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Clinical Reproduction & Urology > Urinalysis > Flashcards

Urinalysis Flashcards

1
Q

Indications for Urinalysis

A
  • to eval clinical renal & lower UT abnormas (PU/PD, Dysuria, Haematuria)
  • azotaemia
  • assess hydration status
  • assess metabolic & endocrine dzs
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2
Q

Components of Urinalysis

A
  • physical eval
  • biochemical testing
  • urine sediment
  • urine culture
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3
Q

Method of collection of urine

A
  • free catch, midstream if possible
  • catheterisation
  • cystocentesis
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4
Q

What are important factors must be taken into accound when taking a free-catch sample?

A
  • morning sample best
  • contains cells + bacteria from urethra & vulva/prepuce
  • midstream reduces qty of contaminants
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5
Q

What factors must be considered for catheterisation for urine collection?

A
  • sterile polypropylene tubing
  • Easiest in male dog
  • female & some male anatomy is problematic
  • blood contamination due to trauma of procedure
  • bacteria & cells from terminal urethra may be collected
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6
Q

What factors must be considered for cystocentesis for urine collection?

A
  • clip & Surgical prep
  • good restraint essential (chemical or physical)
  • samples have only bacteria & cells from bladder, may get small amt of blood contamination from needle
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7
Q

Physical exam of urine should include

A
  • colour
  • turbidity
  • odour
  • USG
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8
Q

Colour physical exam indicates…

A
  • concentration & presence of pigmentation
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9
Q

Red urine

A

haematuria, haemaglobinuria

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10
Q

Brown to black urine

A

myoglobinuria

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11
Q

light to med yellow urine

A

assess depth of colour to assess kidney fxn

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12
Q

mild urine small indicates

A

ammonia from bacterial urease

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13
Q

foul urine smell

A

cystitis, infection

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14
Q

sweet urine smell

A

acetone = diabetes, starvation

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15
Q

drug smell

A

Penicillin - yeast-like smell

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16
Q

diet smells of urine

A

high protein increases ammonia smell

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17
Q

lack of smell of urine

A

excretion of water, tubular dz

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18
Q

Turbidity reflects

A

increase in suspended substances (crystals or cells)

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19
Q

Definition of USG

A

Ratio of weight (density) of urine to that of an equal volume of water at the same temperature.

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20
Q

Values of USG depends on

A
  • hydration status & water intake
  • kidney’s concentrating ability
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21
Q

USG is a test of…

A

renal tubular fxn & w/ blood Ur/Cr discriminates btw dehydration & renal dz

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22
Q

Hypersthenuria

A

increased strength (aka concentrated)

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23
Q

Isosthenuria

A

1.008-1.012
Not dilute or concentrated

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24
Q

Hyposthenuria

A

below 1.008, dilute

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25
Q

Causes of Low USG

A
  • PD (common)
  • Iatrogenic
  • endocrine
  • diuretic therapy
  • renal dz
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26
Q

Contraindications of a water deprivation test

A
  • depressed, dehydrated, or azotaemic animals or if renal failure is suspected
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27
Q

Indications for Water Deprivation Test

A

Confirmation of the animal’s ability to concentrate urine when water is withheld

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28
Q

Protocol of water deprivation test

A

monitor USG q 2 hrs until 5% of body wt is lost or USG is >1.020

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29
Q

Interpretation of water deprivation test

A
  • USG increases to 1.020: tubular fxn & ADH availability confirmed
  • If USG remains <1.020: diabetes insipidus suspected
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30
Q

Important things to remember about urine dipsticks

A
  • Ensure in-date or will give false +/-
  • contamination of sample affects results
  • requires cross check w/ history, signs
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31
Q

USG on dipstick

A
  • inaccurate in animals
  • ignore it
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32
Q

Dipstick protein values

A
  • detect protein, esp albumin but may miss globulin-losing conditions
  • trace or + protein may be normal in healthy animal, esp if high USG
  • interpret w/ USG & serum albumin in mind
  • increases w/ inflammation/infection, haemorrhage, protein-losing neuropathy
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33
Q

UPC Ratio

A
  • used to assess clinical significance of proteinuria
  • TP & creatinine conc. measured in single urine sample & expressed in same units
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34
Q

Interpretation of UPC

A
  • <1.0: Proteinuria if present is not significant
  • mild to mod increase (1-2): proteinuria from urogenital haemorrhage, urogenital inflammation, glomerular protein loss
  • mod to marked increase (>2): glomerular protein loss
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35
Q

Dipstick glucose

A
  • accurate for animals
  • absent in healthy animals
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36
Q

Reasons why glucose may be present in urine

A
  • Diabetes mellitus
  • stress, cystitis in cats
  • severe exertion, fits
  • drugs - Rompun & ketamine
  • Fanconi syndrome
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37
Q

What test should be done w/ a glucose dipstick?

A
  • UPC
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38
Q

Dipstick ketones

A
  • accurate in animals
  • detects ONLY acetoacetate, not beta-hydroxybutyrate
  • not common in urine normally, EXCEPT in rabbit
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39
Q

Reasons for ketonuria

A
  • DM in small animals
  • pregnancy toxaemia
  • ketosis & fatty liver in cattle
  • secondary to anorexia, starvation, other conditions
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40
Q

Blood on dipsticks

A
  • reliable
  • detects haem found in RBCs & Hb/Myoglobin
  • check RBCs in sediment exam
  • catehterisation & cystocentesis give positive blood results
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41
Q

Common illnesses that lead to blood in the urine

A
  • oestrus, trauma, coagulopathy, urogenital inflammation, neoplasia
  • most common from catheterisation
  • FUS, IMHA
  • Hburia - acute HA, baciliary
  • Hburia - Cu toxicity
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42
Q

Bilirubin on dipstick

A
  • reliable in animals
  • normal dogs have 0 or + bilirubin
  • no bilirubin in cat expected
  • soluble: i.e. conjugated bilirubin detected
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43
Q

Diseases that cause increased bilirubin on dipstick

A
  • increased in icteric animals - hepatic & post-hepatic
  • haemolytic anaemia
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44
Q

Urobilinogen on dipstick

A
  • unreliable in animals
  • presence confirms patency of bile duct & bile is entering intestine
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45
Q

Unreliable dipstick measurements

A
  • Nitrite
  • WBC
  • USG
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46
Q

Urea is measured in…

A
  • serum or plasma
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47
Q

Urea is a

A

nitrogenous waste product excreted by kidneys & is non-toxic

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48
Q

Why would urea increase?

A
  • pre-renal, renal, or post-renal causes
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49
Q

azotaemia

A

increased urea

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50
Q

BUN

A

Blood urea nitrogen
= concentration of nitrogen component of urea in blood

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51
Q

BUN value is lower than

A

urea value

52
Q

BUN is often interchangeable with…

A

urea

53
Q

BUN: urea ratio is approximately

A

1:2

54
Q

Ammonia can be…

A

neurotoxic

55
Q

Ammonia is detoxed in the

A

liver –> passses into urea cycle –> excreted by kidney after being in blood stream

56
Q

Reasons urea is increased…

A
  • due to renal dz (>75% fxnl mass lost)
  • uraemia clinical syndrome due to reduced renal excretion of toxic substances - urea is increased w/ uraemia
57
Q

Uraemia

A

clinical syndrome due to reduced renal excretion of toxic substances

58
Q

Urea is increased w/ what clinical syndrome?

A

uraemia

59
Q

Reasons for decreased urea

A
  • usually anorexia, protein deficient diet or malabsorption
  • markedly decreased liver fxn (PSS, hepatic insufficiency)
  • overhydration
  • young animals w/ hepatic metabolic system not fully fxning
60
Q

Creatine breaks down to

A

creatinine

61
Q

creatinine is from

A

spontaneous degradation of creatine in muscle

62
Q

Rate of fomraiton of creatine is constant reflecting

A

muscle mass

63
Q

Decreased creatinine may occur with…

A

loss of muscle mass (body weight)

64
Q

Creatinine is filtered by glomeruli and…

A

not absorbed by tubules

65
Q

Fxn of Creatine, Creatinine, cK

A

PCr works w/ CK to buffer atp & shuttle energy from mitochondria to cytoplasma & w/ ATPase as an energy transducer in muscle, heart, brain

66
Q

Deficiency of fxn of creatinine, creatine, CK

A
  • mitochondrial dysfxn, cell energy def, myopathy, marked intellectual disability
  • May be dietary or AGAT, GAMT, CK, CrT mutation
67
Q

Supplementation of Creatine

A
  • treats deficiency
  • increase muscle mass, strength, high-intensity exercise performance in humans/dogs
    Ruminants & horses do not have a mechanism for absorption, so is useless in these animals
68
Q

Reasons creatinine would increase

A
  • 80-90% of nephrons must be lost for creatinine to rise significantly
  • better marker of severe renal dz in ruminants & horses due to excretion of urea into digestive tract in species
69
Q

Pre-renal azotaemia is due to

A
  • decreased renal perfusion
  • haemoconcentration, endotoxaemia or reduced CO, shock –> decreased perfusion of the kidney
  • high protein diet or GI haemorrhage
70
Q

Serum creatinine is a biomarker of

A

muscle mass

71
Q

Creatinine is especially useful

A

in muscle wasting such as renal dz, anorexia

72
Q

Creatinine is proportional to

A

muscle mass

73
Q

serum creatinine is lower in

A

females over males
juveniles over adults
Adults over geriatrics
sedentary vs athletic mammals
Vegetarians

74
Q

Cr dependence on muscle mass weakens its use as…

A

a GFR biomarker

75
Q

Cr is a more effective muscle biomarker if corrected for…

A

renal fxn & dietary meat intake

76
Q

Serum creatinine, creatinine, urinary creatinine excretion, endogenous creatinine clearance all

A

increase w/ body weight

77
Q

Severe renal dz will cause what changes to creatinine or urea?

A

Creatinine normal
urea increase

78
Q

chronic renal dz will cause a chronic & progressive loss of

A

muscle mass, & thus creatinine

79
Q

In CRD, there will be a lower relative

A

increase in Cr than in urea but not when compared to resting or post-dialysis values

80
Q

If creatinine is not increased as much as urea in CRD, then there is likely

A

muscle wasting to the degree to which increases differ

81
Q

In acute renal dz, the absence of other debilitating dz means changes in Cr & Ur will be…

A

similar

82
Q

Urine sediment will look for…

A
  • rbcs, wbcs, casts, epithelial cells, bacteria, crystals, sperm, fat droplets, yeasts, contaminants unless from cystocentesis
83
Q

Haematuria in FUS has mainly blood in its

A

urine & struvite crystals

84
Q

primary finding in FUS

A

haematuria

85
Q

Increased s/p urea/creatinine & USG greater than the ideal numbers means you should consider

A

pre-renal causes

86
Q

Increased s/p urea/creatinine & USG is less than the ideal numbers means you should consider

A

primary renal dz

87
Q

Normal USGs of importance for horse, dog, cat

A

Horse: 1.025
Dog: 1.030
Cat: 1.035

88
Q

increased epithelial cells in a urinary sediment exam occurs in what conditions?

A

inflammatory conditions
neoplasia

89
Q

When should a sediment smear be stained?

A

increase in epithelial cells to look for evidence of malignancy

90
Q

transitional cells shed in urine

A
  • small to mod no.’s may be shed by healthy animals
  • high no’s in inflammation & some neoplasias
91
Q

squamous cells in urine

A
  • small to mod no’s shed in healthy animals
  • common in non-catheterised samples or indication of contamination sample from tract
92
Q

Neoplastic cells in urine

A

inconsistent finding, but positive is diagnostic

93
Q

Formation of casts

A

distal tubules & collecting ducts

94
Q

Matrix of casts

A

Tamm-Horsfall glycoprotein

95
Q

Different types of casts have

A

Different clinical meanings

96
Q

With casts in urine and BG is high, what is the high differential?

A

Diabetes

97
Q

What type of cast?

A

Hyaline cast

98
Q

What type of cast?

A

epithelial cast

99
Q

What type of cast?

A

RBC cast

100
Q

What type of cast?

A

WBC cast

101
Q

What kind of crystals are found in acidic urine?

A

Ca Oxalate dihydrate

102
Q

What types of crystals are common in birds & reptiles?

A

urate crystals

103
Q

What type of casts were present in alkaline urine?

A

phosphate/struvite crystals

104
Q

Crystalluria definition

A

Too many crystals in urine (above normal limits)

105
Q

Dihydrate crystals are always…

A

harmless

106
Q

What crystals are common in liver dz?

A

cystine, tyrosine, leucine

107
Q

What crystals are common in Dalmatians, E. bulldogs, liver dz & pss?

A

Ammonium biurate

108
Q

Crystalluria depends on…

A

pH & temperature of the urine sample

109
Q

What type of crystals?
What conditions?

A

Calcium oxalate dihydrate
(Maltese cross)
Conditions: normal in cows/horses/cats, hyperparathyroidism, genetic defect in Schnauzers

110
Q

What crystal? Conditions?

A

Calcium oxalate monohydrate
Conditions: ethylene glycol poisoning - pathognomonic

111
Q

What crystal? Conditions?

A

Calcium oxalate monohydrate
Conditions: chocolate poisoning in dogs

112
Q

What is present here? Condition present?

A

Haemoglobin globules w/ bilirubin crystals
Condition: IMHA w/ intravascular haemolysis (or extravascular)

113
Q

What type of crystal? Condition?

A

Calcium carbonate crystals
Condition: alkaline urine, little or no clinical significance

114
Q

What types of crystals? When are they seen and in what animal?

A

Calcium carbonate & calcium oxalate dihydride crystals
Equine, winter

115
Q

What crystals are common with liver dz? What conditions?

A
  • leucine - liver dz
  • cysteine - genetic liver dz
  • tyrosine - liver dz
  • ammonium biurate - PSS (congenital or acq’d)
116
Q

Crystal type?

A

Ammonium biurate - thorn apple

117
Q

Crystal type?

A

Cystine (hexagonal)

118
Q

Crystal type?

A

leucine

119
Q

Crystal type?

A

tyrosine

120
Q

What crystal type? Normal in what species?

A

Urate crystals
normal in Dalmatians & E. bulldogs

121
Q

Struvite crystals are known as…

A

triple phosphate (“coffin lids”)

122
Q

struvite crystals are made of

A

Mg ammonium phosphate

123
Q

What crystal is common in UTIs?

A

Struvite crystals

124
Q

What crystals are pathognomonic for FUS if present in large no’s?

A

Struvite

125
Q

What type of crystals?

A

Struvite crystals

Clinical Reproduction & Urology (29 decks)

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