Urine Studies

Question 1

urinalysis can be used to diagnose

Answer 1

renal or urinary tract disease
monitor renal or urinary tract disease
detect metabolic or systemic disease (DM)

Question 2

cystocentesis

Answer 2

remove fluid from the bladder using a suprapubic catheter

Question 3

first morning specimen

Answer 3

pt. gets specimen first thing in the morning

must use a preservative

Question 4

random urine specimen

Answer 4

obtained during the day w/o pt prior notice

• drug testing
• most common

Question 5

timed urine collection

Answer 5

pt collects all urine over a period of 24 hours

• does not include the first morning void (would include urine produced during the night)
• proteinuria

Question 6

urine for culture and sensitivity

Answer 6

examines bacteria, sterile, midstream collection, cultured w/in one hour of collection (doesn’t usually happen)
-avoids contamination and cell lysis

Question 7

cloudy urine indicates

Answer 7

presence of WBC, RBC, bacteria

Question 8

pale yellow to amber urine indicates

Answer 8

urochrome (a pigment which is a product of bilirubin metabolism)

Question 9

red urine indicates

Answer 9

pt is bleeding, dark red (from the kidneys)
bright red (from bladder)

Question 10

dark yellow urine indicates

Answer 10

bilirubin

Question 11

specific gravity

Answer 11

measures kidney’s ability to conc the urine

• weight is compared to weight of distilled water
• value is affected by amt of solutes, volume, hydration

Question 12

low specific gravity indicates

Answer 12

diabetes insipidus

chronic renal diseases (diminished conc ability)

Question 13

renal threshold

Answer 13

180mg/dl

point at which kidneys start allowing sugar through

Question 14

anti-diuretic hormone

Answer 14

in posterior pituitary, keeps your body from diuresing (urinating)

Question 15

high specific gravity indicates

Answer 15

DM
excessive water loss (dehydration)
increased secrection of ADH (urine is concentrated)
lots of solute in the urine

Question 16

urine osmolality

Answer 16

number of particles in a unit of solution-correlates w/specific gravity but not the same thing
normal is 50-1200 mOsm/kg

Question 17

pH

Answer 17

normal is 4.6-8.0 (avg is 6.0)

Question 18

low pH (acidic)

Answer 18

acidosis, diet high in cranberries

Question 19

high pH (basic)

Answer 19

some bacteria, UTI

Question 20

protein

Answer 20

no protein should be in the urine
measured negative (-) to 4+
qualitative check

Question 21

proteinuria indicates

Answer 21

glomerular injury (allows proteins, albumin, to seep into filtrate)
if pos for protein, should f/u with 24 hr specimen

Question 22

proteinuria indicates also

Answer 22

preeclampsia-HTN, edema, proteinuria
eclampsia
diabetes -decreased renal flow
glomerulonephritis

Question 23

blood

Answer 23

measured negative (-) to 4+

Question 24

hematuria

Answer 24

bleeding w/i the urinary tract may be gross or microscopic

Question 25

positive microscopy needs to have

Answer 25

3-5 RBC per high power field

Question 26

hematuria indicates

Answer 26

cystitis (most common cause of hematuria) glomerulonephritis cancer

Question 27

false positive on a heme test could be caused by

Answer 27

beets

Question 28

microscopy

Answer 28

looking at urine under the microscope

Question 29

glucose

Answer 29

normally negative | positive is 100-2000 mg/dl

Question 30

glucose in urine indicates

Answer 30

possible diabetes (unless pregnant)

Question 31

ketones in urine

Answer 31

normally negative | positive reported as 1+ to 4+

Question 32

ketone (definition)

Answer 32

byproduct of fatty acid catabolism used as energy source when glucose cannot be used breakdown of muscle

Question 33

ketonuria indicates

Answer 33

``` poorly controlled DM (insulin resistance) hyperglycemia diabetic ketoacidosis alcoholic ketoacidosis starvation high protein diets ```

Question 34

bilirubin

Answer 34

breakdown product of hemoglobin

Question 35

urobilinogen

Answer 35

bilirubin that has been transformed by the kidney | -water soluble

Question 36

urobilinogen increase indicates

Answer 36

hemolysis

Question 37

leukocyte esterase

Answer 37

screens for WBC

Question 38

positive leuk esterase indicates

Answer 38

UTI | -may be contaminated by vaginal discharge

Question 39

nitrites

Answer 39

gram negative bacteria takes nitrates and turns them into nitrites

Question 40

positive nitrites indicates

Answer 40

UTI with a gram negative bacteria

Question 41

microscopic examination can note

Answer 41

RBC, WBC, epithelial cells (squamous, renal tubular) | crystals (indicates stone formation) varies w/ dz and pH

Question 42

most common cause of a urinary stone

Answer 42

calcium oxalate

Question 43

uric acid crystals

Answer 43

crystals in acidic urine indicates gout

Question 44

calcium oxalate

Answer 44

crystals in acidic urine composes kidney stones (envelopes)

Question 45

calcium phosphate

Answer 45

crystals in alkaline urine

Question 46

lots of epithelial cells indicate

Answer 46

contamination from vagina or penis

Question 47

triple phosphate

Answer 47

coffin lids a/w stones, chronic cystitis

Question 48

casts

Answer 48

formed in DCT form when overproduction of cells, and conc of Na+, decreased urine flow cells in the form of whatever area it came out of

Question 49

hyaline cast

Answer 49

protein cast | strenuous excercise or dehydration

Question 50

cellular cast

Answer 50

abundance of red or white blood cells

Question 51

granular cast

Answer 51

cellular or protein material that has been broken down - renal disease - strenuous excersize

Question 52

fatty cast

Answer 52

overproduction of lipids oval fat bodies within cellular cast -nephrotic sydrome

Question 53

waxy cast

Answer 53

``` cell or hyaline cast that has been present for a long time and has broken down diminished flow -long term kidney disease -diabetic nephropathy -malignant HTN ```

Question 54

epithelial cast

Answer 54

may be squamous cell or renal tubule - renal tubular indicates glomerulonephritis - from bladder indicates tumor, infection or polyps

Question 55

WBC cast

Answer 55

found in infections - pyelonephritis - inflammatory nephritis (lupus)

Question 56

RBC cast

Answer 56

found in disruption of blood/urine barrier | indicates membrane damage (glomerulonephritis)

Question 57

conjugated bilirubin

Answer 57

bilirubin that has passed through the liver and is now water soluble

Question 58

unconjugated bilirubin

Answer 58

bilirubin that has not passed through the liver and is fat soluble

Question 59

Tamm-Horsfall protein

Answer 59

most common protein that makes up hyaline casts