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LABS Flashcards

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1
Q

Fatty casts are ass/w?

A

Nephrotic syndrome mostly

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2
Q

ARF cause if FE sodium is <1 percent

A

Decreased perfusion (Hypovolemia or dehydration)
Kidney is retaining water/NA to increase volume -
UA Na is low

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3
Q

Crystal types

A

Uric acid
Calcium phosphate/oxalate
Cystine - Hereditary cystinuria
Struvite - Infection stones - (urease- proteus/klebsiella)

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4
Q

Trace protein indicates quan of?

A

<150mg/D

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5
Q

Other reasons keytones would be positive?

A

Starvation/Fasting, Carb free diet, dehydration, preg, ETOH

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6
Q

Gold standard of GFR measurement is?

A

Inulin Carb - (MC and convenient is Creatinine clearance)

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7
Q

Increased SG indicates?

A

Dehydration/Shock

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8
Q

Decreased SG indicates?

A

Overhydration, Cant concentrate urine

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9
Q

RBC casts are hallmark of?

A

Glomerulonephritis

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10
Q

GF pH is?

A

7.4 (acidifies thru tubules)

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11
Q

MOst important measurement of renal FX?

A

GFR - (Kidney status and RX adjustments)

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12
Q

FE sodium concept is

A

Amount of NA remaining in urine after filtration

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13
Q

pH is good for assessing?

A

UTI, Stones, Renal tubular acidosis

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14
Q

Cockcroft & gault formula?

A

(140-age) x (Ideal body weight Kg) / Plasma Cr x 72

Multiple total by 0.85 for females

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15
Q

NL GFR range is?

A

90-120mL/min

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16
Q

NL bun range is?

A

5-20mg/dL

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17
Q

BUN is decreased w/?

A

**Liver DZ - (Cant metabolize ammonia to urea)
Renal HYPERperfusion (Preggo, SIADH)
Overhydrated

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18
Q

WBC casts w/ EOS are seen W/?

A

Acute interstitial nephritis

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19
Q

Broad casts indicate what?

A

Severe urinary stasis

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20
Q

Random UA pH NL range?

A

4.5-8.0

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21
Q

Waxy casts are ass/w?

A

Severe urine stasis in tubules - CKF

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22
Q

WBC Casts are ass/w?

A

Acute pyelonephritis vs Low UTI D/O

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23
Q

Protein is often an 1st indication of?

A

Renal disease

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24
Q

Micro- Types of epithelial cells

A

Squam - >10/HPF = contamination
Transitional - LRG/Clumping = neoplasm (req cytology)
R. Tubular - DX for ATN (ischemic or nephrotoxic)

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25
F= of Blood Dipstick due to?
High Vit-C (ascorbic acid)
26
W/out using a 24hr creatine clearance collection what is another way to determine GFR?
1. Cockcroft & Gault | 2. Modification of diet in renal disease (MDRD)
27
Increased Scr is due to ?
Renal failure | Increased protein diet/muscle
28
Azotemia is?
Excess nitrogenous waste
29
Decreased Scr is due to?
Veg diet | Decreased muscle mass (OLD/PED)
30
Mechanisms of regulating GFR?
Controlling BF in/out by changing diameter of AFF/EFF | Control Glom surface area by contract/relax mesangial cells.
31
F= Leukocyte esterase can be due to?
Concentrated Urine Glycosuria RX - Tetracycline/Cephalexin
32
ARF cause if FE sodium is >1 percent (often >3)
Intrinsic renal disease | Kidney is losing NA inappropiately - Urine Na is high.
33
Another name for transitional epithelials?
Urothelial cells
34
Casts are formed how?
Formed in the DCT/CD w/ Tamm-Horsfall protein and suggest parenchymal DZ
35
Increased BUN:Creatinine ratio is due to?
Prerenal - Dehydration | Postrenal - Obstruct
36
F+ nitrite due to?
Contamination/gross hematuria
37
Waxy casts are essentially what?
End stage disinegration of a cast
38
Bilirubin dispstick detects?
Conjugated bili (unconjugates is insoluble)
39
Dipstick keytones detects what? Useful for?
Acetic acid - ketosis, DKA
40
If you suspect UTI or Pyelonephritis should order?
UA Cx (>100k pos - 1-10k can still be + however)
41
Fractional excretion of sodium is used when?
Suspecting acute renal failure (most accurate with oliguria)
42
RBC morphology characteristics
Round/NL - Dz along epithelial lining Dysmorphic - Irreg shape = nephritic disease Crenated - Concentrated urine Ghost RBC - swollen (dilute urine)
43
Micro - WBC eval cutoff?
>5 WBC/HPF = pyuria (urinary tract injury)
44
Most accurate creatinine clearance is by?
24h UA collection (impractical)
45
Urobiligen range? detects?
NL= 0.2-1.0mg/dL | Byproduct of Conjugated bili breakdown in GI by bacteria
46
Orange colored urine RX
Phenazopyridine Nitrofuranotin Rifampin Metronidazole
47
1st AM UA pH NL range?
5.0-6.0
48
BUN Creatinine ratio NL ratio is?
10:1
49
Factors of GFR are?
Age, Size, Physiological status
50
Leukocyte esterase is from?
Seg enzymes (Neutrophils predominate)
51
Scr is used for?
Measuring GFR (creatinine clearance - muscle metabolism)
52
MDRD Ccr is useful for?
OLD/Obese and corrects for sex/black
53
Oligura is defined as
<400ml
54
Micro - RBC eval cutoff?
>3 RBC/HPF
55
Regulation pathways of GFR?
1. Renal autoregulation 2. Neural regulation 3. Hormonal regulation
56
Dipstick blood measures?
RBC, free Hgb, myoglobin
57
Urea is a?
End product of protein catabolism measured w/ BUN
58
Increased urobili suggests?
Hemolysis or Hepatocellular disease
59
Bun is inverse to what?
GFR
60
Normal SG range? Used for?
1.005-1.030 - Hydration status/Concentrating ability
61
Sterile pyuria labs?
Pos WBC - Neg Cx
62
R. tubular casts are ass/w?
ATN
63
BUN is increased w/?
Renal hypoperfusion (CHF, Hypovolemia) Dehydrated Accelerated catabolism (ill, trauma) RX (CCS, tetracycline)
64
Dipstick protein is sensitive to?
Albumin mostly (No Bence-jones)
65
Granular casts can be ass/w?
ATN - Nonspecific, correlate
66
DS nitrite is from?
Nitrate to nitrite reduction from GNB (E.Coli esp)
67
NL Scr range is?
0.5-1.2mg/dL
68
Decreased BUN:Creatinine ratio is due to?
Intrinsic DZ like (ATN-AIN)
69
Broad casts are essentially formed by?
Dilated/atrophic tubules

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