Urinalysis Flashcards

1
Q

Calcium Oxalate

A

Octahedral “envelope” crystal (dihydrate, most common); Spherical monohydrate esp. with Ethylene Glycol Poisoning; Normal Acidic/Neutral

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2
Q

Triple Phosphate

A

“Coffin-lid” crystal; Normal Alkaline

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3
Q

Ammonium biurate

A

“Thorny apple”; Normal Alkaline

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4
Q

Amorphous urates

A

irregular granules; normal acidic

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5
Q

Amorphous phosphates

A

irregular granules; normal alkaline

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6
Q

Uric acid

A

Pleomorphic. 4-sided, 6-sided, star shaped, rosettes, spears, plates; normal acidic

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7
Q

Calcium phosphate

A

needles, rosettes, “pointing finger”; Normal alkaline

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8
Q

Calcium carbonate

A

“Dumbbells” or aggregates; normal alkaline

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9
Q

Leucine

A

Oily spheres, concentric circles; abnormal acid/neutral (Severe liver disease)

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10
Q

Tyrosine

A

Needles in sheaves or rosettes; abnormal acid/neutral (Severe liver disease)

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11
Q

Cystine

A

Hexagonal (6-sides); abnormal acid (Cystinuria, metabolic disease)

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12
Q

Cholesterol

A

Flat plates, notched out corners “stair-steps”; abnormal acid (Nephrotic syndrome)

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13
Q

Bilirubin

A

Yellowish brown needles, plates, granules; abnormal acid (Liver disease)

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14
Q

Acute glomerulonephritis

A

Cause: Inflammation and damage to glomeruli
Macro: protein, blood
Micro: RBCs, WBCs, red cell casts
Notes: Frequently follows untreated group A strep

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15
Q

Nephrotic syndrome

A

Cause: Increased glomerular permeability
Macro: protein (4+)
Micro: Casts (all kinds), free fat, oval fat bodies

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16
Q

Pyelonephritis

A

Cause: Kidney infection (upper UTI)
Macro: Protein, LE, nitrite
Micro: WBCs, WBC casts, bacteria

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17
Q

Cystitis

A

Cause: bladder infection (lower UTI)
Macro: LE, nitrite
Micro: WBCs, bacteria, possible RBCs, no casts

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18
Q

Renal Calculi

A

AKA: Kidney Stones
Macro: Blood (4+)
Micro: RBCs, crystals (usually Ca Oxalate)

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19
Q

Major protein component of casts

A

Tamm-Horsfall protein

20
Q

Fat in urine can be identified by

A

stain (Sudan III or IV); polarized light

21
Q

Glucose reflex test. Condition?

A

Clinitest. Patient <2 yrs old.

22
Q

Bilirubin reflex test. Condition?

A

Ictotest. Positive bilirubin.

23
Q

Protein reflex test. Condition?

A

SSA. Trace protein result.

24
Q

Renal threshold for Glucose

A

160-180 mg/dL

25
Q

Yeast Infection

A

Macro: (+/-) protein, LE, Blood
Micro: WBC, RBC, Yeast

26
Q

High Uro, +/- Bili

A

Liver disease

27
Q

Normal Uro, + Bili

A

Biliary Obstruction

28
Q

High Uro, - Bili

A

Hemolytic disorder

29
Q

End-stage Renal Disease

A

Cause: any renal condition can lead to this
Macro: protein, +/- blood
Micro: Renal Epithelial cells, granular casts, broad waxy casts

30
Q

If >2 hrs unpreserved before testing

A

Macro: pH up, protein slightly up, glucose down, ketones down, bili down, nitrite up
Micro: Casts down, RBCs down, Bacteria up, WBCs down

31
Q

Creatinine clearance reference range

A

80-130 mL/min

32
Q

Angiotensin

A

Produced when low plasma Na+, promotes Na+ reabsorption in PCT

33
Q

Aldosterone

A

Produced when low plasma Na+, promotes Na+ reabsorption in DCT

34
Q

ADH

A

opens door for passive transport of H2O in DCT (more ADH, more H2O reabsorbed)

35
Q

GFR vs. Kidney disease

A

Stage 1: >= 90 mL/min
Stage 2: 60-89 mL/min
Stage 3: 45-59 mL/min
Stage 4: 15-29 mL/min
Stage 5: <15 mL/min

36
Q

Nephritic

A

sterile, RBC casts

37
Q

Nephrotic

A

fatty and waxy casts, protein +++

38
Q

Broad casts

A

tubular dilation and stasis (chronic renal failure)

39
Q

PKU (phenylketonuria)

A

Symptoms: Mousy-smelling urine, developmental delays
Pathology: Missing enzyme phenylalanine hydroxylase
Testing: Guthrie (B. subtilis on blood) or Ferric Chloride (urine)

40
Q

MSUD (maple syrup urine disease)

A

Symptoms: very sweet smelling urine (keto acid buildup)
Pathology: buildup of leucine, isoleucine, and valine
Testing: 2,4-DNPH

41
Q

Alkaptonuria

A

Symptoms: urine darkens as it turns alkaline at room temp
Pathology: buildup of homogentisic acid due to missing oxidase
Testing: Silver nitrate test

42
Q

Melanuria

A

Symptoms: dark brown or black urine
Pathology: malignancy of melanocytes (melanoma)

43
Q

Indicanuria

A

Symptoms: urine turns blue when exposed to air (“blue diaper syndrome”
Pathology: Deficient intestinal reabsorption of tryptophan (sometimes general aminoaciduria a.k.a. Fanconi syndrome)

44
Q

Porphyria/Porphyrinuria

A

Symptoms: red/port wine colored urine
Pathology: Errors in heme synthesis (porphyrin metabolism)
Causes: inherited (rare), lead poisoning, iron deficiency, +++ alcohol
Testing: Watson-Schwartz test

45
Q

Cystinuria

A

Symptoms: calculi of cystine crystals
Pathology: poor reabsorption of cystine and lysine (and sometimes arginine and ornithine) in renal tubules
Testing: Cyanide Nitroprusside (+), Silver Nitroprusside (-)

46
Q

Homocystinuria

A

Symptoms: cataracts, FTT, intellectual disability, stroke, death
Pathology: buildup of homocystine (defects in methionine metabolism)
Testing: Cyanide Nitroprusside (+), Silver Nitroprusside (+)

47
Q

Watson-Schwartz Test

A

Urine/Chloroform; Butanol/Urine
Y/R; R/Y = Urobilinogen
R/Y; Y/R = Porphobilinogen
R/Y; R/Y = Ehrlich-reactive
R/R; R/R = Urobilinogen/porphobilinogen