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Vis Dis > Part1 > Flashcards

Part1 Flashcards

1
Q

Where are casts formed?

A

Renal tubules

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2
Q

The body excretes how may grams of substrate a day? Half is what?

A

60 grams, 50% is urea

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3
Q

Most kidney stones are made with what kind of crystals?

A

Calcium oxalate (75%)

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4
Q

What is the initial and most common follow up for gallstones?

A

Expectant management

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5
Q

Cholesterol plates in the urine are usually indicative of what condition?

A

Hyperlipidemia

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6
Q

Which physical exam test would be positive with a patient with WBC casts in the urine?

A

Punch test (kidneys –> pyelonephritis

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7
Q

What could be the cause of post-hepative liver disease

A

Biliary tree obstruction

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8
Q

What is the normal color range for unwind?

A

Straw to amber (light yellow to dark yellow)

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9
Q

What does ketonuria indicate in non diabetic patients?

A
  • Reduced carbohydrate metabolism and excessive fat metabolism
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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
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11
Q

Frothy urine due to

A

Proteins

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12
Q

Milky urine is associated with what?

A

Hyperlipidemia (risk factor for heart disease)

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13
Q

Urine may appear _______in nephrotic syndrome?

A

Frothy

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14
Q

Acidic urine is associated with what kinds of stones?

A

Xanthine, cysteine, Uric acid

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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)

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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
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17
Q

Which form of bilirubin is pre hepatic?

A

Unconjugated

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18
Q

Orthostatic proteinuria is associated with what spinal change?

A

Exaggerated lumbar lordosis

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19
Q

What is the diagnosis for red, pink, smokey colored urine with increased RBC count?

A

Hematuria

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20
Q

What screening test is used to detect WBCs in urine?

A

Leukocyte esterase

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21
Q

Excess of what vitamin can cause bright yellow urine?

A

B vit

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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

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23
Q

Diets high in citrus fruits and vegs are usually what (pH)?

A

Alkaline

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24
Q

What kind of UTI has a pH that you’d want to drink cranberry juice?

A

Alkaline (>7)

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25
Q

A feces odor of urine usually indicates what?

A

Enterobladderfistula or asparagus

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26
Q

Acidic pH is assocaited with what?

A

Respiratory acidosis (emphysema)

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27
Q

What is the primary indication of renal disease?

A

Proteinuria

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28
Q

Which are acid urine crystals?

A

Calcium oxalate, uric acid

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29
Q

What is the procedure used to measure the exact amount of Bence Jones proteins?

A

Immunoelectrophoresis

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30
Q

Why is it important to always analyze for proteinuria?

A

Primary indicator for renal disease

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31
Q

What is the term for when a patient presents with normal urine when supine and displays proteinuria when standing

A

Orthostatic proteinuria

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32
Q

What is the normal rage or urine a day?

A

600-2000ml/day

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33
Q

What is the function/purpose of specific gravity ?

A

To evaluate the kidneys ability to concentrate urine

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34
Q

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?

A

Smoldering MM

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35
Q

What technically is SpG?

A

Weight of urine compared to distilled water

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36
Q

What is the Normal rage of specific gravity for urine in an adult?

A

1.015-1.035

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37
Q

What color froth is assoacited with proteins?

A

White

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38
Q

Milky urine is associated with what?

A

Hyperlipidema

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39
Q

If a patient presents with yellow and clear urine with moderate occult blood but WBC and RBC counts are normal, what is the issue?

A

Either microhemo- or micromyoglobinuria (due to no RBC elevation but present occult blood)

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40
Q

What condition is present with a serum M protein level less than 3g/dL,

A
  • Monoclonal gammopathy of undetermined significance (MGUS)
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41
Q

How does liver/biliary tract disease affect liver enzyme amounts?

A

Increase

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42
Q

Hazy or cloudy Urine is due to/?

A

Infection

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43
Q

hat is the possible diagnosis of yellow colored urine and occult blood with normal RBC?

A

Micromyo- or micro-hemoglobinuria

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44
Q

What does a positive leukocyte esterase test indicate?

A

UTI

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45
Q

The functional unit of the kidney is?

A

Nephron

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46
Q

What binds to bilirubin to transport it to the liver to be conjugated

A

Albumin

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47
Q

What can cause black urine?

A

Alkaptonuria, melanin probs like malignant melanoma

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48
Q

Which crystals are seen in kidney stones with gout patients?

A

Uric acid

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49
Q

Occult blood in the urine with no elevation of RBCs following a heart attack would indicate what diagnosis?

A

Myoglobinuria

50
Q

What color is urine when they are dehydrated from fever, vomiting and food like rhubarb?

A

Orange

51
Q

More alkaline pH (>7) is associated with what?

A

Respiratory alkalosis

(Hyperventilation ) , UTI

52
Q

What amount of sugar and ketones are normal in unkind?

A

None

53
Q

Brownish yellow/green urine is associated with what?

A

Liver prob, check bilirubin and urobiliogen

54
Q

What would cause brownish yellow green urine?

A

Liver probs so check biliburin and urobilinogen

55
Q

What happens to turbidity and ph of urine that is unpreserved?

A

Increases

56
Q

What percent of cardiac output perfuse the kidneys each min?

A

25%

57
Q

Alkaline urine is associated with what kind of stones?

A

Calcium, carbonate, calcium carbonate, and magnesium phosphate stones

58
Q

What do waxy, broad, and fatty casts indicate?

A

Chronic renal failure (NOT GOOD)

59
Q

What is the diagnosis for red, pink, smokey colored urine with normal RBC count?

A

Myo- or hemoglobinuria

60
Q

What is the test used for finding a monoclonal immunoglobulin in urine (aka looking for Bence-Jones proteins for a patient with suspected MM)?

A
  • Protein electrophoresis (urine immunofixation
61
Q

If a chiropractor chooses to do his lab work in his office what standards must be met for legalities?

A

CLIA AND OSA

62
Q

Normal amounts of bilirubin and urobil in urine?

A

None and less than 1

63
Q

What does a positive dipstick for proteinuria need to be confirmed with?

A
  • Sulfosalicylic Acid Precipitation Test (SSA)
64
Q

Pylonephritis is an infection of what park of the kidney?

A

Interstitum

65
Q

a diagnosis of hematuria, which substance must be elevated in the blood?

A

RBCs (if not, then look to hemoglobinuria or myoglobinuria)

66
Q

What is normal ph?

A

4.5-7.5

67
Q

What type of UTI is usually self-limiting: lower or upper?

A

Low

68
Q

Colorless urine is associated with what?

A

Diabetes insipidus or over hydration

69
Q

If the history doesn’t indicate protein what does this tell us about a UTI?

A

It’s lower

70
Q

What color froth is assocaited with levels of bilirubin ?

A

Yellow

71
Q

RBC cast?

A

Glomerulonephritis

72
Q

What is the term for neutrophils seen in the urine (WBCs undergoing phagocytosis), and what does it indicate?

A

Glitter cells; indicates UTI

73
Q

What is the pain location for upper vs lower UTIs?

A

Upper = flank pain; Lower = lower back and pubic pain

74
Q

What is the most common cause of hematuria due to glomerulonephritis?

A

Mismanaged strep

75
Q

What is the oldest clinical lab procedure?

A

Urinalysis

76
Q

What does red, pink or smoky tell us/

A

It’s not micro

77
Q

What is the classic condition that causes hyperglycemia and glucosuria?

A

Diabetes mellitus

78
Q

What time of day makes for the best urine sample?

A

Early morning

79
Q

What does a positive nitrite test indicate with urine?

A

Bacteria present (enough gram negative bacteria to convert or reduce nitrates to nitrites)

80
Q

What us the name for urine output over 2000 ml a day?

A

Polyuria

81
Q

What kind of sickness is a common complication in patients with MM?

A

Respiratory inf

82
Q

Where would kidney stones appear on a lateral X-ray?

A

Either overly vertebral bodies or be slightly anterior (because they’re retroperitoneal)

83
Q

WBC cast?

A

Pyleonephritis

84
Q

What would be the diagnosis with increased RBCs although there is no change in urine color (yellow)?

A

Microhematuria

85
Q

What percent of urine is water?

A

95%

86
Q

Where would gallstones be on an AP X-ray?

A

Right UPPER abdominal quadrant

87
Q

Bilateral sacroilitis would be indicative of which group of pathologies?

A

Seronegative spondyloarthropathies like reactive/Reiter’s arthritis, enteropathic, and psoriatic

88
Q

A fruity or sweet urine smell usually indicates what?

A

Diabetes mellitus or ketosis

89
Q

Decreased SpG indicates what?

A

Glomerulonephritis (hematuria, blood casts), renal failure

90
Q

What type of UTI (upper or lower) needs a consult right away?

A

Up

91
Q

What is the “CRAB” mnemonic to remember signs and symptoms associated with MM?

A

Calcium (elevated), Renal failure/dysfunction, Anemia, Bone lesions

92
Q

What is the term for urine output less than 500ml a day?

A

Oliguria

93
Q

What are the 2 lower UTIs discussed?

A

Cystitis and urethritis

94
Q

What does ketonuria indicate in diabetic patients?

A

Uncontrolled disease

95
Q

Most amino acids are usually insignificant except for which 3, and what do they possible indicate?

A

Tyrosine, leucine, cysteine; indicative of severe liver disease

96
Q

Nephrotic syndrome has what protein?

A

+4

97
Q

WHAT 3 properties make up a routine UA?

A

Physical, chemical microscopic

98
Q

High levels of what tell us its prostate cancer

?

A

Alkaline phosphatase

99
Q

Feces order urine?

A

Enterobladder fistula

100
Q

Proteinuria because of kidney disease usually indicates what?

A

Upper UTI

101
Q

Why don’t bone scans contribute to a MM diagnosis

A
  • Lack of osteoblastic activity
102
Q

Which will detect Bence Jones proteins: routine UA or PEP?

A

Pep dumbass

103
Q

what does yellow urine and occult blood tell us?

A

Either hemoglobinuria or myoglobinuria

104
Q

What does isothenuria indicate?

A

Protein free plasma and end stage renal failure

105
Q

What are the 3 probable causes of pathological fracture in order from most common to least common?

A

1: osteoporosis 2: lytic metastasis 3: multiple myeloma

106
Q

Diet high in animal is usually more what (ph)?

A

Acidic

107
Q

When acted on by bacteria, what is the byproduct of bilirubin

A

Urobilinogen

108
Q

What is fixed SpG at 1.010?

A

Isosthenuria

109
Q

What is the normal range for daily volume of urine?

A

600-2000 ml a day with an average of 1200-1500

110
Q

Fruity, sweet urine is indicative of

?

A

Diabetes mellitus/ketosis

111
Q

What bacteria is usually to blame for positive nitrates seen in urine?

A

E. coli (normal flora in the GI tract that becomes pathological elsewhere)

112
Q

Which are alkaline urine crystals?

A

Amorphous phosphates, calcium carbonate, triple phosphate

113
Q

What extra test should be run on all patients with a 4+ protein level?

A
  • Bence Jones test (PEP
114
Q

What color urine is found with dehydration from fever, vomiting, certain foods, and meds?

A

Orange

115
Q

Is clear urine normal?

A

Yes

116
Q

Is cystitis upper or lower urinary tract infection?

A

Lower

117
Q

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?

A

Tru emm

118
Q

What happens do nitrites in underserved urine?

A

Increase

119
Q

Does a negative nitrite test mean there’s absence of bacteria?

A

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
Q

When does filtrate become urine/

A

Distal convoluted tubule

121
Q

What is the term for fixed SpG of urine at 1.010?? `

A

Isothenuria

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