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Diagnostics > Urinalysis > Flashcards

Urinalysis Flashcards

1
Q

When to order urinalysis?

A

Abdominopelvic pain, back/flank pain, painful/frequent urination, change in color, med compliance

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2
Q

What does urinalysis test for?

A

Glucose, nitrite, ketones, myglobin

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3
Q

First morning test

A

compare kidney function when laying down

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4
Q

Microscopic components

A

WBC, RBC, epithelial cells, casts, crystals, microorganisms

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5
Q

Chemica reagents

A

Protein, glucose, ketone, bilirubin, pH, blood, nitrite, leukocyte esterase, urobilinogen, specific gravity

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6
Q

Normal Urine

A

Start colored/yellow and clear

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7
Q

What does yellow color come from?

A

Urochrome-byproduct of hemoglobin breakdown

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8
Q

Transparency Grades

A

Clear, slightly cloudy, cloudy, turbid (can’t see through)

Cloudy-turbid=WBC/bacteria (UTI), fecal contamination, prostatic fluid, seminal vesicle fluid, vaginal secretions

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9
Q

Causes of foamy urine

A

Protein, bilirubin, pneumaturia (air in urine-rectal vesicle fistula)

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10
Q

Leukocytes

A

Pyuria
normally negative
presence of WBC, suggests UTI

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11
Q

Nitrites

A

Normally negative
Positive=Ecoli (UTI), kelbsiella, proteus, staph, pseudomonas
Nitrate reduced to nitrite by bacteria
*does not test for streptococcus

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12
Q

Urobilinogen

A

Low-heptobiliary obstruction

High-liver disease, hemolytic disease, excessive exposure of bilirubin to intestinal bacteria

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13
Q

Protein

A

Detects albumin
normally negative
Dipstick highly specific but insensitive (may not detect up to 300mg)
Causes-stress, dehydration, pregnancy, exercise, fever
serious causes-hypertension, diabetes w/ CKD, glomerular damage, multiple myeloma

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14
Q

pH

A

Normal 4.5-8

increases with UTI and over time

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15
Q

Blood

A

Normally negative
Causes-UTI, exercise, pyelonephritis, glomerular nephritis, renal/bladder cancer, menses
Excessive muscle breakdown>myoglobin (trauma, MI, rhabdomyolosis)
Do microscopic after dipstick to determine blood vs myoglobin

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16
Q

Specific gravity

A

Increased (concentrated)-dehydration, decreased RBF, glycosuria, proteinuria
Decreased (dilute)-overhydration, diabetes insipidus, chronic renal failure

17
Q

Ketones

A

Normally negative
Product of fat catabolism
Causes-diabetic ketoacidosis, fasting/starvation/vomiting, exercise, dehydration

18
Q

Diabetic ketoacidosis

A

increased lipolysis from decreased insulin in cells

19
Q

Bilirubin

A

normally negative
Foam test=positive
Follow-up with liver function to find cause of bilirubin

20
Q

Glucose

A

Normally negative
Seen when BS is over 180
Renal disorders/diabetes

21
Q

Normal microscopic

A

No bacteria/casts/crystals, occasional epithelial cells

22
Q

Chronic Kidney Disease

A

Rarely reversible
Progressive decline in renal function due to hypertrophy of nephrons, continues even after treated-less nephrons so they’re working harder causing them to die out also

23
Q

RBC association

A

Pylonephritis, cystitis, ureterlithiasis, GU malignancy, renal cyst, acute kidney injury

24
Q

WBC association

A

Infections, renal inflammatory processes (nephritis)

25
Q

Renal tubular epithelial cells

A

Acute tubular necrosis, interstitial nephritis, nephrotic syndrome

26
Q

Squamous epithelial cell

A

contaminated catch

27
Q

Oval fat bodies

A

Nephrotic syndrome, polycystic kidney disease

28
Q

Urinary Casts

A

cylindrical, cigar shaped bodies
Tamm-horsfall glycoprotein forms common matrix of casts
Unique to kidney
concentrated urine, urinary flow ceases, low pH, high Na concentration

29
Q

Urinary crystals

A

Normal finding, different ones associated with pH changes

Abnormal requires confirmation from chemical testing, typically in acidic urine

30
Q

Urine culture

A

If suspicious of complicated infection/pyelonephritis, failure to respond to original treatment, recurrent symptoms
Pretreat while waiting for results

Diagnostics (7 decks)

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