Urinalysis (Coderes) Flashcards by Michaella Morano

Red quadrant in NFPA hazard classification:

Flammability hazard

How well did you know this?

Not at all

Perfectly

E in RACE:

Extinguish

How well did you know this?

Not at all

Perfectly

Glucose is reabsorbed in what part of the nephron?

PCT

How well did you know this?

Not at all

Perfectly

Urine odor in acute tubular necrosis (ATN):

Odorless

How well did you know this?

Not at all

Perfectly

Principle of automated reagent strip readers:

Reflectance photometry

How well did you know this?

Not at all

Perfectly

Reagents used in Split Fat Stain procedure:

Sudan III and 36% acetic acid

How well did you know this?

Not at all

Perfectly

Source of anti-hCG in pregnancy test kits:

Rabbit

How well did you know this?

Not at all

Perfectly

Renal stone — yellow, brown, greasy and resembles old soap:

Cystine

How well did you know this?

Not at all

Perfectly

Dilution of a slightly bloody CSF spx:

1:200

How well did you know this?

Not at all

Perfectly

Counting chamber used for undiluted semen spx:

Makler

How well did you know this?

Not at all

Perfectly

Spx in Diagnex tubeless (Diagnex blue) test:

Urine

How well did you know this?

Not at all

Perfectly

SG of 9% sucrose using refractometer:

1.034 (NaCl = 1.022; K2SO4 = 1.015)

How well did you know this?

Not at all

Perfectly

Bronchial asthma:

Dittrich’s plugs
Charcot leyden crystals
Curschmann’s spirals
Creola bodies

How well did you know this?

Not at all

Perfectly

Enzyme added to reduce viscosity of synovial fluid:

0.05% hyaluronidase

How well did you know this?

Not at all

Perfectly

Amniotic fluid test for HDN:

OD 450

How well did you know this?

Not at all

Perfectly

Tumor markers for urinary blood cancer:

NMP and BTA

How well did you know this?

Not at all

Perfectly

Mx that forms a halo of light around an object:

Phase contrast

How well did you know this?

Not at all

Perfectly

Centrifuges are calibrated every:

3 months

How well did you know this?

Not at all

Perfectly

Positive color in the MPS paper test:

Blue

How well did you know this?

Not at all

Perfectly

Precipitated with tyrosine crystals if alcohol is added to urine:

Leucine

How well did you know this?

Not at all

Perfectly

Part of nephron that resembles a sieve:

Glomerulus

How well did you know this?

Not at all

Perfectly

Renal threshold for glucose:

160 to 180 mg/dL

How well did you know this?

Not at all

Perfectly

Urine pH in renal tubular acidosis (RTA):

Alkaline

How well did you know this?

Not at all

Perfectly

Urine color in melanuria:

Brown

How well did you know this?

Not at all

Perfectly

SG range detected by urine reagent strip readers:

1.000 to 1.030

Ehrlich unit:

Urobilinogen

NV for albumin excretion rate (AER):

0 to 20 ug/min

Addis count — specimen and preservative:

12H urine; formalin

Oval fat bodies are seen in:

Nephrotic syndrome

Colorless needles that tend to form bundles following refrigeration:

Anpicillin

Anti-glomerular basement membrane Ab is seen in:

Good pasture syndrome

Crystal in Fanconi syndrom:

Cystine

Preservation of urine culture:

Refrigeration

Documentation of proper sample ID:

Chain of custody

11th pad:

Ascorbic acid (causes interferences in BB LNG: Blood, Bilirubin, Leukocytes, Nitrite, Glucose)

Least commonly encountered renal stone:

Cystine calculi

Precipitated with tyrosine crystals if alcohol is added to urine:

Leucine

Hands are not visibly soiled:

Alcohol based hand rub (sanitizer)

Chain of infection:

IREMES 1. Infectious agent 2. Reservoir 3. Exit portal 4. Mode of transmission 5. Entry portal 6. Susceptible host

Best way to break an infection:

Handwashing (Happy Birthday song 2x)

Biohazard symbol:

3 dark bordered circles joined together

NFPA symbol:

You (Yellow = Reactivity) Were (White = Specific) Born (Blue = Health) Right (Red = Flammability)

Yellow quadrant:

Reactivity/Stability (SUVSM)

Blue quadrant:

Health (NSHED)

Degree of hazards:

01234 = NSMSEx

Chemical spills:

Large amounts of water for 15 minutes

Fire:

``` RACE Rescue Actuvate Close Extinguish ```

Fire extinguisher:

``` PASS Pull Aim Squeeze Sweep ```

Type A fire:

Paper/word (ordinary combustibles) Extinguish with WATER

Type B fire:

Flammable liquid (B = basa) Extinguish with halon foam

Type C fire:

Electrical equipment (CURYENTE) Extinguish with halon (recommended)

Type D fire:

Flammable metals Extinguish with Metal X

Type E fire:

Arsenal fire Allowed to burn out

Type K fire:

Cooking media (KITCHEN) Extinguish with liquid

Type of fire for dry chemicals extinguisher:

Type A/B/C fire

Basic structural and functional unit of kidney:

Nephron

Renal blood flow:

1200 mL/min

Renal plasma flow:

600 to 700 mL/minute

Filtered plasma with 1.010 SG and (-) for albumin:

Glomerular filtrate

Non selective filter of glomerulus:

MW < 70 000 Da

First ti be affected in renal disease:

Tubular reabsorption

Major site of reabsorption:

PCT Reabsorbs SWAGU (salt, water, amino acids, glucose, urea)

Water reabsorption:

ADH/Vassoprein (prod. by hypothalamus, stored in post. pituitary gland)

Sodium reabsorption:

Aldosterone

ADH deficiency:

Diabetes insipidus

ADH excess:

SIADH

Renin acts on:

Angiotensinogen

ACE acts in:

Angiotensin I

Angiotensin II causes:

Vasoconstriction (⬆️ BP) | Release of ADH/Aldosteron (⬆️ Water/Salt reabsorption)

Used to evaluate GFR:

Clearance tests (Urea, Creatinine, Inulib, Cystatin C)

Used to evaluate tubular reabsorption:

Concentration tests (Fishbetg, Mosenthal, SG, Osmolality)

Creatinine clearance:

(UV/P)(1.73/A)

Gold standard for clearance tests:

Inulin

Cockgroft and gault variables:

Age, sex, and body weight in kg

MDRD variables:

Ethnicity, BUN, serum albumins

Concentration test wherein px is deprived of fluid for 24H:

Fishberg test (SG > 1.026)

Major organic component:

Urea

Major inorganic component of urine:

Chloride (Cl > Na > K)

Principal salt in urine;

NaCl

Bacterual culture spx for OPD:

Midstream clean catch

Bacterial culture for bed ridden px:

Catheterized spx

Three glass technique: | • If 3rd spx is 10x > than 1st spx

Prostatic infection

Three glass technique: | • 2nd specimen serves as

Control

Three glass technique: | • If all 3 specimens contain WBCs and bacteria

UTI

Urine spx for nitrite determination:

4H/first morning

Urobilinogen determination:

Afternoon urine spx (2 to 4 PM)

Drug specimen: | • urine volume

30 to 45 mL (60 mL container capacity)

Drug specimen: | • Temperatures within 4 minutes

32.5 to 36.7'C

Drug specimen: | • Prevent soeciment adulteration

Blueing agent

Increased in unpreserved urine:

``` pBaON pH Bacteria Odor Nitrite ```

Least affected urine parameter:

Protein

Disintegrates in alkaline urine:

Casts

Preservative that prevents bacterial growth for 24H:

Refrigeration

Bacteriostatic preservative:

Boric acid

Excellent sediment preservative; for addis count:

Formaldehyde

Used for urine cytology:

Saccomanno's fixative (50% ethanol + 2% carbowax); 50 mL urine

Polyuria:

> 2000 mL/24H DM (⬆️ SG due to glucose) DI (⬇️ SG due to dilution)

Oliguria:

<599 mL/24H Dehydration

Anuria:

<100 mL/24H

Nocturia:

>500 mL at night Pregnancy 🤰

Rough indicator of hydration:

Urine color

Major urine pigmenth:

Urochrome (yellow)

Deposits in AU and UA crystals:

Uroerythrin (pink)

Color of urobilinogen:

Colorless Brown when oxidized

Yellow foam / tea colored urine:

Bilirubin

Brown/black urine color upon air exposure:

Melanin

Few particulates, print easily seen:

Hazy

Many particulates, print blurred:

Cloudy

AP and carbonates:

Alkaline urine

RBCs, AP, carbonates:

Soluble in dilute acetic acid

AU, UA crystals:

Soluble with heat

Lipids, lymphatic fluid, chyle:

Soluble in ether

Fruit odor:

Normal urine odor:

Aromatic

Cabbage odor:

Methionine malabsorption

Rotting fish odor:

Trimethylaminuria

Pungent odor:

Asparagus due to methymercaptan

Odorless urine:

Acute tubular necrosis

SG > 1.040:

Radiographic dye

Urinometer correction: | • Below 20'C

-0.001

Urinometer correction: | • Above 20'C

+0.001

Correction for 1 g/dL glucose:

-0.004

Correction for 1 g/dL protein:

-0.003

SG of distilled water:

1.000

SG if 5% NaCl:

1.022

SG if 9% sucrose:

1.034

Yellow IRIS (harmonic oscillation):

2 mL (of 6 mL)

White foam in urine when shaken:

Protein

NV of albumin:

<159 mg/day for 24H

Temperature at which BJP precipitates and dissolves:

Precipitates at 40 to 60'C | Dissolves at 100'C

Test for microalbuminuria:

Micral test (EIA)

``` First morning (-) 2H after standing (+) ```

Orthostatic proteinuria

``` First morning (+) 2H after standing (+) ```

Clinical proteinuria

Negative SSA:

No inc. turbidty (<6 mg/dL)

Trace SSA:

Noticeable turbidity (6 to 30)

1+ SSA:

Turbidity (30 to 100)

2+ SSA:

Turbidity + grabulation (100 to 200)

3+ SAA:

Turbidity + granulation + flocculation (200 to 400)

4+ SSA:

Clumps (>400)

⬆️ Blood glucose | ⬆️ Urine glucose

Hyperglycemia assocuated

Normal blood glucose | ⬆️ urine glucose

Renal-associated due to impaired tubular reabsorption (Fanconi's syndrome)

Sensitivity of glucose reagent strip;

100 mg/dL

False (+) for glucose strip:

Oxidizing agents (detergents)

False (+) for copper reduction test (clinitest/benedict's):

Reducing agents (ascorbic acid)

False (-) for copper reduction test (clinitest/benedict's):

Oxidizing agents (detergents)

To prevent pass through phenomenon in Clinitest:

Use 2 gtts urine

Major ketone but not detected in reagent strip:

Beta-hydroxybutyric acid (78%)

Tablet test for ketones:

Acetest

Cloudy red urine:

Hematuria Glomerulonephritis

Clear red urine

Hemoglobinuria Seen in Intravascular hemolysis

Clear ted urine (reddish brown)

Myoglobinuria seen in rhandomyolysis

Differentiate Hgb vs Mgb:

Blondheim's test (Ammoniym sulfate)

Precipitated hgb + (-) blood strip:

Hemoglobin

Myoglobin in supernatang + (+) blood strip:

Myoglobin

Tablet test for bilirubin:

Ictotest

⬆️ UB (-) urine bilirubin (CB) 3+ urine urobilinigen

Prehepatic jaundice (EVH)

⬆️UB/CB -/+ urine bilirubin (CB) 2+ urine urobilinogen

Hepatic jaundice (liver damage)

⬆️CB 3+ urine bilirubin (CB) (-) urine urobilinigen

Posthepatic jaundice (bile duct obstruction = ❌ of Urobilinog n)

Watson-Schwartz Test: | • Soluble in chloroform + butanol

Urobilinogen (R: CB)

Watson-Schwartz Test: | • Insoluble in chloroform + butanol

Phorphobilinogen (R: UU)

Watson-Schwartz Test: • Inoluble in chloroform • Soluble in butanol

Other ehrlich reactive conpounds (R: UB)

Rapid screening test for phorphobilinogen:

Hoesch test (inverse ehrlich)

Interference contrast microscopy:

Can be adapted to BF Mx

Nomarski:

Differential

Hoffman:

Modulation

Differentiates WBCs and RTE cells:

Toluidine blue

Stains TAG and neutral fat, but NOT cholesterol:

Oil Red K + Suand III

IDs urinary eosinophils:

Hansel's stain (Eosin Y + Methylene blue)

Glitter cells (neutro) are seen in:

Hypotonic urine

RBC in hypertonic urine:

Crenate and shrink

RBC un hypotonic urine:

Swell and lyse

Dysmorphic, with projections, fragmented RBCs:

Glomerular membrane damage

Largest cell:

Squamous EC

Centrally located nucleus; | Seen following catheterization:

Transtional EC (Urothelial)

Most clinically significant cell with eccentric nucleus:

RTE cell

>2 RTE/HPF:

Tubular injury

Nonlipid filled RTE cell seen in acute tubular necrosis:

Bubble cell

Most frequent parasite encountered in urine:

T. vaginalis

Blood fluke with terminal spine that causes hematuria:

S. harmatobium

Bladder cancer:

NMP BTA CYFFA 21-1

Most common fecal contaminant:

E. vermicularis

Major constituent of casts:

Tamm Horafall protein (uromodulib)

Sequence of casts:

HCGW 1. Hyaline 2. Cellular 3. Granular (coarse, then fine) 4. Waxy 5. Broad*

Prototype cast:

Hyaline casts

Casts seen in strenuous exercise:

Hyaline cast RBC cast Granular cast

Casts seen in Glomerulonephritis:

Hyaline casts RBC cast Granular cast

Casts seen in pyelonephritis:

Hyaline cast | WBC cast

Cast NOT stained by Sternheimer-Malbin stain:

Fatty cast

Cast seen in nephrotic syndrome:

Fatty casts

Final degenerative form of all types of cast:

Waxy cast

Renal failure casts:

Broad casts

Brick dust / yellow brown granules / pink sediment crystal

Amorphous urates

Most pleomorphic crystal; lemon shaped:

Uric acid crystal

Crystal seen in ethylene glycol poisoning:

Monohydrate CaOx (whewelitte)

Envelope / pyramidal CaOx:

Dihydrate / Wheddelite CaOx

Cigarette butt appearance crystal

Calcium sulfate

Normal acidic crystals:

``` AU UA CaOx Ca sulfate Hippuric acid ```

Normal alkaline crystals:

``` AP Ammonium biurate Triple PO4 / Struvite Ca PO4 / Apatite Ca carbonate ```

White precipitate crystal

Amorphous phosphates

Thorny apples; seen in old spx:

Ammonium biurate

``` Crystal: Prism shaped Coffin lid Feathery appearance Fern leaf ```

Triple PO4 / Struvite

Flat plate, thin prism crystal | Resemble sulfonamide crystals:

Calcium PO4 / Apatite

All abnormal urine crystals are:

Seen in acidic urine

``` Yellow brown Soluble in ammonia Insoluble in HCl Birefringent (-) cyanide-nitro rxn ```

Uric acid crystal

Colorless Soluble in ammonia + HCl (+) cyanide-nitro rxn

Cystine crystal

Rectangular plates, with nocthed ends Staircase pattern Nephrotic syndrome

Cholesterol crystal

Similar to chole crystals:

Radiographic dye (SG > 1.024)

Colorless to yellow needles crystal:

Tyrosine crystal

Concentric circles and radial striations; | Precipitated with tyrosine after adding alcohol:

Leucine crystal

Needles/granules, bright yellow crystal:

Bilirubin crystal

Sheaves of wheat Petals Mistaken as CaPO4 crystal (+) Lignin test

Sulfonamide crystal

Colorless needle crystal:

Ampicillin

Crystals seen in liver disease:

Tyrosine, Leucine, Bilirubin crystals

Spheres with dimpled center; maltese cross:

Starch

Maltese cross formation:

OFFS Oval fat body Fatty casts Fat droplets Starch granules

⬆️ Amino acid in blood and urine

Overflow aminoaciduria: PKU, MSUD

Normal amino acid in blood | ⬆️ amino acid in urine due to tubular reabsorption

Cystinuria | Fanconi's syndrome

(-) Phenylalanin hydroxylase | Mousy odor

PKU

Bacillus subitilis + beta2-thienyalanine (+) Growth (-) NG

Guthrie Bacterial Inhibition test

Rancid butter odor of urine:

Tyrosinemia

(-) Homogentistic acid | Darkens after becoming alkaline

Alkaptonuria

Overproliferation of melanocytes | Darkens upon air exposure

Melanuria

⬆️Leucine, Isoleucine, Valibe | 2,4-DNPH test

MSUD

Sweaty feat odor:

Isovaleric acidemia

Renal type aminoaciduria due to defective tubular reabsoprtion of COLA (Cystine, Ornithine, Leucine, Arginine):

Cystinuria with sulfur odor urine

Inborn error of metabolism with cystine deposits:

Cystinosis

(-) Homocystine | (+) Ag nitroprusside

Homocystinuria

Mucopolysaccharide accumulate in cornea of eye | Skeletal abn + metal retardation

Hurler syndrome

Sex linked recessive | Skeletal abn + mental retardation

Hunter syndrome

Sanfilippo syndrome

Mental retardation only:

CTAB test:

(+) white turbidity

Lead poisoning urine color:

Colorless

CDc recommended test for lead poisoning:

FEP

Immune complexes | Group A Streptococcus (S. pyogenes)

APGN

Immune complexes Systemic immune disorder (SLE) Form crescents

Rapidly progressive (crescentic) glomerulonephritis

Anti-glomerular basement membrane Ab

Goodpasture syndrome

Anti-neutrophilic cytoplasmic auto-Ab (ANCA)

Wegener's grabulomatosis

⬇️ platelets ff. viral respi infxn

Henoch Schönlein Purpura

Thickening of glomerular basement membranr ff. IgG immune complexes deposition

Membranous glomerulonephritis

Cellular proliferation that forms tram tracks

Membranoproliferatuve glomerulonephritis

Marked decrease in renal function | Waxy and broad vasts

Chronic glomerulonephritis

Deposition if IgA

Berger'a disease

Disruption of electrical charges | Massive loss of proteins and lipids

Nephrotic syndrome

Disruption of podocytes in children

Nil disease

Disruption of podocytes in certain numbers and aread

FSGS

Most common cause of EARD | Deposition of glycosylated proteins

Disbetic nephropathu / Kimmelstiel-Wilson Dae

Lamellated and thinning of glomerular basement membrane

Alport syndrome

Damage to RT cells

Acute tubular necrosis

Lower UTI (bladder)

Cysititis

``` Upper UTI (renal tubules/interstitium) WBC casts ```

Pyelonephritis

Major constituent of renal calculi | Hard, dark, rough

Calcium oxalate calculi

Yellow to brown, moderately hard

Uric acid / Urate calculi

Greasy, old soap like | Least common

Cystine calculi

Pale friable stone

Phosphate calculi

Branching or staghorn shaped in urinary infections

Triple PO4 calculi

Conditions favoring the formation of renal calculi:

pH Chemical composition Urinary stasis

Primary urinalysis finding in renal lithiasis:

Microscopic hematuria

Conditions favoring the formation of renal calculi:

pH Chemical composition Urinary stasis

Primary urinalysis finding in renal lithiasis:

Microscopic hematuria