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Clin Chem > Urinalysis > Flashcards

Urinalysis Flashcards

1
Q

3 Major components of complete UA

A
  1. Physical
  2. Chemical
  3. Sediment
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2
Q

Urine turbidity

A

Concentrated samples in healthy animals

  • cells
  • protein
  • mucus –seen in healthy horse
  • crystals –seen in healthy rabbits and horse
  • lipids
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3
Q

Mechanisms/ causes of Proteinuria

A
  1. Urinary Tract Hemorrhage
  2. Urinary Tract Inflammation
  3. Pre-Renal Proteinuria
    - -Physiologic
    - -Overflow
  4. Primary Renal dz
    - -Glomerular
    - -Tubular
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4
Q

2 main mechanisms of Glucosuria

A
  1. Overflow = increased serum glucose

2. Decreased tubular function

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5
Q

Adequate Urine Concentration (define / critical cut offs)

A

“Minimum SG in otherwise healthy animal that NEEDS to conserve fluid”

Cat = >1.035
Dog = >1.030
others = >1.025
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6
Q

3 ketone bodies

A
  1. Acetone
  2. Acetoacetate –mainly detected
  3. B hydroxybuterate –mainly produced
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7
Q

Dz associated with Ketone formation, and why it occurs.

A

Due to NEGATIVE ENERGY BALANCE

  1. Diabetes mellitus
  2. Lactation
  3. Late Pregnancy
  4. Starvation
  5. (hepatic lipidosis)
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8
Q

What changes would you see in Diabetes mellitus in a UA?

A

Ketonuria and Glucosuria

increase serum glucose

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9
Q

Renal threshold for glucose (define / species values)

A 
The concentration at which the PCT can no longer fully reabsorb glucose.
Cows = 100
Horses= 150
Dogs =  180
Cats =   280
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10
Q

Only form of bilirubin found in urine (and why?)

A

only CONJUGATED bilirubin

-water soluble and NOT protein-bound –> freely filtered

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11
Q

Form of bilirubin detected by urine test trips

A

Specific for CONJUGATED bilirubin

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12
Q

What is the “tablet test” called/ used for?

A

Ictotest

  • confirms presence of conjugated bilirubin
  • more sensitive when urine is dark
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13
Q

Severe hemolysis –> bilirubinuria

A

Severe hemolysis –> rapid drop in Hct –> traumatic insult to liver (ALT) –> swelling –> compression of ductules and ducts –> cholestasis! –> back up of conjugated bilirubin in blood –> filtered –> bilirubinuria

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14
Q

Occult blood on test strips

- 3 processes and what would be detected

A
  1. Hemorrhage –> Intact RBCs
  2. Hemolysis –> Hb
  3. Rhabdomyolysis –> Myoglobin
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15
Q

To differentiate the 3 types of occult blood.

A

RBCs

  • patchy chem strip
  • spin –> RBCs will spin out
  • examine sediment

Hb

  • Check Hct and RBC morph
  • pink/ red serum –due to haptoglobin

Myoglobin

  • Hx &PE
  • clear serum –bc freely filtered
  • check muscle enzymes
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16
Q

pH change in stored urine

A

CO2 lost to environment –> alkalization

this also breaks down organic components

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17
Q

Bacteria –> alkaline urine

A

Urease producing bacteria –> increased ammonia –> alkalization

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18
Q

Alterations caused by alkaline pH

A

pH > 8

–> Trace to 1+ protein AND breakdown of organic components

19
Q

Where are casts formed?

A

DISTAL tubules

20
Q

Mucoprotein that forms cast matrix

A

Tamm-horsfall protein –secreted via DCT epithelium

21
Q

Process for presence of EPITHELIAL casts

A

-Tubular degeneration (aka granular casts)

22
Q

Process for presence of GRANULAR casts

A

-Tubular degeneration (aka epithelial casts)

23
Q

Process for presence of WAXY casts

A
  • Tubular degeneration (+/- slowed transit)

- -further degenerate than granular cast

24
Q

Differentiate btwn Pyelonephritis and cystitis

A

Cystitis = WBCs in urine
- no systemic inflamm

Pyelonephritis = WBC or WBC casts in urine
- systemic inflamm, fever

25
Q

Pigmented urine crystals

A
  1. Bilirubin –golden
  2. Leucine –yellow spheres
  3. Urates –yellow-red to yellow-brown
  4. Sulfa-type drugs
26
Q

Healthy Dalmatian urine crystals

A
  • Ammonium Urate / biurate (“Thornapple”)

* Uric acid crystals are a common pathologic crystal in Dalmatians

27
Q

Crystals associated with Ethylene glycol

A

Calcium oxalate

  • Monohydrate form –specific for ethylene glycol
  • Dihydrate form –normal w/ plant diet (also in EG tox)
28
Q

Crystals associated with Hepatic insufficiency

A

-ammonium urate / biurate / “thornapple”

29
Q

Crystals associated with cholestasis

A

Bilirubin Crystals

30
Q

Dumb-bell crystal

A

Calcium carbonate

-in healthy Lg animals

31
Q

Hear the word Bilirubin-uria… THINK?

A

CHOLESTASIS!!!

32
Q

Why is it more significant to have a small amt of protein in dilute urine (vs concentrated)?

A

USG is on a sliding scale, which means normal amounts of solute will be in a dilute or concentrated…
Concentrated sample is more likely to have detectable proteins, bilirubin, etc

33
Q

What is hyposthenuria

A

<1.005

Indicates dilutional funx

34
Q

What to components of urine can affect USG?

A
  • increases USG 0.001
  • High levels of ALBUMIN (3+)
  • Small Amt of GLUCOSE (1+)
35
Q

3 tests for Protein

A
  1. Chem strip
  2. SSA –sulfosalicylic acid
  3. UPC – urine protein: creatinine ratio
36
Q

For Protein, what does chem strip detect?

A

Albumin mainly

**alkalinity –> falsely elevates

37
Q

What is the purpose of the SSA test?

A
  1. confirm protein in alkaline urine

2. confirm presence of NON-albumin proteins

38
Q

What is the purpose of UPC?

A
  1. Confirm that the degree of proteinuria is signify

2. Provide baseline value for monitoring dz progression

39
Q

Interpretation of UPC >10

A

GN or amyloidosis

40
Q

When is is appropriate to use UPC?

A
  • When there is NOT evidence for inflammation or hemorrhage
41
Q

Which comes first… Ketonemia or -uria?

A

Ketonuria

-freely filtered w/o reabsorption

42
Q

How does storage affect bilirubin in the urine?

A

**Exposure to light –> neutralization of bilirubin –> false negatives!! w/in 30mins

43
Q

What is the significance of detecting Nitrite?

A
  • determines if bacteria are present by detecting product than their enzyme produces
    • Nitrate –Reductase–> Nitrite

*Urine must be in bladder >4 hrs (not likely w/ UTi)

44
Q

Factors associated w/ crystal formation

A
  1. Urine pH
  2. High USG
  3. Cyrstalloid solubility
  4. Temp –fridge promotes crystals

Clin Chem (12 decks)

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