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Intro To MLT > Urinalysis and Body Fluids Exam 1 > Flashcards

Urinalysis and Body Fluids Exam 1 Flashcards

1
Q

Two dominant manifestations of acute glomerulonephritis and give examples of various causes of this condition:

A
  1. Proteinuria ex. streptococcal infection
  2. Hematuria with RBC casts
    i. e streptococcal infection, immune complex diseases.
    * chronic glomerulonephritis is a slow progressing disease.
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2
Q

What are two clinical manifestations of acute tubular necrosis and what is it often associated with:

A

Manifestations: -decreased urine flow
-inability to produce urine
-loss of many tubular epithelial cells into
urine
Often associated with reduced blood supply to renal tubes.

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3
Q

3 manifestations of nephrotic syndrome

A
  1. proteinuria
  2. Hypoproteinemia (low protein in blood)
  3. edema (fluid retention)
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4
Q

common causes of urinary obstruction

A
  • stones
  • tumors
  • congenital malformation
  • stricture from infection
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5
Q

explain pyelonephritis

A

severe kidney infection that often originates from a bladder infection.

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6
Q

What are 2 main clinical findings in urine that may indicate diabetes mellitus and what would you expect to see in regards to SG

A 
Glucose (glycosuria) 
Ketone bodies (ketonuria)

Both high SG/high volume

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7
Q

Unconjugated Bilirubin

A

Not found in the urine. Travels to the liver where it is separated from albumin and is insoluable in water.
i.e. free or indirect

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8
Q

Conjugated Bilirubin

A

Conjugated in the liver by esterfication with glucuronic acid. water soluble.
i.e. direct bilirubin and bilirubin diglucronide

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9
Q

Urobilinogen

A

conjugated bilirubin travels to the bile duct to the small intestine. 99.9% excreted into feces. Absorbed into the intestinal mucosa and travels back to the liver.

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10
Q

Healthy patient bilirubin and urobilinogen

A

bilirubin-negative

urobilinogen- normal or decreased

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11
Q

Hemolytic disease bilirubin and urobolinogen

A

bilirubin- negative

urobolinogen-normal or increased

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12
Q

Hepatic Disease bilirubin and urobolinogen

A

bilirubin- positive or negative

urobolinogen-normal or increased

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13
Q

Biliary obstruction bilirubin and urobolinogen

A

bilirubin- positive

urobolinogen- low or absent

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14
Q

PKU

A

Lack phenylalanine hydroxylase for the conversion of phenylalanine to tyrosine
Phenylalanine accumulates and it’s metabolite phenylpyruvic acid appears in the urine
mousy odor
*phentest = dark green/blue green color

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15
Q

alkaptonuria

A

-Lacks homogenistic acid oxidase. Homogenistic acid accumulates in the blood and body fluids and is found in urine.
-urine darkens upon standing
Occurs in middle-age
*clinitest-orange

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16
Q

maple syrup disease

A

Lacks enzyme needed in branched-chain amino acid metabolism. Excessive accumulation of valine, leu one, insole icons and their keto & hydroxy acid in urine, blood, CSF. Causes keto acidosis, vomiting, seizure and lethargy.
*acetest-purple
urine smells like burnt sugar

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17
Q

Fanconi’s syndrome

A
  • proximal convuluted tuble function is impaired

- failure to reabsorb glucose, water, phospurus, potassium and calcium

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18
Q

cystinuria

A

-cystine crystals in the urine
-inability of renal tubes to reabsorb cystine as well arginine, lysine and ornithine due to inherited trait.
Frequent cystine calculi(stones)

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19
Q

galactosemia

A

-lack of enzyme necessary to convert galactose to glucose
-detected in early infancy as diarrhea, vomiting and failure to thrive occurs
Positive on clinitest and negative on dip stick for glucose.

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20
Q

Define hematuria and name some conditions that may cause it:

A

presence of an abnormal # or RBC’s which often accompanies disease or the urinary system

  • glomarular disease
  • tubular disease
  • vascular disease
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21
Q

Physical changes that occur as urine specimen remains at room temperature

A
  • color darkens or changes
  • clarity decrease
  • odor-foul smelling
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22
Q

Chemical changes that occur as urine specimen remains at room temperature

A

pH-increase urobilinogen-decrease
glucose-decrease nitrates-increase
-ketones-decrease
bilirubin-decrease

23
Q

Microscopic changes/cellular changes that occur as urine specimen remains at room temperature

A

blood cells-decrease
casts-decrease
bacteria-increase
thichomonads- decrease

24
Q

state the time limit for examination of urine specimens held at room temerature

A

no longer than an hour

25
Q

Explain what addis count is used for, the duration of the collection,and the preferred status of the urines pH and concentration.

A
  • used to follow renal disease
  • 12 hr. over night period
  • low pH high concentration
26
Q

Define catheterization and suprapubic aspiration and state when and on what patients each is used.

A
  • Catheter-insert a sterile catheter through the urethra into the bladder.
  • used on elderly, immoblile patients and pediatrics.
  • Suprapubic aspiration- using sterile needle and syringe the abdominal wall is punctured and urine is aspirated from the bladder.
  • used when an individual can NOT pas urine
27
Q

Name three characteristics of urine routinely recorded in the physical examination of urine:

A
  • color
  • clarity
  • odor
28
Q

Identify the urine preservative in each of the following descriptions

A

a. gives a false positive for albumin in a protein precipitation(turbidity) test *thymol
b. best for the preservation of bacteria
* Refrigeration
c. preserves the cellular elements *formalin

29
Q

Name the reactions of the Multisitix for which time is not critical and state the total time required to read all reactions of the Multistix.

A

Protein and pH can be read after the others ones needing to be read at 60 secs. Total time required is 2 mins.

30
Q

List the ten tests performed in the chemical analysis of urine.

A
  • glucose
  • ketones
  • bilirubin
  • SG
  • nitrate
  • uribiliogen
  • blood
  • protein
  • pH
  • Leucocyte
31
Q

State the abnormal colors of urine and state a cause for the colors

A 
amber-excessive urobilinogen/billirubin
pink/red-blood
brown-myoglobin
blue/green infection UTI
Orange food or drugs
32
Q

List the constitutes of urine that may cause a cloudy appearance:

A
  • Increased WBC’s
  • Increased bacteria
  • mucus
  • amorphous
  • crystals
33
Q

What may cause large amounts of white or yellow foam in the urine when shaken?

A

white=protein

yellow=bilirubin

34
Q

Correlate abnormal odors of urine with their cause:

A

Sweet-ketone production
pungent, fetid-UTI
burnt sugar- maple syrup disease
PKU- mousy odor
rancid tyrasinemia

35
Q

state the specific gravity range of normal urine

A

1.002-1.030

36
Q

State the type of urine container and/or urine specimen the following tests should be collected in:

A

a. urine culture-sterile or clean catch
b. overall patient health-random collection
c. Addis count-12 hr overnight period
d. postprandial urine-2-3 hrs after eating
e. protein-morning
f. GFR(glomerular filtration rate or renal clearance)-24 hr
g. glucose (quantitative)-24 hr

37
Q

name the 3 substances that might be present in urine that may cause high specific gravity readings

A

protein
glucose
radio graphic dyes

38
Q

Define refractive index

A

Ratio of the velocity of light and air to the velocity of light in the solution

39
Q

Define osmolality

A

Expresses concentration as the # of solutes present.

Not concerned with large heavy molecules.

40
Q

Define specific gravity

A 
# of solutes per volume of solution
Concerned with the size of molecules
41
Q

name the two constituents urine contribute the most to its specific gravity

A

Sodium chloride and uria

42
Q

Name one condition that may be responsible for an abnormally low specific gravity

A

Diabetes insipidus

43
Q

Oliguria

A

Decreased urine excretion less than 400mL/day
-related to obstruction, infection and dehydration
Volume low SG high

44
Q

Anuria

A

no urine excreted

Obstruction, tumor,

45
Q

hyposthenuria

A

urine can not be concentrated due to lack of water absorbtion. Has low specific gravity
-diabetes insipidus

46
Q

polyuria

A

increased urine

  • diabetes mellitus, drugs and renal disease being the cause
  • more than 3L/day
47
Q

nocturia

A

increased urine at night

Kidney disease

48
Q

isosthenuria

A

fixed SG at 1.010 unable to concentrate or dilute urine

- chronic renal disorders

49
Q

hypersthenuria

A

high SG and increased urine flow

  • nephrotic syndrome with proteinuria and dehydration
  • diabetes mellitus with glycoseria
50
Q

state the cause of refrigerated urine specimens becoming cloudy

A

Increased amorphous crystals

51
Q

name a property that is utilized in the determination of urine osmolality

A

freezing point

52
Q

state the normal volume of urine excreted by the average adult in a 24 hr. period

A

600-1800mL normal urine

1200mL-1500mL average

53
Q

Correlate the color of urine to whether the urine is dilute of concentrated, i.e. fluid intake

A

*colorless-yellow-dilute-high fluid intake or increased urine excretion due to diabetes normal
*dark yellow-concentrated-related to low fluid intake or dehydration
Most concentrated is 1st morning urine

Intro To MLT (4 decks)

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