Urine 4

Question 1

hemoglobinuria

Answer 1

represents free hemoglobin in the urine

anything that increases RBC descrutction increases free hemoglobin

Question 2

extravascular causes of hemolysis

Answer 2

drugs
crushing injuries
transfusion reactions
burns

Question 3

intravascular causes of hemolysis

Answer 3

hemolytic anemia

Question 4

myoglobinuria

Answer 4

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

Question 5

microhematuria

Answer 5

increased RBCs although there is no urine color change

Question 6

occult blood in urine could be due to?

Answer 6

UTI
menses
kidney stones
appendicitis
diverticulitis
bladder stones
rectal cancer that invades bladder

Question 7

yellow urine and increased RBC

Answer 7

microhematuria

Question 8

yellow urine and normal RBC

Answer 8

microhemaglobinuria

micromyoglobinuria

Question 9

red/pink/smoky urine and increased RBC

Answer 9

hematuria

Question 10

red/pink/smoky urine and normal RBCs

Answer 10

hemoglobinuria

myoglobinuria

Question 11

leukocyte esterase

Answer 11

a screening test to detect WBCs in urine

Question 12

a positive leukocyte esterase test indicates?

Answer 12

UTI

Question 13

> __WBCs/HPF is 50% positive for UTI

Answer 13

> 5

Question 14

> __WBCs/HPF is 90% positive for UTI

Answer 14

> 10

Question 15

nitrites

Answer 15

normal is negative

testing for UTI

Question 16

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

Answer 16

bacteria in the urine (gram-)

usually due to ecoli, normal flora in GI

Question 17

how should we not interpret negative nitrites?

Answer 17

abscence of bacteruria

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

Question 18

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

Answer 18

staph and strep

Question 19

urinary sediment

Answer 19

microscopic exam of urine

based on lab protocols, physcian request or abnormal findings

Question 20

what is the best specimen for urinary sediment?

Answer 20

first morning urine

Question 21

describe how urinary sediment works?

Answer 21

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

Question 22

WBCs normal for urinary sediment

Answer 22

0-3 WBCs/HPF

Question 23

RBCs normal for urinary sediment

Answer 23

0-3 RBCs/HPF

Question 24

TNTC

Answer 24

too numerous to count

Question 25

RBCs in microscopic urinalysis is increased in?

Answer 25

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

Question 26

WBCs in microscopic urinarysis increased in?

Answer 26

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

Question 27

increase in number of WBCs suggest?

Answer 27

infection

Question 28

how do we usually report urinary crystals/sediment

Answer 28

few, moderate or many

Question 29

are crystals normally found in urine?

Answer 29

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

Question 30

what do crystals in the urine indicate?

Answer 30

stone formation

Question 31

characteristics of urine with crystals?

Answer 31

sandy/cloudy urine | acid crystals, alkaline crystals, amino acid crystals

Question 32

alkaline crystals

Answer 32

amorphous phosphates calcium carbonate triple phosphate

Question 33

acid crystals

Answer 33

calcium oxalate, uric acis

Question 34

demographics for kidney stones

Answer 34

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

Question 35

most kidney stones are mixed with?

Answer 35

phosphate

Question 36

what are some ways to get kidney stones

Answer 36

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

Question 37

when do we usually discover kidney stones?

Answer 37

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

Question 38

where is the pain for a kidney stone?

Answer 38

kidney region and radiates into abdomen, genetalia and legs

Question 39

symptoms of kidney stones

Answer 39

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

Question 40

how to help with kidney stones

Answer 40

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

Question 41

what characteristics do crystals have in a urinary sediment

Answer 41

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

Question 42

who has high serum uric acid levels?

Answer 42

people with gout

Question 43

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

Answer 43

tyrosine leucine cysteine

Question 44

how are epithelial cells reported?

Answer 44

``` rare occasional few moderate many +1, +2, etc ```

Question 45

why might someone have epithelial cells in their urine?

Answer 45

sloughing due to irritation

Question 46

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

Answer 46

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

Question 47

where is squamous epithelium found?

Answer 47

lower 1/2 of bladder and urethra

Question 48

where is transitional epithelium found?

Answer 48

upper 1/2 of bladder and ureters

Question 49

what does renal cell epithelium in a UA imply?

Answer 49

kidney disease

Question 50

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

Answer 50

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

Question 51

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

Answer 51

contamination

Question 52

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

Answer 52

infection

Question 53

what are some symptoms of a UTI?

Answer 53

LBP, dysuria

Question 54

a normal amount of mucous in the urine is?

Answer 54

negative

Question 55

how is mucous reported?

Answer 55

``` scant moderate heavy few frequent many ```

Question 56

significant mucous is usually associated with?

Answer 56

infection