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Lab Dx Test1 > quizlet Urinalysis mikem > Flashcards

quizlet Urinalysis mikem Flashcards

1
Q

Describe the clean catch method

A

For women, it’s important to wipe 2x from front to back with an antibacterial wipe in order to prevent the collection of a contaminated sample. You must also catch the urine mid stream.

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2
Q

Name 3 reasons for ordering a urinalysis.

A

Diagnose Renal or UT Disease, Monitor Disease, Detect Metabiolic or systemic

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3
Q

What are 3 advantages to ordering a urinalysis

A

Cost Effective, painless (usually), quick

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4
Q

What are the four types of urine specimens?

A

First Morning Specimen

Random

Timed

Culture and sensitivity

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5
Q

What is the most common reason for ordering a 24 Hour urine collection?

A

Because you found protein in the urine and you want to asess proteinuria

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6
Q

How long can you wait to culture a urine specimen?

A

Must be cultured within a hour

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7
Q

In a 24 hour collection why do you flush your first morning specimen?

A

Because that is from the previous day.

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8
Q

True or False? In a 24 hour collection you will collect the first morning void of the 2nd morning.

A

True

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9
Q

What is the most common pathogen that causes urinary tract infection?

A

E.Coli

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10
Q

True or False? Men are more likely to get a UTI.

A

False Women are most likely to get a UTI due to a shortened urethra

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11
Q

What does a gram stain tell you?

A

Whether the bacteria is gram positive or gram negative this can help you select a proper antibiotic

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12
Q

Is it ok to give antibiotics to a patient before you send the specimen for sensitivity and culture?

A

No, always send the specimen for culture and sensitivity before you give antibiotics.

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13
Q

What would cloudy urine indicate?

A

presence of WBCs, RBCs, bacteria

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14
Q

What is the normal color of urine?

A

Pale yellow to amber

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15
Q

What gives urine its color?

A

Urochrome (a pigment which is a product of bilirubin metabolism)

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16
Q

What would dark yellow colored urine indicate?

A

Bilirubin in the urine

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17
Q

What would bright red colored urine indicate?

A

Bleeding from the bladder

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18
Q

What would dark red colored urine indicate?

A

Bleeding from the kidney

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19
Q

True or False? 90% of blood in the urine is from the bladder.

A

True

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20
Q

The measure of the kidney’s ability to concentrate urine (remove wastes)

A

Specific Gravity

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21
Q

In a specific gravity test the weight of urine is compared to the weight of what?

A

Distilled Water (1.00)

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22
Q

The value of __________ is affected by the amount of solutes and volume/hydration status

A

Specific Gravity

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23
Q

A low specific gravity may indicate

A

Diabetes Insipidus

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24
Q

_______ is the bodies inability to produce ADH or the inability of ADH to work in the body.

A

Diabetes Insipidus

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25
Q

Drinking _______ inhibits the production of ADH.

A

Alcohol

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26
Q

A high specific gravity may indicate (3)

A
  1. Diabetes Mellitus
  2. high ADH level
  3. dehydration
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27
Q

True or False? Urine osmolarity is measured as a part of the urinalysis.

A

False, it is seperate

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28
Q

The number of particles in a unit of solution (not specific to a particular particle)

A

Urine Osmolality

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29
Q

True or false? The same diseases that are correlated with a high or low specific gravity are correlated with urine osmolality.

A

True

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30
Q

How would an increase in ADH effect your specific gravity?

A

It would increase it

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31
Q

Average PH of urine

A

6

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32
Q

_______ actually makes your PH lower and is a good preventative measure for UTI but can’t treat a UTI

A

Cranberry Juice

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33
Q

What condition may result in alkaline urine?

A

Bacteria, especially UTI

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34
Q

An increase in hydrogen ions would make the environment _______ and a decrease in hydrogen ions would make the environment ________

A

Acidic / Basic

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35
Q

The distal and proximal conv tubule include what transporter important in urine pH?

A

Hydrogen (secretion) - Na (reabsorption)

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36
Q

What can cause transient proteinuria? (2)

A

Exercise, fever

37
Q

Why is protein typically not seen in the urine?

A

Because the spaces of the glomerular membrane are too small to allow passage

38
Q

Why is protein in the urine a concern?

A

It indicates glomerular injury. If the spaces of the glomerular membrane are enlarged, protein (usually albumin, smaller than globulins) seeps into filtrate

39
Q

What type of protein is most commonly found in the urine?

A

Albumin

40
Q

Clinical causes for proteinuria (4)

A

Preeclampsia (HTN, edema), Eclampsia (w/seizures), diabetes complications, glomerulonephritis

41
Q

What is the leading cause of end-stage renal disease?

A

Diabetes

42
Q

MCC of hematuria

A

Cystitis (in women, men typically do not get cystitis or UTIs)

43
Q

What are 3 common causes of blood in the urine?

A

Cystitis, glomerulonephritis, cancer

44
Q

What is the renal threshold for glucose?

A

>180 mg/dl in the serum

45
Q

How much glucose is filtered from the blood

A

100% (then 100% is reabsorbed in prox tubule)

46
Q

Byproduct of fatty acid catabolism; used as energy source when glucose cannot be utilized

A

Ketones

47
Q

What are the clinical implications of ketones in the urine? (5)

A

Poorly controlled diabetes (hyperglycemia), diabetic ketoacidosis, alcoholic ketoacidosis, starvation, high protein diets

48
Q

What is bilirubin?

A

Breakdown product of hemoglobin

49
Q

Bilirubin is conjugated in the ________ and excreted in the _______ which is metabolized in small intestine by bacteria to _________.

A

Liver / bile / urobilinogen

50
Q

What type of bilirubin is fat soluble, difficult to excrete, and excreted in the feces?

A

Unconjugated

51
Q

What type of bilirubin is water soluble and easily excreted by kidneys?

A

Conjugated

52
Q

How is urobilinogen made?

A

Bilirubin is metabolized and transformed to urobilinogen in the small intestine by bacteria.

53
Q

True or False? It is abnormal to have urobilinogen in the urine.

A

False, a small amount of urobilinogen is normal (up to 0.2 mg/dl)

54
Q

A portion of ________ is absorbed and carried to liver and excreted in bile and urine .

A

urobilinogen

55
Q

What are the clinical implications of having increased levels of urobilinogen.

A

An overproduction of RBCS / Hemolytic anemia

56
Q

What type of data do you get from a urine dip?

A

Qualitative

57
Q

True or False? Urinalysis is not a good monitor for liver disease

A

True

58
Q

A urinalysis with increased bilirubin and increased urobilinogen levels is indicative of __________ .

A

Hemolytic Anemia

59
Q

A urinalysis with increased bilirubin and normal urobilinogen level is indicative of ___________.

A

an obstruction of excretion (unable to get to bowels e.g. gallstones)

60
Q

A screening test for WBCs in urine

A

Leukocyte Esterase

61
Q

A positive leukocyte esterase test suggests the presence of a ______.

A

UTI (or STI)

62
Q

The most reliable test for detecting urinary tract infections - 90% accurate in detecting WBCs in urine

A

Leukocyte Esterase

63
Q

True or False, a positive leukocyte esterase test is diagnostic of a UTI.

A

False, you can’t say that there are WBCs in the urine without actually looking at a slide. Don’t diagnose based on this test alone.

64
Q

What type of bacteria is e.coli, gram negative or positive?

A

Gram negative

65
Q

Why would you test nitrites in the urine?

A

To screen for UTI

66
Q

What bacteria will give a positive nitrite test?

A

gram negative with the nitrate reductase enzyme

67
Q

What indicates a good probability of stone formation?

A

Crystals

68
Q

Do crystals cause pain?

A

No, they do not produce symptoms until they form stones

69
Q

Name a reason you might have a false positive for proteinuria.

A

RBCs can give you a false positive due to the hemoglobin component

70
Q

What would a lot of epithelial cells indicate in a urine specimen?

A

Contaminated sample

71
Q

Where are casts formed? (2)

A

distal convoluted tubule or collecting duct

72
Q

The formation of cast are favored by what? (3)

A

decreased urine flow (stasis)

73
Q

envelope-shaped crystals in acidic urine

A

Ca oxalate

74
Q

Composed primarily of mucoprotein called Tam-Horsfall

A

Hyaline Cast

75
Q

Where are mucoproteins secreted?

A

tubule cells

76
Q

Can be seen in normal patients, especially after strenuous exercise, dehydration

A

Hyaline casts

77
Q

Tamm-Horsfall is indicative of ______________

A

multiple myeloma

78
Q

When __________ remain in nephron long time, may degenerate into coarsely granular casts, then finely granular casts and ultimately broad waxy casts

A

cellular casts

79
Q

Result from degeneration of cellular material into granular particles within WBC or epithelial cell cast

A

Granular cast

80
Q

In Fatty casts, fat within epithelial cell casts becomes incorporated with protein into casts or coalesce to large droplets called ____________.

A

oval fat bodies

81
Q

What type of cast is a hallmark of nephrotic syndrome (large amount of proteinuria)?

A

Fatty casts

82
Q

These casts are associated with chronic renal diseases, chronic renal failure, diabetic nephropathy, and malignant HTN.

A

Waxy Casts

83
Q

Occur when flow thru tubule diminished and granular casts degenerate

A

Waxy Casts

84
Q

May be cell casts or hyaline casts

A

Waxy Casts

85
Q

Renal tubular cell casts indicate _____________.

A

glomerulonephritis

86
Q

Cast that is typically found in infections, mostly pyelonephritis, inflammatory nephritis (lupus)

A

WBC cast

87
Q

Found w/ disruption of blood/urine barrier at any level of tract, usually bladder, ureteral, urethral diseases

A

RBC cast

88
Q

On a slide what is the difference between epithelial tissue in a sample and a epithelial cell cast?

A

In epithelial cell casts the cells are clustered rather than randomly found in the sample

89
Q

In epithelial cell casts, ___________ casts can be normal and ___________ Casts indicate membrane damage - glomerulonephritis

A

Squamous epithelial cell / renal tubular cell

Lab Dx Test1 (6 decks)

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