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Urinalysis > Urine > Flashcards

Urine Flashcards

1
Q

Principle constituents of urine

A

Water
Urea
Uric acid
Creatinine

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2
Q

Functions of kidney

A

Regulate water and inorganic ion balance
Remove metabolic waste products from blood
Remove foreign chemicals from blood
Secrete hormones
Gluconeogenesis

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3
Q

Hormones secreted from kidney

A

Erythropoietin, controls RBC production
Renin, controls angiotensin release
1,25 Dihydroxyvitamin D

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4
Q

Functional unit of kidney

A

Nephron

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5
Q

Capillary network of nephron

A

Glomerulus

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6
Q

Parts of tubule system

A

Proximal convoluted tubule
Loop of henle
Distal convoluted tubule

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7
Q

Glomurulus filters what from blood

A 
Water
Glucose 
Salt 
Urea 
Creatinine
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8
Q

80% of glomerular filtrate is reabsorbed where?

A

Proximal convoluted tubule

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9
Q

Concentrating segment of loop of henle

A

Descending loop, absorbs water

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10
Q

Diluting portion of loop of henle

A

Ascending loop active absorption of Na, Cl, Mg, Ca

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11
Q

Main functions of distal convoluted tubule

A

Maintain water/electrolyte balance by final reabsorption of sodium
Maintain acid-base balance by removing excess acid from body

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12
Q

ADH

A

Makes distal tubule and collecting tubule walls permeable to water in order to conserve it, increasing osmolality

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13
Q

Renal disease that are most often immunologically mediated

A

Glomerular diseases

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14
Q

Decreased urine output

A

Oliguria

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15
Q

Important finding in glomerular inflammation

A

RBC casts

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16
Q

Syndrome characterized by increased glomerular membrane permeability

A

Nephrotic syndrome, permeability results in massive proteinuria and excretion of fat bodies

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17
Q

Renal disease most likely due to toxic or infectious agents

A

Tubular disease

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18
Q

Disorder caused by defective secretion of H+ ions by renal tubules in presence of normal/near normal GFR

A

Renal tubular acidosis

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19
Q

Type 1 RTA

A

Distal type
Problem occurs in collecting ducts
Calcium carbonate drawn from bones in attempt to act as buffer

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20
Q

Type 2 RTA

A

Proximal type

Reduced bicarbonate reabsorption in proximal tubule, depletes bicarbonate content in blood and tissues

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21
Q

Group of inherited renal diseases

A

Fanconi syndrome

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22
Q

Renal disorder that effects tubules, interstitium, and renal pelvis

A

Pyelonephritis

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23
Q

Acute pyelonephritis

A

Sudden onset, flank pain, fever, malaise, WBCs and WBC casts

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24
Q

Pyuria

A

WBCs in urine

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25
Q

Chronic pyelonephritis

A

Chronic tubulointerstitial inflammation, renal scarring

May be caused by chronic obstruction by lesions or chronic reflux of urine due to anatomical abnormality

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26
Q

Thrombosis of renal vein characteristics

A

Clot formation, massive proteinuria, nephrotic syndrome, increased pressure

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27
Q

Cystitis

A

Infection of bladder

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28
Q

Anuria

A

Absence of urine

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29
Q

Renal calculi

A

Kidney stones, passage produces renal colic and hematuria, calcium oxalate most common constituent

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30
Q

Renal colic

A

Severe back pain radiating to groin

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31
Q

Acute renal failure classes

A

Abrupt deterioration of renal function
Prerenal occurs before blood reaches kidney
Renal occurs in kidney
Postrenal occurs after blood leaves kidney, usually due to obstruction

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32
Q

Chronic renal failure stages

A

Progressive loss of function,
1st decreased renal function, normal serum creatinine and BUN
2nd mild renal insufficiency
3rd frank renal failure with advancing anemia and acidosis
4th uremia, increased creatinine and BUN, acid base and electrolyte imbalance

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33
Q

Creatinine clearance formula

A

(Urine creatinine*total volume/1440)/serum creatinine

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34
Q

Normal creatinine value man/woman

A

Man: 107-139
Woman: 87-107

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35
Q

Advantages of creatinine clearance

A

Relatively constant amount produced endogenously
Freely filtered at glomerulus
Not reabsorbed in tubules

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36
Q

Disadvantages of creatinine clearance

A

Becomes increasingly inaccurate at lower filtration rates lower in females, elderly, small people because it is related to muscle mass

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37
Q

Correcting for body mass

A

(1.73/body mass) *GFR

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38
Q

Method of choice when precise GFR is required

A

Inulin clearance

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39
Q

Secretory function test of renal tubules reagent

A

Paraaminohippurate

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40
Q

Parts of nephron contained in cortex

A

Blood vessels
Glomerulus
Short loops of henle
Proximal and distal convoluted tubules

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41
Q

Parts of nephron contained in medulla

A

Long loops of henle

Collecting ducts

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42
Q

Fixed specific gravity of ultrafiltrate

A

1.010

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43
Q

Function of renin

A

Splits angiotensinogen into angiotensin 1 and other proteins

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44
Q

Angiotensin 1 function

A

Split by angiotensin converting enzyme aka ACE to form angiotensin 2

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45
Q

Angiotensin 2 function

A

Hormone which causes constriction of muscle in small arteries increasing blood pressure,
Triggers release of aldosterone from adrenal glands and ADH from pituitary

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46
Q

Aldosterone functions

A

Causes kidneys to retain salt and excrete potassium, salt causes water retention which increases blood volume and pressure

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47
Q

Changes in unpreserved urine

A 
Color darkens, 
decreased clarity due to amorphous material or bacterial multiplication,
Increased odor 
Increased pH 
Decreased glucose 
Decreased ketones, bilirubin, urobilinogen 
Increased nitrite 
Decreased RBC, WBC cells and casts 
Increased bacteria
48
Q

Physical characteristics of urine reported on routine UA

A

Color
Appearance (clarity)
Specific gravity

49
Q

Chief pigment in urine, other pigments?

A

Urochrome chief

Uroerythrin and urobilin

50
Q

Amorphous material of alkaline urine

A

Phosphates and occasionally carbonates

51
Q

Amorphous material in acidic urine composed of

A

Urates and uric acids

52
Q

Components of normal urine which contribute most to specific gravity

A

Urea and sodium chloride

53
Q

Normal range for specific gravity

A

1.003-1.030

54
Q

Hyposthenuric

A

Specific gravity >1.007

55
Q

Isosthenuric urine

A

1.010

Caused by chronic renal disease where concentrating and diluting ability is lost

56
Q

Hypersthenuric urine

A

SG >1.020

Caused by proteinuria, dehydration or radiographic dyes

57
Q

A urinometer must be corrected for what

A

Changes in temperature,

Presence of glucose and protein

58
Q

Ammonia smell of urine indicates what

A

Bacterial growth

59
Q

Sweet, fruity smelling urine incidents what

A

Presence of ketones

60
Q

Polyuria

A

> 2000 ml of urine produced in 24 hours

Caused by excessive fluid intake, diabetes mellitus, renal disease effecting concentration ability

61
Q

Term for any increase in urine volume

62
Q

Griess test associated with which test on urine test strip

A

Nitrite

Diazomium salt reaction

63
Q

Ketones tested on urine test strip

A

Acetoacetic acid
Acetone
Beta hydroxybutyric acid also a ketone but not tested by test strip

64
Q

Test associated with lactose

A

Rubner’s test

65
Q

Test for pentose

A

Bial orcinol test

66
Q

Sucrose test

A

Thin layer chromatography

67
Q

Constituents of normal protein excreted in urine

A

1/3 Tamm Horsfall glycoprotein
1/3 albumin
Remaining portion small globulins

68
Q

Bence Jones proteinuria associated with what disorders

A

Multiple myeloma, macroglobulinemia,

Malignant lymphoma

69
Q

Heavy proteinuria

A

3-4 g/day

Seen in nephrotic syndrome

70
Q

Moderate proteinuria

A

1-3 g/day

Seen in renal diseases glomerular in nature and multiple myeloma

71
Q

Bilirubin

A

Breakdown product of hemoglobin

72
Q

Type of bilirubin filtered by glomerulus

A

Conjugated/direct

Water soluble

73
Q

Urobilinogen

A

Breakdown product of conjugated/direct bilirubin

74
Q

Test associated with urobilinogen

75
Q

Hemolytic jaundice characteristics

A

Increased urobilinogen

No change in bilirubin

76
Q

Hepatocellular jaundice characteristics

A

Increased urobilinogen and bilirubin

77
Q

Obstructive jaundice characteristics

A

Decreased urobilinogen and increased bilirubin

78
Q

Increased indican associated with what

A

Small bowel bacterial contamination or abnormalities of GI tract

79
Q

Oval fat bodies

A

Renal tubular cells or macrophages with globules of accumulated fat

80
Q

Concentrating and diluting ability is measured with what 2 tests

A

Osmolality

Specific gravity

81
Q

Urinometer temperature correction

A

Every 3C above 20 add .001 to SG

Every 3C below 20 subtract .001 from SG

82
Q

Urinometer correction for glucose or protein

A

Every 1g/dL of protein or glucose subtract .003 from SG

83
Q

Tamm Horsfall protein aka

A

Uromodulin

84
Q

RTA produces urine of what pH

A

Alkaline urine

85
Q

Ketones occur from complete or incomplete breakdown of fat

A

Incomplete

86
Q

Reasons for increased fat metabolism

A

Diabetes mellitus,
Vomiting or diarrhea
Starvation
Dehydration

87
Q

Glucose oxidase/peroxidase test used for what analyte

88
Q

Presence of what may mask positive reaction on glucose test strip

89
Q

Which sugar is not a reducing substance

90
Q

Resorcinol used to test for what sugar

91
Q

Newborns screened for what reducing substance transferase deficiency at birth

A

Galactose, usually seen in people of middle eastern descent

92
Q

Urine with black/brown appearance most likely due to

93
Q

Protein test strip sensitive only to what protein

94
Q

Error or pH indicators methodology used for what analyte

95
Q

Nitroprusside test used to test for which analyte

96
Q

Phenylketonuria characteristics

A

Seen in people of Scandinavian descent

Guthrie test used to test for

97
Q

Presence of what in urine causes it to darken upon standing

A

Homogentisic acid oxidase

98
Q

Fat globules seen in what disorder

A

Nephrotic syndrome

Severe renal disease

99
Q

Watson Schwartz test used to test for what

A

Porphyrins

100
Q

Confirmatory test porphyrins

A

Hoesch test

101
Q

Sulkowitch test used for which analyte

102
Q

What disorder is suspected with more than 400 mg/24 calcium excreted in urine

A

Hyperparathyroidism

103
Q

Type of cast associated with pyelonephritis

104
Q

Hormone which controls Na/K pump

A

Aldosterone

105
Q

6 sided crystal

106
Q

Two non pathological crystals seen in acidic urine

A

Utica acid

Calcium oxalate

107
Q

Non pathogenic crystals seen in alkaline urine

A

Triple phosphate urine

Ammonium biurate

108
Q

Radiographic dye effect what specific gravity methodology

A

Refractometer

Doesn’t effect urinometer or test strip

109
Q

Confirmatory tests for protein in urine

A

Sulfosalicylic acid

Heat and acetic acid test

110
Q

Rhabdomyelosis

A

Myoglobin released in urine

111
Q

Indican presence indicative of what

A

Bacterial overgrowth

112
Q

Test for urobilinogen

A

Ehrlichs aldehyde reaction

113
Q

Accumulation of homogentistic acid called what

A

Alkaptonuria

114
Q

Principle means of waste product excretion in man

114
Q

Minimal proteinuria

Urinalysis (1 decks)

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