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UA > Intro > Flashcards

Intro Flashcards

1
Q

the urinary system is composed of what four main components and their functions

A
  1. Kidneys- produce urine/ metabolic balance / produce hormones ( erythropoitin, renin, calcitrol)
  2. ureters- carry urine to bladder
  3. bladder- stores the urine produced
  4. urethra - delivers the urine for excretion
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2
Q

The renal artery, renal vein and ureter all leave the kidney through the indentation of the ___ of each kidney

A

Hilus

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3
Q

The internal kidney consists of what:

A
  • cortex
  • medulla ( pyramids
  • minor calyces, major calyces
  • renal pelvis
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4
Q

what is the main functional unit of the kidney

A

nephron

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5
Q

where are the nephrons located

A

renal cortex

renal medulla

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6
Q

the nephron consists of:

A

glomerulu - for blood filtration

  • proximal convuluted tubule
  • loop of hence
  • distal convoluted tubule
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7
Q

T/F

proximal convoluted tubule, loop of henle and distal convolutes tubule are for blood filtration

A

False

glomerulus is for blood filtration .. the rest is for reabsorption and secretion

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8
Q

Nephrons empty into ____ that run out to the minor calyx, major calyx , renal pelvis

A

collecting ducts

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9
Q

Name the 2 nephron types and their location

A
  • cortical nephrons are mostly within the cortex, have short length of the loop of hence
  • Juxtamedullary - extend deep into the medulla and ;have long loop of henle
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10
Q

____ % of the blood leaving the left ventricle of the heart enters the kidneys via the renal arteries

A

20-25

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11
Q

what is the rate of the blood passes through the kidneys

A

1200 ml/min or 600ml/min/kidney

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12
Q

T/F

the Efferent arterioles form the capillary tuft known as the glomerulus

A

False

afferent

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13
Q

what surrounds each glomerulus

A

bowman’s capsule

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14
Q

The outer layer of Bowman’s capsule is composed of squamous epithelium … what is the AKA of those cells

A

parietal epithelial cells

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15
Q

the visceral layer of bowman’s capsule is composed of what kind of specialized cells

A

podocytes

aka visceral epithelial cells

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16
Q

what are the three major components of glomerular capillary wall accounting for the glomerular filtration

A
  1. endothelial cells with fenestra
  2. glomerular basement membrane
  3. visceral epithelial cells aka podocytes
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17
Q

T/F

glomerular walls are ultra filters that are very permeable to water

A

true

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18
Q

approximately ___ or ___ of the renal plasma is filtered in the glomeruli

A
  • 90- 120

- one- fifth

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19
Q

Ultrafiltrate is composed of what:

A 
- water
electrolytes
- glucose
- amino acids
- urea
- uric acid 
- creatinine 
- ammonia
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20
Q

what is a key indicator of kidney function and is used to monitor kidney disease progression

A

Glomerular filtration rate ( GFR)

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21
Q

AKA for dipstick

A

reagent strip testing

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22
Q

what are the two main objectives of pH

A
  1. diagnostic ( metabolic abnormalities )

2. Therapeutic ( regulation of diet )

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23
Q

pH color chart

  • acid indicator= ?
  • alkaline indicator = ?
A
  • methyl red

- bromthymol blue

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24
Q

T/F

read dipstick 90 seconds after dipping

A

false

60 seconds

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25
Q

what is the pH ranges

A

5.0 to 8.5

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26
Q

List the factors in persistent acidity

A
  • acidifying drugs
  • dehydration
  • diarrhea
  • fever
  • diabetes
  • gout
  • high protein diets
  • pulmonary emphysema
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27
Q

List the factors resulting in persistent alkalinity

A
  • alkaline drugs
  • acute and chronic renal failure
  • diuretics
  • urinary tract infections
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28
Q

T/F

Mucoprotein Tamm- Horsfall (T-H) is derived from blood plasma

A

False
it is not derived from blood plasma
is secreted by the renal tubules

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29
Q

less than ___ or ___ of T-H protein is excreted

A
  • 150 mg/24h

- 20 mg/dl

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30
Q

T-H is a matrix for formation of ___ or ___

A
  • calculi

- casts

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31
Q

what is testing for protein based on phenomenon what does it mean

  • which protein is most sensitive
  • which is the most common indicator
A

protein error of indicators

  • ability of protein to alter the color of some acid - base indicators without altering the pH
  • albumin
  • tetrabromphenol blue
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32
Q

urine protein false positive may result from

A
  • highly buffered alkaline urine (meds or old pee)
  • prolonged exposure to the sample
  • container cleaning compounds
  • some skin cleaners
  • blood in urine
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33
Q

urine protein false negative may result from :

A
  • dilute urines

- elevated amounts of proteins other than albumin

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34
Q

list the factors that could result in temporary proteinuria (transient proteinuria)

A
  • strenuous exercise
  • postural proteinuria
  • dehydration
  • exposure to heat or cold
  • fever
  • emotional stress
  • pregnancy
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35
Q

name the diseases causing persistent proteinuria

A
  • glomerulonephritis
  • pyelonephritis
  • malignant hypertension
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36
Q

T/F

Glucose is usually present in urine

A

False

usually not present unless threshold levels exceeded 160–180 in blood mg/dl

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37
Q

List the factors for urine glucose : false positive :

A
  • after using oxidizing cleaning agents for urine containers
    - peroxide - hypochlorite
  • patients taking levodopa
  • when high levels of ketones are present in urine
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38
Q

Urine glucose False negative:

A
  • cool urine
  • urine with high specific gravity due to uricosuria
  • alkaline urine due to bacterial contamination of old urine
  • ascorbic acid ( vitamin C) in high doses
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39
Q

What is know ass Transient glucosuria

A
  • glucose can be present in urine in two hours after sweet food
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40
Q

Glucosuria dependent on :

A
  • blood glucose levels
  • glomerular filtration rate
  • tubular reabsorption
  • seen in diabetes mellitus and congenital forms of glucosuria
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41
Q

Persistent glucosuria develops in

A
  • diabetes mellitus
  • CNS problems (stroke , neoplasms)
  • kidney problems
  • endocrine problems
  • liver disorders
  • pharamaceutical agents
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42
Q

what test is used as a method for the measurement of sugars in urine

A
  • Clinitest
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43
Q

Clinitiest detects all reducing sugars except ___

A

glucose

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44
Q

Clnitest is used predominately for diagnosis of ____ because the dipstick test does not work

A

galactosemia

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45
Q

Clinitest false positive

A
  • ascorbic acid
  • cephalosporins
  • probenecid
  • urinary preservatives
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46
Q

Clinitest false negative

A

technique errors

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47
Q

This test is a screening test for diagnosis of genetic disorders of carbohydrate metabolism

A

Urine reducing sugar test

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48
Q

the urine reducing sugar test predominately used for early detecting of what disorder

A

Galactosemia

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49
Q

____ are produced normally by the liver as part of fatty acid metabolism

A

Ketones

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50
Q

when may it occur that ketones would show up in the urine

A

if the body cannot get enough glucose for energy it will switch to using body fats - resulting in an increase in ketone production

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51
Q

Ketones bodies that commonly appear in the urine when fats are burned for energy are:

A
  • acetoacetic acid
  • beta- hydroxybutric acid
  • acetone is also produced and is expired by the lungs
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52
Q

T/F

the urine should contain a noticeable concentration of ketones to give a positive reading

A

False

it should not contain

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53
Q

T/F

dipstick test determine acetoacetic acid and acetone but not beta- hydroxybutric acid

A

False

it only determines acetoacetic acid

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54
Q

T/F

dipstick test determine acetoacetic acid and acetone but not beta- hydroxybutric acid

A

False

it only determines acetoacetic acid

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55
Q

name the characteristics of urine ketones with false positive or atypical color

A
  • highly pigmented urines
  • combination of high specific gravity and low pH
  • dehydration
  • phenlketones
  • meds
  • ascorbic acid
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56
Q

What determines urine ketone falls negative

A

delay in testing (old purine)

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57
Q

ketone bodies can be determined in :

A
  • diabetes mellitus
  • malabsorption syndrome
  • exposure to cold
  • fasting - fever
  • insufficient carbohydrate intake
  • maltutrition
  • strenous exercise
  • vomiting
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58
Q

Urine blood test false positive

A
  • oxidizing contaminants
  • hypochlorites
  • bacterial peroxidases
  • menstrual blood
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59
Q

Urine blood test false negative

A
  • technique errors inadequate mixing
  • formalin preservative
  • high concentrations of absorbic acid
  • high specific gravity
  • nitrates
  • proteins
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60
Q

what is the significance of hematuria

A
  • intact RBCs are found in urine sediment
  • if they are lysed - ghosts cells
  • urine may appear normal with small amounts of RBCs
  • urine gets red color with greater amounts of blood
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61
Q

Transient hematuria may result from :

A
  • strenous exercise

- menstrual contamination

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62
Q

when would persistent hematuria occur

A
  • renal diseases
  • patients with
  • urolithiasis
    urinary tract infections
  • urinary tract tumors
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63
Q

when would persistent hematuria occur

A
  • renal diseases
  • patients with
  • urolithiasis
    urinary tract infections
  • urinary tract tumors
  • prostatic cancer
    -related to anticoagulant therapy
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64
Q

significance of hemoglobinuria ?

A
  • incompatible blood transfusion
  • hemolytic anemias
  • immunohemolytic anemias
  • burns
  • electric shock
65
Q

Myoglobinuria may be due to

A
  • damage to cardiac or skeletal muscles
  • rhabdomyolysis
  • electric shock
  • myocardial infection
  • heroin abuse
  • alcoholism
  • after strenuous physical activity
66
Q

T/F

both hemoglobin and myoglobin will produce positive reagent strip blood results because both contain heme

A

True

67
Q

clear plasma plus red urine equals ____

A

myoglobulin

68
Q

Red plasma plus red urine equals ___

A

hemoglobin

69
Q

Red plasma plus red urine equals ___

A

hemoglobin

70
Q

Red plasma plus red urine equals ___

A

hemoglobin

71
Q

The amount go conjugated bilirubin present in serum in healthy subjects is less than ___ %

A

10

72
Q

An elevated level of conjugated serum bilirubin implies:

A
  • liver disease

- cholestatic diseases

73
Q
  • bilirubinuria also implies what
A

liver or cholestatic diseases

74
Q

urine bilirubin false positive

A
  • technique errors
  • atypical color reactions produced by some medicines
  • confirm results with ictotest
75
Q

urine bilirubin false negative

A
  • large amounts of ascorbic acid decrease the sensitivity of the dipstick
  • high levels of nitrite
  • exposure to light and room temp
76
Q

when bilirubin is present in urine it may indicate :

A
  • gallbladder - bile duct obstruction

- liver pathology

77
Q

when bilirubin is present in urine it may indicate :

A
  • gallbladder - bile duct obstruction

- liver pathology

78
Q

urobilinogen (colorless) oxidizes to ____

A

urobilin

79
Q

what is the normal level of urobilinogen

A

1-4mg/24h or less than 1.0 ehrlich

80
Q

urine urobilinogen false positive

A
  • aspririn
  • sulfonamides
  • nitrites
  • porphyria
81
Q

urine urobilinogen false negative

A
  • use of stale urine that has been exposed to light

- formalin

82
Q

what is the significance of urine urobilinogen significance

A
  • normally present in low amounts
  • peak levels between 2-4 pm
  • elevated in
    • liver disease
    • intestinal obstruction
      • hemolytic anemia
      • hemolysis
83
Q

urine nitrite false positive

A

dipstick is highly sensitive to air exposure

- specimen contaminating by bacteria

84
Q

urine nitrite : false negative

A
  • specimen containing non- nitrate reducing pathogens
  • insufficient time in the bladder
  • low or no nitrate diet
  • elevated specific gravity of urine
  • high level of urobilinogen in urine
  • ascorbic acid
85
Q

what is the appearance of a RBC when specific gravity is more than 1.025

A

it becomes crenated the RBC loses the smooth texture

the urine becomes hypertonic

86
Q

when urine is hypotonic urine .. the speicif gravity is less than ____

A

1.025

87
Q

what does the RBC appear like in hypotonic urine

A

it appears as Ghosts cells ( partially lyesd)

88
Q

More than 3 RBC per high power field is ____

A

hematuria

89
Q

list the causes of Hematuria

A
  1. Glomerular disease
  2. Other renal diseases
  3. other urniary tract diseases
  4. pathology outside of urinary system
90
Q

what is the normal amount of WBC in a high power field

A

0-5 per high power

91
Q

More than 20 WBC per HPF may indicate _____

A

pyuria

92
Q

T/F

WBC contain nuclei and granules

A

True

93
Q

Increased WBC could be found in what type of physiological states

A
  • dehydration , fever

- strenous exercise

94
Q

Increased WBC could also be found in what other type of diseases

A
  • acute pyelonephritis
  • kidney stones
  • inflammation of ureter , bladder, urethra
  • urolithiasis
  • prostatis
  • balantis
95
Q

name the three type of epithelial cells found in urine

A
  • rena
  • transitional
  • squamous cells
96
Q

Name the origin of the epithelial cells

  • renal
  • transitional
  • squamous
A
  • convuluted tubules
  • renal pelvis to proximal two thirds of urethra
  • lower urethra or vagina
97
Q

T/F

renal cells are very common to be seen in urine

A

False

very rare

98
Q

increased numbers of renal epithelial cells may suggest tubular damage in

A
  • pyelonephritis
  • acute tubular necrosis
  • acute trauma of kidney
  • kidney transplant rejection
  • neoplasms
99
Q

Oval Fat bodies are what kind of epithelial cell

A

Renal tubular epithelial

100
Q

What are Oval Fat bodies

A

absorbed lipoproteins with cholesterol and triglycerides leaked from nephrotic glomeruli

101
Q

The presence of any oval fat bodies may be accompanied by what kine of problems

A
  • proteinuria ( nephrotic syndrome)
102
Q

T/F

Fat is detected by chemical tests

A

False

103
Q

Lipilduria develops due to :

A
  1. degeneration of tubules
  2. fat embolism
  3. extensive injuries
  4. fractures of the long bones
104
Q

What type of cell originates outside of kidneys .. look like hard boiled egg and contains small nucleus

A

Transitional cell

105
Q

What is the normal amount of transitional cells

A

0-few

106
Q

increased amount of transitional cells could be found in what disorders

A
  • urinary tract infection
  • cetherterisation
  • cancer of unrinary tract
107
Q

Which cell is flat scale - like

contains small nuclei

A

Squamous

108
Q

larger number of squamous cells could represent in what

A
  • vaginitis
  • urethritis
  • testicular tumor
109
Q

what is the normal amount of squamous cells

A
  • 30 cells per field
110
Q

what is smooth, colorless

  • may be budding
  • can be mistaken as RBC
A

Yeast

111
Q

T/F

crystals are usually not found in freshly voided urine

A

true

112
Q

what are the prerequisites for identification of crystals

A
  • pH of urine
  • morphology of crystals
  • crytsals solubility
  • crystals polarization
113
Q

What type of light is used for identification of crystals

A

polarized

114
Q

Normal crystals found i acidic urine

A
  • uric acid
  • calcium oxalates
  • amorphous urates
115
Q

uric acid is commonly formed when urine pH is ___

A
116
Q

when are uric acid crystal pathological

A

when seen in freshly voided uroine

117
Q

a high uric acid level in urine may be due to what

A
  • gout
  • high purine diet
  • Lesch- Nyhan syndrome
  • cancer metatases
  • rhabdomyolisis
  • myeloproliferative disroders
118
Q

Low uric acid levels may indicate what

A
  • inability of kidney to get rid of uric acid well
  • chronic glomerulonehritis
  • lead poisoning - long- term alcohol use
119
Q

Amorphous urates often seems in :

A
  • acidic urine
  • ## after refrigeration
120
Q

Sodium urates are formed in urine when pH is what

A

6.8 - 7

121
Q

What are the crystals commonly found in alkaline urine

A
  • triple phosphates
  • calcium carbonates
  • ammonium biurate
122
Q

AKA for triple phosphate crystals

A

magnesiums ammonium phospahte

123
Q

Ammonium Biurate in alkaline urine pH ___

A

9

124
Q

what are the abnormal crystals of metabolic origin

A
  • Cystine
  • tyrosine
  • leucine
  • cholesterol
125
Q

Cystine are typically found in ___ urine with pH ___

A

acidic

pH

126
Q

Cystine stones which fill in ___ system , results in formation of ____

A

renal collecting

- staghorn

127
Q

Which abnormal crystal is found in severe liver disorders

A

Tyrosine

128
Q

Cholesterol crystals are accompanied by

A
  • positive biochem test for protein
  • oval fat bodies
  • fatty casts
  • free fat droplets
129
Q

Epithelial cell casts may be present in what type of kidney problems

A
  • acute tubular necrosis after exposure to nephrotoxic agents
  • due to damage that accompanies glomeerular injury
  • in rejection of a kidney allograft
130
Q

which casts can result from either from breakdown of cellular casts or inclusion of aggregates of plasma proteins or immunoglobulin
- usually indicate chronic renal diseases

A

Granular casts

131
Q

___ casts represent the end stage of cast evolution , suggest the very low urine flow associated with severe longstanding kidney disease such as renal failure

A

Waxy Casts

132
Q

GFatty casts are present in which type of degenerative tubular disease

A
  • nephrotic syndrome with heavy proteinuria
  • diabteticnephropathy ( diffuse glomerulosclerosis Kimmelstiel- Wilson lesions)
  • Luppus nephritis
  • toxic renal poisoning
133
Q

The formation of casts at the distal convoluted tubule may produce structures with a tapering end, referred to as _______

A

cylindroids

134
Q

what are some congenital variations affecting the urinary tract

A
  • duplicate set of ureters
  • horeshoe kidney
  • Vesicoureteral reflex
135
Q

what are some acquired problem affecting the urinary tract

A
  • accidents and injures damage the kidneys or UT

- Benign prostatic hyperplasia

136
Q

which is the most common renal congenital abnormality which is characterized by presence of additional ureter

A

Duplicated ureter

137
Q

Renal fusion or super kidney is a congenital disorder affecting 1 out 500 people

A

horseshoe kidney

138
Q

what are the most common disorders seen with horseshoe kidney

A
  • turner syndrome

- trisomy 18

139
Q

T/F
Trisomy 21 is a serious chromosome abnormality characterized by defects in nearly all organs and systems , including development of kidney in 20% of affected children

A

False

it is trismoy 18

140
Q

T/F

horseshoe kidney is most common in females

A

True

141
Q

T/F

horseshoe kidney is often very symptomatic

A

False

it is asymptomatic

142
Q

Horseshoe kidney may increase risk for development of :

A
  • kidney obstruction
  • hydronephrosis
  • pyelonephritis
  • urolithiasis
  • kidney cancer
143
Q

_______ is an abnormal retrograde movement of urine from bladder into ureters

A

Vesicoureteral Reflux (VUR)

144
Q

T/F

VUR primary occurs when an obstruction in the bladder or urethra causes urine to flow backward into kidneys

A

False — secondary

- primary is the defect in development of the uretral valve at the end of the ureter ( only in children)

145
Q

VUR may result in :

A
  • hydronephrosis

- pyelonephritis

146
Q

Name the signs and symptoms for acute cystitis

A
  • dysuria
  • increased frequency of urination
  • increased urinary urgent
  • lower abdominal pain
  • rare fever, chills
147
Q

list the signs and symptoms of pyelonephrits

A
  • fever, chills
  • flank pain
  • dysuria
  • nausea, vomitting
148
Q

what are the urinary tract infection urinalysis findings

A
  • increased count of leukocytes
  • positive leukocyte esterase
  • prescience of bacteria
  • may be positive for nitrite
  • WBC ssts may be present, they indicate only kidney infection
149
Q

______ are common cause of upper urinary tract obstruction

A

Kidney stones

150
Q

what is the classic presentation for a patient with acute renal colic

A

sudden onset of severe pain originating in the flank and radiating inferiorly and anteriorly

151
Q

chemical substances that forms stones

A
  • calcium oxalte
  • calciumm phosphate
  • magnesium ammonium phosphate
  • uric acid
  • cystine
152
Q

Diabetic neuropathy is characterized by

A
  • glomerular lesions
  • renal angiopathy
  • pyelonephritis
153
Q

what is the significance of good pasture’s syndrome

A
  • autoimmune
    formation of autoantibodies againsts glomerular and alveolar basement membranes
    – lungs are also affected
154
Q

Berger’s disease is characterized by deposition of IgA and IgA immune complexes into mesangium
T/F

A

True

155
Q

the most common disease associated with nephrotic syndrome in adults

A

mebranous glomerulunephritis

156
Q

what is characterized with membranous glomerulunephritis

A

diffuse thickening of the glomerular capillary wall

157
Q

what is the most frequent cause of nephrotic syndrome in children

A

minimal change disease ( Lipoid Nephrosis)

158
Q

what is characterized by Lipod Nephrosis

A

diffuse loss of foot processes of podocytes that cannot be detected by light microscopy but can be found by electron microscopy

159
Q

this lesion is characterized by sclerosis of some glomeruli and in the affected glomeruli and in the affected glomeruli only a portion of the capillary tuft is involved

A

Focal segmental glomerulosclerosis

UA (3 decks)

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