Urinalysis Flashcards Preview

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Flashcards in Urinalysis Deck (67):
1

What is pictured?  What are some causes?

Red blood cells (crenated due to hypertonic urine).

Causes of hematuria: Renal or lwr UT disease

Ex: Urinary calculi, polycystic kidney, etc.

2

What is pictured?  Possible causes?

RBCs, Distorted from passage through small holes of GBM.

Causes: Renal or lwr UT disease.

Ex: Urinary calculi, Polycystic kidney disease, etc.

3

What is pictured?  Possible causes?

Neutrophils (WBCs) in urine.

Causes: 

1. Acute Glomerulonephritis

2. Infection

4

What is pictured?  Possible causes?

Oval fat bodies 

Causes:

1. Nephrotic syndrome

2. Hyperlipidemia

5

What is pictured?  Possible causes?

"Maltese cross" formation of oval fat bodies

Causes:

1. Nephrotic syndrome

2. Hyperlipidemia

6

What is pictured?  Composition? Site of formation? Possible causes?

Hyaline cast

Gelled protein (Tamm-Horsfall protein from tubule cells)

Distal convoluted tubule

Causes: Tubular or GBM necrosis

7

What is pictured?  Possible causes?

Hyaline Cast stained with bile (hyperbilirubinemia)

Causes:

1. Hepatocellular disease

2. Biliary obstruction

8

What is pictured?  Composition? Site of formation? Possible causes?

RBC cast in urine

RBCs

Distal convoluted tubule

Causes: GBM or tubular damage (glomerulonephritis)

9

What is pictured?  Composition? Site of formation? Possible causes?

RBC cast

RBCs

Distal convoluted tubule

Causes: GBM or tubular damage (glomerulonephritis)

10

What is pictured?  Composition? Site of formation? Possible causes?

WBC cast

leukocytes

 

Causes: 

1. pyelonephritis

2. interstitial nephritis

3. acute glomerulonephritis

11

What is pictured?  Composition? Site of formation? Possible causes?

Renal tubular epithelial cells

Severe tubular damage

Causes:

1. Renal tubular epithelial cells
    -necrosis

    -pyelonephritis
2. Transitional epithelial cells from the
     renal pelvis, ureter or bladder
    -Inflammation

12

What is pictured?  Composition? Site of formation? Possible causes?

Course Granular Cast

Degenerated epithelial cells

Cause:  

1. Cellular cast that has remained in nephron for some time

2. Associated with Proteinuria

13

What is pictured?  Composition? Site of formation? Possible causes?

Fine Granular Cast

Degeneration from epithelial cell cast then Coarse granular cast

Causes:

1. Prolonged time in nephron

2. Associated with Proteinuria

14

What is pictured?  Composition? Site of formation? Possible causes?

Waxy cast

End stage degeneration of epithelial cell cast

Causes:

1. Chronic nephron obstruction associated with advanced renal disease

15

What is pictured?  Composition? Site of formation? Possible causes?

Broad waxy cast

Formed in dilated tubules

Suggest acute tubular necrosis

16

What is pictured?  Composition? Site of formation? Possible causes?

Broad cast in urine

Formed in dilated tubules

Suggest acute tubular necrosis

17

What is pictured?  

Candida (fungal infection)

18

What is pictured?

Trichomonas (Parasite)

19

What is pictured?

HSV (Viral infection)

20

What is pictured?

CMV (viral infection)

21

What is pictured? Possible causes?

Calcium oxalate crystals

Cause: Acidic urine from metabolic or respiratory acidosis

22

What is pictured? Possible causes?

Ammonium magnesium phosphate crystals ("coffin lid crystals")

Cause: Alkaline urine from:

1. respiratory or metabolic alkylosis

2. UTIs from bugs that produce urease

23

What is pictured? Possible causes?

Tyrosine crystals (can also form cystine or leucine crystals)

Cause: Severe liver disease

24

Cause of red/brown urine

Food dyes

Beets

Drug

Hemoglobin

25

Cause of yellow-brown or green-brown urine

Bile pigments 

(bilirubinuria)

26

Cause of Turbid urine

Recipitation of salts

Cells

27

Ammonia-smelling urine

bateria

28

Musty-smelling urine

Phenylketonuria

29

Pungent and aromatic-smelling urine

cirrhosis

30

Acetone-smelling urine

ketonuria

31

Significance of high/low Specific gravity of urine

Proportion to urine osmolality

High value = dehydration

or

diabetes (high volume + glucosuria)

Low value = overhydration

or 

renal tubular injury

32

Causes of proteinuria (>150mg/day)

>150mg/day = nephritic syndrome

> 3.5g/day = nephrotic syndrome

Persistant protein

33

Causes of proteinuria >3.5g/day

> 3.5g/day = nephrotic syndrome

 

34

Causes of Glucosuria

diabetes

Cushings syndrome

Glycogen storage diseases

renal tubular disease

Liver disease

35

Causes of Bilirubinuria

hepatocellular disease

biliary obstruction

36

Causes of urobilinogen in urine

hemolytic anemia

hepatocellular disease

37

Causes of ketouria

Diabetic ketosis

Severe calorie restriction

(complete metabolization of FAs)

38

Positive nitrite test signifies

Bacteriuria (gram negative)

39

Positive leukocyte esterase test signifies

detects whole or lysed WBCs

pyuria (infection)

 

40

Causes of hematuria

renal or lwr UT disease

41

Causes of hemoglobinuria

UT bleeding with hemolysis 

or

intravascular hemolysis

42

Causes of myoglobinuria

traumatic muscle injury

burns

muscle disease

severe exercise

43

Composition and Cause of chylous effusion

fluid rich in protien, triglycerides, and LDLs

leakage of thoracic duct

44

Causes of serosanguineous pericardial exudate 

TB

neoplasia

uremia (failure of renal excretory function)

Viral infection

45

Cause of glucose lvl <40mg/dL in CSF

Bacterial infection

46

Amylase lvl in pleural effusions >125u/l

Pancreatitis

Malignancy

47

WBC>500uL in peritoneal effusion

bacterial peritonitis

48

Indications for lumbar pucture

Meningitis

Encephalitis

CNS leukemia

subarachnoid hemorrage

49

How to distinguish between traumatic puncture or hemhorrage if there is blood in the CSF

Sequential collection

Traumatic = less bloody in each successive tube

Hemorrhage = equally bloody

50

common cause of xanthochromia in CSF

xanthochromia = colored supernatant

Cause: RBC lysis

51

When does clotting occur in CSF?

traumatic puncture

Elevated CSF protein

TB meningitis

Meningeal inflammation

52

Causes of Neutrophil pleocytosis in CSF

meningitis by pyogenic bugs

53

Causes of Lymphocyte pleocytosis in CSF

Viral or syphilitic meningitis

meningoencephalitis

54

Causes of Eosinophilic pleocytosis in CSF

parasites

coccidioidomycosis

55

Causes of low protein in CSF

leakage of CSF

56

Causes of elevated CSF proteins

meningitis

meningoencephalitis

Brain abcess

degenerative CNS disease

neoplasia

diabetic neuropathy

57

Causes of elevated IgG in CSF

MS

infection

58

Cause of increased C-reactive protein in CSF

bacterial infection

59

What is hypoglycorrhachia?  Possible causes in CSF?

low glucose lvls

Bacterial or fungal infections (CSF)

60

Positive VDRL serology test in CSF

syphilis

61

Causes of positive Nucleic acid amplification tests

enteroviruses

herpesviruses

arboviruses

62

Diagnose the patient:

200-750 mm Hg, faint xanthochromia, purulent with 500-20,000 cells/ìl, neutrophilic
pleocytosis, 15–50 mg/dL protein, 0-45 mg/dL glucose

Bacterial meningitis

Diagnose by microscopic examination, serology, culture

 

 

63

Diagnose the patient:

150-750 mm Hg, faint xanthochromia, opalescent with 25-500 cells/ìl, lymphocytic

pleocytosis, 45-500 mg/dL protein, 0-45 mg/dL glucose

TB meningitis

Diagnose by microscopic examination and culture

 

64

Diagnose the Patient:

130-750 mm Hg, may be xanthochromic, clear, cloudy, or turbid with 5-5000 cell/ìl,
mixed or lymphocytic pleocytosis, 20-200 mg/dL protein, normal glucose

 

Aseptic (viral) meningitis

Diagnose by culture, NAAT, serology

 

65

Diagnose the Patient:

Normal to 300 mm Hg, colorless, clear, 10-150 cells/ul, lymphocytic pleocytosis, 45-150
mg/dL protein, normal glucose

Neurosyphilis

Diagnose by microscopic examination, serology

 

66

Diagnose the Patient:

Normal-450 mm Hg, colorless, clear, 10-150 cells/ìl, lymphocytic pleocytosis, 15-110
mg/dL protein, normal glucose

Viral meningoencephalitis

 

Diagnose by culture, NAAT, serology

67