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Clinical Lab > Intro, Urine Studies, & CMP > Flashcards

Intro, Urine Studies, & CMP Flashcards

1
Q

Presence of ketones could be from?

A 
Metabolic abnormalities (DM, hyperthyroidism)
Dietary conditions (vomiting, diarrhea, anorexia, high fat/low carb diet)
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2
Q

Increased levels of Magnesium can be found in:

A 
acute/chronic renal failure
dehydration 
hypothyroidism 
Addison's disease 
Magnesium supplementation
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3
Q

Alkaline urine seen in:

A

Chronic renal failure

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4
Q

Diseases that would have hypersthenuria

A

DM
dehydration
CHF

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5
Q

Decreased levels of Magnesium can be found in:

A

hypercalcemia; diabetic acidosis; hemodialysis; chronic pancreatitis; chronic cirrhosis; chronic glomerulonephritis

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6
Q

Calcium is important for:

A

neuromuscular activity
blood coagulation
bone metabolism
maintaining functional integrity of cell membranes

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7
Q

What are reasons for increased total bilirubin?

A 
bile duct obstruction
cirrhosis of the liver
hepatitis 
infectious mono
chemotherapy
malignancy of the liver or gallbladder
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8
Q

A cause of this could be patients who are post dialysis

A

Hypokalemia

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9
Q

Increased levels of blood phosphorous levels are most commonly found:

A

In association with kidney dysfunction

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10
Q

Symptoms of hypermagnesium

A 
Weakness
Nausea/vomiting 
Impaired breathing 
Hypotension
Arrhythmias
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11
Q

Symptoms of hypomagnesium

A

Tetany

Involuntary contraction of muscles

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12
Q

What type of cast can be found in patients who were exposed to a toxin or virus?

A

Epithelial casts

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13
Q

This most commonly occurs with hypervolemia caused from diseases of the liver and kidney, like cirrhosis and chronic kidney disease

A

Hyponatremia

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14
Q

Calcium oxalate crystals can indicate

A

chronic renal failure; or be from high doses of ascorbic acid/Vitamin C

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15
Q

Liver functions:

A

protein synthesis; production of biochemicals; decomposition of RBCs; metabolize and store carbohydrates; hormone production; production of blood clotting factors; breakdown drugs, alcohol and other toxins

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16
Q

A 24 hour urine collection useful when looking at patients is?

A 
Electrolyte balance
Acid-base balance
Total protein excretion
Metabolism Imbalance
Hormonal imbalance
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17
Q

Too much or too little sodium in the body leads to?

A

Cell malfunction and possibly cell death

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18
Q

Hypernatremia causes:

A

sodium overload from ingestion
intravenous infusion
hyperaldosteronism

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19
Q

Acidic urine may be seen in:

A

Metabolic acidosis
Respiratory acidosis
UTI

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20
Q

People who are on diuretics can suffer from?

A

Hyponatremia

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21
Q

Most commonly caused by renal insufficiency, acute or chronic

A

Hyperkalemia

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22
Q

symptoms of liver damage include:

A

pale stools; dark urine; jaundice; swelling of the abdomen, ankles, and feet; excessive fatigue; bruising and easy bleeding

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23
Q

Hypercalcemia is associated with

A

Hypoparathyroidism
Malignancy (CA)
Vitamin D toxicity

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24
Q

3 types of crystals in patients with kidney stones?

A

Uric acid crystals
Crystine crystals
Calcium oxalate crystals

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25
Q

What type of cast is found in patients with pyelonephritis?

A

WBC cast

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26
Q

What type of cast indicates severe renal failure or nephrotic syndrome?

A

Waxy casts

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27
Q

What type of cast is found in nephrotic syndrome?

A

Fatty casts

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28
Q

What are the 4 most probably pathogens in a UTI?

A

E. coli–>most common
S. saprophyticus
P. aeruginosa
S. aureus

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29
Q

Reddish urine can be from?

A

hematuria; hemoglobinuria; myoglobin; menstrual contamination; certain medications; consumption of foods (beets, rhubarb and food dyes)

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30
Q

sodium levels of >160 can lead to?

A

Heart failure

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31
Q

Casts are made of?

A

WBCs, RBCS OR

kidney cells and proteins secreted from the renal tubule

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32
Q

What type of cast is found in glomerulonephritis?

A

RBC cast

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33
Q

What type of cast indicates acute tubular necrosis?

A

Granular casts

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34
Q

Green urine can be from?

A

Pseudomonal infection
Bilirubin
Medications

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35
Q

Increased cellular uptake of potassium into the cells as in excessive amount of insulin and metabolic acidosis can lead to

A

Hypokalemia

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36
Q

Increased urobilinogen may be present in what diseases?

A

Hemolytic disease
Hepatic disease
*Not biliary obstruction

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37
Q

Ketones evaluate for the presence of?

A

Acetone

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38
Q

5 non-renal causes for proteinuria:

A

Infection; Stress: Leukemia; Pre-eclampsia in pregnancy; Kidney stones

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39
Q

When the body loses water, what is the order the body pulls excess fluid from?

A

Plasma
Interstitial Fluid
Intracellular fluid

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40
Q

How are protein results recorded?

A

Negative
Trace
1+, 2+, 3+, or 4+

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41
Q

Symptoms of hypernatremia:

A

Lethargy; weakness: confusion; muscle twitching; tremors; seizures; irritability

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42
Q

A serum sodium level of <110 can lead to

A

Seizures and coma

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43
Q

Symptoms of hyponatremia:

A

Nausea; Malaise; HA; Lethargy; Confusion; Muscle twitching; Weakness

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44
Q

Acidosis, low insulin levels, and beta blocker therapy can cause

A

Hyperkalemia

45
Q

“Pins and Needles” feeling is due to:

A

Hypocalcemia

It is an example of tetany

46
Q

______% of Calcium is bound in the skeleton

47
Q

Hypocalcemia is associated with:

A

Hypoparathyroidism
Vitamin D deficiency
Hypoalbuminemia
Pancreatitis

48
Q

______ is required for generation of bony tissue and functions in the metabolism of glucose and lipids, in the maintenance of acid-base balance, and in the transfer of energy from site in the body to another

49
Q

Urine bilirubin indicates

A 
Liver dysfunction (hepatitis or cirrhosis)
Biliary tract infection
50
Q

_____ removes bilirubin from the blood

51
Q

Muscle cramping, pre-ventricular contractions, fatigue, confusion, weakness are all signs of issues with

A

Neuromuscular control

52
Q

This electrolyte helps maintain electrolyte balance, hydration and osmotic balance

53
Q

What are ways the body loses water?

A

Sweating
Fever
Hydration

54
Q

Gastrointestinal losses prolonged vomiting or nasogastric suctioning is the most common reason for:

A

Hypochloremia

55
Q

What is the treatment for neonatal jaundice?

A

Phototherapy

56
Q

How many days does it take neonatal jaundice to occur?

57
Q

Neonatal jaundice is due to an elevated?

A

Unconjugated bilirubin

58
Q

What type of bilirubin is water soluble?

A

Conjugated bilirubin

59
Q

What form of bilirubin is not water soluble?

A

Unconjugated bilirubin

60
Q

Total bilirubin can be divided into:

A

Conjugated and unconjugated bilirubin

61
Q

Total bilirubin is a product of?

A

The breakdown of hemoglobin

62
Q

What is the most abundant electrolyte in the human body?

63
Q

When Calcium levels are ____, phosphorous levels are increased

A

Decreased

*Calcium levels increased, Phosphate levels are decreased

64
Q

Peaked T-waves on an EKG indicate?

A

Hyperkalemia

65
Q

______-______% of Potassium is excreted in urine

66
Q

Potassium is excreted in the urine by the?

A

Glomeruli of the kidneys

67
Q

Potassium is the major ____ cation

A

Intracellular

68
Q

How many mL of urine are filtered daily?

69
Q

Glomeruli function

A

Main filtering system in the kidneys (cortex)

70
Q

Tubule function

A

Reabsorption and secretion

71
Q

Components of a nephron

A

Glomerulus and tubule

72
Q

What helps to maintain salt and water balance?

A

Loop of Henle of the nephron and the collecting ducts

73
Q

Components of urine

A

95% water
2% urea
Other: chloride, sodium, potassium, sulfur, phosphate, creatinine, hormones, vitamins, meds

74
Q

Patient steps for peeing in a cup

A
  1. Clean external genitalia
  2. Collect midstream
    - Collect from catheter tubing and not from the bag
75
Q

2 components of gross evaluation

A

Turbidity and Color

76
Q

Orange urine can be from?

A

Medications; Large consumption of carrots

77
Q

what type of container should be used for collecting a culture and sensitivity

A

Sterile container

78
Q

Urine dipstick test components (10):

A

specific gravity; pH; protein; glucose; ketones; heme; leukocyte esterase; nitrite; bilirubin; urobilinogen

79
Q

Diseases that would have hyposthenuria

A

Diabetes Insipidus

Glomerulonephritis

80
Q

What are 3 indications for culture (after positive dipstick)?

A
  1. Patient has atypical symptoms or complicated infection
  2. Patient didn’t respond to first abx
  3. Symptoms reoccur within one month of last UTI
81
Q

What type of cast is considered a normal finding

A

Hyaline casts

82
Q

What type of crystal is the most common in kidney stones?

A

Calcium oxalate crystals

83
Q

Uric acid crystal may correlate with?

84
Q

Main cells found in urine sediment? (3)

A
  • RBCs
  • WBCs
  • Epithelial cells (majority are squamous epithelial–>benign; renal epithelial cells–>tubular damage)
85
Q

What 4 things does the microscopic exam of urine sediment examine?

A

Microorganisms
Cells
Casts
Crystals

86
Q

High glucose levels are seen with patients who have?

A

DM

Gestational diabetes

87
Q

How are bilirubin results recorded

A

Negative
1+, small
2+, moderate
3+, large

88
Q

Decreased levels of bicarbonate

A

Metabolic acidosis

89
Q

This electrolyte regulates the total amount of water in the body

90
Q

Sodium is a ____ cation

A

Extracellular

91
Q

Protein in the urine is usually in the form of?

92
Q

Increased levels of bicarbonate

A

Metabolic alkalosis

93
Q

Protein in the urine often indicates?

A

Renal disease

94
Q

The presence of nitrites in the urine indicates the presence of?

95
Q

Ketonuria in DM patients suggests:

A

Inadequate blood sugar control

96
Q

What fraction of ECFV is in interstitial fluid

A

3/4th–>interstitial fluid

97
Q

What fraction of ECF is in plasma volume

A

1/4th–>plasma volume

98
Q

What fraction of TBW is in intracellular fluid

A

2/3rd is in ICFV

99
Q

What fraction of TBW is in the extracellular compartment

A

1/3rd is in ECFV

100
Q

What is urobilinogen?

A

product from the breakdown of bilirubin in the intestine

101
Q

What type of bilirubin is found in the urine if present?

A

Conjugated/direct bilirubin

102
Q

3 functions of electrolytes

A
  1. Water maintenance
  2. pH balance
  3. Neuromuscular control
103
Q

What part of contrifuged blood is used in a CMP

A

Plasma portion

104
Q

Is conjugated bilirubin water soluble or not?

A

Water soluble

*Unconjugated is not water soluble

105
Q

Components in a CMP

A

Potassium; Chloride; Sodium; Glucose; Creatining; Blood Urea nitrogen; ALT; AST; ALP; Total bilirubin; Calcium; Bicarbonate; Total protein; Albumin

106
Q

What are the 2 types of bilirubin?

A

Unconjugated/Indirect & Conjugated/Direct

107
Q

A complete urinalysis includes:

A
  1. Gross evaluation
  2. dipstick
  3. Microscopic Exam
108
Q

pH range

109
Q

Normal arterial pH

Clinical Lab (4 decks)

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