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clinical pathology > Urinalysis > Flashcards

Urinalysis Flashcards

1
Q

what does a complete UA consist of?

A

physical examination, chemical examination, microscopic examination

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2
Q

normal physical examination color

A

yellow, amber, straw

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3
Q

what does a milky color urine indicate?

A

pus, bacteria, fat

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4
Q

what does red/smoky brown urine indicate?

A

blood

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5
Q

what does yellow foam urine indicate?

A

bile pigments

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6
Q

what does white foam urine indicate?

A

albumin

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7
Q

what does coca-cola colored urine indicate?

A

Acute glomerulonephritis; strep. infections

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8
Q

normal physical examination appearance/clarity

A

clear

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9
Q

abnormal appearance/clarity

A

reported as turbid or extremely turbid

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10
Q

normal urine odor

A

aromatic

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11
Q

abnormal urine odor

A

ammoniacal, fruity, stale water, foul

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12
Q

ammonical urine odor

A

bacterial decomposition of urine; smells like cleaning supplies; urinary retention

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13
Q

fruity urine odor

A

ketone bodies; diabetes mellitus

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14
Q

stale water urine odor

A

advanced kidney disease

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15
Q

foul urine odor

A

bacteruria (UTI)

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16
Q

what does the chemical examination assess?

A

specific gravity, pH, protein, glucose, ketones, blood, leukocyte esterase, nitrite, bilirubin, and urobilinogen

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17
Q

specific gravity

A

measure of dissolved substances in urine (density or urine/density of water)

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18
Q

normal specific gravity levels

A

1.005-1.030

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19
Q

why would specific gravity be low?

A

excessive hydration, diabetes insipidous

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20
Q

why would specific gravity be high?

A

dehydration, diabetes mellitus, fever

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21
Q

normal pH for urine

A

4.5-8.0

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22
Q

what does a low pH indicate?

A

acidosis, fevers, high protein diets

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23
Q

what does a high pH indicate?

A

alkalosis, cystitis

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24
Q

proteinuria

A

protein in urine

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25
Q

what is proteinuria mostly indicative of?

A

renal disease

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26
Q

trace proteinuria

A

generally not clinically significant

27
Q

functional proteinuria

A

not associated with easily demonstrable systemic or renal damage (increased renal blood flow)

28
Q

orthostatic proteinuria

A

increased protein in urine only when an individual is in an upright position

29
Q

organic proteinuria

A

prerenal, renal, postrenal

30
Q

glucosuria

A

glucose in the urine

31
Q

normal renal threshold for glucose

A

180 mg/dL

32
Q

what does glycosuria without hyperglycemia indicate?

A

pregnancy

33
Q

what does glycosuria with hyperglycemia indicate?

A

diabetes mellitus

34
Q

ketonuria

A

ketones in urine

35
Q

causes of ketones in urine

A

type I diabetes mellitus, starvation, severe dehydration, fever in kids

36
Q

hematuria

A

blood in urine as a result of trauma or irritation

37
Q

hemoglobinuria

A

lysis of RBCs in urinary tract, intravascular hemolysis, or transfusion reactions

38
Q

myoglobinuria

A

muscular destruction that may appear in hypothermia, convulsions, extensive exertion (rhabdomyolysis)

39
Q

what could cause a false negative results of hematuria?

A

high dose of vitamin C

40
Q

pyuria

A

presence of WBCs, inflammation, leukocyte esterase

41
Q

what causes nitrite in urine?

A

gram negative bacteria; they have a reductase that takes it from nitrate to nitrite, incubation takes ~4hr (E.Coli)

42
Q

bilirubinuria

A

bilirubin in urine

43
Q

causes of bilirubinuria

A

biliary tract obstruction, liver disease, cholelithiasis; conjugated bilirubin

44
Q

urobilinogen in urine

A

similar significance to bilirubin, small amount is normal, could get false + from warm urine

45
Q

microscopic examination

A

done on centrifuged urinary sediment

46
Q

main pathological elements of the microscopic examination

A

RBCs: 0-2 HPF

WBCs: 0-5 HPF

Casts

47
Q

less important elements of microscopic examination

A

yeasts, crystals, epithelial cells

48
Q

best specimen of microscopic examination

A

first morning urination, midstream

49
Q

causes of RBCs on microscopic exam

A

nephrolisthiasis, AGN, GU malignancy, benign prostatic hyperplasia, cystitis, pyelonephritis, benign hematuria, contamination

50
Q

clinically significant hematuria

A

> 2 HPF

51
Q

pyuria in microscopic exam

A

indicates inflammation, may originate anywhere in urinary tract, WBC casts are definite evidence that urinary WBCs originate in the kidney

52
Q

causes of pyuria in microscopic exam

A

pyelonephritis, renal TB, cystitis

53
Q

clinically significant pyuria

A

> 5 HPF

54
Q

epithelial cells in microscopic exam

A

> 10 squamous epithelial cells/low-power field is a sign of contamination

55
Q

casts

A

protein conglomerates in shape of renal tubules

56
Q

hyaline casts

A

little concern

57
Q

waxy casts

A

advanced renal failure

58
Q

RBC cast

A

acute glomerulonephritis

59
Q

WBC cast

A

acute pyelonephritis

60
Q

fatty cast

A

advanced renal disease, nephrotic syndrome

61
Q

pseudocasts

A

fibers, dust; fake-outs

62
Q

triple phosphate crystals

A

found in alkaline urine, no clinical significance, coffin lid

63
Q

calcium oxalate crystals

A

found in normal urine, no clinical significance, cross/X

clinical pathology (6 decks)

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