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Diagnostics > Urinalysis > Flashcards

Urinalysis Flashcards

1
Q

What substances in excreted urine may signal a metabolic disturbance?

A

glucose, nitrite, ketones

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2
Q

What is an example of intrinsic renal condition?

A

acute kidney disease

chronic kidney disease

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3
Q

Name 3 important types of urine specimens?

A
  1. Random
  2. Catheter
  3. Midstream clean-catch
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4
Q

Name the 4 types of urinalysis orders?

A
  1. Dipstick UA
  2. Dipstick UA with micro
  3. Complete UA (includes micro)
  4. Complete UA with reflex urine culture
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5
Q

What are the 3 components of UA?

A
  1. Physical
  2. Chemical
  3. Microscopic
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6
Q

What are some examples of chemical components of UA?

A
  • protein
  • glucose
  • ketone
  • pH
  • leukocyte esterase
  • blood
  • nitrite
  • urobilinogen
  • specific gravity
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7
Q

What are some microscopic components of a UA?

A

“formed elements”

  • WBCs
  • RBCc
  • Epithelial cells (renal vs. epithelial)
  • crystals
  • oval fat bodies
  • Microorganisms
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8
Q

What would turbid urine look like?

A

more turbid= more cloudy

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9
Q

What is reflexive testing?

A

Reflexive testing is when a microscopic examination of a urine sample is performed after a physical or chemical abnormality is found

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10
Q

When is a microscopic examination of urine sediment performed?

A
  • Patient with renal disease
  • Specifically ordered by clinician
  • Reflexive testing: if physical or chemical abnormality is found
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11
Q

What can be identified with a microscopic examination of urine sediment?

A
  • Cells
  • Casts
  • Crystals
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12
Q

What do squamous epithelial cells indicate in a UA?

A

contamination!

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13
Q

What conditions make it easy for casts to form?

A
  • Low pH (acidic)
  • High urinary salt concentration
  • Concentrated urine
  • Stasis (no flow)
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14
Q

What are urinary casts molds of?

A

lumen of the renal tubule

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15
Q

Where do urinary casts form?

A
  • Distal convoluted tubule

- Collecting duct

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16
Q

What is the major protein of normal urine?

A

Tamm-Horsfalll glycoprotein.

-common matrix of casts

17
Q

What is the function of Tamm-Horsfall glycoprotein?

A

-Major defense protein of urothelium against bacteria

18
Q

Is Tamm-horsfall glycoprotein detected on reagent chemical strips?

A

No, because it is so heavily glycosylated.

19
Q

Name the 7 common urinary casts?

A
  1. Hyaline
  2. WBC
  3. RBC
  4. Granular
  5. Renal tubular epithelial cell
  6. Waxy
  7. Broad
20
Q

What disease process is suggested by waxy and/or broad casts?

A

chronic renal disease

21
Q

What disease process is suggested by RBC, WBC, and or epithelial cell casts?

A

Acute kidney injury, nephritic syndrome

22
Q

What pH level are you likely to see Uric acid, Amorphous urates, and calcium oxalate crystals?

A

Acidic (low pH)

23
Q

What pH level are you likely to see Triple phosphates, ammonium biurate, calcium carbonate crystals?

A

Neutral or alkaline pH

24
Q

What pH level are you most likely to see calcium phosphate or amorphous phosphates?

A

alkaline pH

25
Q

What pH will you most commonly see urinary crystals?

A

acidic

26
Q

When is a urinary cultur indicated?

A
  • suspicion of complicated infection
  • suspicion of pyelonephritis
  • failure to respond to initial therapy
  • recurrent symptoms
27
Q

What type of people/factors may be most likely to have complicated UTIs?

A
  • Pregnant
  • Male
  • Old people
  • DM
  • immunosuppression
  • renal failure
  • History of UTIs in childhood
  • Having symptoms for more than 1 week
  • Hospital-acquired infection
  • Urinary tract obstruction
  • Prostatic hypertrophy
  • Catheter
28
Q

What does presence of protein in the urine suggest?

A

nephropathy

29
Q

When does glucose start to appear in the urine?

A

when it surpasses 250 in the blood

30
Q

What is the most specific test for infection?

A

nitrite

31
Q

Which 4 tests should always be negative?

A
  • Protein
  • Glucose
  • Nitrite
  • Leukocyte esterase

Diagnostics (5 decks)

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