Urinalysis

Question 1

what does a complete UA consist of?

Answer 1

physical examination, chemical examination, microscopic examination

Question 2

normal physical examination color

Answer 2

yellow, amber, straw

Question 3

what does a milky color urine indicate?

Answer 3

pus, bacteria, fat

Question 4

what does red/smoky brown urine indicate?

Answer 4

blood

Question 5

what does yellow foam urine indicate?

Answer 5

bile pigments

Question 6

what does white foam urine indicate?

Answer 6

albumin

Question 7

what does coca-cola colored urine indicate?

Answer 7

Acute glomerulonephritis; strep. infections

Question 8

normal physical examination appearance/clarity

Answer 8

clear

Question 9

abnormal appearance/clarity

Answer 9

reported as turbid or extremely turbid

Question 10

normal urine odor

Answer 10

aromatic

Question 11

abnormal urine odor

Answer 11

ammoniacal, fruity, stale water, foul

Question 12

ammonical urine odor

Answer 12

bacterial decomposition of urine; smells like cleaning supplies; urinary retention

Question 13

fruity urine odor

Answer 13

ketone bodies; diabetes mellitus

Question 14

stale water urine odor

Answer 14

advanced kidney disease

Question 15

foul urine odor

Answer 15

bacteruria (UTI)

Question 16

what does the chemical examination assess?

Answer 16

specific gravity, pH, protein, glucose, ketones, blood, leukocyte esterase, nitrite, bilirubin, and urobilinogen

Question 17

specific gravity

Answer 17

measure of dissolved substances in urine (density or urine/density of water)

Question 18

normal specific gravity levels

Answer 18

1.005-1.030

Question 19

why would specific gravity be low?

Answer 19

excessive hydration, diabetes insipidous

Question 20

why would specific gravity be high?

Answer 20

dehydration, diabetes mellitus, fever

Question 21

normal pH for urine

Answer 21

4.5-8.0

Question 22

what does a low pH indicate?

Answer 22

acidosis, fevers, high protein diets

Question 23

what does a high pH indicate?

Answer 23

alkalosis, cystitis

Question 24

proteinuria

Answer 24

protein in urine

Question 25

what is proteinuria mostly indicative of?

Answer 25

renal disease

Question 26

trace proteinuria

Answer 26

generally not clinically significant

Question 27

functional proteinuria

Answer 27

not associated with easily demonstrable systemic or renal damage (increased renal blood flow)

Question 28

orthostatic proteinuria

Answer 28

increased protein in urine only when an individual is in an upright position

Question 29

organic proteinuria

Answer 29

prerenal, renal, postrenal

Question 30

glucosuria

Answer 30

glucose in the urine

Question 31

normal renal threshold for glucose

Answer 31

180 mg/dL

Question 32

what does glycosuria without hyperglycemia indicate?

Answer 32

pregnancy

Question 33

what does glycosuria with hyperglycemia indicate?

Answer 33

diabetes mellitus

Question 34

ketonuria

Answer 34

ketones in urine

Question 35

causes of ketones in urine

Answer 35

type I diabetes mellitus, starvation, severe dehydration, fever in kids

Question 36

hematuria

Answer 36

blood in urine as a result of trauma or irritation

Question 37

hemoglobinuria

Answer 37

lysis of RBCs in urinary tract, intravascular hemolysis, or transfusion reactions

Question 38

myoglobinuria

Answer 38

muscular destruction that may appear in hypothermia, convulsions, extensive exertion (rhabdomyolysis)

Question 39

what could cause a false negative results of hematuria?

Answer 39

high dose of vitamin C

Question 40

pyuria

Answer 40

presence of WBCs, inflammation, leukocyte esterase

Question 41

what causes nitrite in urine?

Answer 41

gram negative bacteria; they have a reductase that takes it from nitrate to nitrite, incubation takes ~4hr (E.Coli)

Question 42

bilirubinuria

Answer 42

bilirubin in urine

Question 43

causes of bilirubinuria

Answer 43

biliary tract obstruction, liver disease, cholelithiasis; conjugated bilirubin

Question 44

urobilinogen in urine

Answer 44

similar significance to bilirubin, small amount is normal, could get false + from warm urine

Question 45

microscopic examination

Answer 45

done on centrifuged urinary sediment

Question 46

main pathological elements of the microscopic examination

Answer 46

RBCs: 0-2 HPF WBCs: 0-5 HPF Casts

Question 47

less important elements of microscopic examination

Answer 47

yeasts, crystals, epithelial cells

Question 48

best specimen of microscopic examination

Answer 48

first morning urination, midstream

Question 49

causes of RBCs on microscopic exam

Answer 49

nephrolisthiasis, AGN, GU malignancy, benign prostatic hyperplasia, cystitis, pyelonephritis, benign hematuria, contamination

Question 50

clinically significant hematuria

Answer 50

>2 HPF

Question 51

pyuria in microscopic exam

Answer 51

indicates inflammation, may originate anywhere in urinary tract, WBC casts are definite evidence that urinary WBCs originate in the kidney

Question 52

causes of pyuria in microscopic exam

Answer 52

pyelonephritis, renal TB, cystitis

Question 53

clinically significant pyuria

Answer 53

>5 HPF

Question 54

epithelial cells in microscopic exam

Answer 54

>10 squamous epithelial cells/low-power field is a sign of contamination

Question 55

casts

Answer 55

protein conglomerates in shape of renal tubules

Question 56

hyaline casts

Answer 56

little concern

Question 57

waxy casts

Answer 57

advanced renal failure

Question 58

RBC cast

Answer 58

acute glomerulonephritis

Question 59

WBC cast

Answer 59

acute pyelonephritis

Question 60

fatty cast

Answer 60

advanced renal disease, nephrotic syndrome

Question 61

pseudocasts

Answer 61

fibers, dust; fake-outs

Question 62

triple phosphate crystals

Answer 62

found in alkaline urine, no clinical significance, coffin lid

Question 63

calcium oxalate crystals

Answer 63

found in normal urine, no clinical significance, cross/X