Urinalysis Flashcards
GFR = best indicator of ___
overall renal function
best indicator of overall renal function = ?
GFR
GFR can depend on ___
hydration status
most of fluid reabs along with proteins to achieve homeostatic balance
3 parts of examining urine
1) UA and micro
- visual
- chemical
- microscopic
Urine specimens for urinalysis must be tested within ___
24 hr specimens are ___ for urinalysis testing
2 hours of specimen collection
unacceptable
for culture, you need a ___
if antibotic therapy is noted, lab will process with ___
midstream clean catch
longer incubation
urine collection for 24 hrs or timed cocmponents
1) preservatives
2) adequately pre-hydrate patient
procedure for 24 hr urine collection
1) void before begin
2) start collecting
3) exactly 24 hrs void one more time
criteria for specimen evaluation
1) label
2) preservative
3) voided v. suprapubic vs. cath
4) first morning void usu
Urinalysis method
1) mix specimen
2) observe physiochemical prop
3) perform reagent dipstick
4) centrifuge
automated
visual examination of 24 hour collection ddx polyria (> 2000 mL SG
1) decr ADH
2) defective renal salt/water reabsorption
3) osmotic diuresis (Diabetes)
1) prerenal, postrenal, or renal
yellow-green brown
orange-red brown
pink-red
dark brown/black
1) bile pigments = bilirubin
2) urobilinogen
3) hematuria, hemoglobin, myoglobin, porphyria
4) methemoglobin, rhbdo,
clarity (turbidity)
1) ddx chyluria
2) ddx lipiduria
1) lymphatic flow obstruction = filariasis
2) fat globules in nephrotic syndrome, trauma
recommendations for reagent strips
1) check
2) test urine ___
3) urine samples at ___ temp
4) follow exact ___ for each chem test
1) check manufacturer’s directions with lot #
2) test urine ASAP
3) urine samples at room temp
4) timing recommendations
define specific gravity
specific gravity measures ___
ddx SG 1.035
proportion of dissolved solids per volume (urea, NaCl, sulfate, phosphate)
concentrating ability of kidneys
1) polydipsia, diuretic, diabetes
2) dehydration, diabetes, proteinuria, CHF, addison’s
define osmolality
after dehydration, osmolality …
usu __ in parallel with specific gravity unless ___
of particles of solute/volume
incr to 3-4x plasma
incr
glucose/protein
specific gravity > 1.01 suggests…
isothenuria 1.008-1.012 suggest…
intact tubular function and PRE-RENAL
renal tubular dysfunction = renal tubular acidosis
hallmark of renal tubular acidosis is..
alkaline urine
or with UTI = urea splitting organism (proteus)
definition of proteinuria
normal daily value
ddx proteinuria
> 150 mg/dL or btwn 2+ - 3+
postural proteinuria
proteinuria in elderly
nephrotic syndrome
overflow = multiple myeloma
caveats of protein
1) dipstick method sensitive to albumin only NOT GLOBULIINS
2) alkaline = falsely low results
3) bence jones = multiple myeloma
glucose is usually ___ in urine
undetectable
glucose in kidney caveats
1) filtered by ___ and nearly entirely ___
2) positive in …
3) false positive if ___
4) vitamin C can lead to …
5) copper reduction test
1) glomerulus; absorbed
2) diabetes, pregnancy, endocrine, pancreatic
3) collection jar open
4) false negative
5) for reducing sugars in pediatric patients –> TLC
ketones normally ___
positive anytime when ___
1) undetectable
2) incr in lipid metabolism (diabetes, alcoholism, cirrhosis, exercise)
ddx of ketones
signs of nondiabetic ketonuria
diabetic ketonuria
fever, vomiting, cachexia
