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Nephrology / Urology > Urinalysis - More than you ever wanted to know about pee. No, seriously. > Flashcards

Urinalysis - More than you ever wanted to know about pee. No, seriously. Flashcards

1
Q

Urine needs to be looked at within what period of time?

A

1 hour

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2
Q

What are 3 methods for urine collection?

A
  1. midstream clean catch
  2. catheterization
  3. suprapubic bladder aspiration
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3
Q

What’s one thing that indicates you did NOT get a clean catch?

A

squamous cells present in urine

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4
Q

What should be the timing/specifics for a urine collection for:

screening, evaluation for infection

A

random midstream clean catch

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5
Q

What should be the timing/specifics for a urine collection for:

pregnancy

A

first morning urine

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6
Q

What should be the timing/specifics for a urine collection for:

glucose testing/DM monitoring

A

2 hr post-prandial

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7
Q

What should be the timing/specifics for a urine collection for:

gestational diabetes

A

glucose tolerance test + blood samples

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8
Q

What should be the timing/specifics for a urine collection for:

protein

A

24 hr collection

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9
Q

What should be the timing/specifics for a urine collection for:

bacterial culture

A

catheterization

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10
Q

What should be the timing/specifics for a urine collection for:

prostatic infection

A

three-glass collection

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11
Q

What should be the timing/specifics for a urine collection for:

bladder urine for bacterial culture

A

suprapubic aspiration

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12
Q

orange urine

A

pyridium

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13
Q

green urine

A

pseudomonas

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14
Q

pink/red

A

RBCs, hemoglobin, myoglobin

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15
Q

Normal urine pH

Average urine pH

A

Normal: 4.5 - 8.0

Average: 5.0 - 6.0

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16
Q

What happens to the pH of urine as it stands around on your lab counter?

A

becomes more alkaline

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17
Q

What is the significance of a urine pH of 9?

A

Urine never gets to pH of 9. Means you need to re-do the test.

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18
Q

Acidic urine or alkaline urine?

UTI with E. coli

A

acidic

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19
Q

Acidic urine or alkaline urine?

starvation, DKA

A

acidic

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20
Q

Acidic urine or alkaline urine?

Proteus or Pseudomonas

A

alkalotic

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21
Q

Acidic urine or alkaline urine?

CKD

A

alkalotic

22
Q

Range of values of specific gravity

A

1.005 - 1.030

23
Q

specific gravity is usually (directly, inversely) related to amount of urine produced

A

inversely

low urine volume, high specific gravity

high urine volume, low specific gravity

24
Q

Dilute urine has a (high, low) specific gravity

A

low

25
Q

High or low specific gravity?

diabetes insipidus

A

low

26
Q

High or low specific gravity?

DM

A

high

27
Q

High or low specific gravity?

CHF

A

high

28
Q

What biochemical marker is used to monitor DM?

A

ketones

29
Q

What biochemical marker could be used in hemolytic anemia?

A

urobilinogen - increased

30
Q

What biochemical marker would be decreased if bile ducts are obstructed?

A

urobilinogen - decreased

31
Q

What is the main cause of glycosuria?

A

DM

32
Q

What protein is checked for in a standard urinalysis?

A

albumin

33
Q

What level of protein in the urine has a 90% sensitivity for significant renal injury?

A

3+ / 300 mg/dL

34
Q

Proteinuria > 2000mg/24hrs usually indicates what?

A

glomerular problem

35
Q

Proteinuria > 3500mg/24 hrs usually indicates what?

A

nephrotic syndrome

36
Q

What is the difference between hemoglobinuria and hematuria?

A

Hemoglobinuria: when conditions outside the urinary tract results in extensive destruction of erythrocytes -> hemoglobin is filtered through glomerulus

Hematuria: whole RBCs

37
Q

What if urine is cherry red but no RBCs are found in urine?

A

myoglobinuria

38
Q

What is the usefulness of leukocyte esterase?

A

It is useful if tested in conjunction with nitrites - if both leukocyte esterase and nitrites are present, highly sensitive and specific for UTI

39
Q

What is the downside to nitrites being useful in diagnosing UTI?

A

Bacteria need time to produce the nitrites - urine needs to sit in the bladder for a few hours….but if you have a UTI you probably have urinary frequency!

40
Q

What if you see DYSMORPHIC RBCs?

A

glomerular problem!

41
Q

What is this and what does it signify?

A

Red cell casts.

Usually means glomerulus involvement.

CURRENT 2014

42
Q

What is this and what does it signify?

A

Renal tubular epithelial cell cast seen in renal tubular injury.

CURRENT 2014

43
Q

What is this and what does it signify?

A

Pigmented granular cast seen in acute tubular necrosis.

CURRENT 2014

44
Q

What is this and what does it signify?

A

Hyaline cast - notice the parallel sides, tubular shape with rounded edge, and colorless appearance. (Univ. of Delaware)

May occur normally after exercise, or may be pathologic.

45
Q

What is this and what does it signify?

A

Red cell casts.

Usually means glomerulus involvement.

PKM lecture

46
Q

What is this and what does it signify?

A

White cell casts

  • May form in the presence of acute infectious process of the kidney such as pyelonephritis
  • Inflammatory disorders such as lupus nephritis or interstitial nephritis may also cause white cell cast formation

PKM lecture

47
Q

What is this and what does it signify?

A

Waxy cast - broad, brittle, and irregularly shaped

STASIS in the tubules…anuric or oliguric

PKM lecture

48
Q

What are these and what do they signify?

A

Triple phosphate crystals

coffin lid shape

Can form when urine sits around on the counter

Also may indicate infection with a urea-splitting organism like Proteus (not common)

PKM lecture

49
Q

What are these and what do they signify?

A

Oxalate crystals

double pyramid

In abundance, may mean ethylene glycol poisoning

PKM lecture

50
Q

What are these and what do they signify?

A

Uric acid crystals

Variety of shapes and colors

Leukemia, gout, other stuff

PKM lecture

51
Q

What are these and what do they signify?

A

Cystine crystals

hexagon shape

cystinuria

52
Q

What are these and what do they signify?

A

Tyrosine crystals

significant liver disease

PKM lecture

Nephrology / Urology (17 decks)

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