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.