Urinalysis and Basal Metabolic Profile Flashcards
what are the reasons to take a urinalysis
- diagnose urinary tract disease
- monitor urinary tract disease
- detect metabolic disease
- easy, cheap, rapid info
what are characteristics of morning specimen
- patient must void before going to bed in evening; gives a 6-8 hr sample of urine which is accurate to function of 24 hr sample
- more concentrated at night during fasting so it more likely to yield results
- not the most convenient
- must be preserved if not delivered to lab within 2 hrs
what are characteristics of random specimen
- more convenient in clinical setting
- performed when substance testing has little diurnal variation
- method of choice for drug screening
what are characteristics of timed collection
some substances are variably excreted over 24-48 hr period requiring larger sample size for accurate measures
ex - hormones, proteins, electrolytes
what are the methods of collection
routine
midstream/clean catch
24 hr
what information does blood urea nitrogen provide us with
- rough measurement of renal function
free ammonia from protein metabolism is combined in the liver to yield what
what happens to the urea
urea
excreted from the kidney in the urine
most renal diseases interfere with what
what happens if its unilateral
interferes with excretion of urea and other substances
if unilateral, the normal kidney can compensate to yield a normal BUN
what is it called when there is an increase in nitrogenous products in the blood
azotemia
what are the causes of pre-
renal issues resulting in abnormal excretion
pre-renal - accumulation before the kidney
- excessive catabolism of protein
- CHF
- Shock
- Dehydration
simply, either decreased blood volume or renal circulation OR increased protein intake or endogenous catabolism
decreased blood volume
decrease renal circulation
increased protein
increase catabolism of protein
what are the causes of renal issues resulting in abnormal excretion
chronic diffuse bilateral disease or damage
ex - acute tubular necrosis (caused by hypertension or shock)
what are the causes of post-renal issues resulting in abnormal excretion
post-renal - obstruction occurring after the kidney
- ureteral obstruction
- benign prostatic hyperplasia
- bladder tumors
how is creatinine produced
produced by creatine phosphate dephosphorylation in skeletal muscle
what is creatinine dependent on
does it fluctuate
muscle mass
fluctuates very little daily
when is creatinine elevated
only elevated by renal disorders
affected a little by liver function
what rises first, BUN or creatinine
what does this suggest
BUN rises first, creatinine rises later and slower
since creatinine increases later it suggests a chronic problem
creatinine is increased in what conditions
- decreased renal function
- rhabdomylolysis
- gigantism/acromegaly
what is consisted in a basal metabolic proflile
glucose calcium sodium potassium chloride CO2 BUN creatinine
what is consisted in the comprehensive metabolic profile
basal metabolic profile renal function proteins liver function anemia lipids
what is basal metabolic profile used for
what is comprehensive metabolic profile used for
BMP - ER necessity
CMP - appropriate for the office setting
what test values are evaluated for renal function
BUN and creatinine
what test values are evaluated for protein
total protein
albumin
globulin
A/G ratio
what test values are evaluated for liver function
ALT - aka SGPT AST - aka SGOT ALP bilirubin indirect bilirubin LDH
what test values are evaluated for anemia
iron
TIBC
ferritin
what test values are evaluated for lipids
cholesterol
triglycerides
HDL
LDL
