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Clinical Medicine Master > UA (MR) > Flashcards

UA (MR) Flashcards

Clin Med UA lectures

1
Q

What test tells you more information about kidney function earlier than other tests?

A

USG

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2
Q

What will you analyze in a UA?

A

Physical appearance (smell too)
Chemical Examination
Sediment Examination

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3
Q

When does a UA evaluate? (broad) (3)

A

General Health
Hydration
Renal Function (USG) WHEN/ONLY in conjunction with serum chem

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4
Q

What color should urine be?

A

Yellow to Amber depending on how [ ]

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5
Q

Why does alcohol make you pee more?

A

Alcohol inhibits ADH

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6
Q

What makes pee turbid?

How much is ok?

A

Increased Particulate Matter

A Lil - no chunks!

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7
Q

Abnormalities in color: what does red/brown mean?

A

Hematuria
Hemoglobinuria
Myoglobinuria

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8
Q

How can you differentiate between Hematuria, Hemoglobinuria, and Myoglobinuria?

A

more tests

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9
Q

Abnormalities in color: what does Orange to Brown mean?

A

Bilirubinuria

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10
Q

If you spin your pee down and theres a lil pellet at the bottom what is it?

A

Hematuria - RBCs

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11
Q

TQ! What is the MOST specific Renal Function test?

A

USG

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12
Q

What part of the kidney does USG assess?

A

Renal Tubules

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13
Q

What should you use to evaluate USG?

A

Refractometer

Dipstick - unreliable

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14
Q

What does USG tell you the kidney can or cannot do?

A

Concentrate Urine

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15
Q

Is there a “normal” USG?

A

Depends on health and hydration status

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16
Q

Hyposthenuric range?

A

≤ 1.007 or “ten-oh-seven”

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17
Q

What is the exact same Specific Gravity as plasma?

A

Isosthenuric range:1.008 – 1.012

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18
Q

Isothenuric Range?

A

1.008 - 1.012

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19
Q

TQ! Hypersthenuric Range?

A

DOG ≥ 1.030
CAT ≥ 1.035
HORSE ≥ 1.025

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20
Q

If kidneys (CKD) aren’t working what range will USG be within?

A

Isosthenuric, Can’t really do anything with it

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21
Q

Is it possible to be in isosthenuric and not have CKF?

When?

A

Yes, When heavily hydrated

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22
Q

If you have an azotemic dog with USG of 1.029 what does that mean?

A

RENAL DZ, period.

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23
Q

Urine Protein must be evaluated in relation to?

Why?

A

USG.
In SUPER [urine] a 1+ protein is not significant.
In WEAK [urine} a 4+ is BAAADDD!!!

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24
Q

WIth a USG of 1.002 are the kidneys working?

A

YES, diluting urine is also an active process like concentrating urine. Putting water in!

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25
Q

Why are urine tests usually compared with ratio to Creatinine (UPC)?

A

Standardizes by taking GFR out of the picture

26
Q

What if you have a UTI, will protein be higher?

Will Urine Protein:Creatine Ratio tell you anything?

A

Yes.

P:C ratio will not tell you anything bc protein is post renal

27
Q

What can cause elevation in Urine Protein?

A 
Hemorrhage Shock
Fever
Exercise
Inflammation
Tubular Leakage
Glomerular Dz
28
Q

With clean sediment what can cause elevated UPC?

A

Glomerular Disease

Albumin leaking across glomerular membrane

29
Q

Which keytone is NOT detected by dipstick?

A

B Hydroxybutyric Acid

30
Q

List the Ketones?

A

B Hydroxybutyric Acid
Acetone,
Acetoacetic Acid

31
Q

When do Ketones elevate?

A

When fat metabolism replaces carbohydrates:
Starvation
Diet
Diabetic Ketoacidosis

32
Q

Renal Threshold for Glucose in Dog? Cats?

A 
Dog = 180 mg/dL
Cat = 280 mg/dL
33
Q

Why does urine glucose elevate?

A

Kidney Abnormalities (Rare)
Stress
DM

34
Q

What must you remember about testing urine samples?

A

For accurate Glucose reading you must evaluate ASAP

35
Q

What does it mean if there is a small amount of Bilirubin in a dogs urine?

A

Normal for dogs

36
Q

How high is the Renal threshold for Bilirubin in Cats?

A

VERY HIGH - ANY elevation in of concern

37
Q

I say Bilirubin, you say?

A

Prehepatic
Hepatic
Posthepatic

38
Q

Urobilinogen in UA indicates?

Absence?

A

Patent Bile Duct.
Absence: Possible obstructed bile duct but not sensitive or specific and need other tests to confirm.
Of little diagnostic value

39
Q

Occult Blood can test positive due to?

How can you tell what it is?

A

Hematuria
Myoblobin
Hemoglobin
Chemical Analysis

40
Q

What causes Myoglobinuria?

A

Muscle Dz

41
Q

What causes Hemoglobinuria?

A

Hemolysis

42
Q

What causes Hematuria?

A

Hemorrhage or inflammation anywhere in the Urinary Tract.

RBCs in sediment

43
Q

What is the normal pH for Urine?

Affected by?

A

6.0 – 7.5 Wide range including:
Acid/Base Balance systemically
Diet

44
Q

What pH should you start thinking if Urine pH gets up to around 9.0?

A

UTI - Urease + Producing Bacterial Infection

45
Q

What cells can be seen on Urine Sediment?

How many are normal in Cystocentesis?

A

WBC (0-3)
RBC (0-3)
Epithelial (Occational)

46
Q

Which Urine sample cannot be submitted for culture?

A

Free catch duh, there’s bugs all up in that shit…uh, pee.

There will be more cells and more bacteria

47
Q

How much urine should be submitted for analysis?

Bonus if you keep enough?

A

5-10 mL (in recording she harped on 10)

Lab can go ahead and run a Urine Protein: Creatinine Ratio if there was protein in the urine

48
Q

Is Free catch fine?

A

Yes, just expect more cells & don’t submit for culture

49
Q

Which cells on Urine Sediment should you examine together?

Why?

A

WBC & RBC.
Inflammation
Blood Contamination

50
Q

Epithelial cell types on Urine Sediment Exam?

What can elevations mean?

A

Squamos Transitional - likes to get TCC
Renal - Rare
Inflammation, Degeneration, Neoplasia

51
Q

Are crystals stones?

A

NO

52
Q

Which crystals are present in normal urine?

A 
Triple Phosphate  
Calcium Oxylate
Calcium Carbonate
Urate
Amorphous
53
Q

Which crystals can signify pathology if Cx suggest a problem too? Which are most likely?

A 
ANY!
Ammonium Biurate
Tyrosine
Bilirubin
Calcium Oxalate Monohydrate
Cystine
54
Q

If you see casts in urine what should you think?

A

KIDNEYS

55
Q

Which casts are considered horrifying and scary?

A

Cellular

56
Q

Hyaline casts are made of?
What are levels in healthy animal?
What causes them?

A

Hyaline casts = Mucoprotein
Healthy level= low
Caused by: Glomerular Leakage, Dehydration, Exercise, Fever

57
Q

What are cellular casts made of?

A

Any Cells!
WBC - Inflammation
RBC - Hemorrhage
Epithelial - Renal Tubular Damage

58
Q

Which casts aren’t that scary?

A

Hyaline & Granular and Waxy

59
Q

How do casts become granular and waxy?

A

age

60
Q

If there is no bacteria in sediment analysis can you rule out UTI?
Why?

A

Nope; Depends on how dilute the urine is

How long it took to perform sediment

61
Q

What should you always do with a diabetics urine?

A

Culture it! only by cytocentesis

Clinical Medicine Master (17 decks)

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