Urinalysis

Question 1

24 hour specimen. How taken?

Answer 1

Void, discard. Keep all remaining urine for 24 hours.

Question 2

Indications for 24 hour urine?

Answer 2

Accounts for moment-to-moment changes in kidney resorption. 24 hour is more representative of values. Important for proteins in the urine. Also, reference ranges are typically over 24 hours.

Question 3

Visual examination of urine. What look for.

Answer 3

Is volume in normal range (quantity). >2 L is polyuria

Question 4

True/false - urine should be tested ASAP and at room temp.

Answer 4

true

Question 5

Specific gravity

Answer 5

Measures conc. ability of kidneys. Not specific for specific diseases. reflects the relative proportion of dissolved solid components to total volume of the specimen.

Question 6

Osmolality:

Answer 6

number of particles solute per volume. Not part of routine urinalysis. Should trend with specific gravity, in general.

Question 7

What is a particular instance in which specific gravity is helpful?

Answer 7

Acute oliguria. High = suggests that tubules are helping concentrate. Steady SG regardless of intake can indicate inability.

Question 8

Metabolic acidosis will show a urine pH that is:

Answer 8

acidic

Question 9

Renal tubular acidosis will show urine pH that is:

Answer 9

alkaline. Proteus spp. can also give alkaline urine.

Question 10

High levels of vitamin C in the urine will interfere with which results on a urine dipstick?

Answer 10

Glucose and Blood (hemoglobin). And nitrate reduction test for UTI.

Question 11

What is an indirect test for UTI?

Answer 11

Nitrate reduction (some bacteria). Low sensitivity, but good specificity for gram (-) organism. Can combine with a leukocyte esterase test, which has a higher sensitivity but lower specificity.

Question 12

What would be looked for on a microscopic examination?

Answer 12

CCCO.
Cells: (RBC, WBC, squamous epithelial, urothelial, renal tubular epithelial cells [oval fat bodies - seen in nephrotic syndrome])
Casts: (Hyaline - nonspecific, waxy casts - advanced chronic renal failure, red cell casts - glomerular disease, WBC cast - inflammation, tubular cell casts - ATN, viral disease, drug or toxin exposure, granular, fatty - nephrotic syndrome, crystal casts)
Crystals:
Organisms/other: (Tumor cells, etc)

Question 13

Red cells can come from the urinary tract, but RBC casts can only come from:

Answer 13

glomerular disease

Question 14

Can you add a UA to a 24 hour urine sample?

Answer 14

no

Question 15

After a period of dehydration, the osmolality jumps to ___ x normal

Answer 15

3-4x normal

Question 16

Ketones can be seen in

Answer 16

Diabetic
fasting
cachexia
high fever

Question 17

2 tests, that if both positive are a good indication that there is a UTI?

Answer 17

Nitrite and leukocyte esterase