Urinalysis

Question 1

What does basic urinalysis consist of?

Answer 1

1. Gross examination
2. Dipstick:
   - blood
   - White cells
   - sugar
   - protein
   - ect

Question 2

Why is microscopic analysis of urine necessary in some cases?

Answer 2

to detect the 3 C’s and an O

1. Cells
2. Casts
3. Crystals
4. Organisms

Each of them can be causes by several disease states

Question 3

Microscopic examination is usually performed manually or by automated instrument?

Answer 3

Manually

Question 4

Dysmorphic RBCs are often a sign of disease affecting _____

Answer 4

non glomerular hematuria,

high up in the Urinary tract?

Question 5

Why is urine collection in the morning preferred specimen for analysis?

Answer 5

Because that is when it is the most [ ]ed and the 3 C’s might be more readily visible.

Question 6

Are 12-24 hour urine samples suitable for routine urinalysis?

Answer 6

NO! They need to be tested w/in 2 hours.

But they may be helpful for some other testing, NOT routine urinalysis.

Question 7

____ and ____ measure the [ ]ing ability of the kidneys

Answer 7

Specific gravity (on dipstick)

and

Osmolality

Question 8

After a period of dehydration, osmolality should be ______ times that of plasma

Answer 8

3-4x

Question 9

Proteinuria greater than _____ indicates nephrotic syndrome, which is usually seen in _________ disease, but may also be seen in systemic diseases affecting the kidneys

Answer 9

> 3.5 mg/dl

primary renal disease

Question 10

What can be seen in the urine of diabetic indiv? why? Is this specific? When else would you see it?

Answer 10

Ketones!!!!
- usually a product of increased lipid metabolism

Not specific,
can be seen in:
- high fevers
- cachexia
- fasting

Question 11

The ____ and ____ tests are used to help identify urinary tract infections. What should you do to confirm?

Answer 11

Nitride (bacterial conversion of nitrate)

Leukocide esterase (indirect measure of neutrophils in urine)

Question 12

Increase in SG indicates more or less [ ]ed urine?

Answer 12

More - Tubules are able to [ ] urine

Question 13

What is Tamm-Horsfall?

Answer 13

Congealed Protein in Urine that has taken on the form of the tubule (that is equiv to albumin levels in urine (40%))

Question 14

Dipstick [ ]s
1+
2+
3+
4+

Answer 14

1+ : 30mg/dl
2+ : 100 mg/dl
3+ : 300 mg/dl
4+ : 1000 mg/dl

Question 15

What is the definition of proteinuria? Between what two dipstick reads?

Answer 15

> 150 mg/dl of protein in urine

(between 2+ and 3+)

Question 16

If urine jar is left open, false ____ can occur

Answer 16

false positive

false - result with VIt C

Question 17

RBC casts indicate what?

Answer 17

Glomerular hematuria -

glomerular disease

Question 18

Waxy casts indicate what?

Answer 18

Advanced chronic renal failure

Question 19

Tubular casts indicate?

Answer 19

1. acute tubular necrosis
2. Viral disease
3. Drug exposure