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Lab Dx Test1 > quizlet Urinalysis mikem > Flashcards

quizlet Urinalysis mikem Flashcards

1
Q

Describe the clean catch method

A

For women, it’s important to wipe 2x from front to back with an antibacterial wipe in order to prevent the collection of a contaminated sample. You must also catch the urine mid stream.

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2
Q

Name 3 reasons for ordering a urinalysis.

A

Diagnose Renal or UT Disease, Monitor Disease, Detect Metabiolic or systemic

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3
Q

What are 3 advantages to ordering a urinalysis

A

Cost Effective, painless (usually), quick

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4
Q

What are the four types of urine specimens?

A

First Morning Specimen

Random

Timed

Culture and sensitivity

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5
Q

What is the most common reason for ordering a 24 Hour urine collection?

A

Because you found protein in the urine and you want to asess proteinuria

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6
Q

How long can you wait to culture a urine specimen?

A

Must be cultured within a hour

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7
Q

In a 24 hour collection why do you flush your first morning specimen?

A

Because that is from the previous day.

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8
Q

True or False? In a 24 hour collection you will collect the first morning void of the 2nd morning.

A

True

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9
Q

What is the most common pathogen that causes urinary tract infection?

A

E.Coli

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10
Q

True or False? Men are more likely to get a UTI.

A

False Women are most likely to get a UTI due to a shortened urethra

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11
Q

What does a gram stain tell you?

A

Whether the bacteria is gram positive or gram negative this can help you select a proper antibiotic

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12
Q

Is it ok to give antibiotics to a patient before you send the specimen for sensitivity and culture?

A

No, always send the specimen for culture and sensitivity before you give antibiotics.

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13
Q

What would cloudy urine indicate?

A

presence of WBCs, RBCs, bacteria

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14
Q

What is the normal color of urine?

A

Pale yellow to amber

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15
Q

What gives urine its color?

A

Urochrome (a pigment which is a product of bilirubin metabolism)

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16
Q

What would dark yellow colored urine indicate?

A

Bilirubin in the urine

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17
Q

What would bright red colored urine indicate?

A

Bleeding from the bladder

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18
Q

What would dark red colored urine indicate?

A

Bleeding from the kidney

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19
Q

True or False? 90% of blood in the urine is from the bladder.

A

True

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20
Q

The measure of the kidney’s ability to concentrate urine (remove wastes)

A

Specific Gravity

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21
Q

In a specific gravity test the weight of urine is compared to the weight of what?

A

Distilled Water (1.00)

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22
Q

The value of __________ is affected by the amount of solutes and volume/hydration status

A

Specific Gravity

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23
Q

A low specific gravity may indicate

A

Diabetes Insipidus

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24
Q

_______ is the bodies inability to produce ADH or the inability of ADH to work in the body.

A

Diabetes Insipidus

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25
Drinking _______ inhibits the production of ADH.
Alcohol
26
A high specific gravity may indicate (3)
1. Diabetes Mellitus 2. high ADH level 3. dehydration
27
True or False? Urine osmolarity is measured as a part of the urinalysis.
False, it is seperate
28
The number of particles in a unit of solution (not specific to a particular particle)
Urine Osmolality
29
True or false? The same diseases that are correlated with a high or low specific gravity are correlated with urine osmolality.
True
30
How would an increase in ADH effect your specific gravity?
It would increase it
31
Average PH of urine
6
32
\_\_\_\_\_\_\_ actually makes your PH lower and is a good preventative measure for UTI but can't treat a UTI
Cranberry Juice
33
What condition may result in alkaline urine?
Bacteria, especially UTI
34
An increase in hydrogen ions would make the environment _______ and a decrease in hydrogen ions would make the environment \_\_\_\_\_\_\_\_
Acidic / Basic
35
The distal and proximal conv tubule include what transporter important in urine pH?
Hydrogen (secretion) - Na (reabsorption)
36
What can cause transient proteinuria? (2)
Exercise, fever
37
Why is protein typically not seen in the urine?
Because the spaces of the glomerular membrane are too small to allow passage
38
Why is protein in the urine a concern?
It indicates glomerular injury. If the spaces of the glomerular membrane are enlarged, protein (usually albumin, smaller than globulins) seeps into filtrate
39
What type of protein is most commonly found in the urine?
Albumin
40
Clinical causes for proteinuria (4)
Preeclampsia (HTN, edema), Eclampsia (w/seizures), diabetes complications, glomerulonephritis
41
What is the leading cause of end-stage renal disease?
Diabetes
42
MCC of hematuria
Cystitis (in women, men typically do not get cystitis or UTIs)
43
What are 3 common causes of blood in the urine?
Cystitis, glomerulonephritis, cancer
44
What is the renal threshold for glucose?
\>180 mg/dl in the serum
45
How much glucose is filtered from the blood
100% (then 100% is reabsorbed in prox tubule)
46
Byproduct of fatty acid catabolism; used as energy source when glucose cannot be utilized
Ketones
47
What are the clinical implications of ketones in the urine? (5)
Poorly controlled diabetes (hyperglycemia), diabetic ketoacidosis, alcoholic ketoacidosis, starvation, high protein diets
48
What is bilirubin?
Breakdown product of hemoglobin
49
Bilirubin is conjugated in the ________ and excreted in the _______ which is metabolized in small intestine by bacteria to \_\_\_\_\_\_\_\_\_.
Liver / bile / urobilinogen
50
What type of bilirubin is fat soluble, difficult to excrete, and excreted in the feces?
Unconjugated
51
What type of bilirubin is water soluble and easily excreted by kidneys?
Conjugated
52
How is urobilinogen made?
Bilirubin is metabolized and transformed to urobilinogen in the small intestine by bacteria.
53
True or False? It is abnormal to have urobilinogen in the urine.
False, a small amount of urobilinogen is normal (up to 0.2 mg/dl)
54
A portion of ________ is absorbed and carried to liver and excreted in bile and urine .
urobilinogen
55
What are the clinical implications of having increased levels of urobilinogen.
An overproduction of RBCS / Hemolytic anemia
56
What type of data do you get from a urine dip?
Qualitative
57
True or False? Urinalysis is not a good monitor for liver disease
True
58
A urinalysis with increased bilirubin and increased urobilinogen levels is indicative of __________ .
Hemolytic Anemia
59
A urinalysis with increased bilirubin and normal urobilinogen level is indicative of \_\_\_\_\_\_\_\_\_\_\_.
an obstruction of excretion (unable to get to bowels e.g. gallstones)
60
A screening test for WBCs in urine
Leukocyte Esterase
61
A positive leukocyte esterase test suggests the presence of a \_\_\_\_\_\_.
UTI (or STI)
62
The most reliable test for detecting urinary tract infections - 90% accurate in detecting WBCs in urine
Leukocyte Esterase
63
True or False, a positive leukocyte esterase test is diagnostic of a UTI.
False, you can't say that there are WBCs in the urine without actually looking at a slide. Don't diagnose based on this test alone.
64
What type of bacteria is e.coli, gram negative or positive?
Gram negative
65
Why would you test nitrites in the urine?
To screen for UTI
66
What bacteria will give a positive nitrite test?
gram negative with the nitrate reductase enzyme
67
What indicates a good probability of stone formation?
Crystals
68
Do crystals cause pain?
No, they do not produce symptoms until they form stones
69
Name a reason you might have a false positive for proteinuria.
RBCs can give you a false positive due to the hemoglobin component
70
What would a lot of epithelial cells indicate in a urine specimen?
Contaminated sample
71
Where are casts formed? (2)
distal convoluted tubule or collecting duct
72
The formation of cast are favored by what? (3)
decreased urine flow (stasis)
73
envelope-shaped crystals in acidic urine
Ca oxalate
74
Composed primarily of mucoprotein called Tam-Horsfall
Hyaline Cast
75
Where are mucoproteins secreted?
tubule cells
76
Can be seen in normal patients, especially after strenuous exercise, dehydration
Hyaline casts
77
Tamm-Horsfall is indicative of \_\_\_\_\_\_\_\_\_\_\_\_\_\_
multiple myeloma
78
When __________ remain in nephron long time, may degenerate into coarsely granular casts, then finely granular casts and ultimately broad waxy casts
cellular casts
79
Result from degeneration of cellular material into granular particles within WBC or epithelial cell cast
Granular cast
80
In Fatty casts, fat within epithelial cell casts becomes incorporated with protein into casts or coalesce to large droplets called \_\_\_\_\_\_\_\_\_\_\_\_.
oval fat bodies
81
What type of cast is a hallmark of nephrotic syndrome (large amount of proteinuria)?
Fatty casts
82
These casts are associated with chronic renal diseases, chronic renal failure, diabetic nephropathy, and malignant HTN.
Waxy Casts
83
Occur when flow thru tubule diminished and granular casts degenerate
Waxy Casts
84
May be cell casts or hyaline casts
Waxy Casts
85
Renal tubular cell casts indicate \_\_\_\_\_\_\_\_\_\_\_\_\_.
glomerulonephritis
86
Cast that is typically found in infections, mostly pyelonephritis, inflammatory nephritis (lupus)
WBC cast
87
Found w/ disruption of blood/urine barrier at any level of tract, usually bladder, ureteral, urethral diseases
RBC cast
88
On a slide what is the difference between epithelial tissue in a sample and a epithelial cell cast?
In epithelial cell casts the cells are clustered rather than randomly found in the sample
89
In epithelial cell casts, ___________ casts can be normal and ___________ Casts indicate membrane damage - glomerulonephritis
Squamous epithelial cell / renal tubular cell

Lab Dx Test1 (6 decks)

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