Urinalysis

Question 1

Serum creatinine and BUN rise after glomerular filtration rate falls below __________.

Answer 1

40 ml/min

Question 2

Why is creatinine a good indicator of GFR?

Answer 2

Because it is not reabsorbed (mostly)
It is not bound to plasma proteins
It is only partially secreted by the peritubular capillaries

Question 3

Urine must be analyzed within _____ hours to be accurate.

Answer 3

two (if you need to wait longer than two hours, then the sample must be refrigerated)

Question 4

Polyuria is roughly defined as ____________.

Answer 4

greater than 2 liters of urine in 24 hours

Question 5

For urine cultures, incubation must be done for longer if the patient ___________.

Answer 5

is receiving antibiotics

Question 6

What are 24-hour samples used for?

Answer 6

Hormone detection, protein electrophoresis, and electrolyte analysis

Question 7

Anuria is defined as less than __________.

Answer 7

100 ml of urine over 24 hours

Question 8

List the colors of some common urine abnormalities.

Answer 8

Bile: yellow/green/brown
Urobilinogen: orange/red/brown
Blood and hemoglobin: red/pink
Methemoglobin, L-dopa, rhabdomyolysis: black

Question 9

Reagent strips must be ____________.

Answer 9

kept in a cool, dry space with a tight lid

Question 10

Reagent strips should be placed into urine for no longer than ________.

Answer 10

one second

Question 11

Alkaline urine is a hallmark of __________.

Answer 11

renal tubular acidosis

Question 12

Normally, there is less than _______ grams of protein in a day’s worth of urine.

Answer 12

0.5

Question 13

What are some patient characteristics that might increase protein content in the urine?

Answer 13

Age (i.e., the elderly)
Posture (standing makes you have more protein in the urine)
Nephrotic syndrome
Multiple myeloma

Question 14

What two proteins account for most of the urinary protein?

Answer 14

Albumin and Tamm-Horsfall

Question 15

Proteinuria is defined as __________.

Answer 15

greater than 150 mg/dl

Question 16

Glucose is normally _________ in urine.

Answer 16

undetectable

Question 17

Four conditions can lead to glucose in the urine. What are they?

Answer 17

Diabetes, endocrine disorders, pregnancy, and pancreatic disorders

Question 18

__________ are indicative of Gram-negative bacteria in the urine.

Answer 18

Nitrites

Question 19

Even refrigerated urine samples cannot be analyzed after ________.

Answer 19

24 hours

Question 20

Oliguria is defined as __________.

Answer 20

less than 500 ml of urine in 24 hours

Question 21

Do not spin urine samples for ________ testing.

Answer 21

dipstick

Question 22

High specific gravity in a patient with oliguria indicates ____________.

Answer 22

a pre-renal disorder

Question 23

What would the urine pH be in metabolic or respiratory acidosis?

Answer 23

low

Question 24

What organism can cause markedly high pH in a UTI?

Answer 24

Proteus

Question 25

We normally excrete less than ______ grams of protein per day.

Answer 25

0.5

Question 26

On the +1 to +4 scale, what is proteinuria?

Answer 26

At least +3 (+3 is 200 mg/dl, and you need greater than 150 mg/dl to qualify as having proteinuria)

Question 27

The dipstick glucose tests only detect _________.

Answer 27

glucose–no other forms of sugar will be detected

Question 28

If microscopy reveals no RBCs, but the sample tests positive for blood, what is the conclusion?

Answer 28

Presence of hemoglobin!

Question 29

Free RBCs indicate _____________.

Answer 29

post-renal injury

Question 30

___________ is an indicator of neutrophils in the urine.

Answer 30

Leukocyte esterase

Question 31

What can you collect in centrifuged samples?

Answer 31

``` CCCO Cells Casts Crystals Organisms ```

Question 32

Having a few hyaline casts is normal, but more indicate ______________.

Answer 32

dehydration, fever, or renal injury

Question 33

Matrix casts are indicative of ___________.

Answer 33

chronic renal failure

Question 34

Uric acid crystals are nonspecific, but increased numbers suggest _____________.

Answer 34

increased cell turnover (such as in chemotherapy) or Lesch-Nyhan disease

Question 35

Dysmorphic RBCs indicate _________ origin.

Answer 35

glomerular

Question 36

The __________ void is the preferred for analysis.

Answer 36

first morning

Question 37

What else (other than DKA) can cause ketones in the urine?

Answer 37

Alcoholism Cirrhosis Fasting Prolonged exercise