Urinalysis

Question 1

What are the 3 methods of urine collection?

Answer 1

cystocentesis
voided catch/mid-stream flow
catheterization

Question 2

What is the advantage of Cystocentesis?

Answer 2

method of choice

localize source of hematuria, pyuria, and bacteriuria

Question 3

What is the disadvantage of the Voided/Mid-Stream method?

Answer 3

may be contaminated w/ cells, bacteria, etc.

NOT suitable for culture

Question 4

Disadvantage of catheterization?

Answer 4

sample may contain RBCs due to irritation from the catheter

Question 5

Using a dipstick, what are you measuring?

Answer 5

pH
Glucose
USG
Ketones
Blood
Blood-Hemoprotein
Protein
Urobilirubin
Leukocytes and Nitrates

Question 6

Increased urine pH can be due to renal tubular dysfunction often leading to paradoxical alkaline urine bc…

Answer 6

excessive loss of bicarbonate in the urine.

Question 7

What does an alkaline urine pH do to a dipstick reading?

Answer 7

Alkaline pH results in +1 protein reading.

Question 8

How do Bence Jones proteins, very dilute, or very acidic urine affect a dipstick reading?

Answer 8

may cause False negative protein readings

Question 9

What alternate test detects Bence Jones proteins?

Answer 9

Sulphosalicylic Acid Test

Question 10

What does the Blood-Hemoprotein pad detect?

Answer 10

Hematuria
Hemoglobinuria
Myoglobinuria

Question 11

In cats, what can cause a False positive on the Glucose pad?

Answer 11

cats with FLUTD (urethral obstruction)
drugs
pancreatitis
bacterial peroxidases

Question 12

What can cause a False negative on the Glucose pad?

Answer 12

salicylates
tetracyclines
high Vit C concentrations

Question 13

Glucosuria without Hyperglycemia is most commonly found in patients w/…

Answer 13

young puppies - tubule immaturity

renal tubular damage

Question 14

What Ketones do the dipsticks detect?

Answer 14

acetoacetic acid & acetone

NOT Beta-hydroxybutyric acid

Question 15

Why do you get ketones in urine?

Answer 15

deranged energy metabolism where fat is used in excess of carbohydrates

Question 16

What reaction detects conjugated bilirubin?

Answer 16

diazotisation reaction

Question 17

Describe Dogs and Bilirubin…

Answer 17

dogs have a low threshold for Br

Bilirubinuria results from: cholestasis and hemolytic anemia

Question 18

Describe Cats and Bilirubin…

Answer 18

cats have a high threshold for Br

bilirubinuria results from: diabetes mellitus and hyperthyroid cases

Question 19

If you see Urobilinogen in a urine sample you know…

Answer 19

the patient has an intact biliary system.

Question 20

What are the formed elements that can be found in a urine sediment?

Answer 20

epithelial cells
leukocytes
erythrocytes
casts
crystals
infectious agents
debris/contamination and overgrowth

Question 21

What leukocytes are normally seen in a urine sediment?

Answer 21

neutrophils

Question 22

Large numbers of neutrophils in a urine sediment indicates…

Answer 22

presence of inflammatory process in the urogenital system

Question 23

What are casts?

Answer 23

cylindrical particles composed of mucoprotein and epithelial cells lining the loops of henle, distal tubules, and collecting ducts

Question 24

The presence of casts in a urinary sediment allows you to…

Answer 24

localize the lesion to WITHIN the kidney

Question 25

List the 5 types of casts.

Answer 25

``` cellular hyaline granular fatty waxy ```

Question 26

The presence of _______ casts is ALWAYS abnormal.

Answer 26

The presence of cellular casts is ALWAYS abnormal.

Question 27

When do you see hyaline casts in urine sediment?

Answer 27

fever, exercise, or glomerular disease

Question 28

When do you see granular casts in urine sediment?

Answer 28

form as a stage in the degeneration of cellular casts

Question 29

When do you see fatty casts in urine sediment?

Answer 29

associated with degenerative tubular disease (most common type seen in cat urine)

Question 30

What is the most common cast seen in cat urine?

Answer 30

fatty casts

Question 31

When you see waxy casts in urine sediment...what are you thinking?

Answer 31

indicates chronic tubular disease | ALWAYS of pathologic significance

Question 32

Cellular casts can be WBC, RBC or Epithelial. What do each indicate?

Answer 32

WBC - pyelonephritis RBC - renal hemorrhage, and possible inflammation Epithelial - degeneration of tubules

Question 33

Common crystals found in urine sediment...

Answer 33

``` struvite calcium carbonate calcium oxalate dihydrate bilirubin amorphous crystals ```

Question 34

Struvite crystals..

Answer 34

most common in dogs and cats favors pH > 7 seen in UTIs with urease + bacteria

Question 35

Calcium Carbonate crystals..

Answer 35

common in normal horse, rabbit, guinea pig and goat urine

Question 36

Calcium oxalate dihydrate crystals..

Answer 36

normal in horse and cattle urine can occur secondary to increased Ca2+ excretion due to disorders of Ca2+ metabolism and seen in ethylene glycol intoxication

Question 37

Bilirubin crystals...

Answer 37

common in concentrated K9 urine | tend to precipitate onto other formed elements

Question 38

amorphous crystals...

Answer 38

A. urates: Na, Mg, K, or Ca salts A phosphates Xanthine

Question 39

List the uncommon crystals found in urine..

Answer 39

``` cystine biurates drugs tyrosine calcium oxalate monohydrate ```

Question 40

Cystine crystals...

Answer 40

usually in acidic urine | inborn error of metabolism w/ defective renal tubular reabsorption of certain amino acids including cystine

Question 41

biurate crystals...

Answer 41

NH3 Urate favors pH > 7 dalmations and bulldogs common in dogs and cats with liver shunts

Question 42

What drugs commonly form urine crystals?

Answer 42

sulpha drugs

Question 43

Tyrosine crystals...

Answer 43

associated w/ severe liver disease in humans | rare in animals

Question 44

calcium oxalate monohydrate crystals..

Answer 44

virtually always associated with ethylene glycol intoxication

Question 45

T/F - In a normal animal, the urine in the bladder is sterile.

Answer 45

True!

Question 46

Clinically significant bacteria in the urine is normally accompanied with...

Answer 46

leukocytes

Question 47

What are the parasites that can be found in urine?

Answer 47

Dirofilaria immitis Capillaria plica Dioctophyme renale

Question 48

What debris/contaminants can be found in urine?

Answer 48

fat droplets, pollen, mold spores, sperm