URINALYSIS

Question 1

What is the definition of Uroscopy?

Answer 1

Scientific examination of urine

Historical term until the 17th century

Question 2

What is the recommended specimen collection method for urinalysis?

Answer 2

Early-morning voided urine and midstream collection in a clean container

Analysis should occur within 30-60 minutes after collection

Question 3

What influences urine color?

Answer 3

Concentration and chemicals

Normal color ranges from pale to dark yellow

Question 4

What is the normal pH range for urine?

Answer 4

4.5-8.0

Useful in diagnosing renal tubular acidosis

Question 5

What does specific gravity in urine reflect?

Answer 5

Kidney’s concentrating ability

Question 6

What is the normal daily protein excretion in urine?

Answer 6

<150 mg/day

Dipstick tests primarily detect albumin

Question 7

What indicates the presence of glucose in urine?

Answer 7

Diabetes or renal glycosuria

Normal glucose excretion is <130 mg/day

Question 8

What does the presence of ketones in urine indicate?

Answer 8

Ketoacidosis

Question 9

What does the presence of nitrite in urine indicate?

Answer 9

Bacterial infection

Question 10

What does leukocyte esterase in urine indicate?

Answer 10

Pyuria and urinary tract infection (UTI)

Question 11

What do bilirubin and urobilinogen levels indicate?

Answer 11

Liver disease or hemolysis

Question 12

What types of casts can be found in urine microscopy?

Answer 12

• Hyaline
• Granular
• Waxy
• RBC
• WBC
• Fatty

Question 13

What are common urine color syndromes?

Answer 13

• Purple Urine Bag Syndrome (PUBS)
• Blue Diaper Syndrome
• Red Diaper Syndrome
• Black Urine Disease

Question 14

What is the Three Tube Test used for?

Answer 14

Localization of bleeding in hematuria

Question 15

What are the types of proteinuria?

Answer 15

• Glomerular
• Tubular
• Overflow

Question 16

What is orthostatic proteinuria?

Answer 16

Benign condition seen in adolescents

Question 17

What is the expected value for specific gravity in urine?

Answer 17

1.002–1.030

Question 18

What clinical significance does a specific gravity of <1.005 indicate?

Answer 18

Inability to concentrate urine (e.g., diabetes insipidus)

Question 19

What does a positive hemoglobin test indicate?

Answer 19

Presence of erythrocytes or free hemoglobin

Question 20

What does a positive glucose test indicate?

Answer 20

Typical diabetes mellitus or reduced renal threshold for glucose

Question 21

What does a positive albumin test indicate?

Answer 21

Proteinuria (glomerular disease)

Question 22

What does leukocyte esterase positivity indicate?

Answer 22

Urinary tract infection or other causes of sterile pyuria

Question 23

What does nitrite positivity indicate?

Answer 23

Presence of bacteria that convert nitrates to nitrites

Question 24

What conditions can lead to red urine?

Answer 24

• Foods: beets, blackberries
• Medications: laxatives, antipsychotics
• Conditions: urinary tract infections, nephrolithiasis

Question 25

What medications can cause orange urine?

Answer 25

* Rifampin * Phenazopyridine

Question 26

What conditions can cause green urine?

Answer 26

Pseudomonas urinary tract infection

Question 27

What can cause brown urine?

Answer 27

* Foods: fava beans * Medications: antimalarials, metronidazole * Conditions: hepatobiliary diseases

Question 28

What type of urinary casts are associated with acute tubular necrosis?

Answer 28

Muddy-brown heme-granular casts

Question 29

What are the characteristics of calcium oxalate dihydrate crystals?

Answer 29

Envelope shaped ## Footnote Associated with ethylene glycol toxicity

Question 30

What are the characteristics of uric acid crystals?

Answer 30

Diamond or barrel shaped ## Footnote Associated with hyperuricosuria

Question 31

What are the characteristics of triple phosphate (struvite) crystals?

Answer 31

Coffin lid shaped ## Footnote Associated with urinary tract infection caused by urea-splitting organisms

Question 32

What are the characteristics of cystine crystals?

Answer 32

Hexagonal ## Footnote Associated with cystinuria

Question 33

What is glomerular bleeding associated with?

Answer 33

* Proteinuria >500 mg/day * RBC casts * Dysmorphic RBCs

Question 34

What is nonglomerular bleeding associated with?

Answer 34

* Proteinuria <500 mg/day * Absent RBC casts * Absent dysmorphic RBCs

Question 35

What are renal causes of nonglomerular bleeding?

Answer 35

* Tubulointerstitial nephritis * Polycystic kidney disease * Sickle cell disease * Renovascular disease

Question 36

What are urologic causes of nonglomerular bleeding?

Answer 36

* Tumors or malignancies * Stones * Infections: urethritis, prostatitis, cystitis, pyelonephritis

Question 37

What medications can cause nonglomerular bleeding?

Answer 37

* Chemotherapeutic agents: cyclophosphamide, ifosfamide * Anticoagulants

Question 38

What is the significance of a negative dipstick with elevated protein creatinine ratio (PCR)?

Answer 38

Overflow proteinuria, often seen in multiple myeloma

Question 39

What does the presence of fatty casts indicate?

Answer 39

Nephrotic syndrome

Question 40

What can cause purple urine?

Answer 40

Purple Urine Bag Syndrome (PUBS) ## Footnote Often seen in elderly females with alkaline urine and UTIs