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UA exam 1 > exam 1 > Flashcards

exam 1 Flashcards

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1
Q

Shield of negativity

A

An electric field (podocyte) the prevents small poalr proteins from passing through the glomurerleous

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2
Q

Diabetes Mellitus

A

^ specific gravity
v insulin
v function of insulin
^ glucose

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3
Q

Diabetes insipidus

A

v specific gravity
v function/production of ADH

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4
Q

Urine to serum osmolality

A

1:1
Controlled hydration increases to 3:1 for testing

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5
Q

Fix high specific gravity

A

dilute 1:2 with distilled water (saline has stuff in it and would give false results for specific gravity)
Multiple the last 2 digits by the dilution factor eg: 2x 1.010 = 1.020

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6
Q

Color
Normal

A

Urochrome: normal

Uroerythrin: Pink sediment. high salt diet

Urobilin: Oxidation of urobilinogen

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7
Q

Color
Orange

A

Bilirubin: bile duct obstruction or liver disease

Pyridium: Drug for UTIs. shake test looks like bilirubin (needs ictotest)

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8
Q

easy bilirubin test

A

Shake and look for yellow foam. Can be mistaken for pyridium.

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9
Q

Color
Yellow-green

A

Photo-oxidation of products of bilirubin
biliverdin

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10
Q

Color
Red/pink/brown

A

Blood
Methemoglobin
Myoglobin
hemoglobin
Porphyrins/Porphobilinogen

Non-pathogenic: menstruation/food/medication

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11
Q

is it blood/hemoglobin/myoglobin?

A

Blood: Readand cloudy urine

Myoglobin: Clear plasma after spinning down

Hemoglobin: Red plasma after spinning down

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12
Q

Color
Brown/Black

A

Melanin: oxidation of melanogen

Homogentisic acid: Phenylalanine metabolite. Alkaptonuria

Medication

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13
Q

Color
Blue/green and purple

A

Green/ green-blue: Pseudomonas

Blue-indican: intestinal tract infections

Purple: Klebsiella. Catheterized patients can make a purple bag

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14
Q

Colo
Green

A

Medications
Chlorets
Oxidations products of IV medications

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15
Q

Pyridium Vs Bilirubin

A

Pyridium: Yellow foam with negative ictotest

Bilirubin: yellow foam with positive ictotest

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16
Q

Turbidity
nonpathogenic

A

Epithelial cells
Crystals
Semen
Radio contrast media
Talcum powder
Medications

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17
Q

Turbidity pathogenic

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A

RBCs, WBC, Bacteria

Yeast
Non-squamous epithelial cells
abnormal crystals
lipids

18
Q

Specific gravity

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A

First renal function to become impaired: reabsorption process
Presumptive determination
Urometers measures at 20C
Standard is 1.010

19
Q

Specific gravity averages

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A

normal: 1.002 - 1.035
random specimen range: 1.015 - 1.025
Specimins <1.002 = bad sample (diluted or intentionally tampered with)

20
Q

Specific gravity >1.035

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A

Rediographic contrast media
Plasma expanders (dextran

21
Q

Odor

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A

Ammonia = Bacteria breaking down urea
Diabetic ketones = sweet
bacteria and yeast = foul odor
maple syrup urine disease = obvious
PKU = mousy odor

22
Q

Renin-angiotensin-aldosterone

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A

For sodium and fluid retention

BP V -> Renin released -> Angiotensin released -> vasoconstriction of afferent ducts -> aldosterone for Na reabsorption and fluid retenion -> BP goes up locally

23
Q

Light and time effect on urine

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A

Color: modified - oxidation
Clarity: decreased - bacterial growth and precip of crystals
odor: increased - bacterial growth
pH: increased - breakdown of ammonia by bacteria and loss of CO2
Glucose: decreased - bacterial growth
ketones: decreased - volitalization/bacterial growth
bilirubin: decreased - oxidation by light
Urobilinogen: decreased - oxidation to urobilin
nitrite: increased - nitrate reducing bacteria
RBC/WBC: decreased - disintegration in alkaline urine
Bacteria: increase - multiplication

24
Q

Protein confirmation test

25
protein strip false positive
Alkaline urine
26
Test strip pH
Acidosis/alkalosis defects of renal function Identification of crystals renal calculi formation Fluctuation due to diet mostly methyl red : 4-6 bromthymol blue: 6-9
27
test strip Protein
most indicative of renal disease Albumin principle protein Needs constant pH Protein accepts H+ from strip, changes color Interfered with: highly alkaline urine. causes false positive SSA Confirmatory testing if pH >7.5 AND protein is positive
28
test strip protein false positive and negatives
False Positives: pigmented urine ammonia compounds high specific graviy false negatives: proteins other than albumin (Ig's etc)
29
Microalbumin
Small amounts of albumin in urine. too little to detect indicator of renal trouble. detected with immunochemical assays/dye binding assays
30
microalbumin vs creatinine
Creatinine is usually stable. Albumin fluctuates with hydration A:C normal: <30mg A:1g C Microalbuminuria: 30-300mg A: 1g C Clinical albuminuria: >300mg A: 1g C
31
Clinitest
We don't use this anymore (part of the newborn screening tests) Copper reduction test. generats a lot of heat. watch for passthrough (will go positive quickly, then return to baseline)
32
clinically significant RBCs in urine
5 RBC/uL
33
Strip test Blood
Pseudoperoxidase activity first spots turn splotchy for RBC activity False positive: Strong oxidizing detergents Vegetable peroxidases Bacterial peroxidases (requires microscopic confirmation) False negatives: Ascobic acid Formalin, unmixed sample
34
urine rejection criteria
Improper labeling Timing transport (greater than 2hs) quantity
35
24 hour collection
Void and flush at 8 am -> collect everything for 24 hours -> 8 am collect final sample and submit for testing Done for creatinine clearance since it can fluctuate over 24 hours.
36
Loop of henle
Decending loop: Permeable to water. water is reabsorbed here Ascending loop: impermeable to water. Ions are reabsorbed here
37
urine constituents
95% water, 5% soluted 1/2 of solutes is urea Major organics: creatinine, uric acid. Minor organic: hippuric acid Major inorganic: chloride/sodium/potasium Also hormones, vitamins, formed elements (crystals, cells, yeast, bacteria, casts, etc) and medications
38
determine if it's urine
Urea and creatinine tests. higher concentrations in urine
39
Strip test Bilirubin
Diazo rxn Azodye (hidden by azo medication)
40
Ehrlich's reagent
Urobilinogen test (tube) Positive for prophobilinogen.
41
strip test Nitrite
Tests for Nitrate reducing bacteria Rapid screening test for a UTI First morning specimen prefered (bacteria need time to reduce) All meat diet might not have enough nitrates False Negatives: non-nitrate reducing bacteria (yeasts, GP organisms) Too much bacteria reduces the nitrites to gas False positive: Sample isn't fresh Color interference
42
strip test Leukocyte esterase
Tests for granulocytic WBCs detects lysed WBCs. Use in conjunction with nitrite test. False Pos: Formalin Pigmented urine False Neg: high protein and glucose Ascorbic acid crenated WBCs Antibiotics

UA exam 1 (1 decks)

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