Urinalysis Flashcards
1
Q
Urinary tract anatomy
A
- Kidney
- Ureter
- Urinary bladder
- Urethra
2
Q
Function of the kidney
A
- Eliminates of metabolic wastes from the body
- Maintains normal levels of body electrolytes and essential organic molecules
- Produces important hormones
3
Q
where does filtration of the blood occur?
A
glomerulus
4
Q
how is glomerular filtration driven?
A
high blood pressure
5
Q
how is glomerular filtration permitted?
A
semipermeable capillary membrane
6
Q
what is the function of the semipermeable capillary membrane?
A
allows passage of water and dissolved solutes of low molecular weight
7
Q
where does reabsorption happen in the glomerulus?
what is the percentage?
A
the renal tubule
90%
8
Q
where does excretion happen?
A
the renal tubule
9
Q
isosthenuria is…
A
same concentration as plasma
10
Q
what is the specific gravity of isosthenuria?
A
1.010 to 1.012
11
Q
what is the concern if urine is isosthenuria?
A
Kidneys are not concentrating very well
12
Q
Specific gravity is…
A
the measurement of dissolved solids in a fluid
13
Q
what device is the specific gravity tested in?
A
refractometer
14
Q
what is the abreviation for specific gravity?
A
UG or SG
15
Q
what is the specific gravity of distilled water?
A
1.000
16
Q
what spectific gravity should urine have?
A
higher specific gravity
17
Q
what does a higher specific gravity mean?
A
more concentrated
18
Q
what does a higher specific gravity mean?
A
kidneys are doing their job
19
Q
hypersthenuriais…
A
if the concentration is increased
20
Q
Hyposthenuria is…
A
if the concentration is decreased
21
Q
what should the concentration of urine be?
A
1.035 or higher
22
Q
Azotemia is… 1
A
buildup of metabolic waste in the bloodstream
23
Q
what are the lab signs of azotemia?
A
Increased BUN and Creatinine
24
Q
Uremiais…
A
increased uric acid or urea in the bloodstream
25
what constitutes renal failure?
If kidneys are unable to do their job
26
when do animals start showing physical signs of renal failure
75% renal failure.
27
Dysuria is...
difficulties urinating
28
Pollakiuria is...
Frequent urination
29
Polyuria is...
Increased amounts of urine
30
Polydipsia is...
increased thirst
31
Oliguria is...
decreased urine
32
Anuria is...
no urine
33
Diuresis is...
flushing the urine out using a diuretic
34
Urolithiasis is...
stones in the urine
35
urolith is...
single stone.
36
what is a voided sample?
urine collected as animal urinates
37
what is the concern with a voided sample?
bacteria contamination
38
Preprandial means...
before meal
39
what does the voided urine sample look like preprandial?
Most concentrated
40
what is the purpose of a preprandial sample?
Not affected by eating or exercise
41
how should a voided sample be caught?
Midstream sample
42
what patients is a manual express used?
Mainly used in cats and small dogs
43
what health considerations should you a manual express not be used on?
urinary tract obstruction
44
1. what can be found in the urine with a manual express?
| 2. Why?
1. may contain RBC
| 2. bladder can be damaged during compression
45
what are the ways to collect a urine sample?(4)
1. voided sample
2. maual express
3. cystocentesis
4. catheterization
46
which method is the preferred urine colletion method?
Catheterization
47
if done correctly a catheterized urine sample should be ______.
sterile
48
how do you get a catheterized urine sample?
Insert catheter into bladder via urethra
49
what supplies are needed to collect a catheterized urine sample? (2)
1. Sterile catheter
| 2. sterile gloves
50
what trauma can occur during a catheter collection?
trauma to urethral mucosa
51
what can be common in a catheterized urine sample?
RBC
52
which collectoin sample is considered a sterile sample?
Cystocentesis
53
which species is a cystocentesis sample used on?
cats and dogs
54
how is a cystocentesis sample performed?
Insert sterile needle directly into bladder through abdominal wall
55
how should the abdomen be prepared for a cystocentesis procedure?
surgical prep
56
1. when collecting a cystocytesis sample what is important?
| 2. why?
1. remove as much urine as possible
| 2. avoids leakage through the needle hole
57
why should the urine sample be examined ASAP?
eliminate effects of chemical and cellular change
58
If not examined within one hour, how should the urine sample be stored?
refrigerate or chemically preserve
59
how long can a urine sample be refrigerated?
up to 6 hours without affecting results
60
if refriderated, what must happen to the urine sample before a SG is tested?
warmed up to room temperature
61
what are the changes of a urine sample at room temperature?
1. RBC decrease
2. pH increases – due to bacterial breakdown of urea to ammonia
3. Bacteria increase
4. Sample turbidity increases
5. Crystals increase
6. Casts decrease
7. Glucose decreases
62
pH is...
Measure of H+ concentration in urine
63
what is the pH of carnivors?
< 7 in carnivores
64
what is the pH of herbivors?
> 7 in herbivores
65
what can an abnormally low pH be associated with?
1. hypoventilation
2. starvation
3. prolonged vomiting and diarrhea
66
1. what can happen to a cats urine pH when fed a vegetable base diet?
2. what can this cause?
1. pH becomes Alkaline instead of Acidic
| 2. urine crystals and blockages
67
hypoventilation is...
not getting enough oxygen
68
when can an Abnormally low pH (acidic) be caused by hypoventilation?
anesthetic procedure
69
what can be the cause of an abnormally high pH (alkaline) (3)
1. hyperventilation
2. bacteria in the urine
3. postprandial urine sample
70
How can bacteria change the urine pH?
they are changing urea into ammonia
71
what can cause a false abnormally high pH?
if urine is left out at room temperature for a long time before analysis
72
what can affect protein level in urine?
Method of collection
73
proteinuria is...
increase of protein in urine
74
what can proteinuria usually indicate?
disease of the urinary system
75
what can be a false increase of protein?
if urine has prolonged contact w/ the test pad on dipstick
76
what is are the blood glucose level when gucosuria is present?
> 170-180 mg/dl in dog
| > 260-310 mg/dl in cat
77
what are the condition associated with glucosuria? (3)
1. diabetes mellitus
2. stress/excitement
3. high carbohydrate meal
78
how can glucose be falsely decreased in the urine?
refrigerated sample
79
what are ketones?
acids that result from fat breakdown
80
ketones are...
Not normally detected in urine
81
when is ketonuria present?
when fat is metabolized for energy when carbohydrates are not available
82
what are some indications for ketonuria? (3)
1. diabetes mellitus
2. pregnancy toxemia/ketosis
3. starvation/fasting
83
what are bile pigments?
Chemicals derived from the breakdown of hemoglobin
84
what can be the cause of bilirubinuria?
1. RBC destruction
2. hepatocellular damage
3. bile duct obstruction
85
which chem strip values are not normally present in urine?
glucose
ketones
hemoglobin
86
bilirubin is considered ________ in urine.
unstable
87
which chem strip pad is RBC and hemoglobin detected by?
the same pad
88
what can be the cause of hematuria be? (6)
1. bacterial UTI
2. urolithiasis
3. interstitial cystitis
4. neoplasia
5. renal disease
6. trauma
89
what will happen to the color of urine when spun down with hemoglobin present?
color of urine will not change
90
what will happen to the color of urine when spun down with whole RBC present?
urine color will change
91
when is hemoglobinuria present in the urine?
massive RBC destruction
92
what are some indication of hemoglobinuria? (2)
1. autoimmune hemolytic anemia
| 2. blood transfusion incompatibility
93
what is myoglobin?
Oxygen-carrying molecule found in muscle that is similar to hemoglobin
94
which chem strip pad detects myoglobin?
blood test pad
95
when is myoglobinuria observed?
significant muscle damage
96
what are some indications of myoglobinuria?
1. exertional rhabdomyolysis
2. trauma
3. toxicity
97
what is nitrite?
Produced by bacteria from nitrate in urine
98
what do increased levels of nitrite indicate?
Increased levels are supposed to indicate a bacterial UTI
99
what is pyuria?
indicative of inflammation in the urinary tract
100
what are some possible causes of pyuria?
1. bacterial UTI
| 2. urolithiasis
101
when is urine sedimentation performed?
part of complete urinalysis procedure
102
what is the purpose of a urine sedimentation? (2)
1. Detects abnormalities not seen on gross or biochemical analysis
2. Confirms results of biochemical analysis
103
what should the urine sample for sediment analysis look like?
1. Fresh sample
2. Concentrated urine sample
3. Collected by cystocentesis
104
what amount of sediment is normal in urine?
small amount
105
what can RBC in a sediment indicate?
bleeding from somewhere in the urinary tract
106
what can WBC in a sediment indicate
inflammation of the urinary tract
107
what can be seen in a urine sediment?
1. RBC
2. WBC
3. Epithelial Cells
4. casts
5. crystals
108
what are some epithelial cells found in a sediment? (3)
1. Squamous
2. Transitional
3. Renal Tubular
109
where are squamous epithelial cells found in the urinary tract? (4)
distal urethra
vulva
vagina
prepuce
110
where are transitional cell found in the urinary tract? (4)
renal pelvis
ureter
urinary bladder
proximal urethra
111
where are renal tubular cells found int he urinary tract?
renal tubule
112
what are casts?
Cylindrical structures made of precipitated protein that assume the shape of the renal tubular lumen where they form
113
what can casts be an indication of?
renal disease
114
what are the types of casts? (5)
```
Hyaline cast
cellular casts
granular casts
waxy casts
fatty casts
```
115
what does hyaline casts consist of?
Consists of precipitated protein
116
what can be normal finding of hyaline casts?
0-2/LPF
117
what does cellular casts consist of?
incorporation of WBC’s, RBC’s, renal tubular epithelial cells into precipitated protein matrix
118
what does a granular cast consist of?
Cells that has degenerated
119
what can the presence of cellular cast indicate?
most likely indicate inflammation in the renal tubule
120
which cast is considered to be most severe?
Waxy casts
121
what can the presence of waxy cast indicate?
Active degeneration of the renal tubule
122
what is the order of least severe to most severe cast
hyaline
cellular
granular
waxy
123
when do crystals form in the urine?
when the constituent minerals are present in the urine
124
what is the formation of cyrstals dependent on? (3)
1. the concentration of the constituent minerals in the urine
2. the pH of the urine
3. the temperature of the urine
125
what is some other names for struvite crystals
1. Triple phosphate
| 2. MAP – magnesium ammonium phosphate
126
what is the appearence of struvite crystals?
Coffen lid shaped
127
what pH urine are struvites formed in?
alkaline urine
128
which species are struvites normal in?
dogs urine
129
what pH does calcium oxalate dihydrate crystals form in?
neutral to slight alkaline range but prefer an acidic range
130
when are calcium oxalate monohydrate crystals seen?
ethylene glycol toxicity
131
what species are calcium carbonate crystals normal in? (4)
horse, rabbit, guinea pigs and goat
132
what pH does amourphous crystals form in?
Usually form in alkaline urine
133
what can amourphous crystals be a precursor for?
UTI
134
what can be done to prevent any future problems if amourphous crystals are seen
change diets
135
which species are bilirubin crystals abnormal in? (4)
feline, equine, bovine, or camelid
136
which species is low detectable levels of bilirubin normal in?
canine
137
which breed are ammonium urate or biurate crystals normal in?
dalmations and bulldogs
Ammonium urate or biurate
- Can growup to become stones
Can be seen in normal dalmations or bulldogs who are also predisposed to urate urolithiasis
-Rarely ever seen in other dog breeds or any cats. Not been reported in large animals.
Growth is favored in neutral to alkaline urine
138
what pH does ammonium urate/biurate crystals prefer?
neutral to alkaline
139
what does bacteria present in great number w/ WBC mean
UTI
140
what are some miscellaneous things seen in urinary sediments? (6)
```
Mucus threads
Spermatozoa
Fat droplets
Plant fiber, pollen
Starch granules
Parasite
```
141
what amounts of RBC seen in a UA are considered normal?
< 5 per HPF
142
```
RBC notation
1+
2+
3+
4+
```
3-8RBC/hpf
9-30RBC/hpf
>30, but less than packed RBC/hpf
Packed field or TNTC
143
what number of WBC is considered normal ina UA?
< 10 WBC/hpf
144
```
WBC notation
1+
2+
3+
4+
```
6-20 WBC/hpf
21-50 WBC/hpf
>50 WBC but less than packed field
Packed field or TNTC
145
what are uroliths composed of
various minerals
146
what are some common uroliths? (4)
triple phosphate
urate
cystine
oxalate
147
what are triple phosphate stone composed of?
Salts of magnesium, ammonium, calcium, and phosphate
148
what species are triple phosphate stones common in?
dogs and cats
149
what pH are triple phosphate stones common in?
Common in alkaline urine
150
what is the appearence of triple phosphate stones?
Radioopaque, hard, white or yellow
151
what are urate stones composed of?
Composed of ammonium urate
152
what is the apperence of urate stones?
Radioluscent, yellow, brittle
153
what species are urate stones common in ?
dalmations
154
what are cystine stone composed of
amino acid cystine
155
what are the characteristics of cystine stones?
Yellow, smooth, Radioluscent, easily pulverized
156
what are oxalate stones composed of?
calcium oxalate
157
what are the characteristics of oxalate stones?
radioopaque, hard, sharp protrusions
158
what is the main concerns with oxalate stones?
can severely traumatize the bladder
