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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
Why are urine tests usually compared with ratio to Creatinine (UPC)?
Standardizes by taking GFR out of the picture
26
What if you have a UTI, will protein be higher? | Will Urine Protein:Creatine Ratio tell you anything?
Yes. | P:C ratio will not tell you anything bc protein is post renal
27
What can cause elevation in Urine Protein?
``` Hemorrhage Shock Fever Exercise Inflammation Tubular Leakage Glomerular Dz ```
28
With clean sediment what can cause elevated UPC?
Glomerular Disease | Albumin leaking across glomerular membrane
29
Which keytone is NOT detected by dipstick?
B Hydroxybutyric Acid
30
List the Ketones?
B Hydroxybutyric Acid Acetone, Acetoacetic Acid
31
When do Ketones elevate?
When fat metabolism replaces carbohydrates: Starvation Diet Diabetic Ketoacidosis
32
Renal Threshold for Glucose in Dog? Cats?
``` Dog = 180 mg/dL Cat = 280 mg/dL ```
33
Why does urine glucose elevate?
Kidney Abnormalities (Rare) Stress DM
34
What must you remember about testing urine samples?
For accurate Glucose reading you must evaluate ASAP
35
What does it mean if there is a small amount of Bilirubin in a dogs urine?
Normal for dogs
36
How high is the Renal threshold for Bilirubin in Cats?
VERY HIGH - ANY elevation in of concern
37
I say Bilirubin, you say?
Prehepatic Hepatic Posthepatic
38
Urobilinogen in UA indicates? | Absence?
Patent Bile Duct. Absence: Possible obstructed bile duct but not sensitive or specific and need other tests to confirm. Of little diagnostic value
39
Occult Blood can test positive due to? | How can you tell what it is?
Hematuria Myoblobin Hemoglobin Chemical Analysis
40
What causes Myoglobinuria?
Muscle Dz
41
What causes Hemoglobinuria?
Hemolysis
42
What causes Hematuria?
Hemorrhage or inflammation anywhere in the Urinary Tract. | RBCs in sediment
43
What is the normal pH for Urine? | Affected by?
6.0 – 7.5 Wide range including: Acid/Base Balance systemically Diet
44
What pH should you start thinking if Urine pH gets up to around 9.0?
UTI - Urease + Producing Bacterial Infection
45
What cells can be seen on Urine Sediment? | How many are normal in Cystocentesis?
WBC (0-3) RBC (0-3) Epithelial (Occational)
46
Which Urine sample cannot be submitted for culture?
Free catch duh, there's bugs all up in that shit...uh, pee. | There will be more cells and more bacteria
47
How much urine should be submitted for analysis? | Bonus if you keep enough?
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
Is Free catch fine?
Yes, just expect more cells & don't submit for culture
49
Which cells on Urine Sediment should you examine together? | Why?
WBC & RBC. Inflammation Blood Contamination
50
Epithelial cell types on Urine Sediment Exam? | What can elevations mean?
Squamos Transitional - likes to get TCC Renal - Rare Inflammation, Degeneration, Neoplasia
51
Are crystals stones?
NO
52
Which crystals are present in normal urine?
``` Triple Phosphate Calcium Oxylate Calcium Carbonate Urate Amorphous ```
53
Which crystals can signify pathology if Cx suggest a problem too? Which are most likely?
``` ANY! Ammonium Biurate Tyrosine Bilirubin Calcium Oxalate Monohydrate Cystine ```
54
If you see casts in urine what should you think?
KIDNEYS
55
Which casts are considered horrifying and scary?
Cellular
56
Hyaline casts are made of? What are levels in healthy animal? What causes them?
Hyaline casts = Mucoprotein Healthy level= low Caused by: Glomerular Leakage, Dehydration, Exercise, Fever
57
What are cellular casts made of?
Any Cells! WBC - Inflammation RBC - Hemorrhage Epithelial - Renal Tubular Damage
58
Which casts aren't that scary?
Hyaline & Granular and Waxy
59
How do casts become granular and waxy?
age
60
If there is no bacteria in sediment analysis can you rule out UTI? Why?
Nope; Depends on how dilute the urine is | How long it took to perform sediment
61
What should you always do with a diabetics urine?
Culture it! only by cytocentesis

Clinical Medicine Master (17 decks)

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