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Urine Analysis > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

What gives urine its yellow color

A

urochrome

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2
Q

What causes urine to become orange-brown, what causes it if its normal

A

urobilin

conversion of urobilinogen to urobilin over time,

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3
Q

What causes urine to become pink, assuming its normal

A

uroerythrin,

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4
Q

What can turn urine green?

A

biliverdin, improper storage, oxidizes

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5
Q

What turns urine black?

A

homogentistic acid, associated with malignant melanoma

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6
Q

What turns urine blue or green

A

drugs, bacteria like pseudomonas, mouthwash, some antidepressants

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6
Q

What turns urine blue or green

A

drugs, bacteria like pseudomonas, mouthwash, some antidepressants

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7
Q

What turns urine brown

A

myoglobin blood drugs

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8
Q

Match the drug to the reaction that causes the color change in urine: Rhabdomyolysis, metronidazole, methemoglobin

oxidized hemoglobin
treatment for trichomoniasis
myoglobin in urine

A

methemoglobin- oxidized hemoglobin
metronidazole-treatment for trichomoniasis
rhabdomyolysis-myoglobin in urine

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9
Q

What turns urine red-purple

A

oxidation of porphyrinogen and porphobilinogen to color,

can be caused by porphyrias or improper handling of specimen

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10
Q

What turns urine very bright yellow

A

riboflavin from, B complex vitamins

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11
Q

What turns urine orange

A

food and drugs

anticoagulants, tuberculosis treatment, urinary analgesic, certain fruits with carotene

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12
Q

What turns urine yellow-brown

A

antibiotics

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13
Q

What turns urine pink

A

could be blood from a UTI, porphyria due to porphobilin

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14
Q

What turns urine red?

A

blood in urine, hemoglobin or eating too many beets

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15
Q

What can urine foam indicate?

A

dont report it out

could be due to too much protein, bilirubin if foam is yellow

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16
Q

List the term that matches the description
visible particles, can read through it
no visible particles
many particles, print is blurred or hard to read
can’t read through it

A

slightly cloudy
clear
cloudy
turbid

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17
Q

What can urine odor tell us

A

dont report it,
could be due to urea being converted to ammonia by bacteria
certain foods
metabolic disorders- cause sweet smell if diabetes
bleach smell- adulteries drug specimen
pungeant smell- UTI

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18
Q

What is the normal concentration of urine

A

94% water

6% solutes

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19
Q

What two tests are used to measure urine concentration

A

specific gravity-mass of solutes in urine compared to water- faster
osmolality- number of particles in a solution- more specific

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20
Q

What is the possible physiological range for specific gravity

A

1.002 to 1.040

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21
Q

The greater the urine density the ____ the SG value

A

greater

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22
Q

Match the method to the test: reagent strip, urinometry, harmonic oscilation, refractometry

  • measures charged ions, indirect measure of density
  • uses molecular size and structure
  • measure of density, inaccurate
  • measure of density, very accurate
A

reagent strip-measures charged ions, indirect measure of density
refractometry-uses molecular size and structure
urinometry-measure of density, inaccurate
harmonic oscilation denistometry-measure of density, very accurate

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23
Q

What is nocturia

A

when you pee too much over 500mL at night

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24
Q

What is isothenuria

A

when the kidneys cant alter specific gravity of ultrafiltrate, specific gravity is really low

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25
Q

What is polyuria

A

more than 3L of water a day

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26
Q

What is diuresis

A

increase in urine excretion more than 1800 mL per day

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27
Q

What is oliguria

A

decrease in urine less than 400

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28
Q

what is anuria

A

no urine excretion

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29
Q

What could cause a specific gravity result to be more than 1.040

A

could have radiographic contrast

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30
Q

What could cause a specific gravity result to be less than 0.005

A

could be due to the presence of some nonionic solute

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31
Q

What is the normal range for serum osmo? and urine?

A

serum: 275-300
urine: 275-900

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32
Q

What is the normal daily volume of urine

A

600-1800

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33
Q

How much does adding mole of solute particles to 1kg of pure water cause the freezing point to change? increase or decrease?

A

decrease by 1.86C

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34
Q

What are the normal ranges of specific gravity, what are the terms if too low or too high

A

1.010 to 1.025
hyposthenuric too low
hypersthenuric too high

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35
Q

What is the normal range for the urine pH

A

4.5 to 8.0

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36
Q

What is a normal daily protein amount

A

more than 150mg/day

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37
Q

What proteins originate from the urinary tract

A

uromodulin, urokinase, secretory immunoglobulin A

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38
Q

What is the term for increased protein in urine, what causes it? what are the 3 types

A

proteinuria- increase in plasma proteins that are filtered or reduction in the reabsorptive ability of the tubules

pre-renal, renal and post-renal

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39
Q

What are these conditions related to: septicemia, hemoglobinuria, myoglobinuria, multiple myeloma and macroglobulinemia

A

pre renal proteinuria

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40
Q

What are bence jones proteins

A

immunoglobulin light chains found in urine

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41
Q

Match the condition to the description
glomerular proteinuria
tubular proteinuria

capacity for reabsorption Tm is exceeded
reabsorptive function is altered or impaired

A

glomerular proteinuria: capacity for reabsorption Tm is exceeded
tubular proteinuria: reabsorptive function is altered or impaired

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42
Q

What type of proteinuria is the most common and the most serous

A

glomerular proteinuria

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43
Q

How does proteinuria affect the daily excretion of urine

A

glomerular- more than 2.5 a day

tubular-less than 2.5 a day

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44
Q

An inflammatory response in the urinary tract can be a result of what type of proteinuria

A

post renal

45
Q

Leakage of blood products into the urinary tract can be a result of

A

postrenal proteinuria

46
Q

If a specimen is contaminated with vaginal secretions or seminal fluid what test on the reagent strip is affected

A

protein is false positive

47
Q

Match the reagent strip test to the principle
sg, pH, protein, blood leukocyte, nitrite, glucose, ketones, bilirubin, ascorbic acid
- measures ionically charged solutes
-double indicator with bromothymol blue and methyl red
- the protein error of indicators
- pseudoperoxidase activity
- diazotization reaction of nitrite with aromatic amine, creates diazonium salt
-sequential enzyme reaction that detects only glucose
- nitroprusside reaction
- reaction of diazonium salt and bilirubin in an acid medium
– ascorbic acid reduces a dye in the reagent

A

Specific gravity- measures ionically charged solutes
pH-double indicator with bromothymol blue and methyl red
protein- the protein error of indicators
blood leukocyte esterase- pseudoperoxidase activity
nitrite- diazotization reaction of nitrite with aromatic amine, creates diazonium salt
glucose-sequential enzyme reaction that detects only glucose
ketones- nitroprusside reaction
bilirubin- reaction of diazonium salt and bilirubin in an acid medium
ascorbic acid – ascorbic acid reduces a dye in the reagent

48
Q

What dipstick test is SSA related to, what does positive look like

A

protein, looks really milky gets more turbid

49
Q

What reagent strip test is clinitest related to, what does positive look like

A

glucose, reagent strip color change

50
Q

What reagent strip test is acetest related to

A

ketones, purple

51
Q

What reagent strip test is the ictotest related to

A

bilirubin, blue or purple

52
Q

What is the sensitive albumin related to and what does a positive result look like

A

albumin, strip test

53
Q

What are the limitations of the protein strip test

A

most sensitive to albumin, does not detect other proteins

54
Q

What is hematuria and hemoglobinuria, what causes them

A

too many RBCs-kidney disease
too much hemoglobin-hemolysis intravascularly
in urine

55
Q

How does the test strip find blood

A

looks for heme moiety

56
Q

What is myoglobinuria and what causes it

A

muscle trauma,

57
Q

What will intravascular hemolysis lead to in urine usually

A

hemosiderin

58
Q

How can you distinguish hemoglobinuria from myoglobinuria

A

hem- plasma has hemolysis

myo-plasma looks normal

59
Q

How can you distinguish hematuria from hemoglobinuria

A

hematuria- cloudy

hemoglobinura-clear

60
Q

What is the normal range for leukocyte esterase

A

up to 10WBCs, if too many could imply inflammation

61
Q

WBCs are susceptible to lysis in ____ and ____ urine

A

hypotonic and alkaline

62
Q

What WBC does leukocyte esterase not detect

A

lymphs

63
Q

Nitrite is an important tool to identify a ____, the most common organism that causes this is ____

A

a UTI, E coli

64
Q

What is glucosuria vs glycosuria

A

glucosuria- glucose in urine

glycosuria- non glucose sugars like fructose, sucrose and lactose

65
Q

If blood glucose levels exceeds ____, the glucose in the ___ exceeds reabsorptive abilities and results in ____

A

160-180
ultrafiltrate
glucouria

66
Q

What is the most common disease that causes glucosuria

A

diabetes

67
Q

True or False: hyperglycemia can occur without glucosuria

A

True, can cause bp to go down and glucose gets reabsorbs through glomerulus

68
Q 
What causes 
galactosemia
lactose
fructose
pentoses 
maltose and glucose in urine
A 
galactosemia- metabolic issues
lactose- could be pregnant or infant
fructose- too much fruit or honey
pentoses- too much fruit or genetics
maltose and glucose in urine- diabetes
69
Q

Of the sugars that can be present in the urine, only ____ or ____ signify pathologic condictions

A

glucose or galactose

70
Q

What is the principle of the copper reduction clinitest

A

reduces substrates to convert cupric sulfate to cuprous oxide

71
Q

When are clinitests used

A

screen for reducing substances in children less than 2 years old

72
Q

What are the 3 products used to ID ketone bodies

A

acetoacetate, Beta hyrdroxybutyrate, acetone

73
Q

T or F, no levels of ketones are normal

A

T

74
Q

What do ketones mean clincally, what is the most common reason ketones are elevated

A

issues with diabetes, excessive diets, frequent vomiting, diabetes

75
Q

Explain which ketone can convert into the other two

A

acetate can become acetoacetate or beta hydroxy

76
Q

List which ketones are most to least abundant

A

most- beta hydroxy
acetoacetate
acetone-least

77
Q

Which ketone is the first one to form in the liver, which is the most enzymatically reduced

A

acetoacetate- first

beta hydroxy- most reduced

78
Q

Which ketone has no method of detection

A

beta hydroxy

79
Q

What is bilirubin vs urobilinogen

A

bilirubin- breakdown of hemoglobin

urobilingen- if billirubin is exposed to bacteria in the intestines- it becomes urobilinogen

80
Q

What is the normal range for bilirubin in urine

A

any amount is significant

81
Q

What tell tale sign is there of posthepatic altered bilirubin metabolism

A

white poop

82
Q

What test uses ehrlich’s reaction

A

urobilinogen

83
Q

What is ascorbic acid, what can it interfere with?

A

vitamin C,
blood, bilirubin, glucose and nitrite
causes false negatives

84
Q 
Name the normal ranges for 
RBCs
WBCs
Casts
Epethelial cells
squamous cells
transitional 
renal
bacteria and yeast
abnormal crystals
A 
RBCs : 0-3
WBCs: 0-8
Casts: 0-2 only hyaline
squamous cells: few
transitional : few
renal: few
bacteria and yeast: none
abnormal crystals: none
85
Q

What do eosinophils in urine indicate, how are they stained

A

acute intersitial nephritis, Hansel stain

86
Q

ID: smooth, biconcave disk with no nucelus,

A

RBCs

87
Q

ID: spherical, granular cytoplasm, lobed nuclei, glitter cells

A

WBCs

88
Q

What do lymphs in urine indicate

A

renal transplant rejection

89
Q

ID: spherical, large, granular, filled with debris

A

monocyte

90
Q

Refractile monocyte with lipoproteins and fat inside

A

oval fat body

91
Q

large, thin, irregular shapes, central nucleus, lots of cyotplasm

A

squamous epethelial

92
Q

round or pear shape, borders appear firm, clublike, round oval nucleus off center sometimes

A

transitional epithelial cell

93
Q

Small, cuboidal, columnar, off center nucleus

A

renal epithelial cells

94
Q

acid pH, increased solutes, urine stasis, increased plasma

A

casts

95
Q

How are casts formed

A

in distal and collecting ducts out of uromodulin, Tamm Horsfall

96
Q

What conditions cause casts to disintegrate

A

hypotonic and alkaline

97
Q

What type of casts can be in healthy indv

A

hyaline or finely granular

98
Q

What are casts made of

A

uromodulin/ tamm horsefall protein

99
Q

What type of casts are usually present

A

granular or waxy

100
Q

The most clinically significant crystals are found in ____ urine

A

acid

101
Q

What stains are used to see urine?

A

sternheimer-malbin

sudan, gram stain, prussian blue, hansel

102
Q

thin, irregularly angles with a centrally located nucleus. Can be found in increased numbers if collection technique was poor.

A

squamous cells

103
Q

What crystals are found in acidic urine

A

amorphous, acid urate, monosodium, uric acid and calcium oxalate

104
Q

What crystals are in alkaline urine

A

amorphous phosphate, calclium phosphate, ammonium biurate, calcium carbonate

105
Q

What crystals are of metabolic origin

A

bilirubin, cystine, tyrosine, cholesteriol

106
Q

looks like brick dust, common, uroerythrin deposits of crystal making it look pink orange, refrigeration enhances precipitation

A

amorphous urate

107
Q

envelope or dumbbell shape, usually small, possible under any pH

A

calclium oxalate

108
Q

looks like grains of sand, white or grey precipitate, soluble in acid, no clinical significance

A

amorphous phosphate

109
Q

looks like coffin, soluble in acetic acid, can be in healthy patients

A

triple phosphate

110
Q

throny apple, irreglular with striations. Indicates dehydration, can cause renal tubular damage

A

ammonium biurate

111
Q

notched corners, could mean lipiduria and proteinuria

A

cholesterol

Urine Analysis (5 decks)

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