Q

The GREATER the urine density, the _________ the specific gravity

A

larger

31
Q

How is SG different from osmolarity?

A

Osmolality depends on the number of particles in the solution, while specific gravity depends on the number and weight of the solutes. Osmolality is a better indicator of concentrating and diluting abilities of the kidney

32
Q

What value is isosthenuric?

A

1.010 (SG of plasma ultrafiltrate)

33
Q

What value is hypothenuric?
hepersthenuric?

A

lower than 1.010
higher than 1.010

34
Q

Normal random SG range?

A

1.003- 1.035: most common is 1.015- 1.025

35
Q

What is a more representative measure of renal concentrating ability?

A

Osmolarity

36
Q

Osmolarity is ONLY effected by…

A

the number of particles present

37
Q

What does SG depend on?

A

-number of particles present AND the density (size) of the particles

38
Q

Osmolarity can be determined by measuring a property that is mathematically related to the number of particles in a solution known as __________ property.

A

colligative

39
Q

What can cause changes in colligative properties?

A

-Lower freezing pt
-Higher boiling pt
-Increased osmotic pressure
-Lower vapor pressure

40
Q

What instrument is used to measure osmolarity?

A

osmometer

41
Q

Automated osmometer utilizes ______________ to measure osmolarity.

A

freezing point depression

42
Q

What are the most common causes of end stage renal disease?

A

-Diabetes mellitus and related diabetic nephropathy (Kimmelstiel-Wilson disease) -high blood pressure

43
Q

What are 3 diseases that may produce renal tubular epithelial cells?

A

-Alport’s syndrome
-Acute tubular Necrosis
-Acute interstitial nephritis

44
Q

Protein is present in most renal diseases due to __________ malfunction

A

glomerular

45
Q

High levels of protein: glomerular impairment especially __________ syndrome.

A

nephrotic

46
Q

Lower levels of protein are seen with…

A

tubular disorders and pyelonephritis

47
Q

Chronic inability to vary the urine specific gravity and sloughed off renal tubular cells → _________ disorders

A

tubular

48
Q

White blood cell casts usually indicate the infection is where?

A

in the kidneys rather than in the lower UT

49
Q

What should be suspected with there is acute onset of proteinuria and hematuria with suddenly decreased GFR?

A

One of the acute glomerulonephritis disorders

50
Q

Likely renal disease with Red blood cell casts?

A

Acute glomerulonephritis

51
Q

Likely renal disease with White blood cell cast?

A

Pyelonephritis

52
Q

Likely renal disease with Hyaline cast?

A

Strenuous activity, fever, diuretics, concentrated urine-dehydration

53
Q

Likely renal disease with Renal tubular cast?

A

Acute tubular necrosis, interstitial nephritis

54
Q

Likely renal disease with fatty casts?

A

Nephrotic syndrome, minimal change disease

55
Q

Likely renal disease with Broad, Waxy casts?

A

Chronic renal disease, chronic renal failure

56
Q

Likely renal disease with granular casts?

A

Nonspecific, often contains cells that have broken down/degenerated or contains aggregates of plasma proteins, seen more often in chronic conditions, but not exclusively

57
Q

3 causes of chronic kidney disease?

A

-hypertension (damages vessels)
-diabetes (blood vessel damage and edema)
-obesity (increases intraglomerular pressure)

58
Q

Infection of the kidney caused by the same bacteria that cause cystitis but the bacteria have ascended through the ureter to the kidney

A

Pyelonephritis

59
Q

Pyelonephritis can be differentiated from cystitis by the presence of…

A

WBC casts and renal epithelial cells

-both will have many WBCs

60
Q

What is seen in pyelonephritis as the disease progresses?

A

-granular and waxy casts
-high protein

61
Q

What may be absent in chronic pyelonephritis?

A

bacteria and casts

62
Q

Treatment of acute renal failure often leads to…

A

resolution

63
Q

Chronic renal failure almost always goes to…

A

End Stage Renal Disease (ESRD)

64
Q

Mortality rates are high in acute renal failure, but it is not a __________ disease like the chronic form.

A

progressive

65
Q

What are the four stages of renal failure?

A
  1. Diminished renal reserve
  2. Renal insufficiency
  3. Renal failure
  4. End stage renal disease
66
Q

stages of Chronic Renal Failure:

GFR drops to about 50% of normal

A
  1. Diminished renal reserve
67
Q

stages of Chronic Renal Failure:

-further GFR decrease
-BUN and serum creatinine -increase (azotemia)
-Anemia
-Hypertension

A
  1. Renal insufficiency
68
Q

stages of Chronic Renal Failure:

GFR <20%
Loss of urine volume and solute regulation
Acidosis
Edema

A
  1. Renal failure
69
Q

stages of Chronic Renal Failure:

GFR <5%
Scarring
Tubular fibrosis
Loss of kidney mass
Dialysis and/or kidney transplant required for survival

A
  1. End stage renal disease

Urinalysis and Body Fluids 4214 (14 decks)

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