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Organ Systems- Renal > Urinalysis > Flashcards

Urinalysis Flashcards

1
Q

What are the 2 ways to measure concentration of urine?

A

specific gravity and osmolality

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2
Q

How does specific gravity measure the concentration of urine?

A

both number and weight of solutes

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3
Q

When is specific gravity not a good way to measure urine concentration?

A

increased concentration of heavy solutes like in glycosuria and contrast media

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4
Q

how does osmolality measure urine concentration?

A

number of solutes only

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5
Q

What specific gravity represents isotonic urine? What osmolality?

A

1.010; 300 mosm

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6
Q

What is the max dilution of urine in specific gravity and osmolality?

A

1.002; 50-100

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7
Q

What is the max concentration of urine?

A

1.030; 1200mOsm

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8
Q

Urine pH is a reflection of what 2 things?

A

systemic acid-base and intake

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9
Q

What is normal urine pH?

A

5-6.5

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10
Q

What urine pH represents metabolic acidosis?

A

<5.3

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11
Q

What urine pH represents urea splitting gram negative bacteria like in a UTI?

A

7.5-8

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12
Q

What does glucosuria with elevated blood glucose indicate?

A

diabetes uncontrolled

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13
Q

What does glucosuria without elevated blood glucose represent?

A

PT dysfunction

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14
Q

When are ketones present in the urine?

A

fasting, diabetes and alcoholic ketoacidosis

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15
Q

When is bilirubin present in the urine?

A

liver disease, hyperbilirubinemia

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16
Q

When is nitrite present in the urine?

A

Infection by G (-); convert nitrate–> nitrite in UTIs

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17
Q

When is leukocyte esterase in the urine?

A

Specific for WBC, so + in infection, like but not limited to UTI, and inflammation, like lupus

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18
Q

How do you quantitate proteinuria?

A
  1. measure over 24 hours 2. ration of urine protein/creatinine
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19
Q

What is normal excretion of protein in urine?

A

<150 mg/day

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20
Q

In proteinuria, what protein changes are seen in urine?

A

Mostly Tamm-Horsfall protein, which is a small protein, and micro-amounts of albumin

21
Q

The heaviest proteinuria is ____.

A

Glomerular proteinuria

22
Q

Describe glomerular proteinuria.

A

permeability problem, lots of albumin in urine (3+, 4+), dipstick positive,

23
Q

What are the 2 tests for proteins in urine?

A

Dipstick: albumin

Sulfasalicylic acid: ID different proteins

24
Q

What is tubular proteinuria?

A

small amounts of low mw protein means the tubules have a reabsorption problem

25
Q

Excess production of low mw proteins is ____ proteinuria.

A

overflow

26
Q

Describe overflow proteinuria

A

more small proteins are made, like light chains in multiple myeloma. These have a negative dipstick test

27
Q

What kind of proteinuria will have a negative dipstick test?

A

overflow

28
Q

What electrolytes are measured from urine?

A

Na, K, Cl

29
Q

How is the etiology of hyperchloremic metabolic acidosis determined?

A

Anion gap: If Na+K-Cl= negative number:GI loss like diarrhea

positive number: renal tubular acidosis

30
Q

What is the usefulness of creatinine and nitrogen measurements from urine?

A

nutritional assessment and protein intake

31
Q

What is the usefulness of measuring calcium phosphate and uric acid from urine?

A

determine cause of kidney stones

32
Q

Normal urine has ____ rbc/hpf and a ___ dipstick test.

A

0-2; negative

33
Q

How can you tell if RBC in urine are of renal origin?

A

cells are pleomorcphic, casts, no clots, proteinuria associated with it.Cells are crenated with decreased volume

34
Q

How can you tell if RBC are of extra-renal origin?

A

cells are normal, no casts, clots

35
Q

When are WBC seen in urine?

A

UTI, pyelonephritis, nephritis

36
Q

What do renal tubular epithelial cells look like?

A

big cells that look like an egg cut in .5

37
Q

What is the significance of squamous epithelial cells in urine?

A

These are large, plate-like cells from the lower tract with a small nucleus. Doesn’t mean anything about renal function

38
Q

When are renal tubular epithelial cells seen in clumps?

A

when there is acute tubular injury like necrosis

39
Q

What cells secrete Tamm-Horsfall protein?

A

renal tubular epithelial cells

40
Q

What type of cast is normal?

A

Hyaline cast

41
Q

What makes up the matrix of hyaline cast?

A

Tamm-horsfall

42
Q

What is the significance of waxy casts?

A

These are large and pathogenic. They are dense with a white border and sometimes cracks. They mean there is a chronic renal problem.

43
Q

The most common kidney stone is formed by _____ and looks like ____.

A

calcium oxalate; envelopes

44
Q

What do triple phosphate crystals look like and what do they mean?

A

coffins; infection

45
Q

What do cystine crystals look like and what do they mean?

A

Hexagon, cystinuria–> bad

46
Q

Lipiduria means the pt has ____.

A

nephrotic syndrome

47
Q

What does lipiduria look like?

A

maltese croses, oval fat bodies, polarized

48
Q

What are granular casts?

A

abnormal, cellular debris, starch

49
Q

What does a RBC cast mean?

A

glomerulonephritis

Organ Systems- Renal (2 decks)

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