Midterm Flashcards
Clinical significance of pale yellow urine?
Normal
Clinical significance of straw-like colored urine?
Normal—dehydration
Clinical significance of red colored urine
Blood in urine (hematuria)
Clinical significance of coca-cola colored urine
Acute glomerulonephritis
Clinical significance of orange (dark-amber) colored urine
Urobilinogen
Clinical significance of green urine
Bile, bile pigments
Clinical significance of sweet/fruity smelling urine
Ketone bodies—diabetes mellitus
Clinical significance of ammonia smelling urine
Bacteria, urine retention
Clinical significance of foul smelling urine
Bacteriuria
Clinical significance of extremely turbid appearing urine
WBCs, mucus, bacteria, dehydration
Clinical significance of clear appearing urine
Normal
What is the confirmatory test for ketone?
Ketostix
What is the confirmatory test for glucose?
Diastix
What is the confirmatory test for albumin/protein?
Albustix
What is the confirmatory test for bilirubin?
Icotest
What could a WBC cast be indicative of?
Acute pyelonephritis
What could the presence of RBC cast be indicative of?
Acute glomerulonephritis
Greater than ______/HPF of RBCs is abnormal. List DDx
2; hematuria—nephrolisthiasis, acute glomerulonephritis, cystitis, renal infarction
Greater than ____/HPF of WBC is abnormal. List DDx
5; pyelonephritis, renal tuberculosis, cystitis
What are 2 reasons that a patient could have Stix negative for nitrites and still have a UTI?
Not all bacteria can reduce nitrates to nitrite, urine must be in bladder for at least 4 hrs
How can you tell functional proteinuria from organic proteinuria?
If the patient has other associated s/s
What are several causes of functional proteinuria?
High protein diet, orthostatic proteinuria
What are 2 causes of increased specific gravity?
Dehydration, diabetes mellitus
What is a cause of low specific gravity?
Over-hydration, diabetes insipidous
What is the significance of the level of epithelial cells in a UA?
Possible contamination
If a UA has trace ketonuria, how would you tell if it could be diabetes mellitus or not?
Presence/absence of glucose
What is the renal threshold for glucose? What is the significance?
180 mg/100mL; if there is glucosuria, the blood glucose must be greater than 180
What pathognomonic formed element is most likely seen with pyelonephritis?
WBC cast
What pathognomonic formed element is most likely seen with acute glomerulonephritis?
RBC cast
What is the most likely diagnosis of glucosuria?
Type II diabetes mellitus
What UA findings would you expect to find in type I diabetes mellitus?
Glucosuria + ketonuria
Normal specific gravity levels
1.005-1.030
Normal urine pH
4.5-8.0
What does low pH indicate?
Acidosis, fever, high protein diet
What does high pH indicate?
Alkalosis, cystitis
What is proteinuria mostly indicative of?
Renal disease
Causes of ketones in urine
Type I diabetes mellitus, starvation
What could cause a false negative results of hematuria?
High dose of vitamin C
What causes nitrite in urine?
Gram negative bacteria, they can reduce nitrate to nitrite
Causes of bilirubinuria
Cholelithiasis, biliary tract obstruction—conjugated bilirubin
Best specimen of microscopic examination
First morning urination, midstream
MC causes of RBCs on microscopic exam
Nephrolisthiasis, acute glomerulonephritis, cystitis, pyelonephritis
Significance of WBC cast
Definite evidence that urinary WBCs originated from the kidney—pyelonephritis
What specific chromosome abnormality is likely present in a patient with CML?
Philadelphia chromosome
What management is appropriate to confirm diagnosis of CML?
Bone marrow biopsy
What is the most likely cause of stomach bloating in a patient with CML?
Splenomegaly
CBC findings for CML
Anemia, marked leukocytosis, thrombocytosis
Compare/contrast CML and AML
CML: thrombocytosis, multiple myeloid precursors
AML: thrombocytopenia, myeloblasts w/ Auer Rod
Both: leukocytosis, anemia
CBC findings for CLL
Anemia, leukocytosis with lymphocytosis, thrombocytopenia
Characteristics cells of CLL
Smudge cells; monotonous lymphocytes
Diagnostic triad for CLL
> 50 yoa
15,000 WBC
50% lymphocytes
What is appropriate management for CLL?
Bone marrow biopsy
CBC findings for viral infection
Leukopenia with lymphocytosis
CBC findings for bacterial infection
Leukocytosis with neutrophilia
What is the diagnostic triad for infectious mononucleosis?
Fever, sore throat, lymphadenopathy
What is the diagnostic triad for Hodgkin lymphoma?
Fever, pruritis, lymphadenopathy
What chiropractic maneuver should be avoided for patients with mono? Why?
Side posture and thoracics due to possible splenomegaly (dont want to rupture spleen)
How long should a person with mono wait to return to sports?
4 weeks
What s/s are indicative of lower respiratory tract infection?
Crackles on auscultation, chest pain, mucopurulent cough
CBC findings for ALL
Anemia, leukocytosis, thrombopenia
Characteristic cells of ALL
Lymphoblasts
What age group is most commonly affected by ALL?
Pediatrics
Characteristic cells of AML
Myeloblast with Auer Rod
Characteristic cells of CML
Band neutrophils, myelocytes, metamyelocytes, promyelocytes, myeloblasts
Etiology of PCV
Myeloproliferative disorder, blood hyperviscosity (thrombosis)
CBC findings for PCV
Erythrocytosis, thrombocytosis, leukocytosis
EPO level in PCV
Decreased
Etiology of secondary Erythrocytosis
Hypoxia (high altitude, congenital heart disease, chronic lung disease, smoking), renal tumor, testosterone
CBC findings for secondary Erythrocytosis
Erythrocytosis, NL WBC, NL plts
EPO level of secondary Erythrocytosis
Increased
Etiology of relative Erythrocytosis
Dehydration (vomiting/diarrhea, severe burns, lack of water)
Low plasma levels
CBC findings for relative Erythrocytosis
Erythrocytosis, NL WBC, NL plts
EPO levels in relative Erythrocytosis
NL
What complications could a patient with PCV experience?
Blood hyperviscosity leading to thrombosis
What are the differentials for microcytosis?
Iron deficiency anemia, anemia of chronic disease, sideroblastic anemia, (thalassemia)
What are the characteristic cells of Hodgkin lymphoma?
Reed sternberg cells