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CLP 303 > Urinalysis Clinical Significance and Findings (From MTS Module) > Flashcards

Urinalysis Clinical Significance and Findings (From MTS Module) Flashcards

1
Q

What is the most common type of WBC found in urine sediment?

A

Neutrophil

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2
Q

WBC’s enter the urinary system through the ________

A

Glomerulus

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3
Q

When abnormal numbers of WBC are present, the sample will appear _______

A

cloudy

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4
Q

If a sample contains only Lymphocytes, the Leukocyte pad on the dipstick will show ______

A

negative

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5
Q

The _____ of the urine impacts the appearance of RBC

A

Concentration

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6
Q

RBC may be present due to:

A
  1. Injury of Urinary Tract

2. Disease of Urinary Tract

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7
Q

In concentrated urine, RBC’s crenate due to the process of:

A

The cell losing water and shrinking, becomes covered with small spiny projections

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8
Q

In dilute urine, RBCs absorb water and what happens next?

A

The cell swells and loses its Hemoglobin, becomes a Ghost RBC

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9
Q

When significant numbers of RBC are in urine, the sample will appear _________ in colour and ______ (clarity)

A

Red/brown, Cloudy

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10
Q

True or False: Even lysed RBCs will produce a positive dipstick for Blood

A

True

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11
Q

RBC’s in large numbers can be a sign of what 2 diseases?

A

Glomerulonephritis or Malignancy of Kidney/Bladder

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12
Q

What is the origin of Squamous Epithelial Cells?

A

Male: Distal third of urethra
Female: All of the urethra and vaginal tract

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13
Q

True or false: Transitional Epithelial Cells can absorb water and appear larger than normal

A

True

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14
Q

What is the original of Transitional Epithelial Cells?

A

Line the renal pelvis, ureters, bladder and proximal urethra

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15
Q

In large numbers, Transitional Epithelial Cells indicate:

A

Infection or Inflammation of the Urinary Tract

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16
Q

True or False: If Transitional Epithelial Cells appear abnormal, it is not clinically significant.

A

False. Abnormal looking TEC are indicative of disease

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17
Q

Casts are formed in the ______ and ______

A

Distal tubules and Collecting ducts

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18
Q

Protein fibrils may form and attach to tubular walls forming a cast in the presence of what 3 things?

A

Concentrated urine, decreased urine output and acidic pH

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19
Q

True or False: Anything inside the tubular lumen at the time of cast formation can be incorporated into the cells

A

True

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20
Q

Casts will produce a positive dipstick pad for:

A

Protein

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21
Q

T or F: Hyaline casts are commonly seen due to Stress

A

True

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22
Q

T or F: Increased numbers of casts are seen in all diseases of the kidney and are indicative of kidney disease

A

False. Casts are seen in all diseases of the kidney, but are not indicative of renal disorder

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23
Q

Granular casts may be formed by the degeneration of ________

A

Cellular casts

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24
Q

T or F: Granular Casts and Cellular Casts usually go hand in hand

A

True

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25
Q

T or F: If a WBC or RBC cast does not have a distinct border surrounding the cells, it is still considered a RBC or WBC Cast

A

False. Without a distinct border, it is only a clump of cells

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26
Q

WBC casts are indicative that the free WBCs originated in the _______

A

kidney

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27
Q

T or F: RBC can enter the nephron through a healthy Glomerulus

A

False. RBC enter the nephron through a damaged glomerular membrane or injury to the renal tubule

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28
Q

A RBC Cellular cast will produce a positive dipstick for what 2 things?

A

Protein and Blood

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29
Q

T or F: RBC Casts are the most diagnostic of all elements in urinary sediment

A

TRUE

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30
Q

The presence of RBC Casts in urine sediment is always _________

A

Pathological

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31
Q

RBC Casts are primarily indicative of an acute disorder of the _______

A

Glomerulus

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32
Q

Waxy Casts represent the last stage in the degeneration of _________

A

Hyaline, Granular or Cellular casts

33
Q

Waxy Casts form when the flow of urine is ______

A

decreased or slow

34
Q

Waxy Casts are indicative of _______ disease

A

End Stage Renal Disease

35
Q

Fatty Casts are usually associated with _______ (disease)

A

Nephrotic Syndrome

36
Q

What is the ideal chemical property of Calcium Oxalate crystals?

A

Acidic or Neutral

37
Q

________ is the major component of kidney stones in adults

A

Calcium Oxalate

38
Q

Calcium Oxalate Monohydrate are also seen in ________ poisoning

A

Ethylene Glycol

39
Q

What is the ideal chemical property of Struvite crystals?

A

Alkaline only

40
Q

T or F: Struvites in urine are always normal.

A

False Can be associated with Kidney disease

41
Q

What is the ideal chemical property of Calcium Carbonate crystals?

A

Alkaline only

42
Q

T or F: Ammonium Biurate presence indicated disease

A

False. Usually normal or poorly preserved sample

43
Q

Bilirubin is associated with several ______ disorders

A

Hepatic

44
Q

T or F: Bilirubin is always found single, on its own

A

False. It is often adhered to surfaces of cells or dissipating through casts

45
Q

The ideal chemical property of Cholestrol crystals is:

A

Acidic only

46
Q

Cholsterol crystals are often accompanied by a positive dipstick for _____

A

Protein

47
Q

Cholesterol crystals are often associated with _______ (disease)

A

Nephrotic Syndrome

48
Q

The description best fits which Crystal:

Colourless, thin, hexagonal plates found in Acidic Urine, Often stacked on top of each other, Often cracked

A

Cystine crystals

49
Q

Cystine crystals are found in the inherited condition:

A

Cystinuria

50
Q

______ are the most frequent cause of kidney stones in (human) children

A

Cystine

51
Q

Crystals often following antibiotic use are called

A

Sulfonamide

52
Q

Sulfonamide crystals are sometimes associated to what disease?

A

Kidney stones

53
Q

Name 3 urine artifacts of little or no clinical significance

A
  1. Fiber
  2. Mucus
  3. Starch crystals
54
Q

The most common bacterial causes of Urinary Tract Infection are _________

A

Gram Negative Rods

55
Q

Gram negative rods produce a dipstick positive for _____

A

Nitrate

56
Q

Presence of bacteria in a fresh sample may indicate infection of the ______ or ______, especially if WBC are present too

A

Kidney, Lower Urinary Tract

57
Q

If WBC are not present, large amounts of bacteria may indicate ______

A

poor sample handling

58
Q

Long, snake like bacterial rods are called ______ and are commonly seen in vaginal contamination

A

Lactobacillus

59
Q

______ is the most common cause of UTI in immunocompromised or diabetic patients

A

Yeast

60
Q

2 things that cause air bubbles in sediment:

A
  1. Sample mixed too vigorously

2. Drop of sediment is unevenly distributed

61
Q

Starch Crystals most commonly come from:

A

Latex powdered gloves

62
Q

What is Glomerulonephritis?

A

Renal disorder characterized by inflammation and damage to glomeruli

63
Q

What are 3 things you would expect to find in urine sediment from a patient with ACUTE Glomerulonephritis

A
  1. Positive dipstick for protein and blood
  2. RBC and WBC
  3. RBC Casts, Hyaline and Granular Casts
64
Q

What are 3 things you would expect to find in urine sediment from a patient with CHRONIC Glomerulonephritis

A
  1. Positive dipstick for Protein and Blood
  2. RBC and WBC
  3. Granular and Waxy casts
65
Q

Define Nephrotic Syndrome

A

Increased permeability of the glomerulus and simultaneous clinical findings such as decreased levels of protein in the blood, increased levels of fat in the blood and edema

66
Q

Define Pylonephritis

A

Acute or chronic infection of the Upper Urinary Tract involving tubules or pelvis of kidney

67
Q

Pylonephritis (infection of Upper Kidney) will produce a positive dipstick for what 3 things:

A

Protein, Leukocytes and Nitrate (if the bacteria creates Nitrite)

68
Q

Define Acute Tubular Necrosis

A

Destruction of the renal tubular epithelial cells due to reduced blood flow or a toxic insult

69
Q

T or F: Kidney damage as a result of End Stage Renal Disease is often reversible

A

False. It is irreversible

70
Q

Chronic Renal Failure/End Stage Renal Disease is defined as:

A

Progressive loss of renal function

71
Q

A fixed specific gravity of 1.010 is an indicator of what disease

A

Chronic Renal Failure/End Stage Renal Disease

72
Q

Lower Urinary Tract Infection includes Infection of the:

A

Urethra (urethritis) or Bladder (cystitis)

73
Q

80% of Lower Urinary Tract Infections are caused by _________ bacteria

A

E. Coli

74
Q

Kidney Stones are also called _____

A

Calculi

75
Q

______ % of Renal Calculi (Kidney Stones) contain Calcium Oxalate

A

70-80%

76
Q

Renal Calculi containing cystine are associated with the inherited disorder _______

A

Cystinuria

77
Q

The presence of RBC’s without any other abnormal findings may be early indication of ________

A

Bladder Cancer

78
Q

Abnormal transitional epithelial cells are indicative of _____

A

Bladder Cancer

CLP 303 (6 decks)

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