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E&E > Urinalysis > Flashcards

Urinalysis Flashcards

1
Q

Diuresis

A

increased urine production due to a non pathologic process

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2
Q

polyuria

A

increased urine production due to a pathologic process

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3
Q

oliguria

A

decreased urine production given the degree of hydration

pathologic: dehydration, fever, acute kidney injury

non-pathologic: increased ambient temperature and panting

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4
Q

anuria

A

minimal to no production

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5
Q

pollakiuria

A

increased frequency of urination with normal urinary volume

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6
Q

what artifacts are associated with delayed urinalysis?

A
  • formation of crystals
  • bacti growth
  • cell degeneration
  • increased pH
  • Decreased bilirubin and urobilinogen
  • increased USG
  • Equine urine can turn red/brown with storage
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7
Q

what are the different collection methods for urinalysis?

A
  1. Free catch
  2. Catheterization
  3. Cystocentesis
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8
Q

Pros and Cons of Free Catch

A

Pros: owner can obtain sample and there is not risk of trauma

Cons:
- likely contamination with cells and bacteria
- kidneys, ureters, bladder, genital tract, external skin
- depends on animals willingness to provide sample

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9
Q

Pros and Cons of Catheterization

A

Pros:
- minimizes external contamination
- sample obtained immediately
- relieve obstruction

Cons:
- difficult in females
- increases number of squamous epithelial cells
- possible catheter-induced hematuria

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10
Q

Cystocentesis Pros and Cons

A

Pros:
- least amount of contamination
- sample obtained immediately
- can relieve bladder distension

Cons:
- requires cooperative animal/sedation
- Iatrogenic blood contamination
- risk of bladder laceration/rupture or enterocentesis
- risk of tumor seeding

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11
Q

what is the impact of bacteria on urine test results?

A
  • contamination
  • bacterial urease breaks urea down to ammonia -> will increase urine pH
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12
Q

what is the difference between urine dipstick protein and SSA test?

A

Urine dipstick: can be performed on unspun urine or on the supernatant post-centrifugation. Analyzes the amount/value of pH, Glucose, Ketones, Blood, Bilirubin, Protein

Protein via SSA: used to confirm proteinuria in alkaline samples. It is better than dipstick at detecting Bence-Jones proteins, but can still have false -

Both are more sensitive for albumin than other proteins

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12
Q

red urine color

A

RBC, hemoglobin, myoglobin

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13
Q

red-brown urine

A

RBC, hemoglobin, myoglobin, methemoglobin

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14
Q

Brown-black urine

A

methemoglobin from hemoglobin or myoglobin

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15
Q

yellow - orange urine

A

bilirubin

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16
Q

yellow-green or yellow-brown urine

A

bilirubin and biliverdin

17
Q

prolonged storage or urine in snow in horses can discolor urine to __

A

red-brown

18
Q

what are the causes for RBC lysis in urine?

A

Bilirubinemia

19
Q

what is the relationship between urine volume and USG?

A

in general, USG and urine volume have an inversely proportional relationship

low urine volume = high USG
high urine volume = low USG

20
Q

what artifacts cause refractometer USG errors?

A

the refractometer must be temperature - calibrated

  • USG values from a human refractometer will be very similar to the values from a veterinary refractometer in dogs and large animals but will overestimate the USG in cats
  • Turbid samples may make the line difficult to read
  • interferences: false increases with marked proteinuria or glucosuria
21
Q

causes of increased bilirubin in urine

A
  • dogs with concentrated urine (>1.025) can have trace to 1+
  • Bilirubinemia: hemolysis and hepatoniliary disease
22
Q

causes of increased glucose in urine

A

normal urine should not contain glucose

  • hyperglycemia-persisten (DM)>transient (stress)
  • Fanconi syndrome - proximal tubular defect
  • some antibiotics (amoxicillin, gentamycin) - tubular damage
23
Q

causes of increased ketones in urine

A

ketones should not be present in the urine of healthy animals

Diabetes mellitus
Negative energy balance caused by anorexia, starvation, bovine ketosis, pregnancy toxemia

24
Q

How to interpret changes in the UPC ratio?

A

UPC ratio is used to detect glomerular or tubular disease and should not be used on post or pre-renal proteinuria

Normal < 0.2
Borderline 0.2-0.5
Renal proteinuria 0.5-1.0

do not use this metric if there is active urine sediment, hemoglobinuria, myoglobinuria

25
Q

glomerular proteinuria

A
  • primarily albumin
  • UPC>3
  • may lead to hypoalbuminemia (PLN)
26
Q

tubular proteinuria

A
  • LMW proteins
  • UPC 0.5-3
  • will not lead to hypoalbuminemia
27
Q

UPC is helpful to differentiate glomerular from tubular disease when __

A

we know the proteinuria is renal

28
Q

laboratory data with nephrotic syndrome

A

proteinuria
hypoalbuminemia
hypercholesterolemia
edema

29
Q

what crystals when seen in relatively low numbers are normal?

A
  • Amorphous
  • magnesium ammonium phosphate (struvite)
  • calcium oxalate dihydrate
30
Q

Amorphous Crystals

A

small, irregularly shaped crystals

variable composition
seen in healthy patients

31
Q

magnesium ammonium phosphate (struvite) crystals

A

can be seen in healthy dogs, cats, and ruminants

also seen with bacterial-induced alkalinuria

32
Q

calcium oxalate dihydrate crystals

A

colorless octahedrons or envelopes

can be seen in healthy animals, with hypercalciuria or hyperoxaluria

can develop with prolonged sample storage

33
Q

Bilirubin Crystals

A

yellow to red-orange, needle like to granular crystals

indicates bilirubinemia
can be seen in healthy dogs
abnormal in other species

34
Q

calcium carbonate crystals

A

colorless to yellow, spherical with radial striations, oval, or dumb bell shapes

normal in horses and guinea pigs

not seen in dogs, cats, and ruminants

35
Q

ammonium biurate crystals

A

brown, spherical with irregular projections “thorn apple”

common in dalmations and english bulldogs

in other dog breeds or cats they suggest liver dysfunction and portosytemic shunting

36
Q

less common crystals

A

calcium oxalate monohydrate
cystine

37
Q

with casts (cyllindruria) low numbers are __ while increased numbers indicate ____

A

normal, renal tubular damage

38
Q

hyaline casts

A

protein

39
Q

granular to waxy casts

A

different stages of cellular cast degeneration

E&E (41 decks)

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