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Vis Dis > Urine 4 > Flashcards

Urine 4 Flashcards

1
Q

hemoglobinuria

A

represents free hemoglobin in the urine

anything that increases RBC descrutction increases free hemoglobin

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2
Q

extravascular causes of hemolysis

A

drugs
crushing injuries
transfusion reactions
burns

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3
Q

intravascular causes of hemolysis

A

hemolytic anemia

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4
Q

myoglobinuria

A

represents free myoglobin in the urine
results from muscle trauma/destruction typically due to crushing injuries or MI
OCCULT BLOOD WITHOUT ELEVATED rbcS

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5
Q

microhematuria

A

increased RBCs although there is no urine color change

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6
Q

occult blood in urine could be due to?

A 
UTI
menses
kidney stones
appendicitis
diverticulitis
bladder stones
rectal cancer that invades bladder
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7
Q

yellow urine and increased RBC

A

microhematuria

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8
Q

yellow urine and normal RBC

A

microhemaglobinuria

micromyoglobinuria

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9
Q

red/pink/smoky urine and increased RBC

A

hematuria

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10
Q

red/pink/smoky urine and normal RBCs

A

hemoglobinuria

myoglobinuria

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11
Q

leukocyte esterase

A

a screening test to detect WBCs in urine

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12
Q

a positive leukocyte esterase test indicates?

A

UTI

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13
Q

> __WBCs/HPF is 50% positive for UTI

A

> 5

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14
Q

> __WBCs/HPF is 90% positive for UTI

A

> 10

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15
Q

nitrites

A

normal is negative

testing for UTI

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16
Q

if there are nitrites in the urine, what does that mean?

A

bacteria in the urine (gram-)

usually due to ecoli, normal flora in GI

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17
Q

how should we not interpret negative nitrites?

A

abscence of bacteruria

the sample could have had not enough time to convert nitrates to nitrites in bladder

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18
Q

what are some infections that do not convert nitrate into nitrite?

A

staph and strep

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19
Q

urinary sediment

A

microscopic exam of urine

based on lab protocols, physcian request or abnormal findings

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20
Q

what is the best specimen for urinary sediment?

A

first morning urine

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21
Q

describe how urinary sediment works?

A

urine is centrifuged for 5 minutes and supernatant is discarded
sediment is resuspended and placed on slide
10 fields are examined and average number is reported
subjectivity is reduced by test standardization

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22
Q

WBCs normal for urinary sediment

A

0-3 WBCs/HPF

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23
Q

RBCs normal for urinary sediment

A

0-3 RBCs/HPF

24
Q

TNTC

A

too numerous to count

25
Q

RBCs in microscopic urinalysis is increased in?

A

GMN, PN, stones, tumor, infarction, trauma, lower UTI, extrarenal disease such as appendicitis, drug reactions, exercise, menses, etc

26
Q

WBCs in microscopic urinarysis increased in?

A

renal and urinary tract diseases
(PN, cystitis, urethritis, UTI)
transient after exercise and with fevers

27
Q

increase in number of WBCs suggest?

A

infection

28
Q

how do we usually report urinary crystals/sediment

A

few, moderate or many

29
Q

are crystals normally found in urine?

A

no, but if it sits long enough, then it could form

30
Q

what do crystals in the urine indicate?

A

stone formation

31
Q

characteristics of urine with crystals?

A

sandy/cloudy urine

acid crystals, alkaline crystals, amino acid crystals

32
Q

alkaline crystals

A

amorphous phosphates
calcium carbonate
triple phosphate

33
Q

acid crystals

A

calcium oxalate, uric acis

34
Q

demographics for kidney stones

A

men
20-30 years
familial and hereditary tendiencies as well as dietary
inborn errors of metabolism (gout)

35
Q

most kidney stones are mixed with?

A

phosphate

36
Q

what are some ways to get kidney stones

A

supersaturation
decreased urine volume
pH factors
foreing body seed (crystals, bacteria, debris, clot, etc)

37
Q

when do we usually discover kidney stones?

A

when they obstruct, cause an ulceration or you have hematuria
smaller stones may pass into ureters and produce colicky pain

38
Q

where is the pain for a kidney stone?

A

kidney region and radiates into abdomen, genetalia and legs

39
Q

symptoms of kidney stones

A

nausea, vomiting, sweating, frequent urge to urinate, pain

40
Q

how to help with kidney stones

A

increase fluid intake to dilute urine
modify diet
manipulate pH of urine
cystoscopy, lithotripsy, surgery

41
Q

what characteristics do crystals have in a urinary sediment

A

uric acid crystals seen in patient’s with high serum uric acid levels
phosphate crystals w/ parathyroid problems and malabsorption states

42
Q

who has high serum uric acid levels?

A

people with gout

43
Q

which amino acids indicated severe liver disease if they are in the UA

A

tyrosine
leucine
cysteine

44
Q

how are epithelial cells reported?

A 
rare
occasional
few
moderate
many
\+1, +2, etc
45
Q

why might someone have epithelial cells in their urine?

A

sloughing due to irritation

46
Q

what kind of epithelial cells do we see in a UA?

A

squamous (assume this one if not specified)
transitional
renal epithelial

47
Q

where is squamous epithelium found?

A

lower 1/2 of bladder and urethra

48
Q

where is transitional epithelium found?

A

upper 1/2 of bladder and ureters

49
Q

what does renal cell epithelium in a UA imply?

A

kidney disease

50
Q

when might you assume someone have you a contaminated sample of urine?

A

if you have bacteria and epithelial cells with no other bacterial findings

51
Q

yellow urine, slightly hazy, 7.2 pH, neg protein, 0.8 urobilinogen, neg occult blood, 2 RBC, 2 WBC, +bacterial, few epithelial cells

A

contamination

52
Q

yellow urine, slightly hazy, 7.2 pH, neg protein, 0.8 urobilinogen, neg occult blood, 2 RBC, 20 WBC, +bacterial, few epithelial cells

A

infection

53
Q

what are some symptoms of a UTI?

A

LBP, dysuria

54
Q

a normal amount of mucous in the urine is?

A

negative

55
Q

how is mucous reported?

A 
scant
moderate
heavy
few
frequent
many
56
Q

significant mucous is usually associated with?

A

infection

Vis Dis (20 decks)

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