4. 5 - 8.0 4. 5 - 5.5 = acidic 6. 5 -8.0 = alkaline

UA (lec 1) Flashcards by Wendy Pitts

Abnormal urine colors?

red/brown = blood or Hgb

dark brown/black = bile/bilirubin

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Causes of turbid urine? (7)

crystal precipitate
bacteria/yeast
WBC/RBC
mucus
squamous epithelial cells
sperm/prostatic fluids
lipids

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Causes of abnormal urine odors? (4)

UTI
ketone bodies
smoke
AA disorders

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Dipsticks test for what? (10)

pH
Specific Gravity
Glucose
Ketones
Protein
Blood
Nitrite
Leukocyte Esterase
Bilirubin
Urobilinogen

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pH normal range?

5 - 8.0
5 - 5.5 = acidic
5 -8.0 = alkaline

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Specific Gravity (SG) is what?

Normal range?

measure comparing urine to pure H2O (solutes),
water = 1.0

1.003 - 1.035

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SG tells us?

kidney ability to concentrate/dilute urine

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Isosthenuria is?

inability of kidney to concentrate urine,

SG fixed at 1.010

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Normal Urine volume/24 hrs?

Oliguria =

Anuria =

Polyuria =

500 - 2000 cc

Oliguria = < 500 cc

Anuria = < 100 cc

Polyuria = excessive w/ SG = 1.0 - 1.002

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Glucose in urine?

abnormal in urine

plasma glucose threshold = 150 - 180 mg/dL ,
excess spills into urine

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Glucose dipstick ranges?

Trace - 4+

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(P) causes of false negatives for urine glucose?

ascorbic acid (vit C)
aspirin

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Ketones result from?

3 kinds?

incomplete fat metabolism when carb stores ↓

acetoacetic acid
acetone
β-hydroxybutyrate

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(P) causes Ketones in urine?

acidosis (DM, starvation, pregnancy)

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Normal urine protein level?

< 150 mg/24hrs

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Protein dipstick ranges?

trace - 4+

small, mod, large

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Urine protein levels affects by SG how?

High SG = (P) false high protein level

Low SG = (P) false low protein level

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(P) causes of false positive urine protein?

high pH
hematuria
high SG
pyridium (UTI painkiller)

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Microalbuminuria is?

Normal level is?

level of albumin in urine below detection of dipstick (< 300mg/24h) BUT above upper limit for normal (30mg)

<30mg albumin/gram urinary creatinine

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Microalbuminuria may indicate? (5)

early diabetic nephropathy,
exercise,
fever,
cystitis,
CHF

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Best test for Microalbuminuria?

10 - 24 hr collection

or 1st void

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Proteinuria may indicate?

kidney dx (glomerular capillary leakage of protein)

Proteinuria tx?

BP management (SBP <120)
ACE inhibitors
low protein diet

Dipstick detection of blood:
will show + for what 3 things?

Sensitivity?

RBC, Hgb (RBC lysis), myoglobin (mm breakdown)

sensitivity:
5 - 10 RBCs
0.05 - 0.3 mg/dL Hgb

Abnormal range for RBCs?

> 3 RBC/hpf

Blood dipstick ranges?

trace - 4+ small, mod, large

Urine Nitrate test for? Normal results should be?

bacteria capable of reducing nitrates negative

(P) causes for false negatives of urine nitrites?

urine in bladder < 4hrs (no time to reduce) nitrate-deficient diet bacteria w/o necess enz

Urine Leukocyte Esterase (LE) tests for? Can detect as low as? Sensitivity?

leukocytes 5 WBCs/hpf 80% in dx UTI, higher if + LE and + nitrites

(P) causes of false positive urine LE?

vaginal contamination | trichomonads

LE dipstick ranges?

trace - 4+ small, mod, large

Bilirubin/Urobilinogen (U) excreted how? What causes presence in urine?

in stool liver dx

Dipstick results for Bilirubin/Urobilinogen?

(U) negative

RBC sediment abnormal level? RBCs appear as?

> 3 RBCs/hpf refractile disks, (P) crenated (shrunken) appearance if hypertonic urine

(P) causes of ↑ RBCs?

``` UTI renal or lower UT trauma kidney stones glomerular damage nephrotoxins vaginal contamination ```

kidney dx CA BPH

Approach to red/brown urine: red sediment? red supernatant + positive heme dip? - > + clear plasma? - > + red plasma? red supernatant + negative heme dip?

see slide 41 red sediment = blood red supernatant + positive heme dip = Mgb or Hgb - > + clear plasma = Mgb - > + red plasma = Hgb red supernatant + negative heme dip = diet, meds, etc

WBCs in urine abnormal level? Next step?

> 5 WBC/hpf 10-20 suspicious UTI >= 20 indicates UTI C&S

Appearance of WBCs in urine?

lobed nuclei, | refractile cytoplasmic granules

U/A w/ reflex C&S is?

tells lab to run C&S if U/A suggests infection

Renal Tubular/Transitional Epithelial Cells present in large #s if?

tubular degeneration

If Lipiduria, Renal Tubular/Transitional Epithelial Cells contain?

oval fat bodies

Oval Fat Bodies are?

degenerated tubular cells w/ refractile-appearing lipid configured in "maltese cross" seen w/ hyperlipidemia

↑ # of Squamous Epithelial Cells (U) indicates?

contaminated specimen

Urine Casts are?

clumps of cells formed in distal convoluted tubule or collecting duct ** NOT formed in proximal convo tube or loop of Henle

Hyaline Casts made of? Appearance?

mucoprotein from tubule cells (benign, common) very pale, slighly refractile

RBC Casts cause by? (2)

glomerular injury glomerulonephritis (assume this until proven otherwise)

WBC Casts (U) caused by?

``` acute pyelonephritis (upper kidney) "pie alone a fright us" ```

Renal Tubular Cell Casts suggest?

tubular epithelium injury

Granular Casts from?

broken-down renal tubular cell casts

Waxy Casts from? Appearance?

broken-down renal tubular cell casts sharp edges w/ cracks

Most reliable test for infection?

Urine Cx

Colony level consistent w/ infection?

> 100k colonies/ml