Renal

Question 1

Causes of Elevated BUN (azotemia)

Answer 1

Prerenal: decreased renal perfusion (HF, renal artery stenosis, dehydration) & increased protein breakdown (diet, upper GI bleed)
Renal: acute/chronic renal failure
Post renal: obstruction of ureter/bladder neck

Question 2

Causes of Decreased BUN

Answer 2

Severe liver disease, malnutrition (low protein diet), fluid overload (dilute out BUN levels)

Question 3

SCr norm

Answer 3

0.6-1.2 mg/dL

Question 4

Causes of Elevated SCr

Answer 4

Prerenal: decreased renal perfusion (HF, dehydration)
Renal: acute/chronic renal insufficiency

Question 5

Causes of Decreased SCr

Answer 5

Prerenal: loss/lack of muscle mass (ELDERLY), severe liver dysfunction (cirrhosis)

Question 6

Normal BUN/SCr ratio

Answer 6

Less than or equal to 20:1

Question 7

BUN/SCr prerenal ratio

Answer 7

> 20:1

Question 8

BUN/SCr renal/post renal ratio

Answer 8

10:1 or 20:1

Question 9

CrCl norm

Answer 9

90-140 mL/min

Question 10

Hazy yellow/cloudy urine indicates:

Answer 10

Infection

Question 11

Froathy foam urine indicates:

Answer 11

Excess proteins

Question 12

Red-orange urine indicates:

Answer 12

Myoglobin (rhabdomyolosis), hgb (hemolysis), RBCs (bleeding), drugs

Question 13

Brown-black urine indicates:

Answer 13

Myoglobin, hgb, iron, drugs

Question 14

Nitrite positive in urine indicates:

Answer 14

Bacteriuria (possible UTI)

Question 15

Leukocyte Esterace positive in urine indicates:

Answer 15

Presence of “inflammation”

Question 16

RBCs in urine Indicates:

Answer 16

Suggests kidney injury or damage to urinary tract

Question 17

WBCs in urine indicates:

Answer 17

Suggest inflammation or infection

Question 18

Tubular epithelial cells in urine indicates:

Answer 18

Suggests damage/inflammation to tubules of nephron

Question 19

Hyaline cast

Answer 19

Clear = no renal disease

Question 20

Cellular cast

Answer 20

Variable color = EARLY renal disease

Question 21

Granular cast

Answer 21

Muddy brown = CHRONIC renal disease

Question 22

Urine pH norm

Answer 22

4.5-8, deters bacterial colonization

Question 23

Specific gravity (SG) norm range

Answer 23

1.010-1.025, ratio of urine density compared w/ water

Question 24

Increased SG indicates:

Answer 24

Diabetes MELLITUS (glucose), nephrotic syndrome (proteins)

Question 25

Decreased SG indicates:

Answer 25

Diabetes INSIPIDUS

Question 26

Extrinsic urinalysis factors:

Answer 26

Glucose, ketones, bilirubin, urobilinogen, blood/hgb,

Question 27

Intrinsic urinalysis factors:

Answer 27

Blood/hgb, nitrite, leukocyte esterace, protein

Question 28

Glucose in the urine indicates:

Answer 28

Diabetes Mellitus

Question 29

Ketones in the urine indicates:

Answer 29

Type 1 DM/specific diet

Question 30

Bilirubin in the urine colors urine ______

Answer 30

Colors urine dark yellow/brown

Question 31

Urobilinogen in the urine indicates:

Answer 31

Hemolytic anemia, hepatitis, liver injury

Question 32

Hgb in urine indicates:

Answer 32

Severe hemolysis

Question 33

Causes of Transient proteinuria:

Answer 33

Exercise, seizures, fevers, dehydration

Question 34

Causes of Persistent proteinuria:

Answer 34

Specific disease state problem, decreased renal mass

Question 35

Fraction of excreted sodium (%FeNa) norm

Answer 35

0.5%

Question 36

Low FeNa (less than 1%) indicates:

Answer 36

Prerenal: azotemia (dehydration, volume depletion, CHF)

Hepatorenal syndrome

Question 37

High FeNa (> 1%) indicates:

Answer 37

Acute tubular necrosis, SIADH, diuretics

Question 38

BUN norm

Answer 38

8-23 mg/dL