Part1 Flashcards
(121 cards)
1
Q
Where are casts formed?
A
Renal tubules
2
Q
The body excretes how may grams of substrate a day? Half is what?
A
60 grams, 50% is urea
3
Q
Most kidney stones are made with what kind of crystals?
A
Calcium oxalate (75%)
4
Q
What is the initial and most common follow up for gallstones?
A
Expectant management
5
Q
Cholesterol plates in the urine are usually indicative of what condition?
A
Hyperlipidemia
6
Q
Which physical exam test would be positive with a patient with WBC casts in the urine?
A
Punch test (kidneys –> pyelonephritis
7
Q
What could be the cause of post-hepative liver disease
A
Biliary tree obstruction
8
Q
What is the normal color range for unwind?
A
Straw to amber (light yellow to dark yellow)
9
Q
What does ketonuria indicate in non diabetic patients?
A
- Reduced carbohydrate metabolism and excessive fat metabolism
10
Q
What are the steps when suspecting lytic metastasis as a cause for a pathological fracture due to findings on X-ray?
A
- Bone scan —> MRI —> Biopsy
11
Q
Frothy urine due to
A
Proteins
12
Q
Milky urine is associated with what?
A
Hyperlipidemia (risk factor for heart disease)
13
Q
Urine may appear _______in nephrotic syndrome?
A
Frothy
14
Q
Acidic urine is associated with what kinds of stones?
A
Xanthine, cysteine, Uric acid
15
Q
What would conjugated bilirubin in the urine indicate?
A
Obstruction to flow of bile from liver (possible gall stones, tumor, pancreatic cancer, liver inflammation/infection)
16
Q
What are the steps when suspecting MM as a cause for a pathological fracture due to findings on X-ray?
A
- PEP —> Skeletal Survey —> MRI —> Biopsy
17
Q
Which form of bilirubin is pre hepatic?
A
Unconjugated
18
Q
Orthostatic proteinuria is associated with what spinal change?
A
Exaggerated lumbar lordosis
19
Q
What is the diagnosis for red, pink, smokey colored urine with increased RBC count?
A
Hematuria
20
Q
What screening test is used to detect WBCs in urine?
A
Leukocyte esterase
21
Q
Excess of what vitamin can cause bright yellow urine?
A
B vit
22
Q
What are the federal regulatory standards that apply to all clinical lab testing performed on humans in the us? Except clinical trials and basic research?
A
CLIA
23
Q
Diets high in citrus fruits and vegs are usually what (pH)?
A
Alkaline
24
Q
What kind of UTI has a pH that you’d want to drink cranberry juice?
A
Alkaline (>7)
25
A feces odor of urine usually indicates what?
Enterobladderfistula or asparagus
26
Acidic pH is assocaited with what?
Respiratory acidosis (emphysema)
27
What is the primary indication of renal disease?
Proteinuria
28
Which are acid urine crystals?
Calcium oxalate, uric acid
29
What is the procedure used to measure the exact amount of Bence Jones proteins?
Immunoelectrophoresis
30
Why is it important to always analyze for proteinuria?
Primary indicator for renal disease
31
What is the term for when a patient presents with normal urine when supine and displays proteinuria when standing
Orthostatic proteinuria
32
What is the normal rage or urine a day?
600-2000ml/day
33
What is the function/purpose of specific gravity ?
To evaluate the kidneys ability to concentrate urine
34
What condition is present with a serum M protein level greater than 3g/dL, >10% bone marrow plasma cells present, and no CRAB signs and symptoms?
Smoldering MM
35
What technically is SpG?
Weight of urine compared to distilled water
36
What is the Normal rage of specific gravity for urine in an adult?
1.015-1.035
37
What color froth is assoacited with proteins?
White
38
Milky urine is associated with what?
Hyperlipidema
39
If a patient presents with yellow and clear urine with moderate occult blood but WBC and RBC counts are normal, what is the issue?
Either microhemo- or micromyoglobinuria (due to no RBC elevation but present occult blood)
40
What condition is present with a serum M protein level less than 3g/dL,
- Monoclonal gammopathy of undetermined significance (MGUS)
41
How does liver/biliary tract disease affect liver enzyme amounts?
Increase
42
Hazy or cloudy Urine is due to/?
Infection
43
hat is the possible diagnosis of yellow colored urine and occult blood with normal RBC?
Micromyo- or micro-hemoglobinuria
44
What does a positive leukocyte esterase test indicate?
UTI
45
The functional unit of the kidney is?
Nephron
46
What binds to bilirubin to transport it to the liver to be conjugated
Albumin
47
What can cause black urine?
Alkaptonuria, melanin probs like malignant melanoma
48
Which crystals are seen in kidney stones with gout patients?
Uric acid
49
Occult blood in the urine with no elevation of RBCs following a heart attack would indicate what diagnosis?
Myoglobinuria
50
What color is urine when they are dehydrated from fever, vomiting and food like rhubarb?
Orange
51
More alkaline pH (>7) is associated with what?
Respiratory alkalosis
| (Hyperventilation ) , UTI
52
What amount of sugar and ketones are normal in unkind?
None
53
Brownish yellow/green urine is associated with what?
Liver prob, check bilirubin and urobiliogen
54
What would cause brownish yellow green urine?
Liver probs so check biliburin and urobilinogen
55
What happens to turbidity and ph of urine that is unpreserved?
Increases
56
What percent of cardiac output perfuse the kidneys each min?
25%
57
Alkaline urine is associated with what kind of stones?
Calcium, carbonate, calcium carbonate, and magnesium phosphate stones
58
What do waxy, broad, and fatty casts indicate?
Chronic renal failure (NOT GOOD)
59
What is the diagnosis for red, pink, smokey colored urine with normal RBC count?
Myo- or hemoglobinuria
60
What is the test used for finding a monoclonal immunoglobulin in urine (aka looking for Bence-Jones proteins for a patient with suspected MM)?
- Protein electrophoresis (urine immunofixation
61
If a chiropractor chooses to do his lab work in his office what standards must be met for legalities?
CLIA AND OSA
62
Normal amounts of bilirubin and urobil in urine?
None and less than 1
63
What does a positive dipstick for proteinuria need to be confirmed with?
- Sulfosalicylic Acid Precipitation Test (SSA)
64
Pylonephritis is an infection of what park of the kidney?
Interstitum
65
a diagnosis of hematuria, which substance must be elevated in the blood?
RBCs (if not, then look to hemoglobinuria or myoglobinuria)
66
What is normal ph?
4.5-7.5
67
What type of UTI is usually self-limiting: lower or upper?
Low
68
Colorless urine is associated with what?
Diabetes insipidus or over hydration
69
If the history doesn't indicate protein what does this tell us about a UTI?
It's lower
70
What color froth is assocaited with levels of bilirubin ?
Yellow
71
RBC cast?
Glomerulonephritis
72
What is the term for neutrophils seen in the urine (WBCs undergoing phagocytosis), and what does it indicate?
Glitter cells; indicates UTI
73
What is the pain location for upper vs lower UTIs?
Upper = flank pain; Lower = lower back and pubic pain
74
What is the most common cause of hematuria due to glomerulonephritis?
Mismanaged strep
75
What is the oldest clinical lab procedure?
Urinalysis
76
What does red, pink or smoky tell us/
It's not micro
77
What is the classic condition that causes hyperglycemia and glucosuria?
Diabetes mellitus
78
What time of day makes for the best urine sample?
Early morning
79
What does a positive nitrite test indicate with urine?
Bacteria present (enough gram negative bacteria to convert or reduce nitrates to nitrites)
80
What us the name for urine output over 2000 ml a day?
Polyuria
81
What kind of sickness is a common complication in patients with MM?
Respiratory inf
82
Where would kidney stones appear on a lateral X-ray?
Either overly vertebral bodies or be slightly anterior (because they're retroperitoneal)
83
WBC cast?
Pyleonephritis
84
What would be the diagnosis with increased RBCs although there is no change in urine color (yellow)?
Microhematuria
85
What percent of urine is water?
95%
86
Where would gallstones be on an AP X-ray?
Right UPPER abdominal quadrant
87
Bilateral sacroilitis would be indicative of which group of pathologies?
Seronegative spondyloarthropathies like reactive/Reiter's arthritis, enteropathic, and psoriatic
88
A fruity or sweet urine smell usually indicates what?
Diabetes mellitus or ketosis
89
Decreased SpG indicates what?
Glomerulonephritis (hematuria, blood casts), renal failure
90
What type of UTI (upper or lower) needs a consult right away?
Up
91
What is the "CRAB" mnemonic to remember signs and symptoms associated with MM?
Calcium (elevated), Renal failure/dysfunction, Anemia, Bone lesions
92
What is the term for urine output less than 500ml a day?
Oliguria
93
What are the 2 lower UTIs discussed?
Cystitis and urethritis
94
What does ketonuria indicate in diabetic patients?
Uncontrolled disease
95
Most amino acids are usually insignificant except for which 3, and what do they possible indicate?
Tyrosine, leucine, cysteine; indicative of severe liver disease
96
Nephrotic syndrome has what protein?
+4
97
WHAT 3 properties make up a routine UA?
Physical, chemical microscopic
98
High levels of what tell us its prostate cancer
| ?
Alkaline phosphatase
99
Feces order urine?
Enterobladder fistula
100
Proteinuria because of kidney disease usually indicates what?
Upper UTI
101
Why don't bone scans contribute to a MM diagnosis
- Lack of osteoblastic activity
102
Which will detect Bence Jones proteins: routine UA or PEP?
Pep dumbass
103
what does yellow urine and occult blood tell us?
Either hemoglobinuria or myoglobinuria
104
What does isothenuria indicate?
Protein free plasma and end stage renal failure
105
What are the 3 probable causes of pathological fracture in order from most common to least common?
1: osteoporosis 2: lytic metastasis 3: multiple myeloma
106
Diet high in animal is usually more what (ph)?
Acidic
107
When acted on by bacteria, what is the byproduct of bilirubin
Urobilinogen
108
What is fixed SpG at 1.010?
Isosthenuria
109
What is the normal range for daily volume of urine?
600-2000 ml a day with an average of 1200-1500
110
Fruity, sweet urine is indicative of
| ?
Diabetes mellitus/ketosis
111
What bacteria is usually to blame for positive nitrates seen in urine?
E. coli (normal flora in the GI tract that becomes pathological elsewhere)
112
Which are alkaline urine crystals?
Amorphous phosphates, calcium carbonate, triple phosphate
113
What extra test should be run on all patients with a 4+ protein level?
- Bence Jones test (PEP
114
What color urine is found with dehydration from fever, vomiting, certain foods, and meds?
Orange
115
Is clear urine normal?
Yes
116
Is cystitis upper or lower urinary tract infection?
Lower
117
What condition is present with a serum M protein level greater than 3g/dL, >10% bone marrow plasma cells present, AND CRAB signs and symptoms?
Tru emm
118
What happens do nitrites in underserved urine?
Increase
119
Does a negative nitrite test mean there's absence of bacteria?
Not necessarily (sometimes UTIs can be caused by infections that don't convert nitrate to nitrite and therefore aren't detected on this test...examples = staph and strep)
120
When does filtrate become urine/
Distal convoluted tubule
121
What is the term for fixed SpG of urine at 1.010?? `
Isothenuria
