Partial 2 - Urinalysis

Question 1

UREA/BUN reference range

Answer 1

2,5-6,7 mmol/l (15-40 mg/dl)

Question 2

Factors that causes increased urea

Answer 2

Dehydration
Low GFR
High rate of protein catabolism

Question 3

Factors that causes decreased urea

Answer 3

Overhydration
Newborns and children
High rate of anabolism (androgens)
Low protein diet
Severe liver injury
Kidney failure

Question 4

Uric acid reference range

Answer 4

120-300 umol/l

Question 5

Creatinine reference range

Answer 5

62-124 umol/l

0,7-1,4 mg/dl

Question 6

Increased production of creatinine can be caused by

Answer 6

Physical exercise
Acromegaly
Gigantism

Question 7

Reduced excretion of creatinine can be caused by

Answer 7

Renal failure
Drugs
Organic and inorganic compounds

Question 8

Decreased formation of creatinine can be caused by

Answer 8

Fasting

Corticosteroids

Question 9

Glucosuria causes

Answer 9

Prerenal glucosuria: Diabetes, steroid treatment, stress, overactivity of sympathetic nervous system

Renal glucosuria: Disturbed reabsoprtion in proximal tubule, Fanconi syndrome

Non-glucose glycosuria: Fruktosuria, galactosuria, lactosuria

Question 10

What is the only type of bilirubin in urine?

Answer 10

Water-soluble conjugated bilirubin

Question 11

Bilirubinuria causes

Answer 11

Hepatitis A,B,C
Cirrhosis
Dubin-Johnson or Rotor Syndrome
Intra and extrahepatic cholestasis 
Toxic liver injury

Question 12

Ketonuria causes

Answer 12

Starvation
Prolonged diarrheas
Ketoacidosis
Diabetes 
Uremia
Low carbohydrates diet
High fat diet
Fever with vomits

Question 13

Blood in urine causes

Answer 13

Hematuria (nephritis, trauma)
Hemoglobinuria (hemolysis)
Myoglobinuria (rhabdomyolysis)

Question 14

Physiological pH

Renal range pH

Answer 14

Physiologically: 5,5-6,5

Renal range: 5,0-8,0

Question 15

pH<5,5 causes

Answer 15

High protein diet
Starvation
Metabolic acidosis
Acidifying agents
Diarrheas
Gout
Kidney tuberculosis

Question 16

pH>7,5 causes

Answer 16

Vegetarian or vegan diet
Tubular acidosis
Gram-negative bacteria’s

Question 17

Only protein that is recognizable by the dipstick test

Answer 17

Albumin

Question 18

Normoalbuminuria
Microalbuminuria
Macroalbuminuria

Answer 18

Normoalbuminuria <30 mg/24
Microalbuminuria 30-300 mg/24h
Macroalbuminuria >300mg/24h

Question 19

Leukocytes in urine causes

Answer 19

Pyuria
Acute inflammatory states
Kidney stones
Gram-negative bacterial infection

Question 20

Erythrocytes under microcope

Answer 20

0-3/HPF (high power filed vision)

They swell in hypotonic urine and crenate in hypertonic urine

Their presence in numbers >3/HPF suggests hemorrhage (hematuria) along the urinary tract (or genital tract in voided samples)

Question 21

Dysmorphic erythrocytes is typical for

Answer 21

Glomerulonephritis

Question 22

Leukocytes under microscope

Answer 22

0-5/HPF

Their presence in numbers >5/HPF (pyuria) suggests inflammation along the urinary tract (or genital tract in voided samples)

Question 23

Squamous cells under microscope

Answer 23

Few in the field of vision

Squamous cells originate from the urethra/vagina or prepuce and are considered contaminants. They have no pathologic significance

Question 24

Common crystals seen in normal urine

Answer 24

Amorphous urates (pH<7)
Amorphous phosphates (pH>/7)

Question 25

Common abnormal urine crystals

Answer 25

Calcium oxalate
Uric acid
Triple phosphate (struvite)
Calcium carbonate
Cystine crystals

Question 26

Organisms found in urine

Answer 26

Bacterias and Yeasts
Fungal hypha
Sperm