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Urinalysis Flashcards

1
Q

Describe the microscopic “formed elements” of a UA

A 
RBCs 
WBCs
Epithelial cells 
Casts (unique to the kidney)
Crystals 
Microorganisms
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2
Q

What are some factors that may alter urine color?

A

Change in specific gravity (how concentrated or dilute)
Foods
Bilirubin (coca-cola color)
Medications

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3
Q

What transparency and pH is normal urine?

A

Clear

Normal pH range is 4.5 – 8.0 with an average of 6.0

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4
Q

What might cause urine to be cloudy to turbid in transparency?

A 
WBCs
Bacteria 
Fecal contamination 
Prostatic fluid 
Seminal vesicle fluid 
Vaginal secretions
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5
Q

What might cause urine to be foamy?

A

protein
bilirubin
pneumaturia (air in the urine, possible fistula from rectum into the bladder)

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6
Q

Pyuria means

A

Pus or white blood cells in the urine

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7
Q

Leukocytes (LEU)

A

Normal is NEGATIVE . Positive suggests UTI

Reflects breakdown of WBCs to produce leukocyte esterase.

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8
Q

Nitrites (NIT)

A

Normal is NEGATIVE
Formed by breakdown of urinary nitrAtes to nitrItes

Positive suggests possible nitrate reducing bacterial infection such as: 
E. Coli *
Klebsiella
Proteus
Staphylococcus
Pseudomonas
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9
Q

What is the one bacteria that is non-nitrate reducing?

A

Streptococcus

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10
Q

Urobilinogen (URO)

A

Normal has a range (0.2-1.0)

Decreased/absent suggests hepatobilliary duct obstruction

Increased suggests liver disease (poor clearance) or hemolytic disease (excessive bilirubin production)

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11
Q

Protein (PRO)

A

Normal is NEGATIVE
protein being detected is Albumin.

Total protein excretion is <150mg/24hours is physiologically normal and is not detected in urine dipstick. <300mg/day may also not be detected.

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12
Q

Benign causes of proteinuria

A 
Dehydration
Stress
Pregnancy ( >300 mg/24 hours is pathologic) 
Fever
Most acute illnesses
Strenuous exercise
Vaginal secretions
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13
Q

Potentially serious causes of proteinuria

A

HTN
Diabetes (secondary to CKD)
Glomerular damage
Multiple myeloma

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14
Q

Blood (BLO)

A

Normal is NEGATIVE

Hematuria may be gross or microscopic. May indicate: 
UTI
Pyelonephritis
Glomerulonephritis
Renal cancer
Bladder cancer (smoking is a risk factor)
Strenuous exercise
Menses
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15
Q

Specific Gravity (SG)

A

normal has a range (1.015 – 1.025)

Increased (concentrated)
Dehydration
Decreased renal blood flow
Glycosuria
Proteinuria

Decreased (diluted)
Overhydration
Diabetes insipidus
Chronic renal failure

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16
Q

Ketones (KET)

A

Normal is NEGATIVE. Product of fat metabolism.

Causes of ketonuria
 DKA
Fasting
Starvation
Vomiting
Strenuous exercise
Dehydration
17
Q

Bilirubin (BIL)

A

normal is NEGATIVE

Bilirubinuria - foam test will be positive.

18
Q

Glucose (GLU)

A

normal is NEGATIVE

“glyosuria/glucosuria” seen when glucose > 180mg/dL

19
Q

Urine microscopic examination is used to identify presence of what?

A

Cells
Casts
Crystals

20
Q

RBCs associated conditions

A 
Infection (pyelonephritis, cystitis)
Ureterolithiasis (kidney stone)
GU malignancy 
Renal cyst 
AKI
21
Q

WBCs associated conditions

A

Infection (pyelonephritis, cystitis, urethritis)

Renal inflammatory processes

22
Q

Renal tubular epithelial cell associated conditions

A

AKI

Nephrotic syndrome

23
Q

Squamous epithelial cells are associated with?

A

contaminated catch

24
Q

Oval fat bodies associated conditions

A

Nephrotic syndrome

Autosomal dominant PKD

25
In what kind of GU infection would you see WBCs but not RBCs?
Urethritis Often a G+C bacterial infection that affects the urethra
26
Where in the renal tubule are casts formed?
Distal convoluted tubule and Collecting duct | Appear as cigar-shaped bodies.
27
What is a Tamm-Horsfall glycoprotein ?
Major protein of normal urine and forms the common matrix of casts. Does not get detected by urine dipstick (specific to albumin only)
28
The only cast that may be normal?
Hyaline. Its non-specific may be due to dehydration/concentrated urine
29
What kind of cast might you see in pyelonephritis?
WBC cast
30
What kind of casts are associated with CKD?
Waxy and broad casts. | Waxy casts are also non-specific.
31
Are normal urine crystals normal? what factors affect their presence?
yes, crystals are a normal urine finding – depends on pH – and most especially when urine becomes concentrated
32
What might be a cause of abnormal urine crystals?
``` Acidic urinary pH Pts drug hx Abx Amino acids (high protein diet) Altered metabolism (Bilirubin, Cholesterol) Radiographic Contrast Media ```
33
CFU # considered infection
>100,000 cfu (colony forming units)
34
When is a suprapubic puncture for urine specimen indicated?
if pt has a urinary obstruction or blockage in urethra

Diagnositcs (2 decks)

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