Urinalysis

Question 1

Creatinine

Answer 1

Waste product of protein breakdown excreted by kidneys.

Question 2

Creatinine normal ranges

Answer 2

Men: .8 - 1.4
Women: .6 - 1.2

Question 3

How much renal fxn must be lost to increase creatinine from 1 - 2?

Answer 3

50%

Question 4

Increased creatinine =?

Answer 4

Renal failure
Diet (more meat)
ACE, diuretics, NSAIDS
Muscular dystrophy

Question 5

Decreased creatinine = ?

Answer 5

Pregnancy

normal pregnant range = .4 - .6

Question 6

BUN

Answer 6

Blood Urea Nitrogen
Byproduct of protein break down.
Measures with Crea to monitor kidney fxn

Question 7

normal BUN range?

Answer 7

6 - 20

Question 8

Increased BUN =?

Answer 8

Renal dz
Tissue necrosis
Very high protein diet
GI bleed

Question 9

Decreased BUN =?

Answer 9

Liver dz

Starvation

Question 10

normal BUN/creatinine ratio?

Answer 10

10:1

Question 11

GFR

Answer 11

Glomerular filtration rate
Equal to the sum of all functioning nephrons
Decreases normally with age

Question 12

Normal GFR range

Answer 12

Men: 130
Women: 120

Question 13

Creatinine Clearance

Answer 13

Endogenous substance used to assess GFR
Overestimates true GFR by up to 40%
(especially in persons with decreased renal fxn)

Question 14

Normal sodium?

Answer 14

135 - 145

Question 15

Normal K+?

Answer 15

3.8 - 5.5

Question 16

normal Cl

Answer 16

98 - 106

Question 17

Normal HCO3

Answer 17

21 - 28

Question 18

Hyponatremia

Answer 18

Low sodium
Most common electrolyte disorder
Excess Na loss relative to water loss
Tx: Na and fluid replacement

Question 19

Normal urine pH

Answer 19

4.5 - 8.0

Question 20

Urinary proteins

Answer 20

Majority is globulins
1/3 is albumin
Also has tamm-horsfall protein

Question 21

Normal protein in random sample

Answer 21

2-8 mg/dl

Question 22

Proteinuria is the single most important indicator of kidney dz.

Answer 22

believe it

Question 23

minumal proteinuria

Answer 23

< .5

Question 24

Moderate proteinuria

Answer 24

.5 - 4

Question 25

Severe proteinuria

Answer 25

> 4

Question 26

How much glucose can the kidneys reabsorb?

Answer 26

up to 200 mg/dl in the serum, | then it spills over.

Question 27

Ketones

Answer 27

Result of fatty acid metabolism and happens in the presence of a low carbohydrate diet or defect in carbohydrate metabolism. Ketones seen in DKA

Question 28

BIlirubin

Answer 28

``` Normally negative (<.02) High levels seen in hepatocellular, liver dz ```

Question 29

Leukocyte esterase

Answer 29

``` Neutrophillic granulocytes release esterases into urine when present. Indicates pyuria (WBC's in urine), UTI ```

Question 30

Nitrites

Answer 30

``` Nitrates are normal, nitrItes are not. Indicates bacteriuria (usually E. coli) ```

Question 31

Hyaline Casts

Answer 31

Implies damage to the glomerular capillary membrane (leakage of proteins)

Question 32

RBC Casts

Answer 32

My be only manifestation of acute glomerulonephritis.