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Urinalysis and Body fluids > Urinalysis > Flashcards

Urinalysis Flashcards

1
Q

pH method

A

double indicator

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2
Q

what does the double indicator method for pH contain?

A

methyl red

bromthymol blue

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3
Q

false high pH

A

bacterial growth

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4
Q

clinical significance of high pH

A 
veg diet
Met / Resp alkalosis
Renal tubular acidosis
vomiting
old specimen
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5
Q

clinical significance of low pH

A

protein diet
met / Resp acidosis
DM
dehydration

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6
Q

glucose method

A

double sequential

glucose oxidase then peroxidase

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7
Q

glucose false +

A

bleach

peroxide

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8
Q

glucose false -

A 
ascorbic acid
prolonged storage
high ketones and SG
acetoacetic acid
salicylates
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9
Q

clinical significance of glucose

A 
DM
pancreatitis
acromegaly
cushings
fanconi
renal disease
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10
Q

bilirubin method

A

diazo

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11
Q

what type of bilirubin is being detected in the urine strip

A

conjugated (only kind that is in urine)

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12
Q

false + bilirubin

A

drug induced color change

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13
Q

false - bilirubin

A

ascorbic acid

high nitrate, storage

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14
Q

clinical significance of bilirubin

A

hepatitis, cirrhosis, other liver disorders, biliary obstruction

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15
Q

urobilinogen method

A

ehrlichs / diazo

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16
Q

false - urobilinogen

A

formalin
storage
light exposure

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17
Q

clinical significance of urobilinogen

A

early detection of liver disease, liver disorders, hemolytic disorders

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18
Q

protein method

A

error of indicators

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19
Q

protein reagent

A

tetra-bromophenol blue

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20
Q

false + protein and why

A 
high pH (overwhelm acid buffer)
color
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21
Q

false - protein

A

protein other than albumin

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22
Q

protein clinical significance pre renal

A

intravascular hemolysis
muscle injury
APR
MM

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23
Q

protein clinical significance renal

A

diabetic nephropathy
strenuous exercise
dehydration
hypertension

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24
Q

protein clinical significance post renal

A

LUTI

injury trauma

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25
Q

ketone method

A

nitroprusside reaction

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26
Q

false + ketone

A

color

levodopa

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27
Q

false - ketone

A

storage ascorbic acid

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28
Q

ketone clinical significance

A 
diabetic acidosis
starvation
malabsorption/pancreatic disorders
strenuous exercise
vomiting
AA
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29
Q

rbc method

A

pseudoperoxidase

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30
Q

false + rbc

A

menses
microbial peroxidase
soaps/detergent

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31
Q

false - rbc

A

ascorbic acid

high SG

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32
Q

clinical significance rbc

A

renal calculi
glomerulonephritis
pyelonephritis
trauma

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33
Q

clinical significance hemoglobin

A

transfusion reaction
hemolytic anemia
burns
infections

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34
Q

clinical significance myoglobin

A

muscular trauma
coma
convulsions
alcoholism

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35
Q

wbc method

A

leukocyte esterase

cleave ester = aromatic + diazo salt

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36
Q

false + wbc

A

color
vaginal contamination
soap / detergent

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37
Q

false - wbc

A

high glucose, protein, SG

drugs

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38
Q

nitrate method

A

diazo reaction

sulfanilamide

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39
Q

false + nitrate

A

color

storage

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40
Q

false - nitrate

A

ascorbic acid

acid pH

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41
Q

wbc clinical significance

A

bacterial UTI
inflammation of tract
screening of urine culture specimens
trich / chlamydia / yeast

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42
Q

nitrate clinical significance

A

cystitis

pyelonephritis

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43
Q

tests with false - due to ascorbic acid

A 
glucose
bilirubin
ketones
rbc
nitrate
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44
Q

tests with false + due to soaps / detergent

A

wbc
rbc
glucose

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45
Q

false + SG

A

high protein, ketones

lactic acid

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46
Q

false - SG

A

high glucose, urea

acidic pH

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47
Q

clinical significance of high SG

A

renal tubular dysfunction

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48
Q

clinical significance of low SG

A

dilute urine

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49
Q

order of urine strip tests

A 
glucose
bilirubin
ketone
SG
blood
pH
protein
urobilinogen
nitrite
wbc
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50
Q

direct method of SG

A

urinometer

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51
Q

indirect methods of SG

A

refractometer

strip

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52
Q

what does the urinometer test measure?

A

solutes, glucose, protein

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53
Q

for what variables does the urinometer have to be corrected for

A

temperature

large amount of glucose and protein

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54
Q

what is the refractometer method testing?

A

ratio of velocity of light in solution vs velocity of light in air

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55
Q

is the degree of refraction proportional or inveresly proportional in the refractometer method?

A

proportional

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56
Q

what factors can affect the refractometer method?

A

protein and glucose

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57
Q

what does the strip test method detect?

A

only ionic solutes

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58
Q

confirmatory test for protein and principle

A 
SSA
cold precipitation (turbidimetric)
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59
Q

false + SSA

A

any substance precipitated by acid

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60
Q

is SSA or the strip more sensitive?

A

strip

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61
Q

confirmatory test for glucose and principle

A

clinitest

benedicts copper reduction

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62
Q

what does it mean if:

+ clinitest and neg strip

A

sugar other than glucose present or strip interference

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63
Q

confirmatory test for ketones and principle

A

acetest

diacetic acid and acetone

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64
Q

what does it mean if:

+ strip, - acetest

A

false +

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65
Q

confirmatory test for bilirubin and principle

A

ictotest

p-nitrobenzene-diazonium-p-toluenesulfonate

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66
Q

what is more sensitive: ictotest or strip?

A

ictotest

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67
Q

confirmatory test for urobilinogen and principle

A

ehrlichs

para-dimethylaminobenzaldehyde

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68
Q

how do you differentiate between hemoglobin and myoglobin in urine

A

chemical pad
2.8 g ammonium sulfate to urine= hgb precipitated
myoglobin stays in supernatant
test supernatant

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69
Q

what are the normal crystals in acidic urine?

A

uric acid
amorphous urates
calcium oxalate

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70
Q

what are the normal crystals in alkaline urine?

A 
amorphous phosphates
triple phosphate
calcium phosphate
ammonium biurate
calcium carbonate
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71
Q

clinical significance of uric acid crystals

A

gout / leukemia patients under chemo

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72
Q

clinical significance of calcium oxalate

A 
clumps = renal calculi
mono= ethylene glycol
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73
Q

amorphous with pink sediment

A

urates

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74
Q

amorphous with white sediment

A

phosphates

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75
Q

crystals soluble in alkali

A

uric acid

amorphous urates

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76
Q

crystals soluble in dilute HCL

A

calcium oxalate

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77
Q

crystals soluble in dilute acetic acid

A

amorphous phosphates
calcium phosphates
triple phosphates

78
Q

crystals soluble in acetic acid with heat

A

ammonium biurate

79
Q

crystals soluble in gas from acetic acid

A

calcium carbonate

80
Q

abnormal crystals

A 
cystine
cholesterol
leucine
tyrosine
bilirubin
sulfonamides
ampicillin
81
Q

clinical significance of cystine crystals

A

cystinuria

82
Q

clinical significance of cholesterol crystals

A

nephrotic syndrome

83
Q

liver disorder crystals

A

leucine
tyrosine
bilirubin

84
Q

cystine crystals soluble in what?

A

ammonia

85
Q

cholesterol crystals soluble in what?

A

chloroform

86
Q

lecuine crystals soluble in what?

A

hot alkali

87
Q

tyrosine crystals soluble in what?

A

alkali / heat

88
Q

bilirubin crystals soluble in what?

A

acetic acid
HCL
NaOH

89
Q

sulfonamides crystals soluble in what?

A

acetone

90
Q

bacteria CS and source

A

UTI

bladder

91
Q

squamous cells CS and source

A

N/A

vagina / urethra

92
Q

tubular cells CS and source

A

tissue destruction, catheterization, heavy metals, hemoglobin/myoglobinuria, viral infections, pyelonephritis
proximal and distal convoluted tubules

93
Q

described tubular cells

A

rectangular, columnar, round, oval, cuboidal

eccentric nucleus

94
Q

describe transitional cells

A

spherical, caudal

central nucleus

95
Q

transitional cell CS and source

A

few = normal, clumps= carcinoma

renal pelvis, calyces, ureters, bladder, male urethra

96
Q

yeast CS and source

A

DM, immunocompromised, UTI, vaginitis

contaminant

97
Q

trichomonas CS and source

A

vaginal inflammation

vagina

98
Q

oval fat bodies CS and source

A

nephrotic syndrome, DM, tubular necrosis

kidney (RTE cells that absorbed lipids)

99
Q

glitter cell CS and source

A

wbc in alkaline/hypotonic urine, granules move

kidney

100
Q

ghost cell CS and source

A

dilute/alkaline urine RBC swell and lose hgb

kidney

101
Q

red cells CS and source

A

renal ut disease, extrarenal disease, trauma, strenuous exercise, renal stone, cystitis
kidney

102
Q

white cells CS and source

A

all renal disease and inflammation, UTI, cystitis, fever, strenuous exercise
kidney

103
Q

significance of red urine

A 
hgb
rbc
myoglobin
porphyrin
beets
fuschin
104
Q

significance of red-brown urine

A

hgb
rbc
myoglobin

105
Q

significance of AMBER urine

A

bilirubin
biliverdin
urobilin

106
Q

significance of yellow-orange urine

A

bilirubin
urobilin
pyridium

107
Q

significance of bright yellow urine

A

vitamin c

108
Q

significance of dark yellow urine

A

concentrated
bilirubin
urobilin

109
Q

significance of brown-black urine

A

methmeglobin
homogentisic acid
melanin

110
Q

significance of blue urine

A

indican

111
Q

significance of green urine

A

old

pseudomonas

112
Q

significance of port wine urine

A

porphyrin

113
Q 
findings in DM for:
polyuria
polydipsia
SG
Glucose
Ketones
A 
polyuria present
polydipsia present
SG increased
Glucose increased
Ketones increased
114
Q 
findings in DI for:
polyuria
polydipsia
SG
Glucose
Ketones
A 
polyuria present
polydipsia present
SG low
Glucose Normal
Ketones Normal
115
Q

defect in DM

A

low insulin production

116
Q

defect in DI

A

low ADH (decreased Water absorption)

117
Q

Following findings are consistent with what condition:
increased BUN:Creat
mild proteinuria and blood
increased RBC, WBC, RTE, RBC casts

A

acute glomerulonephritis

118
Q 
Following findings are consistent with what condition:
Mod elevated protein and blood
low and fixed SG
RBC
WBC
all casts
RTE
A

chronic glomerulonephritis

119
Q

Following findings are consistent with what condition:
marked protein, blood, oval fat bodies
increased casts, RTE, RBCs

A

nephrotic syndrome

120
Q 
Following findings are consistent with what condition:
protein
blood
WBC and nitrate
WBC
RBC 
casts (bacterial, WBC, granular)
RTE
A

acute pyelonephritis

121
Q 
Following findings are consistent with what condition:
protein
WBC
low SG
WBC
casts (granular, waxy, broad)
glucosuria
A

chronic pyelonephritis

122
Q 
Following findings are consistent with what condition:
protein
blood
WBC nitrate
bacteria
RBC
transitional cells
A

cystitis

123
Q

Following findings are consistent with what condition:
cytotoxic antibody against glomerular membrane
viral respiratory infections
proteinuria
RBC casts
hematuria

A

Goodpasture syndrome

124
Q

Following findings are consistent with what condition:
granuloma producing inflammation of small blood vessels
ANCA
hematuria
proteinuria
RBC casts
elevated BUN:creat

A

Wegeners

125
Q

Following findings are consistent with what condition:
children after upper respiratory infections
mild to heavy proteinuria
hematuria
RBC casts

A

Henoch-Schonlein

126
Q 
Following findings are consistent with what condition:
RTE cell damage
mild proteinuria
hematuria
RTE cells
RTE cell casts
A

acute tubular necrosis

127
Q

Following findings are consistent with what condition:
tubular dysfunction
glycosuria
mild proteinuria

A

Fanconi

128
Q

Bilirubin and urobilinogen levels in prehepatic conditions

A

bili- N

uro- increased

129
Q

Bilirubin and urobilinogen levels in hepatic conditions

A

bili- positive

uro- increased / N

130
Q

Bilirubin and urobilinogen levels in posthepatic conditions

A

bili- positive

uro- decreased / absent

131
Q

what are the only analytes that increase in urine on standing?

A

bacteria
nitrate
pH

132
Q

what factors must be present for cast formation?

protein, pH, solutes, flow rate

A

protein- Tamm Horsfall (increased under stress and exercise)
pH- acidic
solutes- Na and Ca
flow rate- stasis

133
Q

mousy odor

A

phenylketonuria

134
Q

rancid odor

A

tyrosinemia

135
Q

sulphur odor

A

cystinuria

136
Q

what cast can be seen with:
protein
blood

A

hyaline

137
Q

CS of hyaline casts

A 
glomerulonephritis
pyelonephritis
chronic renal disease
CHF
stress and exercise
diabetic nephropathy
138
Q

what cast can be seen with:
rbc (strip)
protein
blood

A

RBC

139
Q

rbc cast CS

A

glomerulonephritis

strenuous exercise

140
Q

what cast can be seen with:
wbc
protein
LE +

A

WBC

141
Q

wbc cast CS

A

pyelonephritis

acute interstitial nephritis

142
Q 
what cast can be seen with:
WBC
LE +
nitrate +
protein
bacteria
A

bacterial

143
Q

bacterial cast CS

A

pyelonephritis

144
Q

what cast can be seen with:
protein
RTE

A

epithelial

145
Q

epithelial cast CS

A

renal tubular damage

146
Q 
what cast can be seen with:
protein
cell casts
RBC
WBC
A

granular

147
Q

granular cast CS

A

glomerulonephritis
pyelonephritis
stress and exercise

148
Q 
what cast can be seen with:
protein
cell casts
granular casts
RBC
WBC
A

waxy

149
Q

waxy cast CS

A

stasis of urine flow

chronic renal failure

150
Q

what cast can be seen with:
protein
free fat droplets
oval fat bodies

A

fatty

151
Q

fatty cast CS

A

nephrotic syndrome
toxic tubular necrosis
DM
crush injuries

152
Q 
what cast can be seen with:
protein
WBC
RBC
granular casts
waxy casts
A

broad

153
Q

broad casts CS

A

extreme urine stasis

renal failure

154
Q

what reacts with sodium nitroprusside in the ketone strip reaction

A

acetoacetic acid

155
Q

what is the greiss reaction

A

nitrite at acid pH react with aromatic amine and forms a diazo salt

156
Q

what is the normal creatinine level in urine

A

1.2 mg/24hrs

157
Q

what is the functional unit of the kidney

A

nephron

158
Q

what is renin released in response to

A

decreased blood volume, arterial pressure, sodium
vascular hemorrhage
increased potassium

159
Q

aldosterone function

A

stimulate kidney to retain sodium and water
increase extracellular fluid
increase BP
normalize potassium levels

160
Q

what is the initial ultrafiltrate specific gravity>?

A

1.010

161
Q

what is the SG of isothenuric urine

A

1.010

162
Q

what does it mean if a urine has a specific gravity of 1.010 or less?

A

renal tubular damage

163
Q

where does urine concentration begin

A

descending and ascending loop of henle

164
Q

RAAS pathway

A

Renin - angiotensin- angiotensin II- ADH and Aldosterone, and vasoconstriction of efferent and vasodilation of afferent arteriole

165
Q

where does ADH originate from

A

hypothalamus

166
Q

where does ADH act on and what does it do

A

distal convoluted tubule

Na reabsorption

167
Q

where does aldosterone originate from

A

adrenal cortex

168
Q

where does aldosterone act on and what does it do

A

collecting duct

water reabsorption

169
Q

what does the vasoconstriction and vasodilation of the arterioles cause

A

Na reabsorption in proximal convoluted tubule

170
Q

where is Na reabsorbed

A

proximal convoluted tubule
ascending loop of henle
distal convoluted tubule

171
Q

what is lesch nyhan syndrom

A

purine disorder with massive excretion of urinary uric acid crystals

172
Q

heme synthesis pathway

A 
delta ALA
Porphobilinogen
Uroporphyrinogen
Coproporphyrinogen
Protoporphyrin
Heme
173
Q

what heme precursors are associated with acute intermittent porphyria

A

Delta ALA

PORpho

174
Q

what heme precursors are associated with cutaneous symptoms

A

UR
COP
PROTO

175
Q

elevated ALA / PORph condition

A

acute intermittent porphyria

Lead-ALA only

176
Q

elevated URO condition

A

Porphyria cutanea tarda

Congenital erythropoietic porphyria

177
Q

elevated COPro condition

A

congenital erythropoietic porphyria

variegate porphyria

178
Q

elevated Proto condition

A

erythropoietic protoporphyria

179
Q

in what porphyria conditions will the urine fluoresce

A

porphyria cutanea tarda
congenital erythropoietic porphyria
variegate porphyria
erythopoietic protoporphyria

180
Q

symptoms of porphyrias

A

photosensitivity
pale
port wine urine
psychiatric symptoms

181
Q

most common porphyria

A

porphyria cutanea tarda

182
Q

watson schwartz principle

A

PBG will react with Ehrlichs reagent to form red color

183
Q

watson schwartz differentiation

A

add chloroform to separate PBG and UBG

184
Q

color in top layer (chloroform layer) watson schwartz

A

UBG

185
Q

color in bottom layer watson schwartz

A

PBG

186
Q

what contributes to SG but not osmolality and why

A

protein

osmolality- all substances that dissolve in urine (urea, uric acid, glucose, salts)

187
Q

microalbumin strip principle

A

formation of a copper creatinine complex

188
Q

false - microalbumin strip

A

ascorbate

EDTA

189
Q

false + microalbumin

A

hemoglobin

drugs

190
Q

what does it mean if:
+ glucose
= clinitest

A

true glycosuria

clinitest should not be used to confirm positive glucose

191
Q

creatinine clearance formula

A

U x V / P x 1440 (min / 24 hours)

192
Q

how to correct for body surface area in creatinine clearance formula

A

creat clear x 1.73 / area

Urinalysis and Body fluids (1 decks)

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