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Visceral Disorders > Test 1 > Flashcards

Test 1 Flashcards

1
Q

Urinalysis changes in underserved urine

A 
Darker
Less clear (turbidity)
Increased PH, bacteria and nitrites
DECREASE: Glucose, ketones, bilirubin, and urobilinogen
RBC Lyse
WBC and casts disintegrate
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2
Q

Orange urine

A

Dehydration from fever
Vomiting
Foods
Medication

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3
Q

Black urine

A

Alkaptonuria, melanin problems

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4
Q

Brownish yellow/green urine

A

Liver problems

Check bilirubin/urobilinogen

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5
Q

Milky urine

A

Hyperlipidemia (risk factor for heart disease)

Cholesterol panel

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6
Q

Normal specific gravity of urine

A

1.015-1.035

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7
Q

Hyposthenuria/hypersthenuria

Isosthenuria

A

Low/high specific gravity

Fixed SpG at 1.010= end stage of renal failure

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8
Q

Increased specific gravity

A

Means concentrated urine
Due to…..proteinuria/glucosuria

Dehydration
Decreased renal blood flow (heart failure/renal artery stenosis)

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9
Q

Decreased specific gravity

A

Means dilute urine

Over hydration (polyuria)
Glomerulonephritis (hematocrit/blood casts)
Pyleonephritis 
Diabetes insipidus 
Renal failure
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10
Q

Fruity/sweet urine scent

A

Diabetes mellitus

Ketosis

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11
Q

Foul/fishy urine smell

A

UTI

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12
Q

Normal ph of urine

A

4.5-7.5

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13
Q

Maintain ph of urine how

A

Reabsorption of sodium and secretion of hydrogen and ammonium ions

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14
Q

Ph of diet high in animal product? Fruits/veggies?

A

Animal: acidic
Fruits: alkaline

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15
Q

Acidic pH

A
  • Respiratory acidosis (emphysema)
  • Metabolic acidosis (sugars—diabetic)

Diabetes mellitus

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16
Q

When would cranberry juice be recommended for UTI

A

When the pH is alkaline (7+)

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17
Q

Uric acid stones should be kept ____

A

Alkaline

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18
Q

Ca+/MgP stones should be kept_____

A

Acidic

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19
Q

Proteinuria primary indicator of?

A

Renal disease

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20
Q

What is the screening test for proteinuria?

A

Dipstick

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21
Q

Positive screening test for proteinuria needs to be followed up with?

A

SSA

Sulfosalicylic acid

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22
Q

In SSA test what is found where

A

The supernatant (fluid) is at the top with proteins while WBC/RBC settle to the bottom

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23
Q

Proteinuria because of kidney disease usually indicates an?

A

UUTI

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24
Q

Physiological reason for proteinuria

A 
Strenuous exercise
Cold
Pregnancy
Dehydration 
Febrile illness
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25
What should be run on all patients with a 4+ protein
Bence jones protein test
26
Test for finding a monoclonal immunoglobin in urine is called?
Urine protein electrophoresis. (UPEP) or immunoelectrophoresis
27
A routine UA does NOT detect ______ electrophoresis or immunoelectrophoresis is better
Bence jones proteins
28
What is the screening and confirmatory test for MM
Screening: SSA Confirm: electrophoresis
29
CRAB. What and who
Multiple myeloma Elevated calcium Renal failure Anemia Bone lesions
30
Pathway for OP, lytic mets or MM?
History Old films Lab: CBC, ESR, CRP, BCP, UA
31
Path for Lytic mets
Bone scan MRI Biopsy
32
Path for MM
PEP Skeletal survey MRI Biopsy
33
In 3% of patients with MM M spike cannot be detected and therefore should haev?
Serum free light chain assay
34
MGUS
M< 3g (small m spike) Plasma cells < 10% No CRAB
35
Smoldering MM
M protein > 3 Plasma cells >10% No CRAB
36
MM
M protein > 3 Plasma cells >10% CRAB
37
What is the normal rental threshold value until glucose starts spilling into urine
140-180mg/dl
38
Ketones due to
Lack of available sugar getting into the cells due to lack of insulin Byproduct of fat metabolism
39
Conjugated bilirubin means what
Liver or post liver issue Conjugated in liver May see in urine
40
Unconjucated bilirubin means what
Pre liver | Cannot be in urine
41
A positive test for urine bilirubin confirms that any raised _____ levels are from _____ hyperbilirubinemia
Plasma Conjugated
42
Normal urobilinogen levels
0.1-1.0
43
Increased urobilinogen seen withwhat
Anything that increases bilirubin increases it. | Liver disease and hemolytic conditions
44
Increased urobililinogen causes
RBC breakdown Decreased liver function Liver cirrhosis
45
Low urobilinogen due to
Failure of bile production | Obstruction of bile
46
Urobilinogen: < 1 Bilirubin: -
Normal
47
Urobilinogen: increased Bilirubin: +
Biliary disease or liver
48
Urobilinogen: decreased/none Bilirubin: +
Biliary obstruction
49
Urobilinogen: increased Bilirubin: none
Prehepatic disease/hemolytic anemia
50
What is the main cause of biliary obstruction
Gallstones
51
Treatment for gallstones
Wait and see Liver enzyme function test. If normal: nothing. If abnormal: concurrent care
52
Hematuria due to
``` Kidney or bladder stones Damage to kidney or urinary tract Menses Trauma 1/3 childhood= idiopathic ```
53
Myoglobinuria due to
MI | Muscle damage
54
What does increased WBC mean
Infection Inflammation Almost all renal and urinary tract disease
55
What does increased RBC mean
``` GMN/PN Lower UTI Trauma Systemic Renal disease ```
56
Nitrites mean?
Screening for UTI | May suggest E. coli
57
What AA indicate severe liver disease
Tyrosine Leucine Cysteine
58
Epithelium (renal cell) indicated what
Kidney disease (flank pain)
59
What may indicate contamination
Bacteria | Epithelial cells with no other bacterial findings
60
Bacteria and epithelial cells with no other bacterial findings indicates what
Contamination
61
Mucus findings indicate?
Only significant with other findings | Usually means infection
62
Proteins indicate
Upper urinary tract problem
63
RBC cast
Glomerulonephritis
64
WBC cast
Pylonephritis
65
RBC indicates what
Bleeding in the nephron Glomerulonephritis No organism in kidney (usually immune related)
66
What illness is associated with glomerulonephritis
Strep throat
67
What is elevated in post streptococcal glomerulonephritis?
Antistreptolysin O titer
68
Upper UTI
``` Casts Protein Cloudy Hazy Flank pain WBC ```
69
``` Casts Protein Cloudy Hazy Flank pain WBC ```
Upper UTI
70
Lower UTI
WBC Mucous Blood Lower back/pubic pain NO CAST/PROTEIN

Visceral Disorders (4 decks)

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