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CRRAB II Week 5 - WLB > Renal Physical Diagnostic Skills - Prunuske > Flashcards

Renal Physical Diagnostic Skills - Prunuske Flashcards

1
Q

How do you assess a patient’s hydration status using urine specific gravity?

A
  • Specific gravity correlates with urine osmolality
    • gives important insight into the patient’s hydration status
      • Normal = 1.003 to 1.030
      • Relative hydration: <1.010
      • Relative dehydration: >1.020
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2
Q

What are the causes of false positive urinalysis results for Bilirubin?

A
  • Bilirubin → Phenazopyridine (Pyridium)
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3
Q

What are the causes of false positive urinalysis results for blood?

A
  • Blood → Dehydration, exercise, hemoglobinuria, menstrual bleeding, myoglobinuria, beets
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4
Q

What are the causes of false positives for glucose in urinalysis results?

A
  • Glucose → Ketones, Levadopa
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5
Q

What are the causes of false positive Ketones on urinalysis?

A
  • Ketones → Acidic urine, elevated specific gravity, mesna, phenolphthalein
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6
Q

What are the causes of false positive Leukocyte esterase on urinalysis?

A
  • Leukocyte esterase → contamination
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7
Q

What are the causes of false positive Nitrites on urinalysis?

A
  • Nitrites → contamination, exposure of dipstick to air, phenazopyridine
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8
Q

What are the causes of false positive Protein on urinalysis?

A
  • Protein → alkaline/concentrated urine, phenazopyridine, quaternary ammonia products
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9
Q

What are the causes of false positive elevation Specific gravity on urinalysis?

A
  • Specific gravity → dextran solutions, IV radiopaque dyes, proteinuria
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10
Q

What are the causes of false positive Urobilinogen on urinalysis?

A
  • Urobilinogen → elevated nitrite levels, phenazopyridine
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11
Q

What are the causes of false negative Bilirubin on urinalysis?

A
  • Chlorpromazine (Thorazine)
  • selenium
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12
Q

What are the causes of false negative Blood on urinalysis?

A
  • Captopril (Capoten)
  • elevated specific gravity
  • pH < 5.1
  • proteinuria
  • vitamin C
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13
Q

What are the causes of false negative Glucose on urinalysis?

A
  • Elevated specific gravity
  • uric acid
  • vitamin C
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14
Q

What are the causes of false negative Ketones on urinalysis?

A

Delay in examination of urine

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15
Q

What are the cause of false negative Leukocyte esterase on urinalysis?

A
  • Elevated specific gravity
  • glycosuria
  • ketonuria
  • proteinuria
  • some oxidizing drugs:
    • cephalexin [Keflex]
    • nitrofurantoin [Furadantin]
    • tetracycline
    • gentamicin
  • vitamin C
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16
Q

What are the cause of false negative Nitrites on urinalysis?

A
  • Elevated specific gravity
  • elevated urobilinogen levels
  • nitrate reductase-negative bacteria
  • pH < 6.0
  • vitamin C
17
Q

What are the causes of false negative Protein on urinalysis?

A
  • Acidic or dilute urine
  • primary protein is not albumin
18
Q

What are the causes of false negative depression of Specific gravity on urinalysis?

A

Alkaline urine

19
Q

What is the impact of sensitivity and specificity of urinalysis in the diagnosis of proteinuria?

A
  • Results: ≥ 3+ protein
  • Sensitivity: 96%
  • Specificity: 87%
20
Q

What is the impact of sensitivity and specificity of urinalysis in the diagnosis of hematuria?

A
  • Microscopic hemature results: ≥ 1+ blood
  • Sensitivity: 91 to 100%
  • Specificity: 65 to 99%
21
Q

What is the impact of sensitivity and specificity of urinalysis in the diagnosis of UTI?

A
  • Sensitivity: 94 to 100%
  • Specificity: 14 to 26%
22
Q

What are 3 common causes of hematuria?

A
  • Definition: presence of 3+ red blood cells (RBCs) per high-powered field (HPF) in two of three urine samples
  • Causes:
    • tumors
    • renal calculi
    • infections
23
Q

What are 3 common causes of proteinuria?

A
  • Definition: urinary protein excretion of more than 150 mg per day (10 to 20 mg per dL)
  • Causes:
    • Diabetes mellitus
    • exercise (transient)
    • Minimal change disease
24
Q

What is normal urine pH on urinalysis?

A

Urinary pH can range from 4.5 to 8 but normally is slightly acidic (i.e., 5.5 to 6.5) because of metabolic activity.

25
Q

What nine components are negative on a normal urinalysis?

A
  1. Specific gravity
  2. Glucose
  3. Blood
  4. Ketones
  5. Protein
  6. Urobilinogen
  7. Bilirubin
  8. Leukocyte esterase
  9. Nitrite
26
Q

What is the normal range of WBCs on a urinalysis?

A

0-5 WBCs per high power field

27
Q

What is the normal range of RBCs on urinalysis?

A

0 to 4 per high-power field

28
Q

What is the normal range of Squamous epithelial cells on urinalysis?

CRRAB II Week 5 - WLB (10 decks)

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