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Flashcards in Exam 1 Deck (88)
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1
Q

Patient presents with S/S of pneumonia. What do they need?

A

Chest films

2
Q

Patient presents with burning on urination and flank pain. What do they need?

A

Kidney test

3
Q

Patient presents with pain in the right upper quadrant of the abdomen. What do they need?

A

Liver function test

4
Q

Patient presents with signs and symptoms of anemia. What do they need?

A

CBC test

5
Q

A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is considered…

A

normal

6
Q

A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered…

A

prediabetes

7
Q

A fasting blood sugar level 126 mg/dL (7 mmol/L) or higher on two separate tests is considered…

A

diabetes.

8
Q

Patient presents with mid back pain. The history includes polyuria, polydipsia and family members with adult onset diabetes. What 2 tests should you order?

A

UA and FBS (fasting blood sugar)

9
Q

Patient presents with mid back pain. The history includes polyuria, polydipsia and family members with adult onset diabetes. What is the Dx and what do you do????

  • -UA reveals 3+ glucose and ketones
  • -FBS levels are 325 mg/dl
A

Diabetes Melitus and Ketosis

–concurrent care for diabetic care

10
Q

All labs are governed by…

A

CLIA (clinical laboratory improvement amendments)

11
Q

A patient with a UTI may have subluxations in what spinal region?

A

lumbar region

12
Q

A patient with liver disease may have subluxations in what spinal region?

A

T5 - T9

13
Q

Kidneys are involved in the production what hormone that stimulates RBC production, and renin, an enzyme for controlling blood pressure.

A

erythropoitin

14
Q

Routine UA consists of what 3 things?

A
  1. ) physical properties
  2. ) chemical properties
  3. ) microscopic properties
15
Q

What is the functional uni of the kidney?

A

nephron

16
Q

The glomerular filtrate becomes urine after it leaves…

A

distal convoluted tubule

17
Q

What are the 7 principle solutes of urine?

A
  • -urea
  • -sodium
  • -chloride
  • -potassium
  • -creatinine
  • -uric acid
  • -ammonia
18
Q

The body excretes approximately how many grams of dissolved material/24 hours
–one half is what?

A

60 grams

–half is urea

19
Q

Urine formation is a result of what 3 things?

A
  • -glomerular filtration
  • -tubular reabsorption
  • -tubular secretion
20
Q

What % of urine is water?

A

95% water; 5% dissolved solids

21
Q

What is the average daily volume of urine?

A

1200-1500 ml

–normal range is 600-2000 ml/day

22
Q

What is it called when:

– > 2000 ml/24 hours

A

polyuria

23
Q

What is it called when:

– < 500 ml/24 hours

A

oliguria

24
Q

What is it called wen you have an absence of urine?

A

anuria

25
Q

What is it called when the patient has excessive water intake?

A

polydipsia

26
Q

What are 2 causes of polyuria?

A
    • Diabetes melitus

- - Diabetes Insipidus

27
Q

What are 3 causes of oliguria?

A
  • -renal tubule dysfunction
  • -end stage renal disease
  • -obstruction
28
Q

What are 3 causes of anuria?

A
  • -renal failure
  • -obstruction
  • -heart attack
29
Q

When is the best time to perform a UA?

A

early morning

30
Q

When does a UA begin to decompose?

A
  • -w/in 30 min at room temp

- -w/in 4 hrs if refigerated

31
Q

What happens to unpreserved urine:

  • -color
  • -turbidity
  • -smell
A
  • -color darkens
  • -turbidity increases
  • -odor is more foul smelling
32
Q

What happens to unpreserved urine:

  • -pH
  • -glucose
  • -ketones
  • -bilirubin
  • -urobilinogen
A
  • -pH increases
  • -glucose decreases
  • -ketones decrease
  • -bilirubin decreases
  • -urobilinogen decreases
33
Q

What happens to unpreserved urine:

  • -nitrites
  • -bacteria
  • -RBC’s
  • -WBC’s
  • -casts
A
  • -nitrites increase
  • -bacteria increase
  • -RBC’s lyse
  • -WBC’s disintegrate
  • -casts disintegrate
34
Q

What 2 things does color indicate on a UA?

A

degree of hydration and concentration

35
Q

What UA color is considered normal?

A

straw to amber (light yellow to dark yellow)

36
Q

A red, dark brown urine found with excessive hemoglobin, RBC, and myoglobin is associated with what 3 things?

A
  • -menses
  • -UTI
  • -malignancy
37
Q

What does orange urine indicate?

A

dehydration

38
Q

What does bright yellow urine indicate?

A

excessive B vitamins

39
Q

What does black urine indicate?

A
  • -alkaptonuria

- -melanin problems like malignant melanoma

40
Q

What does colorless urine indicate?

A

diabetes insipidus

41
Q

What does brownish yellow/green urine indicate?

A

liver problems

42
Q

If you find brownish yellow/green urine, what 2 urine properties should be checked?

A

bilirubin and urobilinogen

43
Q

Patient has jaundice skin and sclera, right upper quadrant pain, and brownish yellow/green urine. What do you suspect?

A

hepatitis/liver disease

44
Q

What is milky urine turbidity associated with?

A

hyperlipidemia (risk factor for heart disease)

45
Q

What does clear urine turbidity indicate?

A

normal

46
Q

What does slightly hazy urine turbidity indicate?

A

usually normal (check sediment, if negative then insignificant)

47
Q

What does frothy urine turbidity indicate?

A

protein

48
Q

What does white, small amount of foam in urine indicate?

A

normal

49
Q

What does white, large amount of foam in urine indicate?

A

possible protein

50
Q

What does yellow, large amount of foam urine indicate?

A

may be due to bile/bilirubin

51
Q

What does specific gravity evaluate?

A

kidneys ability to concentrate urine

52
Q

What is the normal range of specific gravity in the adult?

A

1.015 - 1.035

53
Q

What is the specific gravity, technically?

A

The weight of the urine compared to distilled water (SpG of water = 1.000)

54
Q

What is low specific gravity called?

A

hyposthenuria

55
Q

What is high specific gravity called?

A

hypereshenuria

56
Q

What is a fixed specific gravity at 1.010 called?

A

isosthenuria

57
Q

What does isosthenuria indicate?

A

Protein free plasma and the end stage of renal failure

58
Q

What does increased specific gravity indicate?

A

concentrated urine (ie proteinuria, glucosuria)

59
Q

What does decreased specific gravity indicate?

A

dilute urine (ie glomerulonephritis, pyleonephritis, diabetes insipidus)

60
Q

What does foul, fishy urine odor indicate?

A

UTI

61
Q

What does fruity, sweet urine odor indicate?

A

diabetes mellitus/ketosis

62
Q

What does feces odor urine indicate?

A

asparagus, enterobladder fistula

63
Q

Urinalysis chemical characteristics pH indicates the ____ of the patient.

A

acid-base balance

64
Q

What is a normal urinalysis pH range?

A

4.5 - 7.5

65
Q

Why does standing urine become alkaline?

A

due to bacterial growth and breakdown of urea

66
Q

We are able to maintain normal pH primarily through reabsorption of ___ and secretion of ____ and ____ ions.

A
  • -resorption of Na+

- -secretion of H+ and ammonium ions

67
Q

What diet type will produce an acidic pH?

A

animal products

68
Q

What diet type will produce an alkaline pH?

A

citrus fruits and vegetables

69
Q

What are 3 pathological causes of acidic pH?

A
    • Emphysema (respiratory acidosis)
    • Ketoacidosis (metabolic acidosis)
    • Diabetes mellitus
70
Q

A patients UA shows the following, what do you suspect????

  • -pH 4
    • +2 sugar
    • small amount of ketones
A

diabetic/ketosis

71
Q

A patients UA shows the following, what do you suspect????

  • -pH 4
    • history of smoking
  • -barrel chest
A

Emphysema (respiratory acidosis)

72
Q

What are 3 pathological causes of alkaline pH?

A
    • Hyperventilation (respiratory alkalosis)
    • Metabolic alkalosis
    • UTI
73
Q

If a patient has a UTI what type of fluids would you recommend to them?

A

blueberry, cranberry juices to make more acidic

74
Q

A patients UA shows the following, what do you suspect and recommend????

    • pH 8
    • 20-30 WBC’s
      • 2 bacteria
A

UTI

    • recommend cranberry juice
    • rerun UA in 7 - 10 days
75
Q

A patients UA shows the following, what do you suspect and recommend????

    • pH 5
    • 20-30 WBC’s
      • 2 bacteria
A

UTI

    • no cranberry juice, its already acid
    • increase fluids
76
Q

Acidic urine is associated with what 3 types of stones and should be kept alkaline.

A
    • xanthine,
    • cystein,
    • uric acid
77
Q

Alkaline urine is associated with what 3 types of stones and should be kept acidic?

A
    • calcium carbonate
  • -calcium phosphate
    • magnesium phosphate
78
Q

What protein is UA sensitive to?

A

Albumin

79
Q

Is it normal to release protein in the urine?

A

Only in trace amounts… (150mg/day aka non measurable)

80
Q

Albuminuria is used synonymously with…

A

proteinuria

81
Q

Does protein in the urine indicate an upper or lower UTI?

A

Upper

82
Q

Why is it important to always analyze for proteinuria?

A

Primary indicator for renal disease

83
Q

What part of the nephron is damaged when proteinuria is seen?

A

Glomerular filter

84
Q

What does a positive dipstick for proteinuria need to be confirmed with?

A

Sulfosalicylic Acid Precipitation Test (SSA)

85
Q

A 13 year old remale patients UA shows the following, what do you suspect and recommend????

    • color: yellow, clear
    • pH 5
    • protein +1
    • urobilinogen 0.01
    • spg 1.020
    • WBC/HPF 0-1
  • -RBC/HPF 0-2
A

Proteinuria

–pt consider stop exercising and redo after a few days

86
Q

What is the term for when a patient presents with normal urine when supine and displays proteinuria when standing?

A

Orthostatic proteinuria

87
Q

Orthostatic proteinuria is associated with what spinal change?

A

Exaggerated lumbar lordosis

88
Q

Massive proteinuria (+4), frothy (white) in appearance

A

nephrotic syndrome