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Urinary Exam 2 > Urinalysis DIAL > Flashcards

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
Q

Squamous cells in urine:

A

Possible contamination of specimen with skin flora

26
Q

Where are casts formed?

A

Distal convoluted tubule

Collecting duct

27
Q

How are urinary casts formed?

A

Tamm-Horsfall protein (Mucoprotein) secreted in the TAL, DCT is glue that holds constituents together

28
Q

Hyaline casts:

A

Protein cast with long, thin tails formed at TAL DCT junction

29
Q

RBC casts:

A

Glomerulonephritis or severe tubular damage

30
Q

WBC casts:

A

Acute pyelonephritis
Glomerulonephritis
Inflammation of kidney

31
Q

Granular or waxy casts:

A

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
Q

Broad casts:

A

From damaged and dilated tubules seen in end-stage chronic renal disease

33
Q

Common crystals seen in healthy patients?

A

Calcium oxalate
Triple phosphate
Amorphous phosphates

34
Q

Uncommon crystals seen in patients?

A

Cystine
Tyrosine
Leucine

35
Q

Where are cystine crystals found?

A

Neonates with congenital cystinuria or severe liver disease

36
Q

Where are tyrosine crystals found?

A

Congenital tyrosinosis or marked liver impairment

37
Q

Where are leucine crystals found?

A

Severe liver disease or MSUD

Urinary Exam 2 (16 decks)

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