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Clin Lab > Urinalysis > Flashcards

Urinalysis Flashcards

1
Q

What does the urinalysis important for?

A
  • Discovering disease in the urinary tract
  • Estimate renal function
  • Clues as to what causes renal dysfunction
  • Some systemic diseases cause alterations in urine constituents
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2
Q

What is included in a standard urine panel?

A
  • Appearance
  • pH
  • Specific gravity
  • Protein
  • Glucose
  • Ketones
  • Nitrites
  • Leukocyte esterase
  • Urobilinogen
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3
Q

When is appearance of urine reported? What is normal appearance?

A

When it is abnormal

-Should be pale, dark yellow, and clear

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4
Q

What does urine have in it if it is turbid

A
  • Excessive cellular material or protein

- or from crystallization or precipitation of salts

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5
Q

When do salts precipitate?

A

When urine is basic (should be acidic)

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6
Q

If the specimen clears with the addition of small amounts of acid, what is the cause?

A

-Precipitation of salts

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7
Q

What can cause red or brown urine?

A
  • Hemoglobin
  • Myoglobin
  • Fresh beets
  • Pyridium (causes dark orange urine)
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8
Q

What acidifies glomerular filtrate of plasma

A

Renal tubules and collecting ducts from a pH of 7.4 to 5-6

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9
Q

When will you see a pH of 6 or more

A
  • Alkalosis

- If the acidifying mechanism of the kidney fails

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10
Q

What happens to urine if it is left standing

A

-Become alkaline due to bacterial growth

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11
Q

What is directly proportional to urine osmolarity

A

Specific gravity

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12
Q

What does specific gravity measure

A

The ability of the kidney to dilute or concentrate the urine

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13
Q

What diseases cause the inability to concentrate the urine?

A
  • Diabetes insipidus

- Severe hyperthyroidism

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14
Q

What prevents the majority amount of large materials to escape from the blood into the urine

A

Glomerular membrane

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15
Q

What is normal protein excretion

A

150mg/24 hours

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16
Q

What defines proteinuria

A

Protein excretion more than 150mg per day

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17
Q

What classifies severe proteinuria

A

more than 3.5mg/24 hours

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18
Q

What causes severe proteinuria

A

Nephrotic syndrome

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19
Q

+1 protein=

A

200-500 mg/24 hours

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20
Q

+2 protein=

A

500-1500 mg/24 hours

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21
Q

+3 protein=

A

1.5-5 g/24 hours

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22
Q

+4 protein=

A

greater than 5g/24

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23
Q

What is the dominant constituent in proteinuria and why?

A
  • Albumin

- Because it is the smallest

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24
Q

What abnormal protein usually appears in the urine in patients with multiple myeloma

A

Bence jones proteins

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25
Q

What are the 2 types of proteinuria

A
  1. Functional
    - not associated with systemic or renal disease
  2. Organic
    - associated with systemic disease or renal pathology
26
Q

What are examples of functional proteinuria

A
  • Severe muscular exertion

- Pregnancy

27
Q

What are examples of organic proteinuria

A
  • Pre-renal
  • Renal
  • Postrenal
28
Q

Describe pre-renal organic proteinuria

A
  • Not due to renal disease
  • Problem occurs before reaching the kidney
  • Fever
  • Sepsis
  • Hypertension
  • Bence Jones proteins
29
Q

Describe renal organic proteinuria

A
  • Primary kidney disease
  • Glomerulonephritis
  • Nephrotic syndrome
30
Q

Describe post-renal organic proteinuria

A
  • Protein is added to the urine farther down the urinary tract
  • Infection of the ureter
  • Cystic
  • Urethritis/prostatitis
  • Contamination with vaginal secretions
31
Q

What is commonly seen in urine contamination with vaginal secretions

A

High number of squamous epithelial cells

32
Q

What is the most common cause of glucosuria

A

Diabetes mellitis

33
Q

What is the normal renal threshold for glucose before it starts spilling over into the urine

A

180 mg/dl

34
Q

T/F- Individuals can vary in their tubular transfer reabsorptive capacities

A

True

35
Q

If reabsorptive capacity is low, the patient will spill glucose at (higher/lower) levels
-what causes this

A

Lower

-Pregnancy and the exposure to carbon monoxide and lead cause it

36
Q

What are examples of ketones

A
  • Acetone
  • Acetoacetic acid
  • Beta-hydroxyl butyric acid
37
Q

What is the major cause of increased ketones

A
  • Carbohydrate restriction

- impaired carbohydrate metabolism

38
Q

What muscle types can utilize a limited amount of ketones as an energy source when glucose is insufficient

A
  • Skeletal

- Cardiac

39
Q

T/F- After a certain point, metabolic capacity is exceeded and excess ketone bodies are excreted by the kidney

A

True

40
Q

Ketosis is…

A

When ketones accumulate in the plasma

41
Q

Many bacteria produce an enzyme called…

A

reductase

42
Q

What does reductase do?

A

Converts nitrates to nitrites

43
Q

A positive nitrite test indicates that…

A

bacteria may be present in the urine

44
Q

What is the sensitivity of the nitrite test

A

50%

45
Q

What is the gold standard test for urine

A

Urine culture

46
Q

T/F-The nitrite test can enhance the sensitivity of the leukocyte esterase test to detect urinary tract infections

A

True

47
Q

This is an enzyme found in the cytoplasm of neutrophils

A

Esterase

48
Q

When is a positive leukocyte esterase test seen?

A

-When there are WBC as whole or lysed cells in the urine

49
Q

What does positive leukocyte esterase indicate?

A

Pyuria

50
Q

How sensitive is leukocyte esterase test in detecting urinary tract infections

A

80-90% sensitive

51
Q

Can leukocyte esterase differentiate between WBC from the urinary tract or vaginal secretions?

A

Nope

52
Q

What is produced from the conjugated bilirubin by metabolic activity of bacteria in the intestine followed by reabsorption into the blood steam

A

Urobiliogen

53
Q

When can conjugated bilirubin be seen?

A

Secondary to biliary tract obstructions

54
Q

Extrahepatic =

A

Common bile duct obstruction

55
Q

Intrahepatic=

A

Liver cell injury (cirrhosis or hepatitis)

56
Q

When is a microscopic analysis of urine completed

A

After the urine has been centrifuged

57
Q

What is the presence of RBC in the urine called

A

Hematuria

58
Q

What are causes of hematuria

A
  • Glomerular damage
  • Tumors
  • Kidney trauma
  • Nephrolithiasis
  • Urinary tract infections
59
Q

When can contamination with RBC occur

A

During menses or catheriziation (especially if you have prostate problems)

60
Q

How can RBC look

A
  • Normal shape
  • Swollen (dilute urine)
  • Crenated (concentrated urine)
61
Q

When are squamous epithelial cells typically seen

A

Contamination with normal skin flora

62
Q

These are protein conglomerates that outline the shape of the renal tubules in which they were formed

A

Protein casts

Clin Lab (23 decks)

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