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GU > UA/UC + GU Overview > Flashcards

UA/UC + GU Overview Flashcards

1
Q

List the 3 major functions of the urinary system

A
  • cleanses waste left in blood
  • keeps water balanced in body
  • produces erythropoietin
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2
Q

List some DDx for dysuria

A
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3
Q

List some DDx for hematuria

A
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4
Q

List some DDx for acute urinary retention

A
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5
Q

List some DDx for scrotal pain

A
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6
Q

What are the 2 types of dialysis

A
  • hemodialysis
  • peritoneal dialysis
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7
Q

What does a UA evaluate

A
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8
Q

List the 3 parts of a UA

A
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9
Q

List some indications for cath over clean catch

A
  • kids with fever or suspected UTI
  • menstruating women with suspected UTI
  • women with vaginal discharge
  • pts who are physically unable to provide clean catch
  • severely ill pts (sepsis)
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10
Q

List the gross assessment criteria of urine color

A
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11
Q

Gross hematuria typically involves DDx that are pre or post-renal?

A

post-renal

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12
Q

What does a urine dipstick evaluate

A
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13
Q

List some causes of decreased specific gravity

A
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14
Q

List some causes of increased specific gravity

A
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15
Q

What does urine pH screen

A

H+ concentration, reflects the degree of acidification of the urine
- ranges from 4.5-8 depending on systemic acid-base balance

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16
Q

What does urine heme detect on dipstick

A
  • detection of heme by dipstick is highly sensitive for presence of 1-2 RBCs
  • can’t distinguish between hemoglobin & myoglobin
  • if positive, need to differentiate between RBCs or myoglobin
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17
Q

What does leukocyte esterase detect on urine dipstick

A
  • released by lysed neutrophils & macrophages
  • marker of WBCs in urine think infection
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18
Q

What does nitrite detect on urine dipstick

A
  • enterobacteriae species taht produce nitrate reductase converting to nitrite
  • think bacteria
19
Q

What does urine bilirubin detect on urine dipstick

A

extremely high levels of bili in urine - bili metabolism problem

20
Q

what does a high indirect bili suggest

A

hemorrhage/hemolysis

21
Q

what does high direct bili suggest

A

cholestatic issues

22
Q

What does urine protein detect on dipstick

A
  • sensitive to albumin
  • can be misleading if urine is dilute
23
Q

What does urine glucose & ketones assess on dipstick

A
  • glucosuria can be d/t inability of kidney to reabsorb filtered glucose or overflow scenario
  • ketonuria: small amount normal, if cells can’t get enough glucose, body breaks down fat which produces ketones
24
Q

What is evaluated under microscope after urine is centrifuged in urine microscopy

A

the sediment at the bottom of the tube, the rest is discarded

25
Q

What might be seen on urine microscopy

A
  • RBCs (<3/HPF normal)
  • WBCs (<3/HPF normal)
  • Casts: cylindrical structures from tubular lumen
  • Crystals
26
Q

What do RBC casts on urine microscopy suggest

A

glomerular disease (likely glomerulonephritis)

27
Q

What do WBC casts on urine microscopy suggest

A

inflammation or infection

28
Q

What do hyaline casts on urine microscopy suggest

A

usually seen in diuretics or dehydration, nearly transparent & empty appearing

29
Q

What do granular casts on urine microscopy suggest

A

injury to epithelial cells, muddy brown casts characteristic for acute tubular necrosis (primary cause of AKI in hosp patients)

30
Q

What do waxy casts on urine microscopy suggest

A

late stage granular cast degeneration, nonspecific, seen in a variety of acute/chronic renal diseases

31
Q

What are these an example of and is this normal or abnormal

A

RBC in the urine, abnormally high
- biconcave discs

32
Q

What happens if RBCs are squished through a membrane (glomerular disease)

A

dysmorphic RBCs

33
Q

Is microscopic hematuria renal, supra-renal, or post-renal in origin?

A

renal

34
Q

If there is hematuria (RBC) + proteinuria, what is the likely source?

A

glomerular

35
Q

T/F: people on anticoagulants typically have some hematuria

A

false- work it up so you don’t miss something serious like cancer

36
Q

Describe glomerular hematuria

A
  • blood originating from the nephron
  • disruption of the filtration barrier in the glomerulus may result from inherited/acquired abnormalities in structure of glomerular basement membrane

(RBC casts on microscopy)

37
Q

List some of the MC causes of glomerular hematuria

A
38
Q

Describe the urine microscopy of extraglomerular hematuria

A
  • normal appearing RBCs in urine
  • no casts

(coming from renal parenchyma, ureters, bladder, prostate, urethra)

39
Q

List some DDx for extraglomerular hematuria

A
40
Q

List the color and microscopy findings for extraglomerular hematuria

A
  • Color: red/pink
  • clots: maybe
  • proteinuria: <500 mg/day
  • RBC morphology: normal
  • RBC casts: absent
41
Q

List the color and microscopy findings for glomerular hematuria

A
  • color: red, smoky brown, cola
  • clots: absent
  • proteinuria: >500 mg/day
  • RBC morphology: dysmorphic
  • RBC casts: likely present
42
Q

What may be on the DDx for heme+ red supernatant

A
  • hemoglobinuria (Hemolysis d/t SCD, HUS, PNH)
  • myoglobinuria (rhabdo)
43
Q

What might be on the DDx for Heme- red supernatant

A
  • meds (rifampin, nitrofurantoin, phenytoin, ibuprofen)
  • foods (beets, rhubarb, berries, dye)
  • porphyria

GU (13 decks)

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