Red colored urine suggests the presence of?
hemoglobin, myoglobin, or red blood cells
Cloudy or turbid urine suggests the presence of?
Protein, crystals, cells or casts
hematuria from hemolysis
hematuria from skeletal muscle injury or rhabdomyolysis
the higher specific gravity of urine indicates?
Urine protein +4 protein
More than 3.5 gm/24 hours; likely nephrotic syndrome
Bence-Jones and LARGE hyalin cast in kidney
Interpreting the dipstick for blood requires comparison with the microscopic exam and generally there should be (1) on microscopic exam when there is positive blood on dipstick
red cells (erythrocytes)
If the dipstick shows blood without red cells present, then this could be (1), indicating that hemolysis has occurred (for (2) or muscle injury (for (3).
1. hemoglobulinuria or myoglobinuria 2. hemoglobulinuria 3. myoglobin
If nitrite is present in urine by dipstick, it may be an indication that (1) are present
1. nitrite producing bacteria
Another dipstick test for urinary tract infection is the detection of (1) which is not normally found in urine unless the white cells which express (1) are present
1. leukocyte esterase
The most important concept in urinalysis is that casts indicate (1)
1. renal location of disease
form when cells or protein are trapped in tubules and form molds of their surroundings
24-hour urine collection
Check for total protein loss
Red cells, either alone or within casts, lack nuclei so can generally be readily distinguished from (1) casts
white cell or epithelial cell
White cells are usually?
Eosinophils in Urine
Red blood cell casts generally indicate (1) and white blood cell casts indicate (2)
1. glomerular inflammation/type of glomerulonephritis 2. infection within the kidney which is called pyelonephritis
Epithelial cell casts are found in (1) but often degenerate into (2)
1. acute kidney injury (previously called acute tubular necrosis or ATN) 2. granular casts (muddy brown)
Protein can form casts in the renal tubules in patients with (1) which is also useful for diagnosis (if too many)
1. Chronic Pyelonephritis
Stone - kidney
crystals in urine
(1) crystals tend to form in acidic urine while (2) crystals tend to form in alkaline urine
1. Uric acid and cystine 2. triple phosphate
one strategy to try and prevent crystal formation is?
making urine pH more or less alkaline in order to decrease crystal formation
Urinalysis can be ___, ____, and ____
Macroscopic; chemical; or microscopic`
Black urine (on standing)
Sp Gravity 1.010