Urinalysis

Question 1

Specific Gravity

Answer 1

-Normal: 1.003-1.030
(Fixed: 1.010-Advanced kidney fail)
-Low: Excessive Hydration (Diabetes Insipidus)
-High: Dehydration (Diabetes Mellitus/Fever)

Question 2

pH

Answer 2

-Normal: 4.5-8.0
-Low: Acidosis, fevers, high protein diets
-High: Alkalosis, cystitis

Question 3

Proteinuria typically indicates:

Answer 3

Renal Disease

Question 4

Glucose

Answer 4

-Normal: 180mg/dL
(Limitations: Prolonged exposure to urine)
-High: Glycosuria (w/o hypoglycemia-Pregnancy)/(w/hyperglycemia-Diabetes mellitus)

Question 5

Ketones

Answer 5

High: Ketonuria (Diabetes mellitus-Type I, Starvation-Keto Diet, Severe Starvation-Kids)

Question 6

Blood

Answer 6

Hematuria
-Trauma or irritation (Ie. Nephrolithiasis)
-Hemoglobinuria: Lysis of RBCs in urinary tract, intravascular hemolysis, or transfusion reaction
-Myoglobinuria: Muscular destruction that may appear in hypothermia, convulsions, extensive exertion (rhabdomyosis)
*False Negative: High dose of vitamin C

Question 7

Leukocyte Esterase

Answer 7

Pyuria
-Presence of WBCs (Inflammation)

Question 8

Nitrite

Answer 8

Nitrituria->Bacteruria
-Bacteria: Gram Negative
-Reductase: Nitrate->Nitrite
(4 hour incubation)

Question 9

Bilirubin

Answer 9

Bilirubinuria
-Causes: Biliary tract obstruction (cholelithiasis), liver disease
-Conjugated bilirubin (Unconjugated-Not soluable)

Question 10

Urobilinogen

Answer 10

-Similar to bilirubin
-False + from warm urine

Question 11

RBCs

Answer 11

-Normal: 0-2/HPF (High-powered field)
-Clinically Significant: >2/HPF
-Risk Factors: Smoking, analgesic use

Question 12

Causes of RBCs in Microscopic Exam

Answer 12

-Hematuria: Trauma/Irritation
-Nephrolithiasis: Renal
-AGN: Black color
-GU Malignancy: Painless (Smoking)
-Benign prostatic hyperplasia: Post-renal
-Cystitis: Post-Renal
-Pyelonephritis: Renal
-Benign hematuria/Contaminant: Once everything else is ruled out/excluded

Question 13

WBCs

Answer 13

-Normal: 0-5/HPF
-Clinically Significant: >5/HPF

Question 14

Causes of WBCs in microscopic exam

Answer 14

-Pyelonephritis, Renal TB, Cystitis
-Indicates inflammation
-Can occur anywhere in urinary tract
-Pyuria (renal origin): Proteinuria
-Pyuria (cystitis): Bacteriuria/nitrituria

Question 15

Waxy cast indicates:

Answer 15

Advanced renal failure (proteinuria)

Question 16

RBC cast indicates:

Answer 16

Acute glomerular nephritis (AGN)

Question 17

WBC casts indicate:

Answer 17

Acute pyelonephritis (Pathogomic)

Question 18

Fatty Casts Indicate:

Answer 18

Advanced renal disease (nephrotic syndrome)

Question 19

Pseudocasts indicate:

Answer 19

Fibers/Dusts (Typically a fakeout)

Question 20

What do epithelial cells indicate:

Answer 20

Contamination

Question 21

Functional vs. Organic Proteinuria

Answer 21

Functional proteinuria
-Orthostatic Proteinuria: Large excretion of protein when standing up

Organic proteinuria
-Prerenal: Fever, hypertension
-Renal: Glomerulonephritis, Pylonephritis
-Postrenal: Cystitis, urethritis, prostatitis