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urinalysis > macroscopic > Flashcards

macroscopic Flashcards

(79 cards)

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1
Q

what to note for evalutation of macro urine

A

turbidity
color
odor
volume- 24 hr urine

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2
Q

mousy odor

A

phenylketonuria

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3
Q

maple syrup odor

A

maple syrup disease

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4
Q

sweet, fruity acidosis

A

diabetic

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5
Q

sulfur odor

A

cystinuria

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6
Q

strong, unpleasent odor

A

bacterial infection

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7
Q

daily output

A

1200-1500

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8
Q

almost no output of urine

A

anuria

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9
Q

decrease output of urine

A

oliguria

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10
Q

adh is released by

A

pituitary gland

-helps retain water when released

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11
Q

lack of ADH is seen in

A

diabetes insipidus

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12
Q

urinalysis rules

A

urine must be less than 2 hours old

mix urine first

read reactions in appropriate times

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13
Q

strips and color charts are

A

not interchangeable

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14
Q

automated reagent strip readers work

A

refractive or reflectance spectrophotometry

-light refracted off a surface

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15
Q

standard for reflectance spec.

A

magnesium carbonate or barium sulfate

-intensity compared to this

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16
Q

specific gravity

A

assessment of reabsorption ability of kidney

normal 1.001-1.035

increases more concentrated urine is

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17
Q

diabetes insipidus specific gravity

A

low because so diluted

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18
Q

urinometer

A

simple but need large quantity= 10-15 mls

-make correction for protein and glucose

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19
Q

refractometer

A

concentration of dissolved particles by measuring refractive light

no temp corrections

if have to dilute urine have to multiply the decimal point by dilution factor

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20
Q

ideal temp for SG on regractometer

A

20 degrees C

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21
Q

reagent strip tech

A

based on ion concentration and change in pH due to ion concentration

-bromothymol blue

of pH is greater than 6.5 add 0.005 to SG

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22
Q

if SG is greater than 1.035

A

relook no one is this high

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23
Q

pH

A

range from 5-9
diet

uses methyl red and bromothymol blue

enterobacteracre infections cause this to increase

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24
Q

main drawback of pH

A

runover phenonmenon from protein region

causes a decrease

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25
cause of acidic urine
high protein diet diabetes starvation fruit juice
26
cause of alkaline urine
vegetarian old vomitting UTI
27
protein
good indicator of renal disease normal protein= Tamms-Horsfall
28
tamms-horsfall is produced by
tubules aka uromodulin
29
pre-renal protein
bence jones protein inflammation with APRs too many proteins in plasma that spill over into urine
30
renal protein
kidney disease diabetic nephopathy Orthostatis protein
31
what is orthostatic protein
pressure on renal vein first morning urine= negative reexamine later- positive for protein
32
post renal protein
UTI menstration
33
protein test most sensitive for
albumin may get false negatives for other kinds of protein
34
what is protein reaction known as
protein error of indicators -highly buffered at pH of 2 and will change in presence of proteins as releases hydrogen ions into protein
35
SSA (sulfosalicylic acid)
cold precipitation test to detect for protein turbidity comparable to amount of protein in urine detects bence jones protein
36
what would have a + on SSA and - on strip
bence jones protein
37
glucose strip
seen in urine when above 160-180 reagent strip glucose oxidase can detect smaller amounts of glucose than clinitest
38
main interfering substance for glucose
ascorbic acid large number of bacteria false -
39
clinitest tablet
detects all sugars except sucrose (not reducing) tubes hot pass through phenomenon read quickly or glucose passes though copper sulfate reaction
40
if glucose is negative on reagent strip, but + on clinitest think
some other sugar
41
if clinitest - strip + think
old tablets or small amounts of glucose
42
glucose is a double
enzymatic reaction glucose oxidase and peroxidase
43
3 ketones
acetone acetoacetic acid B-hydroxybutyric acid - not tested for seen in starvation, diabetes, dieting sodium nitroprusside
44
must remember when testing ketones that they can
evaporate when left at RT or uncapped if glucose is super high and no ketones- suspect this
45
reaction for ketones is with
nitroprusside
46
false positive for ketones
presence of phenylketone high pigment
47
hematuria
intact RBC may be kidney disease, internal bleeding, UTI cloudy, red urine = period
48
hemoglobinuria
excretion of free Hgb when RBCs lysed intravascular hemolysis
49
in intravascular hemolysis may see
hemosiderin in EC
50
myoglobin
O2 carrying molecule in muscles increases with muscle breakdown -does damage to kidney
51
in true hemolysis will see
red serum but increased myoglobin= serum stays yellow increases in myoglobin can cause decreases in haptoglobin (heme molecule)
52
to determine if hemoglobinuria or myoglobinuria do
ammonium sulfate test- looks for myoglobin larger Hgb will be precipitated and myoglobin in supernatant - will be red color
53
reagent strip for hemoglobinuria based on
Hgb pseudoperoxidase rxn + for Hgb uria and myoglobinuria speckled for hematuria - lysing false -= ascorbic acid
54
false postivies for blood
micro peroxidase-- ex. catalse so staph
55
common reasons for have + on RBC strip and seeing none microscopically
E.coli in urine - peroxidase causes RBC to lyse urine is dilute and alkaline so RBC hypotonic- swell and lyse specimen not mixed anything causing RBC to lyse
56
bilirubin
only conjugated form in urine don't see bili in urine normally because that is unconjugated
57
bili reaction based on
diazo reaction high false + due to other pigmentation false- = ascorbic, exposed to light yellow foam
58
urobilinogen
values above 1.0 alarm - liver dysfunction everyone has a small amount - can't be true negative (bile obsruction)
59
interfering substances for urobilinogen
formalin
60
erhlich's tests
for urobilinogen add sodium acetate to enhance color perform in afternoon for higher concentration can be porphobilinogen or uro
61
to differentiate between porphobilongen and uron do
watson-schartz add chlorform to one -sink butanol to other- flots known how to read!!
62
best time to test for urobilinogen
2 hours after a meal because alkaline urine
63
nitrite
detects UTI caused by enterobacteriaceae CAN STILL have UTI not from this and it will be -
64
leukocyte esterase
looks for esterase in granules of WBCs (will work for lysed ones as well) good indicator for UTI
65
what will give false + on leukocyte esterase
trichomonas
66
pH increase
due to breakdown of urea to ammonia by bacteria
67
glucose decreased
bacteria uses it
68
ketones decreased
volatilization- evaporation
69
bili decreased
exposure to light
70
urobilinogen decreased
conversion to urobilin
71
nitrite increased
conversion of nitrates to nitrites
72
RBC and WBC decreased
lysis on cells
73
bacteria increased
growth
74
protein unaffected
amount will be affected for longer periods of time
75
ascorbic acid causes interferences with
glucose, blood. bilirubin, and nitrite
76
suspect ascorbic acid interference if
+ RBCs seen microscopically but strip - + ketones but glucose is negative +leukocyte and - nitrate
77
diabetes mellitus - type 1
sweet increased H2O excretion to remove glucose increase SG polyuria
78
diabetes inspidus -type 2
tasteless decrease ADH, water is not reabsorbed and lost in kidney low SG increased thirst may see hypernatremia if lose too much water
79
to confirm bili in urine
icotest

urinalysis (3 decks)

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