Lecture 16 - Urinalysis

Question 1

____, a first line drug for TB treatment, can turn urine Red.

Answer 1

Rifampin

Question 2

______, a drug used to treat cystitis, can turn urine Orange.

Answer 2

Pyridium

Question 3

Black urine may indicate malignant ______ (what cancer would make sense for such dark PIGMENT?), or may indicate ______ infection.

Answer 3

Malignant Melanoma

Malaria

Question 4

Blue color urine might indicate _______ infection or clearance of methylene blue.

Answer 4

Pseudomonas

Question 5

Pyuria (WBCs in urine) and accumulation of Chyle would cause the urine to be ______ in color.

Answer 5

White

Question 6

Normal urine pH = ____ - ____.

Answer 6

4.5 - 6.5

Question 7

If a patient exhibits metabolic Alkalosis, which would indicate improvement, alkaline urine or acidic urine?

Answer 7

Alkaline urine indicates improved clearance of HCO3- –> improved metabolic alkalosis.

Question 8

How does a patient’s glucose threshold change during pregnancy?

Answer 8

It decreases, so they may experience Glucouria with normal serum glucose levels.

Question 9

_____ is the only protein measured by dipstick urinalysis. ______ acid (SSA) is used to detect other proteins. If urinalysis comes back negative for ______ but positive for other proteins, consider Multiple Myeloma and other plasma cell dyscrasias.

Answer 9

Albumin

Sufosalicilic Acid (SSA)

Albumin

Question 10

Dipstick urinalysis can also detect ketones. Keep in mind it is more sensitive to ______ than Acetone or Beta Hydroxybutarate (BHB). This is something to consider during treatment of ketosis –> as patients recover, their metabolic redox will shift to producing more ______ and less BHB –> dipstick is more sensitive, so it may falsely appear like the patient is getting worse.

Answer 10

Acetoacetic Acid (ACAC)

ACAC

Question 11

Detection of “blood” on urinalysis actually indicates presence of Hb or Mb. If no RBCs in urine sediment –> diagnostic for ________. To differentiate between Hemoglobinuria and Myoglobinuria, look to the serum. What color will it be for each, respectively?

Answer 11

Rhabdomyolysis

Hemoglobinuria –> Pink
serum
Myoglobinuria –> Clear serum

Question 12

Acute Tubular necrosis:

Dipstick reading: _____

Sediment: Muddy Brown ____ ____ cast (RTCs) comprised of ______ cells.

Answer 12

Dipstick: Negative

Sediment: Renal Tubular Casts (RTCs) comprised of Epithelial cells.

Question 13

Acute Glomerulonephritis:

Dipstick reading: positive for ______ and ______.

Sediment: RBCs - _____ ; WBCs - ______; Casts - _____ and _____. Note: when casts are present, there’s likely a renal problem.

Answer 13

Dipstick: positive for Hematuria and Proteinuria

Sediment: RBCs - MANY

WBCs - FEW

Casts - RBC and WBC

Question 14

Chronic Glomerulonephritis can be distinguished from Acute by presence of MANY _____ on Sediment.

Answer 14

WBCs

Question 15

Acute Interstitial Nephritis:

Dipstick: Hematuria and Proteinuria

Sediment: RBCs - 1-10; WBCs - ____; Casts - _____.

Answer 15

WBCs - MANY

Casts - WBC

Question 16

Nephrotic Syndrome –> look for Proteinuria on dipstick and ___ ___ bodies (look like Maltese crosses) on polarized microscopy and/or ____ Casts.

Answer 16

Oval Fat Bodies

Fatty Casts

Question 17

_____ RBCs on microscopy suggests Renal bleeding as opposed to Cystitis.

Answer 17

Dysmorphic (spicules around the edges)

Question 18

Transluscent/ “Ghost” Casts are composed of _____, which suggests the urine is concentrated or patient is potentially dehydrated.

Answer 18

Hyaline

Question 19

Which type of cast is indicative of Acute Tubular Necrosis (ATN)?

Answer 19

Epithelial casts (Remember these are the Muddy Brown Renal Tubular casts).