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Urinalysis Flashcards

(63 cards)

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1
Q

How much urine do people excrete on average?

A

1-1.5 L

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2
Q

Where does concentration of the urine take place?

A

Loop of Henle, distal tubules, and collecting tubule.

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3
Q

What is the major component of urine?

A

Urea and salt

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4
Q

Urinalysis reveals information about what five topics?

A 
Kidney and liver function
Metabolic processes
Infectious disease
Nutritional status
Occult disease
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5
Q

What diseases is urinalysis effective in revealing?

A 
Glomerulonephritis
Hypertensive nephropathy
Renal failure
DM
End stage renal disease
Urinary tract 
Neoplasm
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6
Q

What Hx/PE findings might prompt a UA dip?

A 
Abdominal pain
Back pain
Dysuria
Urinary frequency / urgency
Hematuria
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7
Q

When might you do a UA dip as part of routine monitoring of a disease?

A

Chronic renal disease
Liver disease
High blood pressure
DM

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8
Q

When might you do a UA dip as a routine screening?

A

Annual check-up

Family Hx of renal disease

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9
Q

What is the major cause of end-stage renal disease?

A

DM

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10
Q

Describe the rules for storage/analysis of urine.

A

Freshly voided is best.
Store for max 1hr at room temp.
Store for max 4hr in fridge.

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11
Q

How might you reduce contamination of a urine sample from an infant?

A

Suprapubic aspiration

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12
Q

What macroscopic physical properties are observed in the UA?

A

Color, clarity

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13
Q

What chemical properties are observed in the UA? (dipstick)

A 
Glucose     Blood
pH              Protein
Bilirubin     Urobilinogen
Ketones     Nitrites
Leukocyte  Specific gravity
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14
Q

What microscopic physical properties are observed in the UA?

A 
Cells
Crystals
Microorganisms
Casts
Debris
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15
Q

What gives urine its color?

A

Urochrome, from bilirubin metabolism.

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16
Q

What might result in red urine?

A

Pathologic: hematuria/hemoglobinuria

Non-path: beets, rhubarb

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17
Q

What might result in orange or amber urine?

A

Bilirubinuria (jaundice)

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18
Q

What might result in green urine?

A

Pseudomonas infection

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19
Q

What might result in brown-black urine?

A

Melanin (due to melanoma)

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20
Q

What might result in colorless urine?

A

DM or DI

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21
Q

What might result in bright yellow urine?

A

Vitamin B2

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22
Q

What might make urine cloudy?

A

Cells (WBCs, epithelial cells, bacteria)
Amorphous urates (acidic)
Amorphous phosphates (alkaline)
Hyperuricosuria (purine-rich foods)

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23
Q

What might make urine hazy?

A

Mucus, protein

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24
Q

What might make urine milky?

A

Fat/lipids

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25
What might make urine smokey?
Blood
26
What results in sweet or fruity-smelling urine?
Uncontrolled diabetes (ketonuria)
27
What results in foul or pungent urine?
Bacterial infection (ammonia)
28
What results in musty-smelling urine?
Phenylketonuria
29
What results in urine that smells like grape juice?
Pseudomonas infection
30
What results in maple-syrup-smelling urine?
Maple syrup urine disease
31
What is a normal adult specific gravity of urine?
1.010-1.025
32
What is the significance of specific gravity?
It reflects the kidneys' ability to concentrate urine.
33
What words describe high and low SG?
Hypersthenuria/hyposthenuria
34
What are some pathological reasons for hypersthenuria?
DM (glycosuria) Proteinuria / Nephrotic syndrome CHF
35
What are some pathological reasons for hyposthenuria?
Chronic renal diseases (constant 1.010--osmolarity of plasma) DI Glomerulonephritis
36
When will SG read false positive/negative?
FP : Proteinuria | FN : high pH
37
What is the threshold for glucosuria?
160-180mg/dL
38
What conditions might result in glucosuria?
DM Cushing's syndrome Acromegaly
39
What tests are skewed by ascorbic acid?
Glucose (FN) Blood (FN) Bilirubin (FN)
40
When will glucose read false?
FP: oxidizing agents FN: ascorbic acid, aspirin, ketones
41
When do you get ketones?
Metabolism of fatty acids due to altered carbohydrate metabolism
42
What is the expected result for glucose?
Negative
43
What is the expected result for ketones?
Negative
44
Which ketone is the dipstick specific for, and when might that be a problem?
Only reads acetoacetic acid. | Predominant ketone in DKA is beta-hydroxybutyrate
45
What conditions might result in ketonuria?
DM | Increased metabolic states (hyperthyroidism, fever, pregnancy)
46
When will ketones read false?
FP: Drugs (levodopa, phenylketones, phthaleins), highly pigmented urine FN: prolonged exposure to air
47
Name three possible pathological sources of blood in urine.
Glomerular disease Kidney stones Pyelonephritis
48
When will blood read false?
FP: Microbial peroxidases, myoglobinuria, menstrual blood FN: nitrites, ascorbic acid, increased SG
49
What is the normal range of urine pH?
4.5-8.0 (usually 6.0)
50
What is an alkaline tide?
Urinary pH is higher after meals
51
Why might you have alkaline urine?
Alkalosis, UTI (proteus, pseudomonas), vegetarian diet
52
Why might you have acidic urine?
Acidosis, DM, UTI (E. coli), starvation, high meat diet
53
What protein is detected on the UA dip?
Albumin
54
When might a patient experience transient proteinuria?
Fever, stress, exercise, CHF
55
What protein score on the dipstick is significant?
1+ is significant and requires followup, indicates 30mg/dl
56
When might protein read false?
FP: vaginal secretions, hematuria, pyridium, alkaline urine FN: dilute sample
57
What is the normal result for bilirubin?
Negative
58
Where does bilirubin come from?
Waste product formed from heme of lysed RBCs, supposed to be excreted in stool
59
What conditions might result in bilirubinuria?
Gallstones, cholestasis, bile duct obstruction, acute hepatitis
60
When might bilirubin read false?
FP: Fecal contamination, Pyridium FN: nitrites, light exposure, ascorbic acid
61
What is a normal result for urobilinogen?
0.2-1.0mg/dL
62
What conditions might result in increased urobilinogen?
Intravascular hemolysis | Intestinal obstruction
63
When might urobilinogen read false?
FP: Fecal contamination, pigmented drugs, beets FN: Formaldehyde, air exposure, antibiotics

Lab Diagnosis (3 decks)

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