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Diagnositcs > Urinalysis > Flashcards

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
Q

In what kind of GU infection would you see WBCs but not RBCs?

A

Urethritis

Often a G+C bacterial infection that affects the urethra

26
Q

Where in the renal tubule are casts formed?

A

Distal convoluted tubule and Collecting duct

Appear as cigar-shaped bodies.

27
Q

What is a Tamm-Horsfall glycoprotein ?

A

Major protein of normal urine and forms the common matrix of casts. Does not get detected by urine dipstick (specific to albumin only)

28
Q

The only cast that may be normal?

A

Hyaline. Its non-specific may be due to dehydration/concentrated urine

29
Q

What kind of cast might you see in pyelonephritis?

A

WBC cast

30
Q

What kind of casts are associated with CKD?

A

Waxy and broad casts.

Waxy casts are also non-specific.

31
Q

Are normal urine crystals normal? what factors affect their presence?

A

yes, crystals are a normal urine finding – depends on pH – and most especially when urine becomes concentrated

32
Q

What might be a cause of abnormal urine crystals?

A 
Acidic urinary pH
Pts drug hx 
Abx 
Amino acids (high protein diet)
Altered metabolism (Bilirubin, Cholesterol)
Radiographic Contrast Media
33
Q

CFU # considered infection

A

> 100,000 cfu (colony forming units)

34
Q

When is a suprapubic puncture for urine specimen indicated?

A

if pt has a urinary obstruction or blockage in urethra

Diagnositcs (2 decks)

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