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Renal > Urinalysis > Flashcards

Urinalysis Flashcards

1
Q

What is used to analyze sediment in urine? The supernatant?

A 
sed = light microscopy
sup = dipstick
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2
Q

Wy is the urine centrifuged?

A

to produce supernatant and urinary pellet

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3
Q

Specific gravity is determined by:

A

number and weight of solutes

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4
Q

Osmolality is determined by:

A

ONLY the number of solutes

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5
Q

Specific gravity is NOT a marker of how concentrated a sample is when:

A

abnormal numbers of heavy solutes are present in urine (e.g. contrast dye)

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6
Q

What are the specific gravity and osmolality of a maximum dilute urine sample?

A

1.002

50-100 mOsm/kg

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7
Q

In metabolic acidosis, urine pH is less than:

A

5.3

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8
Q

Urine pH >7.5-8.0, suggests:

A

UTI with urea splitting bacteria (such as proteus)

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9
Q

How does hyperglycemia cause glycosuria?

A

increases filtered load to greater than the reabsorptive capacity of proximal tubule

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10
Q

What does glycosuria in the presence of normal blood glucose (renal glycosuria) imply?

A

PT dysfunction

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11
Q

When are ketones often present?

A

fasting, DKA, and AKA

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12
Q

How do increased plasma ketoanions lead to ketonuria? How is ketonuria diagnosed?

A

filtered load exceeding proximal tubular reabsorptive capacity

Dipstick specific for acetone and acetoacetate

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13
Q

Elevated levels of plasma conjugated bilirubin lead to:

A

urinary excretion

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14
Q

_______ bilirubin is water soluble, which ______ bilirubin is insoluble.

A

Conjugated

Unconjugated

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15
Q

Which type of bilirubin will NOT be present in urine?

A

unconjugated– non water sol

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16
Q

Nitrite is (present/absent) in normal urine.

A

absent

17
Q

Positive nitrite suggests:

A

UTI with nitrate reducing bacteria
(gram negative)

*Gram negative bacteria = most common uropathogens

18
Q

What is leukocyte esterase and how is it measured in urine?

A

Produced by neutroohils, and positive, when there are increased numbers of neutrophils in the urine

Dipstick (detects a neutrophil-specific leukocyte esterase)

19
Q

What is normal excretion of protein?

A

<150 mg/day

20
Q

What is Glomerular Proteinuria associated with?

A

increased permeability for protein in the glomerular capillary wall
(especially albumin)

21
Q

What test detects all protein in the urine?

A

Sulfosalicylic acid test

22
Q

How and where are low molecular proteins filtered and normally reabsorbed? What if they are not reabsorbed?

A

pinocytosis
proximal tubule

proximal tubular dysfunction

23
Q

What is overflow proteinuria? What will you see via urine dipstick?

A
  1. Excess production of low molecular weight proteins
  2. increased filtered load exceeds reabsorptive capacity of PT

dipstick test:
positive for sulfosalicylic acid
negative for albumin

24
Q

What is a “spot” urine sample?

A

ratio of urine protein over creatinine (both measured as mg/dl) in a “spot” urine sample

**reliable estimate of quantitative proteinuria

25
Q

Urine dipstick is normally (positive/negative) for blood.

A

negative

26
Q

Most common cause of positive dipstick for blood is:

A

presence of rbc’s in urinary sediment

27
Q

Dipstick tests are sensitive to:

A

free hemoglobin and myoglobin

RBC

28
Q

What are 5 characteristics of renal hematuria?

A
  1. Dipstick positive
  2. RBC’s in sediment, some dysmorphic
  3. RBC casts
  4. Absence of clots
  5. Often associated with proteinuria
29
Q

What are 3 characteristics of non-renal hematuria that are different from renal hematuria?

A

1 .no RBC cats

  1. no proteinuria
  2. no abn shaped RBCs
30
Q

Describe urinary WBC’s:

A

Granular cytoplasm
irregular nucleus
“glitter cells” (in polarized light?)

31
Q

What conditions will you see urinary WBC’s in?

A
  1. UTI
  2. pyelonephritis
  3. allergic interstitial nephritis
  4. intense glomerulonephritis
32
Q

Urinary casts represent precipitates of:

A

protein forming in the lumen of tubules

33
Q

Where is Tamm-Horsfall protein formed, and what does it do?

A

by thick ascending limb of Henle cells

forms the matrix of all casts

34
Q

What are the only normal casts?

What type of cast contains cellular debris?

A

hyaline

granular

35
Q

Lipiduria is (present/absent) in normal urine.

A

absent

36
Q

What is lipiduria associated with? What causes it?

A

heavy proteinuria (nephrotic syndrome

presence of lipoproteins

37
Q

What features of lipiduria may be noted using polarizing light?

A

Maltese crosses
oval fat bodies
fatty casts

Renal (33 decks)

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