Urinalysis DIAL Flashcards

1
Q

What are the 7 test on a standard dipstick?

A
Glucose
Ketones
Leukocyte esterase
Nitrate
pH
Protein
Specific gravity
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2
Q

What are the 3 components of a normal urinalysis?

A

Physical examination
Chemical examination
Microscopic examination

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3
Q

How is a proper urinalysis sample collected?

A

Clean genitals
Do a mid-stream catch
Do not let sit for longer than 1 hour

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4
Q

Glucose positive implications?

A

Diabetes mellitus

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5
Q

Ketone positive implications?

A

Diabetic ketosis

Starvation

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6
Q

Leukocyte esterase positive implications?

A

WBC presence either as whole or lysed cells UTI

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7
Q

Leukocyte esterase negative implications?

A

No UTI and further microscopic and or urine culture is not necessary

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8
Q

Nitrate positive implications?

A

Indicates that bacteria may be present in significant numbers

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9
Q

What bacteria will cause a positive nitrate test?

A

Gram negative rods such as E. coli

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10
Q

Protein positive implications?

A

Nephrotic syndrome

Nephritic syndrome

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11
Q

Specific gravity implications?

A

Determined by presence of solutes and directly proportional to urine osmolality

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12
Q

Significance of bilirubin in the urine?

A
Liver dysfunction 
Biliary obstruction
(large amounts of soluble conjugated bilirubin can enter blood then filter)
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13
Q

Significance of urobinogen in the urine?

A

Hepatitis
Hemolytic anemia
(liver cannot uptake all of the urobinogen due to dysfunction in hepatitis or overwhelmed in anemia)

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14
Q

What can urine sodium values tell you?

A

Hypervolemia
Edema
Hyponatremia

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15
Q

What would low urine sodium levels tell you?

A

Early obstruction uropathy

Oliguria of acute glomerular nephritis

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16
Q

What would high urine sodium levels tell you?

A

Diuretics
Emesis
Hypothyroidism
Syndrome of inappropriate antidiuretic hormone (SIADH)

17
Q

What can urine potassium levels tell you?

A

Hypokalemia

18
Q

What can cause low urine potassium levels tell you?

A

Significant decrease in serum plasma potassium over several days

19
Q

What do high urine potassium levels tell you?

A

Hyperaldosteronism

20
Q

How is a urine specimen prepared and examined microscopically?

A

10-15 mL centrifuged for 5-10 minutes decant the supernate leaving .2-.5 mL with the sediment, take sediment and resuspend pour it onto a glass slide and coverslip it

21
Q

What does the presence of dysmorphic RBCs in the urine tell you? Why?

A

Glomerulonephritis

Odd shaped because they squeeze through glomerular structure

22
Q

Renal tubular epithelial cells in urine:

A

Nephrotic syndrome

Smaller than TECs

23
Q

Ovoid fat bodies in urine:

A

Endogenous fats droplets

Maltese cross when seen under polarized light microscopy

24
Q

Transitional epithelial cells in urine:

A

Renal pelvis, ureter or bladder

Large nuclei

25
Squamous cells in urine:
Possible contamination of specimen with skin flora
26
Where are casts formed?
Distal convoluted tubule | Collecting duct
27
How are urinary casts formed?
Tamm-Horsfall protein (Mucoprotein) secreted in the TAL, DCT is glue that holds constituents together
28
Hyaline casts:
Protein cast with long, thin tails formed at TAL DCT junction
29
RBC casts:
Glomerulonephritis or severe tubular damage
30
WBC casts:
Acute pyelonephritis Glomerulonephritis Inflammation of kidney
31
Granular or waxy casts:
Cellular casts remain in the nephron for some time before they are flushed into the bladder urine, the cells may degenerate to become a coarsely granular cast, later a finely granular cast, and ultimately, a waxy cast
32
Broad casts:
From damaged and dilated tubules seen in end-stage chronic renal disease
33
Common crystals seen in healthy patients?
Calcium oxalate Triple phosphate Amorphous phosphates
34
Uncommon crystals seen in patients?
Cystine Tyrosine Leucine
35
Where are cystine crystals found?
Neonates with congenital cystinuria or severe liver disease
36
Where are tyrosine crystals found?
Congenital tyrosinosis or marked liver impairment
37
Where are leucine crystals found?
Severe liver disease or MSUD