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Clinical Laboratory Medicine > UA > Flashcards

UA Flashcards

1
Q

What are the 3 components of a UA?

A

gross examination

urine dipstic

microscopic analysis

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2
Q

Collection of a urine sample requires what two things?

A

aseptic technique (disinfection, spread labia)

clean midstream catch

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3
Q

In gross examination, what two things should you be observing for?

A

color, turbidity

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4
Q

In gross examination, should you smell the urine?

A

yes

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5
Q

dark amber urine is (normal/abnormal) and indicates what?

A

normal, concentrated urine

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6
Q

Red or red-brown urine indicates… (2)

A

hematuria

hemoglobinuria

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7
Q

dark brown/black urine indicates…

A

bile/bilirubin due to biliary or liver disease

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8
Q

Red urine in a female, you must rule out…

A

menstrual contamination

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9
Q

Red urine in a patient of any sex, consider… (3)

A

myoglobin, food dye, beets/rhubarb

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10
Q

The following disorders would cause urine to be what color?

alkaptonuria
homogentisic acid oxidase
malignant melanoma

A

dark brown/black

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11
Q

The following could have what effect on urine clarity?

  • crystal precipitate
  • bacteria/yeast
  • WBCs/RBCs
  • mucous
  • squamous epithelium
  • sperm, prostatic fluid
  • lipids
A

cloudy/turbid

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12
Q

putrid/foul odor of urine indicates…

A

bacteria

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13
Q

fruity odor of urine indicates…

A

ketones

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14
Q

ash-tray urine smell indicates

A

cigarette smoker

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15
Q

phenylketonuira/maple syrup odors indicate…

A

amino acid disorder

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16
Q

10 measures on a urine dipstick…

A 
ph
specific gravity
glucose
ketones
protein
blood
nitrite
leukocyte esterase
bilirubin
urobilinogen
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17
Q

urine pH parallels…

A

serum pH

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18
Q

Increased concentration of urine has what effect on its specific gravity?

A

increased SG

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19
Q

This measure:

reflects ability of kidney to concentrate and dilute urine

A

specific gravity

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20
Q

In kidney disease, specific gravity can become fixed at 1.010. This is called…

A

fixed at

called isothenuria

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21
Q

urine < 500cc / 24 hours

A

oliguria

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22
Q

urine < 100cc/24 hrs

A

anuria

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23
Q

excessive urine, dilute, SG 1.000-1.002

A

polyuria

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24
Q

Glucose can “spill” into urine when plasma glucose exceeds…

A

150-180 mg/DL

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25
Q

What 2 substances can cause false negatives for glucosuria?

A

ascorbic acid

aspirin

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26
Q

Acidosis, DKA, rapid weight loss, fasting, starvation and pregnancy can all cause what to be present in urine?

A

ketones

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27
Q

Urine dipstick is sensitive to what protein?

A

albumin

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28
Q

albuminuria is an indicator of…

A

renal endothelial dysfunction/early kidney disease

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29
Q

albuminuria is an indicator of…

A

renal endothelial dysfunction/early kidney disease

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30
Q

What may cause a false positive for protein in a urine dipstick?

A

pyridium

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31
Q

What is a limitation to detecting protein in urine via dipstick?

A

dilute urine underestimates degree of albuminura

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32
Q

Moderately increased albuminuria in the range of ____ to _____ cannot be detected with dipstick

A

30-300

33
Q

Moderately increased albuminuria is a marker for staging and prognosis of…

A

kidney disease

34
Q

Persistently positive dipstick for protein should have what quantified?

A

albuminuria

35
Q

What two diagnostics outside of urine dipstick can be helpful in staging/prognosis of kindey disease?

A

24 hr collection

Albumin/Cr ratio on randome urine

36
Q

Albuminuria is a good screen for kidney damage in what high risk patients? (3)

A

diabetes, HTN, CVD

37
Q

what can cause a false negative for hematuria?

A

ascorbic acid

38
Q

what must be done in order to determine the presence of RBCs, Hb, or Mb in urine?

A

centrifuge and microscopy

39
Q

Urine diptick sensitivity is ______ for RBCs or _____ for Hb

A

5-10 RBCs, .05-.3 Hb

40
Q

Nitrite test on UA is 50% sensitive for UTI. This means…

A

can’t r/o UTI

41
Q

Nitrite in urine can indicate…

A

bacteria

42
Q

False negatives for nitrite in UA can be caused by…

A

urine in bladder < 4 hrs

bacteria w/out nitrite enzymes

43
Q

What releases leukocyte esterase?

A

neutrophils and macrophages

44
Q

This measure on a urine dipstick is a marker for the presence of WBCs indicating infx…

A

leukocyte esterase

45
Q

Vaginal contamination and trichomonas can give a false positive for…

A

leukocyte esterase

46
Q

LE and Nitrite increases sensitivity for diagnosing…

A

UTI

47
Q

detects metabolic acidosis/alkalosis…

A

pH

48
Q

can detect acute kidney failure…

A

specific cravity

49
Q

indicates DM

A

glucose

50
Q

indicates DKA/acidosis…

A

ketones

51
Q

Can indicate kidney pathology…

A

proteinuria

52
Q

sign of early kidney disease…

A

moderately increased albumin

53
Q

___ + _____ indicates infection

A

nitrate/LE

54
Q

indicates liver disease, hemolysis, biliary obstruction

A

bili/urobili

55
Q

in hypertonic urine, RBCs appear…

A

crenated

56
Q

What age for hematuria via these causes?

Glomerulonephritis
UTI
congenital anomaly

A

0-20yr

57
Q

What age for hematuria via these causes?

UTI
Caliculi
Bladder CA

A

20-60

58
Q

What age for hematuria via these causes?

BPH
Bladder CA
Prostate CA
UTI
Kidney CA
A

> 60 Male

59
Q

What age for hematuria via these causes?

UTI
Bladder CA
Kidney CA

A

> 60 female

60
Q

After centrifuging urine, you see sediment red. This indicates…

A

hematuria

61
Q

After centrifuging urine, you see supernatant red. What do you do next?

A

dipstick heme

62
Q

After centrifuge of supernatant red, you see a positive heme dipstick. If plasma was clear, what was the cause?

A

myoglobinuria

63
Q

After centrifuge of supernatant red, you see a positive heme dipstick. If plasma was red , what was the cause?

A

hemoglobinuria

64
Q

on UA microscopy, you see cells with lobed nuclei and cytoplasmic granules…

What does this indicate?

A

WBCs

65
Q

What types of renal cells can be seen on UA microscopy?

A

transitional epithelial

renal tubular epithelial

66
Q

On UA microscopy, you see the following:

maltese cross by polarized light

refractile, lipoprotein abundant tubular cells

these cells are called ______ and indicate…

A

oval fat bodies, nephrotic syndrome

67
Q

presence of squamous epithelial cells in UA indicates…

A

contamination

68
Q

large polygonal cells on UA…

A

squamous epithelial

69
Q

where are urine casts formed?

A

DCT

70
Q

Very pale, slightly refractile cells

composed of mucoprotein (tamm-horsfall) secreted by tubule cells

common finding in normal urine…

A

hyaline casts

71
Q

red cell casts indicate…

A

glomerulonephritis, tubular injury

72
Q

WBC casts suggests…

A

acute pylonephritis

73
Q

renal tubular casts suggests…

A

acute tubular necrosis

74
Q

these are casts of debris from the tubules that are nonspecific

A

granular/waxy casts

75
Q

this cause of crytalluria is secondary to hyperuricemia in acidic urine…

A

uric acid crystals

76
Q

this cause of crytalluria is a rare genetic cause of kidney stones

A

cystine crystals

77
Q

this cause of crytalluria is found in alkaline urine, secondary to urease-producing bacteria

A

struvite

78
Q

this cause of crytalluria is independent of pH, common cause of kidney stones, can be monohydrate or dihydrate

A

calcium oxylate

Clinical Laboratory Medicine (9 decks)

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