Urinalysis Flashcards Preview

BIO 233 > Urinalysis > Flashcards

Flashcards in Urinalysis Deck (50):
1

What are the types of analysis?

Types of Analysis

  1. Macroscopic Examination
  2. Chemical Analysis (Urine Dipstick)
  3. Microscopic Examination
  4. Culture (not covered in this lecture)

2

Components of macroscopic examination

Macroscopic Examination

  1. Odor/Smell
  2. Color

3

If odor is ammonia-like what does that potentially indicate? 

Ammonia-like:  (Urea-splitting bacteria)

4

If odor is foul, offensive what does that potentially indicate?

 Foul, offensive:  Old specimen, pus or inflammation

5

If odor is sweet what does that potentially indicate?

Sweet:   Glucose

6

If odor is fruity what does that potentially indicate?

Fruity= Ketones 

7

If odor is sulfur what does that potentially indicate?

Sulfer= Asparagus 

8

If color is colorless what does potentially that indicate?

Colorless= Diluted urine

9

If color is deep yellow what does potentially that indicate?

Deep Yellow= Concentrated Urine

10

If color is yellow-green what does that potentially indicate?

Yellow-Green= Bilirubin / Biliverdin

11

If color is red what does that potentially indicate?

Red= Blood / Hemoglobin

12

What does a chemical analysis consist of? 

 Urine Dipstick 

A image thumb
13

What is the range for normal specific gavity?

Normal range of specific gravity: 1.001-1.030

14

What is the cause of low specfic gravity (< 1.001)?

 

Diabetes insipidus (low SG)

15

What is the cause of high specific gravity (> 1.030)?

Dehydration (high SG)

16

What are some limitations of the urine dipstick? 

Limitations of Urine Dipstick Specific Gravity

  • Interference: alkaline urine
  •  Does not measure non-ionized solutes (e.g. glucose)

17

What is the normal pH for urine? 

Normal pH 6

18

What causes urine to be acidic? 

Acidic (less than 4.5):

  • metabolic acidosis
  • high-protein diet

19

What would cause urine to be basic? 

Alkaline (greater than 8.0)

  • renal tubular acidosis (>5.5)

20

What are the limitations of the urine dipstick for pH? 

Limitations

  •   Interference: bacterial overgrowth (alkaline or acidic)
  •   “run over effect” effect of  protein pad on pH indicator pad
    • Buffers from the protein area of the strip (pH 3.0) spill over to the pH area of the strip and make the pH of the sample appear more acidic than it really is.

A image thumb
21

What are some pathological reasons for protein in the urine?

Pathological Reasons for Protein in Urine

  • Glomerulonephritis 
  • Renal tumor 

22

What are some causes of glucose in the urine?

Glucose

  • Diabetes mellitus

  • Renal glycosuria

23

What are some limitations of testing glucose on a urine dipstick?

Limitations

  • Only measures glucose and not other sugars.
  • Renal threshold must be passed in order for glucose to spill into the urine.

24

What are the non-pathological reasons why protein would be in urine?

Non-Pathological Reasons for Protein in Urine

  •  Severe muscular exertion
  • Pregnancy

25

What are some causes of ketones in the urine?

Causes

  • Diabetic ketoacidosis
  • Prolonged fasting

26

What are the limitations of testing for ketones in urine with a urine dipstick?

Limitations

  •  Interference: expired reagents (degradation with exposure to moisture in air)

27

What are some causes for blood in the urine?

Causes

  •  Hematuria (nephritis, trauma, etc)
  •  Hemoglobinuria (hemolysis, etc)
  •  Myoglobinuria (rhabdomyolysis, etc)

28

What is the cause for nitrite in the urine?

Cause

  •  Gram negative bacteriuria

29

What are some causes for bilirubin in the urine?

Causes

  •  Increased direct bilirubin (correlates with urobilinogen and serum bilirubin)
  • Bile or Hepatic obstructions 

30

What are some causes for leukocyte esterase in the urine?

Causes

  •   Pyuria
  •   Acute inflammation
  •   Renal calculus

31

What are some key guidelines for urine preservation for the microscopic examination? 

Preservation

  •   Cells and casts begin to disintegrate in 1 - 3 hrs. at room temp.
  •  Refrigeration for up to 48 hours (little loss of cells).

32

What are some general aspects for specimen concentration for microscopic examination?

Specimen concentration

  •  Ten to twenty-fold concentration by centrifugation.

33

What does the presence of erythrocyte casts indicate?

Erythrocyte Casts:  Glomerular diseases

34

What does the presence of leukocyte casts indicate?

Leukocyte Casts:  Pyuria, glomerular disease

35

What is the Significance of Cellular Casts?

A image thumb
36

What is a renal calcului?

Renal calcului = kidney stone

 

A image thumb
37

What is the diagnosis?

Q image thumb

  • Diluted urine, request a voided urine in the morning
  • If persisting low SG, possible diabetes insipida
  • A microscopic may give negative results

38

What is the diagnosis?

Q image thumb

  • Possible gallbladder or hepatic disease.
  • No hemolytic anemia.  Perform bilirubins in serum
  • Microscopic unlikely to provide additional info

39

What is the diagnosis?

Q image thumb

  • Possible UTI, request culture and antibiotic sensitivity
  • Negative Nitrite test: Gram positive bacteria
  • Lower SG may show less number of cells and bacteria
  • Un-common diagnosis in this type of patient

40

What is the diagnosis?

Q image thumb

  • Diabetes Mellitus
  • May be decompensated and with ketoacidosis
  • Ketones should become negative after treatment

41

What is the diagnosis?

Q image thumb

  • Glomerulonephritis
  • RBC casts reveals renal cortex involvement
  • RBC cast are not always present in GN

42

What is the diagnosis?

Q image thumb

Acute pyelonephritis

A image thumb
43

What is the diagnosis?

 

Q image thumb

Diabetes mellitus, type I

A image thumb
44

What is the diagnosis?

Q image thumb

Nephrotic syndrome

A image thumb
45

What is the diagnosis?

Q image thumb

Renal calculus

A image thumb
46

What is the diagnosis?

Q image thumb

Systemic lupus erythematosus (SLE) with lupus nephritis

A image thumb
47

What is the diagnosis?

Q image thumb

Rhabdomyolysis

A image thumb
48

What is the diagnosis?

Q image thumb

Adult polycystic kidney disease with chronic renal failure

A image thumb
49

What is the diagnosis?

Q image thumb

Transitional cell carcinoma of bladder

 

A image thumb
50

What is the diagnosis?

Q image thumb

Factitious specimen

 

A image thumb