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Urinanalysis Flashcards

1
Q

Normal urine color is due to?

A

Urochrome

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2
Q

Red urine color is due to?

A
  • beets,
  • blood,
  • chemotherapy;
  • ex-lax → laxative, seen when people have eating disorder
  • hemoglobinuria,
  • propofol(used when people of colonoscopy),
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3
Q

Orange urine

A
  • Vit. C
  • Rifampin
  • Phenazopyridine
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4
Q

Green Urine

A
  • Asparagus
  • Propfolol
  • Utis
  • Methylene blue → agent to used to reverse toxicities of some agents
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5
Q

Purple Urine

A

uti patients with catheters

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6
Q

Brown Urine

A

fava beans,
levodopa,
metronidazole,
hepatobiliary disease

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7
Q

Black Urine

A

alkaprotienuria, melanoma

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8
Q

What is the name of the test called when you physically test the urine on a refractometer ? What does it test for?

A

Specific Gravity-test for the concentration of solutes of the urine– a really conc. urine will have a increased specific gravity

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9
Q

What does the chemical analysis dipistick test for?

A

Chemical analysis (dipstick)

Holy God Kate Loves NAPS

  • Heme (Blood)
  • Glucose
  • Ketones
  • Leukocyte esterase
  • Nitrate
  • Albumin (protein)/urobilinogen/bilirubin
  • pH
  • Specific Gravity
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10
Q

Serum glucose >180 results in?

A

Serum glucose >180 results in spilling

glucose into urine

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11
Q 
Normal findings?
Appearance 
Color 
Odor 
pH 
Protein Specific gravity
A 
clear
Yellow (amber) 
Aromatic 
4.6-8.0 0-8 mg/dL 
1.005– 1.030
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12
Q 
Normal findings?
Leukocyte esterase 
Nitrates 
Ketones
Bilirubin 
Urobilinogen Glucose
A 
negative
none
none 
none 
0.01-1 Ehrlich unit/mL none
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13
Q

The term for glucose in the urine?

A

glycosuria

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14
Q

What are casts?

A

“mold” like a cast, from inside renal tubule (solid), tells you if some disease is in the kidney

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15
Q

Findings of calcium oxalate in the urine would be represented of ?

A

Nephrolithiasis

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16
Q

Findings of uric acid in the urine would be represented of ?

A
  • TLS (tumor lysis syndrome)→ really agressive chemo so the dead tumor cells will be in the urine
  • hyperuricosuria
17
Q

Findings of Magnesium Ammonium Phophosphate in the urine would be represented of ?

A

staghorn calculi

18
Q

Findings of Cystine in the urine would be represented of ?

A

cystinuria

19
Q

What of cells would you find in a urine microscopic exam?

A
  • RBCs (Hematuria)
  • WBCs (Pyuria)
  • Transitional Epithelial→ bladder cells
  • Renal Tubular epithelial cells
  • Squamous epithelial cells→ contamination
20
Q

IF you find • Squamous epithelial cells it is an indicator of ?

A

contamination

21
Q

Casts are?

A

cylindrical particles formed

from coagulated proteins in renal tubules

22
Q

What are the different kind of casts you can find and what does each mean? ( 6 types of casts)

A

Hey Ryan, Wait, Wanna FM

Hyaline Cast -non specific, heavy
exercise, diuretics

• RBC Cast –glomerulonephritis, vasculitis

• WBC cast –acute pyelonephritis, tubule
interstitial nephritis

  • Waxy cast –Advanced renal failure
  • Fatty Cast –nephrotic syndrome

• Muddy-brown granular cast -acute
tubular necrosis

23
Q

What are normal finding each category in the urine?

  • Crystals
  • Casts
  • WBCs
  • RBCs
  • RBC Casts
  • Squamous Epi
A
  • none
  • none
  • 0-4 per low power field (lpf)
  • <3
  • none
  • Less than 15-20/hpf
24
Q

Urinalysis Indicators of Infection ?

A 
• Bacteria 
• Leukocyte Esterase positive 
• WBCs > 10 
• Nitrate positive 
• RBCs → can be caused by inflammation
• Ph increased (can indicate
infection)
25
Urine culture Quantitative vs. Qualitative difference?
• Quantitative → Colony count evaluation • Qualitative → Presence of bacteria
26
Lumbar puncture indications?
``` Diagnostic: • CNS infections • Inflammatory Processes • Subarachnoid hemorrhage • Cytologicand protein analysis (ex: malignant cells getting into CSF-ex: Lymphoma) ``` Therapeutic: • Deliver medications • Relieve symptoms of a few specific causes of increased ICP (ex: hydrocephalus)
27
What would be C/I's of reasons why you shouldn't preform a lumbar puncture
``` • Local Skin Infection • Suspected mass lesion • Raised ICP • Bleeding Diathesis • Coagulopathy → Platelet count less than 50,000 → Platelet dysfunction → INR greater than 1.4 • Poor Patient Cooperation → pt. can't stay in fetal position ```
28
Describe the equipment involved in lumbar puncture?
``` Spinal needle • Three way stopcock • Manometer • Connecting Tube • Four Specimen Tubes • Local Anesthesia • Syringes and needles for local anesthesia • Sterile Gloves • Antiseptic Solution ```
29
Where do you inject a lumbar needle and what is important about the collection of the CSF?
``` Collection: • Four tubes labeled #1-4 → normally shouldn't be blood in tuber number 4 • Order of collection is important • L3 –L4 • L4 -L5 ``` → less chance of spinal cord injury in these spots
30
How much CSF do you collect in each tube and do you do with each tube?
Four Tubes • Collect approx. 4-8 ml total. • Tube 1 –Collect Cell Count and Differential • Tube 2 –Glucose and Protein • Tube 3 –Culture and Gram Stain → *** cultures only check for bacteria • Tube 4 –Cell Count and Differential **Cultures
31
What tests should you consider if you suspect a CSF infection?
``` Consider: • AFB or TB PCR • Cryptococalantigen and indiaink • Fungal culture • VDRL • Lyme Antibody • PCR for Viruses (EBV, HSV, CMV, VZV, HHV-6) ```
32
If there is blood in all four tubes you should suspect ?
subarachnoid hemorrhage→ | bleeding between the arachnoid and the Pia matter
33
Subdural hematoma (SDH) occurs because of
- result of the countercoup injuries | - result of venous bleeding stretching of bridging veins
34
Bacterial vs. Viral : CSF analysis Appearance? Glucose? Gram Stain?
Appearance: B: Turbid V: Clear Glucose: B: <2.2 → bacteria will eat the sugar so it will be low V: Normal Gram Stain: B: Positive V: Normal
35
Subarachnoid Hemorrhage vs. Traumatic Tap: - CSF pressure? - Duration of bleeding? -Centrifugation?
CSF Pressure: TP: Low SH: High Duration of when CSF is withdrawn: TP: Decreases when CSF is withdrawn→ will normally see blood in 1st tube b/c you stuck a needle into their back SH: No change in color when CSF is withdrawn→ blood in all 4 tubes Centrifugation: TP: clear fluid SH: Xanthochromia
36
Synovial Fluid Analysis Indications?
* Joint pain • Joint swelling • Joint effusion | * Must take context of clinical history and presentation
37
Synovial Fluid Analysis
look at picture on desktop
38
Physical analysis of urine looks at
color appearance specific gravity
39
What are the two parts to complete an urinalysis
Chemical tests Sediment tests (microscopic)

Diagnostic methods (11 decks)

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