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Lab Diagnosis > UA- Dipstick > Flashcards

UA- Dipstick Flashcards

(45 cards)

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1
Q

What are the ten (and sometimes 11) tests on a dipstick?

A

glucose, bilirubin, ketones, SG, blood, pH, protein, urobilinogen, nitrites, leukocytes & sometimes ascorbic acid

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2
Q

What is normal SG? What does it measure?

A

1.005-1.030
1.010-1.025 for adults
1.001-1.018 for <2 yo
measures kidneys ability to concentrate urine

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3
Q

What is high SG indicative of? What can cause it?

A

high SG= concentrated urine, SG >1.025= hypersthenuria

DM, proteinuria/nephrotic syndrome, drug effects, dehydration, CHF, toxemia of pregnancy

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4
Q

What is low SG indicative of? What can cause it?

A

low SG= dilute urine, SG <1.001-1.010= hyposthenuria

increased fluids, chronic renal disease, DI, diuretics, glomerulonephritis

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5
Q

How does chronic renal disease present in relation to SG?

A

SG may consistently be at 1.010= isosthenuria

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6
Q

What can create a high false positive? What can create a low false positive?

A

high false + = proteinuria

low false + = highly buggered alkaline urine

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7
Q

Where is glucose normally filtered? Reabsorbed? When do you get glucosuria?

A

Normally filtered out in glomerulus, reabsorbed in PCT

glucosuria= blood glucose 160-180 mg/dl and thus spilling over into urine

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8
Q

What diseases can cause glucosuria?

A

DM, cushing’s syndrome, pheochromocytoma, acromegaly, chronic pancreatitis, drugs

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9
Q

What can produce false positives for glucose? false negatives for glucose?

A

false positives: oxidizing agents

false negatives: ascorbic acid, aspirin, ketones

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10
Q

What does increased ketones in the blood lead to?

A
  • electrolyte imbalance
  • dehydration
  • acidosis & coma
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11
Q

What is the only ketone the dipstick can detect? What is this ketone not indicative of (what disease)?

A

only detects acetoacetic acid, not indicative of diabetic ketoacidosis (beta-hydroxybutyric acid is what you would see if someone has DKA)

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12
Q

What are the 3 types of ketones we care about?

A

acetoacetic acid
beta-hydroxybutyric acid
acetone

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13
Q

What 2 diseases have ketonuria?

A
  1. DM

2. increased metabolic states: hyperthyroidism, fever, pregnancy

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14
Q

What can give you a false positive for ketones?

A

drugs, highly pigmented urine

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15
Q

What can give you false negatives for ketones?

A

prolonged air exposure (it is volatile)

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16
Q

What are the three types of blood a dipstick can detect?

A

free hemoglobin: lysed RBCs (hemoglobinuria)

hemogloblin: intact RBCs (hematuria)
myoglobin: muscle protein

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17
Q

What do we need to determine if there is blood in the urine? What can it be indicative of?

A

Need to determine the SOURCE.
glomerular dz, kidney stones, pyelonephritis, trauma, cystitis, bladder cancer, prostate cancer, exercise hematuria, MI, contamination (vaginal secretions)

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18
Q

What are false positives for blood?

A
  • microbial peroxidases
  • myoglobinuria
  • menstrual blood
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19
Q

What are false negatives for blood?

Study These Flashcards
A
  • nitrites
  • increased SG decreases reactivity of test
  • ascorbic acid
20
Q

What is the range of pH for urine? What maintains pH balance?

Study These Flashcards
A

4.5-8 (average of 6.0)

kidneys maintain by excretion of H+ and reabsorption of Na2+

21
Q

What can an alkaline pH reading indicate? (4 things)

Study These Flashcards
A
  1. alkalosis, respiratory or metabolic
  2. UTI
  3. gastric suction, vomiting, renal tubular acidosis
  4. vegetarians, high citrus intake
22
Q

What can an acidic pH reading indicate? (6 things)

Study These Flashcards
A
  1. acidosis, respiratory or metabolic
  2. DM
  3. starvation
  4. COPD
  5. UTI
  6. high meat, high cranberries
23
Q

What is protein in urine a sensitive indicator of?

Study These Flashcards
A

KIDNEY FXN
slit pores normally too small to allow high molecular weight proteins through, also have negative charge to repel proteins

24
Q

What are fxnal renal causes of proteinuria?

Study These Flashcards
A
  • severe muscular exertion
  • glomerulonephritis
  • pregnancy
  • nephrotic syndrome
  • orthostatic proteinuria
  • renal tumor or infection
25
What are pre-renal causes of proteinuria?
- fever - renal hypoxia - hypertension secretions
26
What are post-renal causes of proteinuria?
- cystitis - urethritis or prostatitis - contamination with vaginal secretions
27
When can transient proteinuria occur?
with fever, stress, exercise of CHF
28
What can cause a false positive for protein?
- vaginal secretions - hematuria - pyridium - highly alkaline urine
29
What can cause a false negative for protein?
-dilute sample
30
What protein is the dipstick most sensitive to? What will it not detect?
most sensitive to albumin | won't detect: globulins, glycoproteins, Bence-Jones proteins
31
What is the path of RBCs to urobilinogen excreted in the feces?
RBCs get lysed and release hemoglobin--> (globin &) heme catabolized to--> biliverdin reduced to--> unconjugated bilirubin--> to liver via albumin--> liver conjugates with glucuronic acid--> conjugated bilirubin--> into bile--> into intestines where it gets converted to urobilinogen by intestinal flora
32
What is excess bilirubin called? What can cause it?
``` increased bilirubin= bilirubinuria caused by: -gallstones -cholestasis -bile duct obstruction -acute hepatitis -congenital defects in bilirubin metabolism ```
33
False positives for bilirubin?
- fecal contamination | - pyridium indicans
34
False negatives for bilirubin?
- nitrites - light - ascorbic acid
35
What are normal levels of urobilinogen in urine?
0.2-1.0 mg/dL
36
When will you see increased urobilinogen? Decreased?
Increased: intravascular hemolysis, intestinal obstruction, early stages of hepatitis Decreased: dipstick lacks sensitivity to test for decrease
37
False positives for urobilinogen?
- fecal contamination - pigmented drug metabolites - beets
38
False negatives for urobilinogen?
- formaldehyde - prolonged air exposure - antibiotics
39
What does increased nitrites indicate? What do you have to be careful about assuming though?
UTI | BUT not all bacteria convert nitrates--> nitrites so can get a false negative in this way
40
False positives for nitrites?
- pyridium - beets - bacterial growth in old samples
41
False negatives for nitrites?
-high SG -low nitrate diet -ascorbic diet (urine doesn't sit in bladder long enough/not in contact with bacteria long enough)
42
What does a positive leukocyte test indicate?
UTI most likely | pts can be asx even w/significant infection
43
What are 2 non-urinary causes of pyuria?
- appendicitis | - pancreatitis
44
False positives for leukocytes?
vaginal secretions
45
False negatives for leukocytes?
- glucose - protein - increased SG - some antibiotics - oxalates

Lab Diagnosis (5 decks)

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