urinalysis review Flashcards
kidney cells
renal tubular epithelial cells
ureter + bladder cells
transitional epithelial cell
urethra cells
squamous epithelial cell
order of the nephron
bowman’s capsule
proximal convulated tubule
descending loop of henle
ascending loop of henle
distal convuluted tubule
collecting duct
neutrophils %
50-70%
lymphocyte %
20-44%
monocyte %
2-9%
band neutrophils
2-6%
eosinophil %
0-4%
basophil %
0-2%
leukocyte ->
inflammation of urinary track
nitrite ->
UTI - Bacteria that reduce nitrate
urobilinogen ->
prehepatic or hepatic conditions
protein ->
defective glomerular filtration barrier
pH ->
renal tubular absorption/secretion problem
blood ->
hematuria
hemoglobinuria
myeloglobinuria
specific gravity ->
low: diabetes insipidus
high: adrenal insufficiency, hepatic disease, congestive heart failure, dehydration
ketone ->
diabetes mellitus; inadequate intake/loss of carbohydrates
bilirubin
hepatic or post hepatic conditions
glucose
diabetes melltius, hormone disorders, end stage renal disease
hematuria
presence of intact RBC
hemoglobinuria
presence of free hemoglobin - indicates RBC lysis
myoglobinruia
presence of myeoglobin indicates muscle destruction
example of hematuria
- renal calculi
- glomerulonephritis
- pyelonephritis
- tumors
- trauma
- exposure to toxic chemicals
- anticoagulants
- strenous excercise
example of hemoglobinuria
- transfusion reactions
- hemolytic anemias
- severe burns
- infections/malaria
- strenous excercise
- brown spider bite
bilirubin
prehepatic
hepatic
posthepatic
normal
increased
increased
urobilinogen
pre hepatic
hepatic
post hepatic
increased
increased
normal/absent
prehapatic conditions
- hemolysis
- drugs and toxins
- thalassemia
- hemoglobinopathies
hepatic conditions
cirrhosis
viral hepatitis
toxic hepatitic
intrahepatic cholestasis
post hepatic conditions
biliary obstruction
gallstones
tumors of the bile duct
pancreatic carcinoma
protein confirmatory test
sulfosalicylic acid precipitation test
specific gravity confirmatory test
refractometer
ketone confirmatory test
acetest
bilirubin confirmatory test
icotest
glucose confirmatory test
copper reduction test (clinitest)
RBC
- hypertonic crenated
- isotinic normal biconcave
- hypotonic ghost
glomerulus damage, vascular injury, malignancy in urinary tract, kidney stones, menstrual contamination
WBC
bacterial infections (neutrophil); renal transplant rejections (eosinophil/mononuclear); drug induced interstitial nephritis (eosinophil)
squamous epithelial cell
normal
transitional epithelial cell
normal, catherization, malignancy, viral infection
renal tubular epithelial cells
renal tubular injury, tubular necrosis
oval fat bodies
nephrotic syndrome, tubular necoris s
diabetes mellitus, traume with BM release
Cast formation
- Uromodulin (tamm horsfall protein), is excreted by RTE cells of the distal convulated tubule and upper collecting duct
- other proteins in the ultrafiltrate join the matrix
- protein matrix “gels” more readily in cases of urine flow stasis, acidity, and the presence of sodium ad calcium
- types are based on what the “gel” catches as it solidifies
hyaline cast
glonerulonephritis, pyelonephritis, chronic renal disease, congestive heart failure, stress and excercise
RBC cast
gomerulonephritis, strenous excercise
WBC cast
pyelenopgritis, actute interstitial nephritis
bacterial cast
pyelonephritis
epithelial cell cast
renal tubular damage
granular cast
glomerulonephritis, pyelonephritis, stress and excercise
waxy cast
stasis of urine flow, chronic renal failure
fatty cast
nephrotic syndrome, toxic tubular necrosis, diabetes mellitus, crush injury
broad cast
extreme urinary stasis, renal failure
normal crystals
- uric acid
- amorphous urates
- calcium oxalate
- amorphous phosphates
- calcium phosphatee
- triple phosphate
- ammonium biruate
- calcium carbonate
uric acid
normal
chemotherapy, lesch-Nyhan, gout
amorphous urates
normal
none, sample refrigeration
calcium oxalate
normal
antifreezing poisoning, kidney stones, high oxalic acid diet
amorphous phosphates
none, sample refrigeration
calcium phosphate
normal
none
triple phosphate
normal
none
ammonium biurate
none
old sample
calcium carbonate
normal
none
abnormal crystals
- cysteine
- cholesterol
- leucine
- tyrosine
- bilirybin
- sulfonamides
- radiographic dye
- amphicillin
cystine
abnormal
cystinuria
cholesterol
abnormal
nephrotic syndrome
leucine
abnormal
liver disorder
tyrosine
abnormal
liver disorder, AA metabolism disorder
bilirubin
abnormal
liver disorders
sulfonamides
abnormal
medication and dehydration
radiogrpahic dye
abnormal
recent procedure
amphicillin
abnormal medication
average daily filtered plasma
170,000 ml
average daily urine output
1,200 ml
kidney
ureter
bladder
urethra
formation
transport
storage
excretion
nephron function
renal blood flow
glomerular filtration
tubular reabsorption
tubular secretion
Nephron: proximal convulated tubule
A: sodum, glucose, aa, salts
P: water, uread
descending loop of henle
p: water
ascending loop of henle
a: chloride
P: urear, sodium
distal convulated tubule
a: sodium
collecting duct
p: water
normal urine outpur
600-200 ml/day
dark yellow
first pee
amber
dehydration
orange
bilirubin
yellow-green/yellow-blue
bilirubin oxidized to biliverdin
green
pseudomonas infection
blue-green
medication
pink/red
RBC, hemoglobin, mens
brown/black
RBC oxidized
normal pH of urine
4.5-8.0
normal protein range
<10mg/dL
proteninuria
more than or equal to 30mg/dL
urine specifc gravity range
1.002-1.035
pyuria
increase in urinary WBC
neutrophil is dominant - indicative of bacterial infection