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Urine Flashcards

Introduction, Renal function, Urinalysis (physical examination)

1
Q

A patient presenting polyuria, nocturia, polydipsia, and a low urine specific gravity is exhibiting symptoms of?

A

Diabetes insipidus

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2
Q

The average daily output of urine is

A

1200 mL

Or 1.2 L

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3
Q

An unidentified fluid is received in the lab with a request to det. Wether the fluid is urine or another body fluid. Using routine lab tests, what tests would determine the fluid is most probably urine?

A

Urea and Creatine

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4
Q

A patient with oliguria might progress to having

A

Anuria

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5
Q

Characteristics of recommended urine containers

A
  1. Flat bottom
  2. Made of clear material
  3. A capacity of 50 mL
  4. Disposable
  5. Sterile
  6. Screw-top lids
  7. Bags with adhesive (for pedia)
  8. Individually packaged with secure closures (for Micro)
  9. Large containers for 24-hr urine
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6
Q

the primary inorganic substance found in urine is

A

Chloride

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7
Q

labels for urine containers are

A

placed on the container prior collection

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8
Q

a urine specimen may be rejected by the laboratory for?

A
  1. Spx with unlabeled containers
  2. nonmatching labels with requisition forms
  3. spx. contaminated with feces or toilet papers
  4. containers with contaminated exteriors
  5. Spx of insufficient quantity
  6. Specimens that have been improperly transported
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9
Q

A cloudy spx received in the laboratory may have been preserved using

A

Boric Acid

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10
Q

for general screening, the most frequently collected spx is a

A

Random urine

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11
Q

the primary advantage of the first morning specimen over random spx is that it

A

is more concetrated

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12
Q

if a routine urinalysis and a culture are requested on a catheterized specimen, then:

A

Routine urinalysis

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13
Q

if the patient fails to discard the first specimen when collecting a timed specimen the

A
  • Specimen will be recollected

- Results will be falsely elevated

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14
Q

the primary cause of the unsatisfactory results in an unpreserved routine specimen not tested for 8 hours is

A

Bacterial growth

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15
Q

prolonged exposure of a preserved urine specimen to light will cause

A

Decreased bilirubin

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16
Q

which of the following would be least affected in a specimen that has remained unpreserved at a room temperature for more than 2 hours?

a. urobilinogen
b. ketones
c. protein
d. nitrite

A

c. protein

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17
Q

bacterial growth in an unpreserved spx will

a. dec. clarity
b. inc. bilirubin
c. dec. pH
d. inc. glucose

A

a. dec. clarity

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18
Q

the most sterile spx collected is a

A

suprapubic aspiration

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19
Q

which of the following would not be given to a patient prior to the collection of midstream clean catch spx?

a. sterile container
b. iodine cleanser
c. antiseptic towelette
d. instructions

A

b. iodine cleanser

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20
Q

urine spx collection for drug testing requires the collector to do all of the ff. except:

a. inspect the spx color
b. perform rgt. strip testing
c. read the spx temp.
d. fill out the COC form

A

b. perform rgt. strip testing

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21
Q

the type of nephron responsible for renal concentration is the

A

Juxtaglomerular nephron

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22
Q

the function of the peritubular capillaries is

A

reabsoprtion and secretion

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23
Q

blood flow through the nephron in the ff. order:

A

afferent arteriole - peritubular capillaries - vasa recta - efferent arteriole

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24
Q

filtration of protein is prevented in the glomerulus by

A

the glomerular filtration barrier

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25
Q

the RAAS is responsible for all of the ff. except:

a. vasoconstriction of the afferent arteriole
b. vasoconstriction of the efferent arteriole
c. reabsorbing sodium
d. releasing aldosterone

A

a. vasoconstriction of the afferent arteriole

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26
Q

the primary chemical affected by the RAAS is

A

Sodium

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27
Q

the secretion of renin is stimulated by

A

Macula densa cells

28
Q

the hormone aldosterone is responsible for

A

Sodium retention

29
Q

the fluid leaving the glomerulus has a specific gravity of

30
Q

for active transport to occur a chemical

A

must combine with a carrier protein to create electrochemical energy

31
Q

which of the tubules is impermeable to water

A

ascending loop of henle

32
Q

glucose will appear in the urine when the

A
  • blood level glucose is 200 mg/dL
  • Tm for glucose is reached
  • renal threshold for glucose is exceeded
33
Q

concentration of the tubular filtrate by the countercurrent mechanism depends on all of the following except:

a. high salt conc. in the medulla
b. water-impermeable walls of the ascending loop of henle
c. reabsoprtion of sodium and chloride from the ascending loop of henle
d. reabsoprtion of water in the descending loop of henle

A

d. reabsoprtion of water in the descending loop of henle

34
Q

ADH regulates the final urine conc. by controlling

A

tubular permeability

35
Q

decreased production of ADH

A

produces a high urine volume

36
Q

bicarbonate ions filtered by the glomerulus are returned to the blood

A
  • in the PCT
  • combined with hydrogen ions
  • by tubular secretion
37
Q

if ammonia is not produced by the DCT, the urine pH will be

38
Q

write if the ff. substances are exogenous or endogenous

  1. B2-microglobulin
  2. creatinine
  3. Cystatin C
  4. 125 I-iothalmate
A
  1. exo
  2. endo
  3. endo
  4. endo
39
Q

the largest source of error in the creatinine clearance test is

A

improperly timed urine spx

40
Q

given the ff. info. calculate the creatinine clearance:

24-hr urine volume; 1000 mL; serum creatinine 2.0 mg/dL; urine crea 200 mg/dL

41
Q

creatinine clearance test used to determine the GFR must measure substances that are

A

neither reabsorbed nor secreted by the tubules

42
Q

performing clearance test using radionucleotides

A
  • eliminates the need to collect urine

- provides visualization of the filtration

43
Q

variables tha MDRD-IDSM estimated creatinine clearance calcuations include all of the ff. except:

a. serum crea.
b. weight
c. age
d. gender

44
Q

an advantage to using Cystatin C to monitor GFR is that

A
  • it does not require urine collection
  • it is secreted by the tubules
  • it can be measured by immunoassays
45
Q

solute dissolved in solvent will

A

lower the freeaing point

46
Q

substances that may interfere with freezing point measurement of urine and serum osmolality include all of the following except:

a. ethanol
b. lactic acid
c. sodium
d. lipids

47
Q

clinical osmometers use NaCl as a reference solution because:

A

NaCl is partially ionized similar to the composition of a urine

48
Q

the normal serum osmolarity is

A

275 to 300 mOsm

49
Q

after controlled fluid intake the urine-to-serum osmolarity ratio should be at least

50
Q

calculate the free water clearance from the ff. results:
urine volume in 6 hrs: 720 mL
urine osmolarity: 225 mOsm
plasma osmolarity: 300 mOsm

51
Q

to provide an accurate measure of a renal blood flow, a test substance should be completely

A

cleared on each contact with functional renal tissue

52
Q

given the ff. data, calculate the effective renal plasma flow
urine vol. in 2 hrs: 240 mL
urine PAH: 150 mg/dL
Plasma PAH: 0.5 mg/dL

A

600 mL/ min

53
Q

Renal tubular acidosis can be caused by the

A

inability to produce an acidic urine due to increased production of ammonia

54
Q

tests performed to detect renal tubular acidosis after adminitering an ammonium chloride load include all of the following except:

a. urine ammonia
b. arterial pH
c. Urine pH
d. titratable acidity

A

b. arterial pH

55
Q

Patients with diabetes typically have higher urine output volumes; this is referred to as:

56
Q

The glomerular filtration barrier is composed of:

A

. capillary endothelium, podocytes, and basement

membrane

57
Q

. The glucose renal threshold is 160–180 mg/dL. This

represents the:

A

. plasma concentration above which glucose is

excreted in the urine

58
Q

Which of these is not a mechanism to maintain blood

pH through the kidney?

A

excretion of acetic acid

59
Q

Which of these urinary structures is involved in the

countercurrent exchange mechanism?

A

the vasa recta

60
Q

Aldosterone is involved in the reabsorption of

61
Q 
indicate the most appropriate use for the ff. urine collection methods:
A. Clean-catch
B. Early afternoon
C. First morning
D. Postprandial
E. Random
F. Three-glass
A

a. _ screening for infection
b. urobilinogen quantitation
c. most concentrated specimen
d. diabetic screening
e. routine analysis
f. diagnosis of prostate infections

62
Q 
Match urine appearance with its listed cause:
A. Amber and clear
B. Brown and cloudy
C. Colorless and clear
D. Orange
E. Red and clear
F. Red and cloudy
G. Yellow and clear
7. \_\_\_\_\_\_\_\_ normal urine appearance
8. \_\_\_\_\_\_\_\_ concentrated urine
9. \_\_\_\_\_\_\_\_ very dilute urine
10. \_\_\_\_\_\_\_\_ medications
11. \_\_\_\_\_\_\_\_ red blood cells
12. \_\_\_\_\_\_\_\_ old specimen with RBCs
13. \_\_\_\_\_\_\_\_ porphyrins
A
  1. G
  2. A
  3. C
  4. D
  5. F
  6. B
  7. E
63
Q

Refractive index compares the velocity of light in urine

to the velocity of light in:

64
Q

Which principle is used in the determination of

specific gravity by reagent strip methods?

A

The pKa of a polyelectrolyte is altered by the urine’s

ionic strength.

65
Q 
Match urine odor with their causative
constituent.
A. Fishy
B. Fruity
C. Fusty
D. Pungent
E. Sweaty feet
F. Syrupy
21. \_\_\_\_\_\_\_\_ Ammonia
22. \_\_\_\_\_\_\_\_ Bacteria
23. \_\_\_\_\_\_\_\_ Butyric acid
24. \_\_\_\_\_\_\_\_ Hypermethioninemia
25. \_\_\_\_\_\_\_\_ Ketones
26. \_\_\_\_\_\_\_\_ Leucine and isoluecine
27. \_\_\_\_\_\_\_\_ Phenylalanine
A
  1. D
  2. D
  3. E
  4. A
  5. B
  6. F
  7. C
66
Q 
Match urine preservatives with their description:
A. Boric acid
B. Chorohexidine
C. Formalin
D. Refrigeration
E. Thymol
14. \_\_\_\_\_\_\_\_ preserves urine sediment
15. \_\_\_\_\_\_\_\_ most commonly used
16. \_\_\_\_\_\_\_\_ preserves many constituents
17. \_\_\_\_\_\_\_\_ culture and sensitivity
18. \_\_\_\_\_\_\_\_ routine analysis within 72 hours

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