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Lab Diagnosis > Urinalysis > Flashcards

Urinalysis Flashcards

1
Q

How much urine do people excrete on average?

A

1-1.5 L

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2
Q

Where does concentration of the urine take place?

A

Loop of Henle, distal tubules, and collecting tubule.

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3
Q

What is the major component of urine?

A

Urea and salt

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4
Q

Urinalysis reveals information about what five topics?

A 
Kidney and liver function
Metabolic processes
Infectious disease
Nutritional status
Occult disease
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5
Q

What diseases is urinalysis effective in revealing?

A 
Glomerulonephritis
Hypertensive nephropathy
Renal failure
DM
End stage renal disease
Urinary tract 
Neoplasm
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6
Q

What Hx/PE findings might prompt a UA dip?

A 
Abdominal pain
Back pain
Dysuria
Urinary frequency / urgency
Hematuria
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7
Q

When might you do a UA dip as part of routine monitoring of a disease?

A

Chronic renal disease
Liver disease
High blood pressure
DM

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8
Q

When might you do a UA dip as a routine screening?

A

Annual check-up

Family Hx of renal disease

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9
Q

What is the major cause of end-stage renal disease?

A

DM

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10
Q

Describe the rules for storage/analysis of urine.

A

Freshly voided is best.
Store for max 1hr at room temp.
Store for max 4hr in fridge.

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11
Q

How might you reduce contamination of a urine sample from an infant?

A

Suprapubic aspiration

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12
Q

What macroscopic physical properties are observed in the UA?

A

Color, clarity

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13
Q

What chemical properties are observed in the UA? (dipstick)

A 
Glucose     Blood
pH              Protein
Bilirubin     Urobilinogen
Ketones     Nitrites
Leukocyte  Specific gravity
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14
Q

What microscopic physical properties are observed in the UA?

A 
Cells
Crystals
Microorganisms
Casts
Debris
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15
Q

What gives urine its color?

A

Urochrome, from bilirubin metabolism.

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16
Q

What might result in red urine?

A

Pathologic: hematuria/hemoglobinuria

Non-path: beets, rhubarb

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17
Q

What might result in orange or amber urine?

A

Bilirubinuria (jaundice)

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18
Q

What might result in green urine?

A

Pseudomonas infection

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19
Q

What might result in brown-black urine?

A

Melanin (due to melanoma)

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20
Q

What might result in colorless urine?

A

DM or DI

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21
Q

What might result in bright yellow urine?

A

Vitamin B2

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22
Q

What might make urine cloudy?

A

Cells (WBCs, epithelial cells, bacteria)
Amorphous urates (acidic)
Amorphous phosphates (alkaline)
Hyperuricosuria (purine-rich foods)

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23
Q

What might make urine hazy?

A

Mucus, protein

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24
Q

What might make urine milky?

A

Fat/lipids

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25
Q

What might make urine smokey?

A

Blood

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26
Q

What results in sweet or fruity-smelling urine?

A

Uncontrolled diabetes (ketonuria)

27
Q

What results in foul or pungent urine?

A

Bacterial infection (ammonia)

28
Q

What results in musty-smelling urine?

A

Phenylketonuria

29
Q

What results in urine that smells like grape juice?

A

Pseudomonas infection

30
Q

What results in maple-syrup-smelling urine?

A

Maple syrup urine disease

31
Q

What is a normal adult specific gravity of urine?

A

1.010-1.025

32
Q

What is the significance of specific gravity?

A

It reflects the kidneys’ ability to concentrate urine.

33
Q

What words describe high and low SG?

A

Hypersthenuria/hyposthenuria

34
Q

What are some pathological reasons for hypersthenuria?

A

DM (glycosuria)
Proteinuria / Nephrotic syndrome
CHF

35
Q

What are some pathological reasons for hyposthenuria?

A

Chronic renal diseases (constant 1.010–osmolarity of plasma)
DI
Glomerulonephritis

36
Q

When will SG read false positive/negative?

A

FP : Proteinuria

FN : high pH

37
Q

What is the threshold for glucosuria?

A

160-180mg/dL

38
Q

What conditions might result in glucosuria?

A

DM
Cushing’s syndrome
Acromegaly

39
Q

What tests are skewed by ascorbic acid?

A

Glucose (FN)
Blood (FN)
Bilirubin (FN)

40
Q

When will glucose read false?

A

FP: oxidizing agents
FN: ascorbic acid, aspirin, ketones

41
Q

When do you get ketones?

A

Metabolism of fatty acids due to altered carbohydrate metabolism

42
Q

What is the expected result for glucose?

A

Negative

43
Q

What is the expected result for ketones?

A

Negative

44
Q

Which ketone is the dipstick specific for, and when might that be a problem?

A

Only reads acetoacetic acid.

Predominant ketone in DKA is beta-hydroxybutyrate

45
Q

What conditions might result in ketonuria?

A

DM

Increased metabolic states (hyperthyroidism, fever, pregnancy)

46
Q

When will ketones read false?

A

FP: Drugs (levodopa, phenylketones, phthaleins), highly pigmented urine
FN: prolonged exposure to air

47
Q

Name three possible pathological sources of blood in urine.

A

Glomerular disease
Kidney stones
Pyelonephritis

48
Q

When will blood read false?

A

FP: Microbial peroxidases, myoglobinuria, menstrual blood
FN: nitrites, ascorbic acid, increased SG

49
Q

What is the normal range of urine pH?

A

4.5-8.0 (usually 6.0)

50
Q

What is an alkaline tide?

A

Urinary pH is higher after meals

51
Q

Why might you have alkaline urine?

A

Alkalosis, UTI (proteus, pseudomonas), vegetarian diet

52
Q

Why might you have acidic urine?

A

Acidosis, DM, UTI (E. coli), starvation, high meat diet

53
Q

What protein is detected on the UA dip?

A

Albumin

54
Q

When might a patient experience transient proteinuria?

A

Fever, stress, exercise, CHF

55
Q

What protein score on the dipstick is significant?

A

1+ is significant and requires followup, indicates 30mg/dl

56
Q

When might protein read false?

A

FP: vaginal secretions, hematuria, pyridium, alkaline urine
FN: dilute sample

57
Q

What is the normal result for bilirubin?

A

Negative

58
Q

Where does bilirubin come from?

A

Waste product formed from heme of lysed RBCs, supposed to be excreted in stool

59
Q

What conditions might result in bilirubinuria?

A

Gallstones, cholestasis, bile duct obstruction, acute hepatitis

60
Q

When might bilirubin read false?

A

FP: Fecal contamination, Pyridium
FN: nitrites, light exposure, ascorbic acid

61
Q

What is a normal result for urobilinogen?

A

0.2-1.0mg/dL

62
Q

What conditions might result in increased urobilinogen?

A

Intravascular hemolysis

Intestinal obstruction

63
Q

When might urobilinogen read false?

A

FP: Fecal contamination, pigmented drugs, beets
FN: Formaldehyde, air exposure, antibiotics

Lab Diagnosis (3 decks)

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