Exam 2

Question 1

What gives urine its yellow color

Answer 1

urochrome

Question 2

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

Answer 2

urobilin

conversion of urobilinogen to urobilin over time,

Question 3

What causes urine to become pink, assuming its normal

Answer 3

uroerythrin,

Question 4

What can turn urine green?

Answer 4

biliverdin, improper storage, oxidizes

Question 5

What turns urine black?

Answer 5

homogentistic acid, associated with malignant melanoma

Question 6

What turns urine blue or green

Answer 6

drugs, bacteria like pseudomonas, mouthwash, some antidepressants

Question 6

What turns urine blue or green

Answer 6

drugs, bacteria like pseudomonas, mouthwash, some antidepressants

Question 7

What turns urine brown

Answer 7

myoglobin blood drugs

Question 8

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

oxidized hemoglobin
treatment for trichomoniasis
myoglobin in urine

Answer 8

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

Question 9

What turns urine red-purple

Answer 9

oxidation of porphyrinogen and porphobilinogen to color,

can be caused by porphyrias or improper handling of specimen

Question 10

What turns urine very bright yellow

Answer 10

riboflavin from, B complex vitamins

Question 11

What turns urine orange

Answer 11

food and drugs

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

Question 12

What turns urine yellow-brown

Answer 12

antibiotics

Question 13

What turns urine pink

Answer 13

could be blood from a UTI, porphyria due to porphobilin

Question 14

What turns urine red?

Answer 14

blood in urine, hemoglobin or eating too many beets

Question 15

What can urine foam indicate?

Answer 15

dont report it out

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

Question 16

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

Answer 16

slightly cloudy
clear
cloudy
turbid

Question 17

What can urine odor tell us

Answer 17

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

Question 18

What is the normal concentration of urine

Answer 18

94% water

6% solutes

Question 19

What two tests are used to measure urine concentration

Answer 19

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

Question 20

What is the possible physiological range for specific gravity

Answer 20

1.002 to 1.040

Question 21

The greater the urine density the ____ the SG value

Answer 21

greater

Question 22

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

Answer 22

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

Question 23

What is nocturia

Answer 23

when you pee too much over 500mL at night

Question 24

What is isothenuria

Answer 24

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

Question 25

What is polyuria

Answer 25

more than 3L of water a day

Question 26

What is diuresis

Answer 26

increase in urine excretion more than 1800 mL per day

Question 27

What is oliguria

Answer 27

decrease in urine less than 400

Question 28

what is anuria

Answer 28

no urine excretion

Question 29

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

Answer 29

could have radiographic contrast

Question 30

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

Answer 30

could be due to the presence of some nonionic solute

Question 31

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

Answer 31

serum: 275-300 urine: 275-900

Question 32

What is the normal daily volume of urine

Answer 32

600-1800

Question 33

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

Answer 33

decrease by 1.86C

Question 34

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

Answer 34

1.010 to 1.025 hyposthenuric too low hypersthenuric too high

Question 35

What is the normal range for the urine pH

Answer 35

4.5 to 8.0

Question 36

What is a normal daily protein amount

Answer 36

more than 150mg/day

Question 37

What proteins originate from the urinary tract

Answer 37

uromodulin, urokinase, secretory immunoglobulin A

Question 38

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

Answer 38

proteinuria- increase in plasma proteins that are filtered or reduction in the reabsorptive ability of the tubules pre-renal, renal and post-renal

Question 39

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

Answer 39

pre renal proteinuria

Question 40

What are bence jones proteins

Answer 40

immunoglobulin light chains found in urine

Question 41

Match the condition to the description glomerular proteinuria tubular proteinuria capacity for reabsorption Tm is exceeded reabsorptive function is altered or impaired

Answer 41

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

Question 42

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

Answer 42

glomerular proteinuria

Question 43

How does proteinuria affect the daily excretion of urine

Answer 43

glomerular- more than 2.5 a day | tubular-less than 2.5 a day

Question 44

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

Answer 44

post renal

Question 45

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

Answer 45

postrenal proteinuria

Question 46

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

Answer 46

protein is false positive

Question 47

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

Answer 47

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

Question 48

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

Answer 48

protein, looks really milky gets more turbid

Question 49

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

Answer 49

glucose, reagent strip color change

Question 50

What reagent strip test is acetest related to

Answer 50

ketones, purple

Question 51

What reagent strip test is the ictotest related to

Answer 51

bilirubin, blue or purple

Question 52

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

Answer 52

albumin, strip test

Question 53

What are the limitations of the protein strip test

Answer 53

most sensitive to albumin, does not detect other proteins

Question 54

What is hematuria and hemoglobinuria, what causes them

Answer 54

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

Question 55

How does the test strip find blood

Answer 55

looks for heme moiety

Question 56

What is myoglobinuria and what causes it

Answer 56

muscle trauma,

Question 57

What will intravascular hemolysis lead to in urine usually

Answer 57

hemosiderin

Question 58

How can you distinguish hemoglobinuria from myoglobinuria

Answer 58

hem- plasma has hemolysis | myo-plasma looks normal

Question 59

How can you distinguish hematuria from hemoglobinuria

Answer 59

hematuria- cloudy | hemoglobinura-clear

Question 60

What is the normal range for leukocyte esterase

Answer 60

up to 10WBCs, if too many could imply inflammation

Question 61

WBCs are susceptible to lysis in ____ and ____ urine

Answer 61

hypotonic and alkaline

Question 62

What WBC does leukocyte esterase not detect

Answer 62

lymphs

Question 63

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

Answer 63

a UTI, E coli

Question 64

What is glucosuria vs glycosuria

Answer 64

glucosuria- glucose in urine | glycosuria- non glucose sugars like fructose, sucrose and lactose

Question 65

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

Answer 65

160-180 ultrafiltrate glucouria

Question 66

What is the most common disease that causes glucosuria

Answer 66

diabetes

Question 67

True or False: hyperglycemia can occur without glucosuria

Answer 67

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

Question 68

``` What causes galactosemia lactose fructose pentoses maltose and glucose in urine ```

Answer 68

``` 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 ```

Question 69

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

Answer 69

glucose or galactose

Question 70

What is the principle of the copper reduction clinitest

Answer 70

reduces substrates to convert cupric sulfate to cuprous oxide

Question 71

When are clinitests used

Answer 71

screen for reducing substances in children less than 2 years old

Question 72

What are the 3 products used to ID ketone bodies

Answer 72

acetoacetate, Beta hyrdroxybutyrate, acetone

Question 73

T or F, no levels of ketones are normal

Answer 73

T

Question 74

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

Answer 74

issues with diabetes, excessive diets, frequent vomiting, diabetes

Question 75

Explain which ketone can convert into the other two

Answer 75

acetate can become acetoacetate or beta hydroxy

Question 76

List which ketones are most to least abundant

Answer 76

most- beta hydroxy acetoacetate acetone-least

Question 77

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

Answer 77

acetoacetate- first | beta hydroxy- most reduced

Question 78

Which ketone has no method of detection

Answer 78

beta hydroxy

Question 79

What is bilirubin vs urobilinogen

Answer 79

bilirubin- breakdown of hemoglobin | urobilingen- if billirubin is exposed to bacteria in the intestines- it becomes urobilinogen

Question 80

What is the normal range for bilirubin in urine

Answer 80

any amount is significant

Question 81

What tell tale sign is there of posthepatic altered bilirubin metabolism

Answer 81

white poop

Question 82

What test uses ehrlich's reaction

Answer 82

urobilinogen

Question 83

What is ascorbic acid, what can it interfere with?

Answer 83

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

Question 84

``` Name the normal ranges for RBCs WBCs Casts Epethelial cells squamous cells transitional renal bacteria and yeast abnormal crystals ```

Answer 84

``` 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 ```

Question 85

What do eosinophils in urine indicate, how are they stained

Answer 85

acute intersitial nephritis, Hansel stain

Question 86

ID: smooth, biconcave disk with no nucelus,

Answer 86

RBCs

Question 87

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

Answer 87

WBCs

Question 88

What do lymphs in urine indicate

Answer 88

renal transplant rejection

Question 89

ID: spherical, large, granular, filled with debris

Answer 89

monocyte

Question 90

Refractile monocyte with lipoproteins and fat inside

Answer 90

oval fat body

Question 91

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

Answer 91

squamous epethelial

Question 92

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

Answer 92

transitional epithelial cell

Question 93

Small, cuboidal, columnar, off center nucleus

Answer 93

renal epithelial cells

Question 94

acid pH, increased solutes, urine stasis, increased plasma

Answer 94

casts

Question 95

How are casts formed

Answer 95

in distal and collecting ducts out of uromodulin, Tamm Horsfall

Question 96

What conditions cause casts to disintegrate

Answer 96

hypotonic and alkaline

Question 97

What type of casts can be in healthy indv

Answer 97

hyaline or finely granular

Question 98

What are casts made of

Answer 98

uromodulin/ tamm horsefall protein

Question 99

What type of casts are usually present

Answer 99

granular or waxy

Question 100

The most clinically significant crystals are found in ____ urine

Answer 100

acid

Question 101

What stains are used to see urine?

Answer 101

sternheimer-malbin | sudan, gram stain, prussian blue, hansel

Question 102

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

Answer 102

squamous cells

Question 103

What crystals are found in acidic urine

Answer 103

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

Question 104

What crystals are in alkaline urine

Answer 104

amorphous phosphate, calclium phosphate, ammonium biurate, calcium carbonate

Question 105

What crystals are of metabolic origin

Answer 105

bilirubin, cystine, tyrosine, cholesteriol

Question 106

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

Answer 106

amorphous urate

Question 107

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

Answer 107

calclium oxalate

Question 108

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

Answer 108

amorphous phosphate

Question 109

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

Answer 109

triple phosphate

Question 110

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

Answer 110

ammonium biurate

Question 111

notched corners, could mean lipiduria and proteinuria

Answer 111

cholesterol