Urinalysis Flashcards
What is specific gravity determined by?
number of and wt of solutes in solution
What determines osmolality?
Just the number of solutes in solution
Maximally dilute urine?
1.002(specific gravity) 50-100 mosm/kg
Normal isoosmotic urine?
1.010(specific gravity) 300mosm/kg
max conc urine?
1.030(specific gravity) 1200mosm/kg
urinary pH?
5-6.5
pH in urinary tract infection>
7.5-8.0
Is glucose normally present in urine?
No. hyperglycemia results in a filtered load that is greater than the reabsorption capacity and this can cause glycosuria. Glucose in the urine when there is no high blood glucose signals a proximal tubular dysfunction
Are ketones normally present in urine?
No
When are ketones present?
During diabetic ketoacidosis and fasting
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Kenneth L. Kennedy
Positive nitrite suggests?
UTI…gram negative
What is normal protein excretion?
less than 150 mg/day
What are the two ways to test for proteinuria?
24 hr collection, urine protein over creatinine
What are the three types of proteinuria?
Glomerular, Tubular, Overflow
What is the most abundant protein in glomerular proteinuria?
Albumin
3+ and 4+….what is the significance of these numbers?
These scores suggest nephrotic range proteinuria. Thats bad news
What is tubular proteinuria?
Failure to reabsorb low molecular wt. proteins in the proximal tubule
What is overflow proteinuria?
Excess production of low molecular wt. proteins. Leads to an increased filterel load that surpasses the reabsorptive capacity of the proximal tubule. Associated with light chain proteinuria in multiple myeloma
Urinary anion gap=
(Na + K) - Cl
If the urinary anion gap is positive, what does that suggest?
renal tubular disorder.
If the urinary anion gap is negative (hyperchloremic), what does that suggest?
Gastrointestinal disorder
Normal urine has how many RBCs per high powered field?
0-2
Clues that blood is of renal origin?
RBCs are dysmorphic, presence of RBC casts, often associated with proteinuria
Clues that blood is of extra-renal origin?
Usually normal shape, clots may be present, absence of heavy proteinuria
