Urinalysis Flashcards by Iseoluwa Ojo | Brainscape

Q

Urinalysis

Also known as ______ and _____ ,is an array of tests performed on urine

A

Routine and Microscopy

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Q

Urinalysis is one of the most common methods of Medical diagnosis.

T/F

A

T

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Q

Routine urinalysis includes assessment of ______ characteristic, ______ analyses and a ______ examination of the ______ from a urine specimen.

A

physical

chemical

microscopic

sediment

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Q

SPECIMEN COLLECTION

Specimen should be collected by a clean _________ or _______

A

midstream catch or catheterization.

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Q

SPECIMEN COLLECTION

The urine should be freshly collected into a _____,______ container with a ____________ cover.

A

clean ,dry

tight-fitting

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Q

SPECIMEN COLLECTION

It must be analyzed within ___ of collection if held in at room temperature

A

1hr

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Q

SPECIMEN COLLECTION

Can be analyzed not more than _____ if refrigerated at __-___ C.

A

8hr

2o-8oC

(2-8 degrees Celsius)

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Q

The urine container may or may not be sterile if the urine is to be cultured

T/F

A

F

must be sterile

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Q

Specimen for routine urinalysis are usually _______ or ______ collection.

A

random,or spot

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Q

VISUAL APPEARANCE

Urine is meant to be ______ and ———

A

clear and colorless.

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Q

VISUAL APPEARANCE

Color intensity of urine correlates with ________.

A

concentration

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Q

VISUAL APPEARANCE

Various colors observed in urine are as a result of ________

A

different pigmentation.

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Q

VISUAL APPEARANCE of urine

Yellow and amber- __________.

Yellow-brown to green- ___________.

Red and brown after standing – _________.

A

urochomes

bile pigment oxidation

porphyrins

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Q

VISUAL APPEARANCE of urine

Reddish-brown in fresh specimen- _________ or ______

Brownish-black after standing – _______ and _______

A

heamoglobin or RBC.

alkaptonuria and malignant melanoma.

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Q

ODOR Ordinarily has little significance

T/F

A

T

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Q

ODOR

Characteristic ______ odor of fresh urine is due to __________ ,in contrast to the typical ______ odor of urine that has been allowed to stand.

A

pungent; volatile aromatic acids

ammonia

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Q

ODOR

UTI impart a _____,_______ smell to urine.

A

noxious,fecal

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Q

Urine of diabetics often smells ______ as a result of _______.

A

fruity

ketones

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Q

TURBIDITY

The cloudiness of urine specimen depends on _______ and ________

A

pH and dissolved solids composition.

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Q

TURBIDITY

generally may be due to gross ________.

A

bacteriuria

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Q

TURBIDITY

Smoky appearance is seen in _______.

A

heamaturia

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Q

TURBIDITY

Threadlike cloudiness is observed when the specimen is full of _____.

A

mucus

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Q

TURBIDITY

In alkaline urine-precipitate of ___________ and ________

In acidic urine- _____________.

A

amorphous phosphates and carbonates.

amorphous urates

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Q

VOLUME

It indicates the balance between ________ and _______ from lungs,sweat and intestine.

A

fluid ingestion

water loss

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Q

VOLUME of urine

Most adults produce from ____-____ml every 24hrs with average of ____L/person.

A

750-2000

1.5

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Q

VOLUME of urine

Diabetes mellitus

Polyuria, oligonuria, or anuria

A

Polyuria

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Q

VOLUME of urine

Diabetes insipidus

Polyuria, oligonuria, or anuria

A

Polyuria

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Q

VOLUME of urine

Chronic renal failure

Polyuria, oligonuria, or anuria

A

Polyuria

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Q

VOLUME of urine

Acromegaly

Polyuria, oligonuria, or anuria

A

Polyuria

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Q

VOLUME of urine

Myxedema.

Polyuria, oligonuria, or anuria

A

Polyuria

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Q

VOLUME of urine

______uria–Urinary tract obstruction

A

Anuria or Oliguria

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Q

VOLUME of urine

_____uria -Acute renal failure

A

Anuria or Oliguria

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Q

VOLUME of urine

Polyuria –Nephritis,ESRD

T/F

A

F

Anuria or Oliguria

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Q

SPECIFIC GRAVITY

Normal range for urinary SG is ______ to _____

A

1.005-1.030.

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Q

SPECIFIC GRAVITY

SG of urine is the weight of __________ in ______ (multiplied or divided?) by the weight of _________

A

1ml of urine

grams

Divided

1ml of water.

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Q

SPECIFIC GRAVITY

It varies with the ________ to be excreted.

A

solute load

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Q

SPECIFIC GRAVITY

It is used to assess the state of _______/______ of an individual

A

hydration/dehydration

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Q

SPECIFIC GRAVITY

Used As an indicator of the ______ ability of the kidneys.

A

concentrating

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Q

LABORATORY METHODS

Most commonly encountered analytic method consists of a _______,or _________.

This operates on the principle that the ______ of a urine specimen will vary directly with the ___________ in the sample

A

refractometer

total solid meter

refractive index

total amount of dissolved solids

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Q

LABORATORY METHODS

Unlike the refractometer, _____ measure only _______ and do not take into account of _______ and _____

A

dipsticks

ionic solutes

glucose and protein.

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Q

Specific gravity of urine varies in pathologic states.

T/F

A

T

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Q

Specific gravity of urine

Pyelonephritis

Low or high?

A

Low

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Q

Specific gravity of urine

Glomerulonephritis.

Low or high?

A

Low

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Q

Specific gravity of urine

Diabetes mellitus

Low or high?

A

High

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Q

Specific gravity of urine

Chronic heart failure

Low or high?

A

High

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Q

Specific gravity of urine

Dehydration

Low or high?

A

High

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Q

Specific gravity of urine

Adrenal insufficiency

Low or high?

A

High

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Q

Specific gravity of urine

liver Diseases and Nephrosis.

Low or high?

A

High

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Q

SG will increase about ______ unit for every 1% change in glucose concentration and about ______ units for every 1% change in protein

A

0.004

0.003

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Q

Fixed SG(_________) around 1.010 is observed in ________ in which the kidneys excrete urine that is ______ with the plasma.

A

isosthenuria

severe renal damage

iso-osmotic

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Q

PH

Normal urine pH falls within the range of ____ - ____

A

4.5-8.0.

Q

PH

Determination of urinary pH must be performed on fresh specimens because of _____________

A

the significant tendency of urine to alkalinize on standing.

Q

PH

Acidic urine <7.0 is primarily caused by _______ which are excreted as salts conjugated Na,K and Ca.

A

phosphates

Q

Acidity of urine also reflects the excretion of the nonvolatile metabolic acids: _____,_____, and ______

A

pyruvate,lactate and citrate.

Q

Pathologic states with increased acidity include: Systemic acidosis- _________ and _________

A

DM and Renal tubular acidosis.

Q

Alkaline urine >7.0 is observed post_______.

Which is a Normal reaction to the ______ of ____ dumped into the _____ and then into the circulation.

A

prandially

acidity of gastric HCL

duodenum

Q

Alkaline urine May follow the ingestion of alkaline food or medication.

T/F

A

T

Q

Urinary tract infections and bacterial contamination can lead to (alkaline or acidic?) urine

A

Alkaline

Q

Acidic urine is also found in Fanconi’s syndrome.

T/F

A

F

Alkaline

Q

CHEMICAL ANALYSES

Routine urine analysis is rapid and easily performed with commercially available ________ or ______

A

reagent strips or dipsticks.

Q

reagent strips or dipsticks

These strips are _______ coated with ________ directed toward different analyses.
Abnormal results are followed up by specific quantitative or confirmatory urine assays.

A

plastics

different reagent bands

Q

Centrifuged, decanted urine aliquot, leaves behind a sediment of formed elements that is used for microscopic examination.

T/F

A

T

Q

Sediment examination: cells

Evaluation is best accomplished by _______ and then taking ______ of at least _______ for cellular elements.

A

counting

the average

10 microscopic fields

Q

Sediment examination: RED BLOOD CELLS

Erythrocytes >_____/HPF are considered abnormalgy

A

0-2

Q

Sediment examination: RED BLOOD CELLS

May result from simple _______ / _______ contamination.

A

severe exercise

menstrual blood

Q

Sediment examination: RED BLOOD CELLS

May be indicative of Trauma especially from _____ injury,renal/urinary ______, ________itis or cystitis.

A

vascular

calculi obstruction

pyelonephr

Q

Sediment examination: RED BLOOD CELLS

_______ + ________ - Infection.

A

Heamaturia

leukocytes

Q

Sediment examination: WHITE BLOOD CELLS

Leukocytes >_____/HPF are considered abnormal.

A

0-1

Q

Sediment examination: WHITE BLOOD CELLS

They are usually polymorphonuclear phagocytes-segmented _______.

A

neutrophils

Q

Sediment examination: WHITE BLOOD CELLS

They are observed when there is _______,_______, or ________ of any type.

A

Acute glomerulonephritis,UTI or inflammation

Q

Sediment examination : EPITHELIAL CELLS

Several types are frequently encountered in (normal or abnormal ?) urine.

Due to ____________________ of nephrons and urinary tract

A

Normal

continuously sloughed off the lining

Q

Sediment examination : EPITHELIAL CELLS

(Small or Large?),_____ ,squamous vaginal epithelia-female specimen.

Renal epith cells are _____,uninucleated
cells , if> _____/HPF-Active tubular injury.

A

Large; flat

round

2

Q

Sediment examination : EPITHELIAL CELLS

______ bladder epith may be flat,cuboidal,or columnar- occassionally.

Large numbers will be seen only in cases of urinary __________,bladder _______ or ______.

A

Transitional

catheterization

inflammation

neoplasm

Q

Sediment examination: MISCELLANEOUS

Usually not reported because they are of no pathologic significance
T/F

Spermatozoan-M and F,in Male-________ abnormalities.

A

T

prostate

Q

Sediment examination: MISCELLANEOUS

Yeast

Parasites-fecal(_________) and vaginal(________)

A

Enterobium vermicularis

T.vaginalis

Q

Sediment examination: MISCELLANEOUS

True urinary parasite –ova of the trematode __________

Usually occur with significant _______.

A

S.heamatobium.

heamaturia

Q

Normal urine is sterile with no bacteria.

T/F

A

T

Q

Sediment examination: bacteria

_____ Number of organisms OR —— numbers + _____ and ____ symptoms -True infection.

A

Large

Small

WBCs; UTI

Q

Sediment examination: bacteria

Clinical significant bacteriuria->___orgs/HPF or10^___ OR > registered on a microbiologic colony count.

A

20

5

Q

Sediment examination: bacteria

Most seen pathogen are gram _______ve coliforms e.g ______ and _____

A

Negati

E.coli; proteus

Q

Sediment examination: bacteria

Asymptomatic bacteriuria- ____ girls, ______ woman and patients with ——-.

A

Young

pregnant

DM

Q

Sediment examination: CASTS

They are precipitated, ________ shaped impressions of the ______.

A

cylindrical

nephrons

Q

Sediment examination: CASTS

They comprise ______ ———- from the tubular epithelia in the ____________________

A

Tamm- Horsfall

mucoprotein

ascending loop of Henle

Q

Sediment examination: CASTS

Casts form whenever there is sufficient ______, increased ______ or _____ concentration and decreased ______.

A

renal stasis

urine salt or protein ; urine pH

Q

Casts should be examined under ______ and are most often located around the _____ of the coverslip.

A

low power

edges

Q

Sediment examination: HYALINE

The matrix of these casts is ____ and _______, without _______ or particulate matter.

A

clear ; gelatinuos

embedded cellular

Q

Sediment examination: HYALINE

May be difficult to visualize unless a ___________ is used.

A

high-intensity lamp

Q

Sediment examination: HYALINE

Presence indicates ___________

Leakage may be temporary( fever, ____ posture, dehydration, or emotional stress) or may be permanent.

A

glomerular leakage of protein

upright

Q

The occassional presence of hyaline cast is considered pathologic.

T/F

A

F

Their occassional presence is not considered pathologic.

Q

Sediment examination: GRANULAR cast

Casts are descriptively classified as either _____ or _____.

A

coarse or finely granular

Q

Sediment examination: GRANULAR cast

Is simply a matter of the amount of ______ that the ________ have undergone.

L

A

degeneration

epithelial cell inclusions

Q

Sediment examination: GRANULAR cast

Occasional presence is not pathologic.

T/F

A

T

Q

Sediment examination: GRANULAR cast

Large numbers may be found in chronic _____ toxicity and ___.

A

lead

Q

Sediment examination: CELLULAR casts

RBC Casts- diagnostic for ______ that results in renal ______ ,seen in SBE,kidnry infarcts,collagen dxs and acute glomerulonephritis.

A

glomerular inflammation

heamaturia

Q

Sediment examination: CELLULAR casts

WBC Casts-diagnostic for inflammation of the ______.observed in pyelonephritis, nephrotic syn, and acute glomerulonephritis

A

nephrons

Q

RBC Casts-not always pathologic

T/F

A

F

RBC Casts-always pathologic

Q

WBC Casts- is always pathologic

T/F

A

T

Q

Sediment examination:CELLULAR

Epithelial cell casts- sometimes formed by ____ of ________ after ______.

A

fusion

renal tubular epithelia

desquamation

Q

Sediment examination:CELLULAR

Waxy casts-uniformly ———— color, refractile, and ____ appearing, with (sharply or bluntly ?) defined , often _____ edges.

A

yellowish; brittle

Sharply ; broken

Q

Waxy casts-

Almost always pathologic

T/F

A

T

Q

Sediment examination:Cellular

Waxy cast:

Indicate _____ inflammation.

Formed by ______ in the collecting ducts –CRF.

A

tubular

renal stasis

Q

Sediment examination:Cellular

Fatty casts-

(Normal or abnormal?) , coarse, granular casts with ____ inclusions that appear as ________ of different sizes.

A

Abnormal

lipid

refractile globules

Q

Sediment examination : CRYSTALS

Acid environment:

Ca oxalate-normal _______,may have almost like _____ appearance.

A

octahedrons

starlike

Q

Sediment examination : CRYSTALS

Acid environment:

Amorphous urates-normal ______ masses with a _____ appearance.

A

yellow-red

grain of sand

Q

Sediment examination : CRYSTALS

Acid environment:

Uric acid –normal yellow to red-brown that appear in extremely ____ shapes,such as ______,_____, or______

A

irregular

rosettes, prisms, or rhomboid.

Q

Sediment examination : CRYSTALS

Acid environment:

Cholesterol – ____ color , flat, _____ plates with _____ corners. may be seen in ________

A

clear

rectangular

notched

neprotic syndrome

Q

Sediment examination : CRYSTALS

Acid environment:

Cystine –appear _____ , refractile, nearly flat ______ , somehow similar to _______ .

seen in _______ and _____

A

colorless

hexagons

uric acid

homocystinuria and cystinuria.

Q

Sediment examination : CRYSTALS

Acid environment:

List it!

A

Ca oxalate
Amorphous urates-
Uric acid
Cholesterol
Cystine

Q

Which crystal found in acidic environment is highly pathologic?

A

Cystine

Q

Sediment examination : CRYSTALS

Alkaline environment:

Amorphous phosphates-fine, _____ masses, resembling ____.

A

colorless

sand

Q

Sediment examination : CRYSTALS

Alkaline environment:

Calcium carbonate-small, _____ , ______ or ______ shaped

A

colorless

dumbbells or spheres.

Q

Sediment examination : CRYSTALS

Alkaline environment:

Triple phosphate- ________ prisms of _____ sides, resembling a “________”.

A

colorless

3-6

coffin lids

Q

Sediment examination : CRYSTALS

Alkaline environment:

Ammonium biurates- _____ ,yellow-brown spheres or “ ________”.

A

spiny

thorn apples

Q

Sediment examination : CRYSTALS

Alkaline environment:

List them

A

Amorphous phosphates
Calcium carbonate
Triple phosphate
Ammonium biurates

Q

SG of urine

Dilute specimen-____-_____ ,Concentrated samples- ___-____

A

1.000-1.010

1.025-1.030.

Q

Polyuria = _______ml of urine

Oliguria = _______ml of urine

Anuria = _______ml of urine

A

Greater than 3000

Less than 500

Less than 250

Q

______ and ———- an present as pseudohyponatremia

A

Hyperlipidemia

Hyperlipoproteinemia

Q

In hyperthyroidism , you can find ____ myxedema

In hypothyroidism , you can find ____ myxedema

A

Pretibial

Normal

Q

Growth hormone can predispose to diabetes mellitus

T/F

With reason

A

T

It opposes insulin and stimulates glycogenolysis

Q

________ cast is found AKI

_____ cast is found in ATN, pyelonephritis, and chronic lead toxicity

A

Hyaline

Granular

Q

_______ cast is found in chronic renal failure

A

Waxy

Q

_______ cast is found in eclampsia

A

Epithelial cells

Q

_______ cast is found in amyloidosis

A

Epithelial cell

Q

Eclampsia: ______,_____, and ———- in pregnancy

Pre-Eclampsia: ______ and ———- in pregnancy

A

Hypertension ; Proetinuria; Seizures

Hypertension ; Proetinuria

Q

_______ cast is found in nephrotic syndrome

A

Fatty casts and epithelial cells casts