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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
Q

What should be run on all patients with a 4+ protein

A

Bence jones protein test

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26
Q

Test for finding a monoclonal immunoglobin in urine is called?

A

Urine protein electrophoresis. (UPEP) or immunoelectrophoresis

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27
Q

A routine UA does NOT detect ______ electrophoresis or immunoelectrophoresis is better

A

Bence jones proteins

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28
Q

What is the screening and confirmatory test for MM

A

Screening: SSA
Confirm: electrophoresis

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29
Q

CRAB. What and who

A

Multiple myeloma

Elevated calcium
Renal failure
Anemia
Bone lesions

30
Q

Pathway for OP, lytic mets or MM?

A

History
Old films
Lab: CBC, ESR, CRP, BCP, UA

31
Q

Path for Lytic mets

A

Bone scan
MRI
Biopsy

32
Q

Path for MM

A

PEP
Skeletal survey
MRI
Biopsy

33
Q

In 3% of patients with MM M spike cannot be detected and therefore should haev?

A

Serum free light chain assay

34
Q

MGUS

A

M< 3g (small m spike)
Plasma cells < 10%
No CRAB

35
Q

Smoldering MM

A

M protein > 3
Plasma cells >10%
No CRAB

36
Q

MM

A

M protein > 3
Plasma cells >10%
CRAB

37
Q

What is the normal rental threshold value until glucose starts spilling into urine

A

140-180mg/dl

38
Q

Ketones due to

A

Lack of available sugar getting into the cells due to lack of insulin

Byproduct of fat metabolism

39
Q

Conjugated bilirubin means what

A

Liver or post liver issue
Conjugated in liver
May see in urine

40
Q

Unconjucated bilirubin means what

A

Pre liver

Cannot be in urine

41
Q

A positive test for urine bilirubin confirms that any raised _____ levels are from _____ hyperbilirubinemia

A

Plasma

Conjugated

42
Q

Normal urobilinogen levels

43
Q

Increased urobilinogen seen withwhat

A

Anything that increases bilirubin increases it.

Liver disease and hemolytic conditions

44
Q

Increased urobililinogen causes

A

RBC breakdown
Decreased liver function
Liver cirrhosis

45
Q

Low urobilinogen due to

A

Failure of bile production

Obstruction of bile

46
Q

Urobilinogen: < 1
Bilirubin: -

47
Q

Urobilinogen: increased
Bilirubin: +

A

Biliary disease or liver

48
Q

Urobilinogen: decreased/none
Bilirubin: +

A

Biliary obstruction

49
Q

Urobilinogen: increased
Bilirubin: none

A

Prehepatic disease/hemolytic anemia

50
Q

What is the main cause of biliary obstruction

A

Gallstones

51
Q

Treatment for gallstones

A

Wait and see
Liver enzyme function test. If normal: nothing.
If abnormal: concurrent care

52
Q

Hematuria due to

A 
Kidney or bladder stones
Damage to kidney or urinary tract
Menses
Trauma
1/3 childhood= idiopathic
53
Q

Myoglobinuria due to

A

MI

Muscle damage

54
Q

What does increased WBC mean

A

Infection
Inflammation

Almost all renal and urinary tract disease

55
Q

What does increased RBC mean

A 
GMN/PN
Lower UTI
Trauma
Systemic
Renal disease
56
Q

Nitrites mean?

A

Screening for UTI

May suggest E. coli

57
Q

What AA indicate severe liver disease

A

Tyrosine
Leucine
Cysteine

58
Q

Epithelium (renal cell) indicated what

A

Kidney disease (flank pain)

59
Q

What may indicate contamination

A

Bacteria

Epithelial cells with no other bacterial findings

60
Q

Bacteria and epithelial cells with no other bacterial findings indicates what

A

Contamination

61
Q

Mucus findings indicate?

A

Only significant with other findings

Usually means infection

62
Q

Proteins indicate

A

Upper urinary tract problem

63
Q

RBC cast

A

Glomerulonephritis

64
Q

WBC cast

A

Pylonephritis

65
Q

RBC indicates what

A

Bleeding in the nephron
Glomerulonephritis

No organism in kidney (usually immune related)

66
Q

What illness is associated with glomerulonephritis

A

Strep throat

67
Q

What is elevated in post streptococcal glomerulonephritis?

A

Antistreptolysin O titer

68
Q

Upper UTI

A 
Casts
Protein
Cloudy
Hazy
Flank pain
WBC
69
Q 
Casts
Protein
Cloudy
Hazy
Flank pain
WBC
70
Q

Lower UTI

A

WBC
Mucous
Blood
Lower back/pubic pain

NO CAST/PROTEIN

Visceral Disorders (4 decks)

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