Urine Examination ✅

Question 1

What are the advantages of urine examination?

Answer 1

• Simple

- Non-invasive

Question 2

What is involved in urine examination?

Answer 2

• Visual inspection
• Urine microscopy
• Urine dipstick

Question 3

What can be detected by visual inspection of urine?

Answer 3

• Haematuria

- Pyuria

Question 4

What is the limitation of visual inspection of urine?

Answer 4

Other conditions can mimic the appearance

Question 5

How can findings of haematuria or pyuria on visual inspection of urine be confirmed?

Answer 5

Urine microscopy

Question 6

What can be detected on urine dipstick?

Answer 6

• Glucose
• Urobilinogen
• Bilirubin
• Ketones
• pH
• Specific gravity
• Haemoglobin
• Protein
• Leukocytes
• Nitrites

Question 7

What does a urine dipstick positive for haemoglobin indicate?

Answer 7

Usually that there is blood in th eurine

Question 8

How can haematuria be confirmed?

Answer 8

By the finding of red blood cells on urine microscopy

Question 9

What does the absence of RBCs on urine microscopy when there is a positive dipstick for haemoglobin suggest?

Answer 9

Either haemoglobinuria or myoglobinuria

Question 10

What is the limitation of the detection of protein using urine dipstick?

Answer 10

It does not give an accurate quantitative estimation

Question 11

What is required to quantify protein in the urine?

Answer 11

Spot urine albumin or protein:creatinine ratio, or 24 hour urine protein

Question 12

In who can a 24-hour urine protein estimation be performed?

Answer 12

Older children

Question 13

If a spot urine sample for protein is being done, when is the ideal time of day to collect this?

Answer 13

Morning smile

Question 14

Why is a morning sample preferable for testing urine albumin or protein:creatinine ratio?

Answer 14

It helps exclude false positives seem in children with orthostatic proteinuria

Question 15

What should be suspected in cases of significant proteinuria on dipstick with insignificant albumin on quantitative estimation?

Answer 15

Leak of tubular proteins, indicating tub alar damage

Question 16

What are leukocytes on urine dipstick suggestive of?

Answer 16

UTI

Question 17

What is the limitation of leukocytes on urine dipstick as a tool for diagnosing UTI?

Answer 17

They can be secondary to fever, so is not diagnostic

Question 18

What is the advantage of using nitrites to test for UTI on dipstick?

Answer 18

They have a high specificity

Question 19

What is the limitation of testing for nitrites on urine dipstick in the diagnosis of UTI?

Answer 19

Low sensitivity

Question 20

Why is a positive dipstick for nitrites suggestive of a UTI?

Answer 20

Most pathogenic bacteria produce nitrites

Question 21

When might nitrites be negative in cases of UTI?

Answer 21

Infants and younger children

Question 22

Why might nitrites be negative in infants and younger children with UTIs?

Answer 22

Their increased urinary frequency does not allow sufficient time for nitrites to be produced

Question 23

What is done as a result of dipstick testing being of limited use in diagnosing UTI?

Answer 23

Urine cultures are advisable

Question 24

What is the advantage of urine cultures in UTI?

Answer 24

• Determines bacteriological cause and antibiotic sensitivities
• Confidently uses out UTI in children younger than 3 years

Question 25

What can be identified on urine microscopy?

Answer 25

• Red and white blood cells

- RBC casts

Question 26

What is the significance of a finding of RBC casts on urinary microscopy?

Answer 26

It is considered diagnostic of glomerular involvement