urine Flashcards
what is turbidity of urine
“cloudiness” of urine
list the components of a urine dipstick
- pH
- specific gravity
- glucose
- keytones
- protein
- blood
- nitrite
- leukocyte esterase
- biliruben
- urobilinogen
urine pH has what relationship to serum pH
parallels
which value is described as acidic pH? alkaline pH?
- acidic: 4.5-5.5
- alkaline: 6.5-8
- a pH out of these ranges is not possible; pH > 8 indicates overgrowth of urease producing bacteria
List some causes of alkaline urine
- urea-splitting organisms
- standing urine
- fruit/vegetables
- metabolic or respiratory alkalosis
- meds
List some causes of acidic urine
- large intake of meat
- cranberries, plums, prunes
- metabolic or respiratory acidosis
- meds
urine will have what specific gravity compared to water
- specific gravity of water = 1
- urine will have higher specific gravity due to dissolves substances, primarily urea, sodium, and chloride
- the more concentrated, the higher the specific gravity
with kidney disease, the ability to concentrate the urine may be lost and the specific gravity may become fixed at what value? why this value? what is this called?
- 1.010
- SG at the initial plasma filtrate at the glomerulus
- isosthenuria
what is oliguria in terms of urine volume
< 500 cc/24 hrs
what is anuria in terms of urine volume
< 100 cc/ 24 hours
when plasma glucose is above what, the renal threshold is exceeded and patient will spill glucose into urine
150-180 mg/dl
false negatives of glucose urine dipstick can be caused by
- ascorbic acid
- aspirin
what are products of incomplete fat metabolism occurring when carbohydrate stores are diminished
keytones
presence of keytones in urine may indicate what
- acidosis
- DKA
- rapid weight loss
- fasting
- starvation
- pregnancy
Normal urinary protein excretion should be < 150 mg/24 hours .list the breakdown of what protein is excreted in the urine
- 30% albumin
- 30% globulins (iron/oxygen binding proteins)
- 40% tamm-horsefall protein
how does specific gravity alter dipstick result of protein
- high specific gravity: may show higher protein level
- low specific gravity: may show lower protein level
urine dipstick may be falsely positive for protein if
- high alkaline urine
- high specific gravity
- pyridium present
moderately increased albumin in urine is a prognostic indicator for kidney disease in what conditions?
- Diabetes
- HTN
- cardiovascular disease
- post-streptococcal glomerular nephritis
- ** this test refers to urinary excretion of albumin that is below the detection capability of urine dipstick but above upper limit of normal for healthy individuals
what tests are done to assess for moderately increased albumin
- 24 hour urine collection
- urinary albumin/creatinine ratio (most practical)
- normal: < 30 mg albumin/gram urinary creatinine
- microalbuminuria: 30-300 mg/g creatinine
dipstick detects presence of RBCs or hemoglobin from RBCs
lysed
urine dipstick can have fast negative for blood due to
ascorbic acid
urine nitriate test detects
- bacteria that are capable of reducing nitrates to nitrite
- 50% sensitive in Dx UTI
urine dipstick can have false negatives for nitrite due to
- urine in bladder for < 4 hours
- patient’s diet is deficient in nitrates
- bacteria which do have necessary enzymes
urine dipstick can have false positives for leukocyte esterase from
- vaginal contamination
- trichomonads
function of leukocyte esterase
- detects leukocytes in urine, can detect lysed WBCs
what is biliruben
- product of RBC breakdown carried to liver in unconjugated form (indirect)
- conjugated in the liver (direct)
route of biliruben once it is conjugated
- excreted from liver via bile duct
- goes into small intestine and is converted by bacterial flora to urobilinogen
biliruben and urobilinogen are both normally excreted where
- stool
- thus dipstick is normally negative for both of these
urine turns what color in the presence of biliruben
brown
biliary obstruction can cause which to appear in urine: bilirubin or urobilinogen
bilirubin
hemolytic disease can cause which to appear in urine: bilirubin or urobilinogen
urobilinogen