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Urine 1 Flashcards

1
Q

signs and symptoms to order a UA

A 
frequent urination
inability to urinate
polydipsia (excessive thirst)
polyphagia (excessive hunger)
physicals and wellness screening
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2
Q

what percent of CO perfuse the kidneys every minute?

A

25%

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3
Q

what are kidneys involved in the production of?

A

erythropoitin, renin

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4
Q

erythropoitin

A

a hormone that stimulates RBC production

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5
Q

rening

A

an enzyme for controlling blood pressure

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6
Q

routine UA consists of

A

physical properties
chemical proerties
microscopic properties

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7
Q

functional unit of the kidney is?

A

nephron

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8
Q

how many nephrons are there per kidney? What does a nephron consist of?

A

1 million

proximal convoluted tubule, loop of Henle, descending and ascending limb, distal tubule, collecting duct

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9
Q

what is the oldest lab procedure?

A

UA

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10
Q

when does the glomerular filtrate become urine?

A

after it leaves the distal convoluted tubule

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11
Q

what are the prinicple solutes of urine?

A 
urea
sodium
chloride
potassium
creatinine
uric acid
ammonia
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12
Q

the body excretes approximately __g of dissolved material in 24 hours. how much of it is urea?

A

60 grams

1/2 is urea

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13
Q

what is urine composed of?

A

95% water and 5% dissolved solids

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14
Q

average daily volume of urine?

A

1200-1500ml

normal range is 600-2000ml/day

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15
Q

polyuria

A

> 2000ml/24hours

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16
Q

polyuria can be due to

A

diabetes mellitus
diabetes insipidus
large fluid intake
diuretics

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17
Q

oliguria

A

<500mL/24hours

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18
Q

oliguria can be due to

A 
renal tubule dysfunction
end stage renal disease
obstruction
edema
dehydration
diarrhea
vomiting
shock
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19
Q

anuria

A

abscence of urine

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20
Q

anuria can be due to

A

renal failure
obstruction
heart attack

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21
Q

what specimen is the best for urinalysis

A

early morning urine

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22
Q

how should you catch urine?

A

clean area

start stream, then catch midstream

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23
Q

how soon should you test urine?

A

within 30 minutes at room temp

within 4 hours if referigerated

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24
Q

what is the most common and convienent urinalysis

A

random sample

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25
Q

what is the best urinalysis?

A

24 hour sample with preservative

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26
Q

what happens to urine as it sits out if it is unpreserved?

A 
color becomes darker
turbidity increases
odor is more foul smelling
pH increases
glucose, ketones, bilirubin and urobilinogen decrease
nitrites and bacteria increase
RBCs lyse
WBCs and casts disintegrate
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27
Q

what does urine color depend on?

A

degree of hydration and concentration

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28
Q

what is the normal color of urine?

A

straw to amber (light yellow to dark yellow)

29
Q

red/dark brown urine means?

A

found with excessive hemoglobin, RBC, myoglobin

(ex)menses, UTI, malignancy, prostate, etc

30
Q

what consistutes as “smoky urine”

A

yellow urine+red blood= smoky urine

31
Q

orange urine is found with

A

dehydration from fever, vomiting, certain foods (rhubarb, vit. c, carrots), medications, etc

32
Q

bright yellow urine is found with

A

excessive vitamin B intake

33
Q

black urine is found with

A

alkaptonuria

malignant melanoma

34
Q

do people pee black urine?

A

no, if it sits long enough, then it turns black

35
Q

what is alkaptonuria?

A

a disease where you can’t process amino acids
ochronosis- lack of homoegentistic oxidase
discs are calcified

36
Q

what color is associated with liver problems?

A

brownish yellow/brownish green/greenish yellow, yellowish green
may also be referred to as dark yellow

37
Q

what should you check if you suspect liver problems?

A

bilirubin, urobilinogen

may also see jaundice of skin and sclera

38
Q

milky urine is associated with?

A

hyperlipidemia

39
Q

clear urine

A

normal

40
Q

slightly hazy urine

A

usually normal (check sediment, if negative then insignificant

41
Q

cloudy urine

A

may be pus, bacteria, RBCs, spermatozoa

if associated with crystals, usually insignificant

42
Q

turbidity

A

how clear the urine is

43
Q

hazy/cloudy urine

A

usually due to infection

44
Q

frothy urine

A

assoicated with proteins

if yellow froth- billirubin

45
Q

what do they need to do if there is a change in turbidity

A

need to look microscopically at urinary sediment

46
Q

specific gravity

A

evaluates kidney’s ability to concentrate urine

47
Q

what is an early sign of kidney disease

A

inability to concentrate urine

48
Q

what is the nomal SpG for an adult

A

1.015-1.035

49
Q

what do we compare the weight of urine to?

A

distilled water

50
Q

what do we use to measure the SpG?

A

urinometer/refractometer or dipstick

51
Q

hyposthenuria

A

low specific gravity

52
Q

hypersthenuria

A

high SpG

53
Q

isosthenuria

A

fixed SpG at 1.010 same as protein free plasma and signifies end stage of renal failure
ONLY if they consistently have an SpG of 1.010

54
Q

what does increased specific gravity indicate?

A 
concentrated urine
proteinuria 
glucosuria 
dehydration (fever, vomiting, diarrhea)
decreased renal blood flow (heart failure, renal artery stenosis)
55
Q

what does decreased specific gravity mean?

A 
dilute urine
decreased concentration
overhydration
glomerulonephritis
pyleonephritis
diabetes insipidus
renal failure
56
Q

when is the odor of the urine concerning?

A

foul, fishy (UTI)
fruity, sweet (diabetes mellitus/ketosis)
feces odor (asparagus, enterobladder fistula)

57
Q

what is important to know when using dipsticks?

A

need to be precise in timing

58
Q

urine pH often indicates?

A

renal or lung disease

59
Q

normal pH range

A

4.5-7.5

60
Q

acidic pH

A

<7

61
Q

alkaline pH

A

> 7

62
Q

urine becomes alkaline as it stands due to?

A

bacterial growth and breakdown of urea

63
Q

normal blood pH

A

7.35-7.45

64
Q

how do we maintain normal pH

A

primarily through reabsorption of sodium and secretion of hydrogen and ammonium oins

65
Q

what diets are typically acidic?

A

high in animal products

66
Q

what diet is typically alkaline

A

citrus fruits and vegetables

67
Q

what situations usually have acidic pH?

A

respiratory acidosis (emphysema)
metabolic acidosis (diabetic ketoacidosis)
diabetes mellitus
large amounts of meats and cranberries

68
Q

what situations usually have alkaline pH?

A

respiratory alkalosis
metabolic alkalosis
UTI
diet high in vegetables and citurs fruits

69
Q

what is the most common bacteria to cause UTI?

A

e coli

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