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Urinalysis > Urinalysis > Flashcards

Urinalysis Flashcards

1
Q

What accounts for high false positives with Urinalysis dip?

A

Proteinuria will cause over-estimation of kidney’s concentrating ability

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2
Q

What accounts for low false positives with Urinalysis dip?

A

Highly buffered alkaline urine tends to lower the S.

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3
Q

What structure of the kidney reabsorbs glucose?

A

The proximal renal tubule

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4
Q

What threshold must glucose reach to begin spilling over into the Urine causing glucosuria?

A

160 - 180 mg/dl

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5
Q

Why is glucose considered a threshold substance?

A

If plasma glucose content is above a certain threshold it can’t keep up and the excess (about 160 -180mg) so you reabsorb unless there is more in tubes than can reabsorb

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6
Q

what is a “normal” test glucose dip outcome?

A

“negative” negative glucose is less than .5 g/day

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7
Q

what are potential causes of glucosuria?

A

diabetes mellitus, Cushing’s syndrome due to inappropriate release of cortisol which increase glucose in plasma, drugs

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8
Q

What do you do if you find unexpected glucosuria on your dipstick?

A

order a blood test

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9
Q

What accounts for the high false negative with glucose testing?

A

(VIT C)

ketones, abscorbic acid, asprin

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10
Q

When are keytones produced?

A

keytones are produced when you cant use glucose and start breaking down fatty acids and releasing keytones

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11
Q

How are keytones formed?

A

From the metabolism of fatty acids

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12
Q

What is the outcome of increased keytones in the blood?

A

electrolyte imbalance, dehydration, acidosis and eventual coma

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13
Q

What is the outcome of a dip test for normal keytone level?

A

normal keytone level = negative for keytones

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14
Q

Why is the urine dip not representative of the full load of keytones being produced by the body?

A

The dipstick we use detects only acetoacetic acid. There are 3 types of keytones: beta-hydroxybuturic acid, aceroacetic acid, acetone

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15
Q

In DKA what is the prdominate keytone?

A

beta-hydroxybutyrate

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16
Q

What are the two most common causes of ketonuria?

A
  1. Diabetes Mellitus 2. Increase metabolic states: hyperthyroidism, fever, pregnancy
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17
Q

What accounts for high false negative with keytone testing?

A

Prolonged air exposure - keytones are highly volatile and will lose count to air

18
Q

What is the “normal” finding for a blood UA dip?

A

normal = negative

19
Q

What does the UA dip blood test detect?

A

Free hemoglobin (lysed RBCs), Hemoglobin (intact RBC), myoglobin (muscle protein)

20
Q

Presence of free hemoglobin in urine is referred to as____

A

hemoglobinuria

21
Q

Presence of intact RBCs in Urine is termed ______

A

Hematuria

22
Q

The clinical significance of blood in the Urine must determine the source. what are some example sources?

A

menstrual, glomerular, kidney stones, MI, exercise

23
Q

The presence of _____ could cause a False negative blood UA - e.i. you could miss blood if you have positive of these

A

nitrites

24
Q

What (2) could account for a false positive blood UA?

A
  1. menstrual blood

2. myoglobinuria

25
Q

what accounts for false negative outcomes blood UA?

A

ascorbic acid (vit c) and nitrites

26
Q

When is urinary pH generally higher?

A

after meals

27
Q

What is a normal urine pH range?

A

4.5 -8 (usually 6)

28
Q

what is the role of the kidneys in maintaining acid-base balance?

A

The kidneys facilitate the re-absorption of sodium and excretion of H+

29
Q

Why do we need to be aware of pH run over?

A

Buffers from the protein area of the strip (pH 3.0) spill over to the pH area of the strip and make the pH of the sample appear more acidic that it really is

30
Q

If you suspect a UTI, why would the pH alkaline vs acidic help you eliminate the suspect list?

A

UTI + alkaline indicates pseudomonas

UTI + acidic indicated ecoli

31
Q

what may be indicated by an alkaline urine pH?

A

Alkalosis: metabolic or respiratory, Diet; vegetarians; high citrus intake

32
Q

what may be indicated by an acidic pH?

A

Acidosis: respiratory or metabolic, diabetes mellitus, UTI, diet high meat, high cran

33
Q

What is a normal outcome for UA dip protein?

A

normal = negative

undetectable amounts excreted, normally

34
Q

What organ function is the protin UA dip sensative for? why

A

Kidney function
slit pores in a normal glomerular membrane are too small to allow passage of high molecular weight proteins. they also have a negative charge that repels proteins

35
Q

What are some functional causes of proteinuria?

A

severe muscle exertion, pregnancy

36
Q

what are some renal causes of proteinuria?

A

glomerulonephritis, nephrotic syndrome

37
Q

What are pre- and post- renal causes of proteinuria?

A

fever renal hypoxia (pre)

contamination with vaginal secretions (post)

38
Q

What conditions may have transient proteinuria?

A

fever, stress, exercise, or congestive heart failure

39
Q

what are potential sources of false positives with protein UA

A

vaginal secretions and pyridium (pain)

40
Q

What is the UA dip for bilirubin indicating?

A

increased bilirubin: bilirubinuria possible causes include, gallstones, bile duct obstruction, hepatitis

41
Q

what is a source of false positives in bilirubinuria

A

puridium indicans

42
Q

what is a source of false negatives in bilirubinuria?

A

light (breaks down bilirubin), nitrites, ascorbic acid

Urinalysis (1 decks)

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