UA Flashcards by Anthony Carli

What are the 3 components of a UA?

gross examination

urine dipstic

microscopic analysis

How well did you know this?

Not at all

Perfectly

Collection of a urine sample requires what two things?

aseptic technique (disinfection, spread labia)

clean midstream catch

How well did you know this?

Not at all

Perfectly

In gross examination, what two things should you be observing for?

color, turbidity

How well did you know this?

Not at all

Perfectly

In gross examination, should you smell the urine?

yes

How well did you know this?

Not at all

Perfectly

dark amber urine is (normal/abnormal) and indicates what?

normal, concentrated urine

How well did you know this?

Not at all

Perfectly

Red or red-brown urine indicates… (2)

hematuria

hemoglobinuria

How well did you know this?

Not at all

Perfectly

dark brown/black urine indicates…

bile/bilirubin due to biliary or liver disease

How well did you know this?

Not at all

Perfectly

Red urine in a female, you must rule out…

menstrual contamination

How well did you know this?

Not at all

Perfectly

Red urine in a patient of any sex, consider… (3)

myoglobin, food dye, beets/rhubarb

How well did you know this?

Not at all

Perfectly

The following disorders would cause urine to be what color?

alkaptonuria
homogentisic acid oxidase
malignant melanoma

dark brown/black

How well did you know this?

Not at all

Perfectly

The following could have what effect on urine clarity?

crystal precipitate
bacteria/yeast
WBCs/RBCs
mucous
squamous epithelium
sperm, prostatic fluid
lipids

cloudy/turbid

How well did you know this?

Not at all

Perfectly

putrid/foul odor of urine indicates…

bacteria

How well did you know this?

Not at all

Perfectly

fruity odor of urine indicates…

ketones

How well did you know this?

Not at all

Perfectly

ash-tray urine smell indicates

cigarette smoker

How well did you know this?

Not at all

Perfectly

phenylketonuira/maple syrup odors indicate…

amino acid disorder

How well did you know this?

Not at all

Perfectly

10 measures on a urine dipstick…

ph
specific gravity
glucose
ketones
protein
blood
nitrite
leukocyte esterase
bilirubin
urobilinogen

How well did you know this?

Not at all

Perfectly

urine pH parallels…

serum pH

How well did you know this?

Not at all

Perfectly

Increased concentration of urine has what effect on its specific gravity?

increased SG

How well did you know this?

Not at all

Perfectly

This measure:

reflects ability of kidney to concentrate and dilute urine

specific gravity

How well did you know this?

Not at all

Perfectly

In kidney disease, specific gravity can become fixed at 1.010. This is called…

fixed at

called isothenuria

How well did you know this?

Not at all

Perfectly

urine < 500cc / 24 hours

oliguria

How well did you know this?

Not at all

Perfectly

urine < 100cc/24 hrs

anuria

How well did you know this?

Not at all

Perfectly

excessive urine, dilute, SG 1.000-1.002

polyuria

How well did you know this?

Not at all

Perfectly

Glucose can “spill” into urine when plasma glucose exceeds…

150-180 mg/DL

How well did you know this?

Not at all

Perfectly

What 2 substances can cause false negatives for glucosuria?

ascorbic acid | aspirin

Acidosis, DKA, rapid weight loss, fasting, starvation and pregnancy can all cause what to be present in urine?

ketones

Urine dipstick is sensitive to what protein?

albumin

albuminuria is an indicator of...

renal endothelial dysfunction/early kidney disease

albuminuria is an indicator of...

renal endothelial dysfunction/early kidney disease

What may cause a false positive for protein in a urine dipstick?

pyridium

What is a limitation to detecting protein in urine via dipstick?

dilute urine underestimates degree of albuminura

Moderately increased albuminuria in the range of ____ to _____ cannot be detected with dipstick

30-300

Moderately increased albuminuria is a marker for staging and prognosis of...

kidney disease

Persistently positive dipstick for protein should have what quantified?

albuminuria

What two diagnostics outside of urine dipstick can be helpful in staging/prognosis of kindey disease?

24 hr collection Albumin/Cr ratio on randome urine

Albuminuria is a good screen for kidney damage in what high risk patients? (3)

diabetes, HTN, CVD

what can cause a false negative for hematuria?

ascorbic acid

what must be done in order to determine the presence of RBCs, Hb, or Mb in urine?

centrifuge and microscopy

Urine diptick sensitivity is ______ for RBCs or _____ for Hb

5-10 RBCs, .05-.3 Hb

Nitrite test on UA is 50% sensitive for UTI. This means...

can't r/o UTI

Nitrite in urine can indicate...

bacteria

False negatives for nitrite in UA can be caused by...

urine in bladder < 4 hrs bacteria w/out nitrite enzymes

What releases leukocyte esterase?

neutrophils and macrophages

This measure on a urine dipstick is a marker for the presence of WBCs indicating infx...

leukocyte esterase

Vaginal contamination and trichomonas can give a false positive for...

leukocyte esterase

LE and Nitrite increases sensitivity for diagnosing...

UTI

detects metabolic acidosis/alkalosis...

can detect acute kidney failure...

specific cravity

indicates DM

glucose

indicates DKA/acidosis...

ketones

Can indicate kidney pathology...

proteinuria

sign of early kidney disease...

moderately increased albumin

___ + _____ indicates infection

nitrate/LE

indicates liver disease, hemolysis, biliary obstruction

bili/urobili

in hypertonic urine, RBCs appear...

crenated

What age for hematuria via these causes? Glomerulonephritis UTI congenital anomaly

0-20yr

What age for hematuria via these causes? UTI Caliculi Bladder CA

20-60

What age for hematuria via these causes? ``` BPH Bladder CA Prostate CA UTI Kidney CA ```

> 60 Male

What age for hematuria via these causes? UTI Bladder CA Kidney CA

> 60 female

After centrifuging urine, you see sediment red. This indicates...

hematuria

After centrifuging urine, you see supernatant red. What do you do next?

dipstick heme

After centrifuge of supernatant red, you see a positive heme dipstick. If plasma was clear, what was the cause?

myoglobinuria

After centrifuge of supernatant red, you see a positive heme dipstick. If plasma was red , what was the cause?

hemoglobinuria

on UA microscopy, you see cells with lobed nuclei and cytoplasmic granules... What does this indicate?

WBCs

What types of renal cells can be seen on UA microscopy?

transitional epithelial renal tubular epithelial

On UA microscopy, you see the following: maltese cross by polarized light refractile, lipoprotein abundant tubular cells these cells are called ______ and indicate...

oval fat bodies, nephrotic syndrome

presence of squamous epithelial cells in UA indicates...

contamination

large polygonal cells on UA...

squamous epithelial

where are urine casts formed?

DCT

Very pale, slightly refractile cells composed of mucoprotein (tamm-horsfall) secreted by tubule cells common finding in normal urine...

hyaline casts

red cell casts indicate...

glomerulonephritis, tubular injury

WBC casts suggests...

acute pylonephritis

renal tubular casts suggests...

acute tubular necrosis

these are casts of debris from the tubules that are nonspecific

granular/waxy casts

this cause of crytalluria is secondary to hyperuricemia in acidic urine...

uric acid crystals

this cause of crytalluria is a rare genetic cause of kidney stones

cystine crystals

this cause of crytalluria is found in alkaline urine, secondary to urease-producing bacteria

struvite

this cause of crytalluria is independent of pH, common cause of kidney stones, can be monohydrate or dihydrate

calcium oxylate