Lab assessment of Kidney Disease

Question 1

Pathologic cause of Pink urine

Answer 1

Urates

Question 2

Orange urine is indicative of

Answer 2

Bile pigments

Pyridium (drugs/food)

Question 3

Psychoactive drugs, diuretics can turn urine into what color

Answer 3

Green

Question 4

Rifampicin, Beets, Blacberries, Rhubarb can turn urine into what color

Answer 4

Red

Question 5

T or F: Nitrofurans and diuretics can turn urine into brown color

Answer 5

False, Blue

Question 6

Cloudy urine indicates

Answer 6

Crystallization/precipitation of urates in acidic urine or phosphates in alkaline urine

Question 7

Fruity odor urine indicates

Answer 7

Ketosis

Question 8

if there’s urinary fistula with the bowel the odor of the urine is

Answer 8

Fecal

Question 9

(+) foam in the urine indicates

Answer 9

Proteinuria or billirubinuria

Question 10

Conditions that may cause an increase in specific gravity in the urine

Answer 10

Dehydration
SIADH
Glycosuria
Proteinuria

Question 11

Normal urine PH

Answer 11

5.5-6.5 sa notes

Question 12

Acidic urine indicates

Answer 12

Ketosis
Febrile illness
Hypokalemia
High protein diet
Respiratory acidosis
Metabolic acidosis
Acidication therapy
UTI

Question 13

Glycosuria without high blood sugar is present in

Answer 13

Renal tubular dysfunction

Pregnancy

Question 14

False positive for ketones

Answer 14

Ascorbic acid
Acidic urine
Concentrated urine

Question 15

Urine test to indicate presence of bilirubin and urobilinogen

Answer 15

Foucher’s test

Question 16

T or F: Dipstick urinalysis combining leukocyte esterase and nitrite testing is an effective and appropriate screening for UTI.

Answer 16

True

Question 17

Vegetarian diet can result to false negative in test for

Answer 17

Nitrites

Question 18

Prolonged urine sample can result to false positive in test for

Answer 18

Leukocyte esterase

Question 19

Management If patient is positive in both leukoesterase and nitrate

Answer 19

Start antibiotics, this is UTI

Question 20

Management If px is (+) for nitrate and (-) for Leukoestarse

Answer 20

Start antibiotics and send for culture

Question 21

Management if px is (+) for Leuko and (-) for nitrite

Answer 21

Send for microscopy and culture, don’t start antibiotics unless there’s good clinical evidence of UTI

Question 22

Management If neg for both Leuko and Nitrite

Answer 22

NOT UTI, no need for antibiotcs and sample should not be sent for culture

Question 23

T or F: Random urine sample can be used for nitrite test

Answer 23

False should be first morning urine

Question 24

Epithelial cells of upper or LUT is common if

Answer 24

Specimen is not collected mid stream

Question 25

T or F RBCs are larger than WBCs in urinalysis

Answer 25

False, WBCs are 1.5-2.0 times the diameter of RBCs

Question 26

Epithelial cells occurs in

Answer 26

Renal tubular or lower UTI Acute tubular recurrent viral inf Renal transplant rejection

Question 27

These are formed in the absence of cells in the renal tubular lumen; microscopy would show clear colorless, structureless sediments with low refractive index

Answer 27

Hyaline cast

Question 28

T or F: Red cells casts in urinalysis is sometimes normal

Answer 28

False; ALWAYS pathological

Question 29

Conditions with red cell casts

Answer 29

``` AGN Lupus Nephritis Goodpasture’s syndrome SBE Renal infarct ```

Question 30

Conditions with white cell casts

Answer 30

Acute pyelonephritis Interstitial nephritis Lupus N

Question 31

Conditions with fatty casts

Answer 31

Proteinuria | Nephrotic syndrome

Question 32

Conditions with waxy casts

Answer 32

Severe tubular atrophy Renal failure Transplant rejection

Question 33

Tests for hormonal function

Answer 33

EPO | VIt D

Question 34

Type of crystals found in Lesch Nyhan syndrome

Answer 34

Uric acid crystals

Question 35

Type of crystals with yellow to brown rhobic or hexagonal plates, needlese, or resettes characteristics

Answer 35

Uric acid crystals

Question 36

T or F amorphous crystals indicate nephrotic syndrome

Answer 36

Fasle, amorphous crsytals have no specific clinical interpretation

Question 37

T or F: cysteine crstals is always pathological

Answer 37

True it can be found in Congenital cystinosis Cystiuria Renal stone

Question 38

Type of crystals with readially striated spheres with irregular thorn apple or ox horn projections

Answer 38

Ammonium urate crystals

Question 39

Conditions with cholesterol crystals

Answer 39

Nephritis Nephritic syndrome Chyluria Obstruction to lymphatic flow

Question 40

BUN is an indicator of

Answer 40

GFR

Question 41

Urea is filtered in the _____ and it undergoes reabsorbption in the ______

Answer 41

Glomeruli; renal tubule

Question 42

Reabsorption of urea in the collecting duct is dependent on

Answer 42

Vasopressin

Question 43

Normal BUN-Cr ratio

Answer 43

10:1

Question 44

Exretion of creatinine is predominantly by

Answer 44

Glomerular filtration

Question 45

Elevated serum crea denotes

Answer 45

Diminished renal clearance of creatinine and a decline in GFR

Question 46

How can drugs results to inappropriately low creatinine

Answer 46

It competes for renal tubular transport of creatine. Drugs such as cimetidine, trimethoprim, Probenecid

Question 47

T or F: Blood urea is always recommended for assessment of renal function as it is influenced by numerous non renal factors such as elevated lvl from sequestered blood in the GI

Answer 47

False, not recommended

Question 48

Formula that is widely used in predicting GFR from serum Creatinine

Answer 48

Schwarts formula

Question 49

Most commonly employed and best clinical test for estimation of functioning renal mass

Answer 49

GFR

Question 50

Characteristics of an ideal marker agent for studying GFR

Answer 50

nontoxic when given endogenously should achieve a stable plasma concentration in a steady state should not be bound to plasma protein should be filtered by glomeruli should not be secreted by renal tubules should not be reabsorbed by renal tubules

Question 51

Reference standard for GFR

Answer 51

Inulin clearance

Question 52

Considered an ideal marker and the gold standard for measureing GFR

Answer 52

Inulin

Question 53

T or F: Urinary excretion of creatinine is a product of muscle catabolism and can be used as an index of muscle mass

Answer 53

True

Question 54

This is measured as the sum of creatinine removed from the body

Answer 54

Creatinine index

Question 55

This test is indicated in px who are unable to concentrate their urine and have polyuria

Answer 55

Test for maximal urine concentrating ability

Question 56

Test for maximal urine concentrating ability is used to differentiate

Answer 56

Central DI vs Nephrogenic DI

Question 57

A lack of response to DDAVP and/or pitressin test is indicative of

Answer 57

Nephrogenic DI

Question 58

Tests of proton secretory capability of the distal nephron are often necessary in the evaluation of a px with

Answer 58

Metabolic acidosis and suspected renal tubular acidosis