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RUSVM Clin Path > Urinalysis > Flashcards

Urinalysis Flashcards

(96 cards)

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1
Q

T/F cystocentesis is an invasive procedure

A

true

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2
Q

when is a cysto contraindicated

A

Local pyoderma, coagulopathy, neoplasia (risk of seeding)

Insufficient volume of urine in the urinary bladder

Patient resists restraint and abdominal palpation

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3
Q

what is the recommended technique for urine culture

A

Cystocentesis

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4
Q

Voided urine

A

mid stream flow

generally acceptable for U/A, sediment exam

not suitable for culture

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5
Q

Catheterization can result in

A

Blood or epithelial cell contamination

Trauma

Technically difficult, especially in females

Track materials into bladder and cause bladder infection

Perform re-check UA to check for UTI after catheterization

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6
Q

urine should ideally be evaluated within

A

30 min
– Refrigerate
– Low USG can lead to cellar lysis – analyze soon!

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7
Q

how long can you refrigerate urine for

A

up to 12 h in sterile, opaque, airtight container
– Warm to room temp for 20 min
– Gently swish to remix and resuspend sediment

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8
Q

T/F exposure to light can turn urine a darker yellow

A

true

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9
Q

yellow-orange urine

A

bilirubin

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10
Q

yellow-green/yellow-brown urine

A

bilirubin and biliverdin

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11
Q

red urine

A

RBCs, HgB, and MgB

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12
Q

red-brown urine

A

RBCs, Hb, Mgb, MetHgb

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13
Q

brown to black urine

A

MetHgB

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14
Q

how to differentiate to between RBCs, Hb, Mgb, and MetHgb

A

– Hemoglobin: serum will also be red/pink

– Myoglobin: doesn’t accumulate in serum,

– MetHgb: serum is brown/black serum will not be discolored

– RBCs will settle to the bottom after centrifugation

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15
Q

miscellaneous color changes

A

Drugs - especially drugs with dyes

Horse urine with storage or on snow can turn reddish
– this is not evidence of hematuria

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16
Q

clarity:

A

Clear -> slightly cloudy -> cloudy -> opaque -> flocculent (chunky)

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17
Q

T/F horses tend to have turbid/ cloudy urine

A

true: contains mucous (looks like beer-think budwiser clydesdales)

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18
Q

what is cloudiness or turbidity caused by

A

– “formed elements”

– Cells, crystals, bacteria, casts, and lipid droplets (some lipid normal in cats)

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19
Q

read the SpGr off of the

A

supernatant

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20
Q

why is it important to use room temp urine for SpGrq

A

Cold fluids are more dense, FALSELY increases SpGr

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21
Q

what do you interpret USG with

A
  1. Serum [BUN] & [CREA]
  2. Amount of urine
  3. Hydration status
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22
Q

T/F each species has a normal USG value

A

False: there is no “normal” USG; indicative of adequate [ ] ability

  • Dog >1.030
  • Cat >1.035
  • Horse & Cattle >1.025
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23
Q

what are the “big 6” on a dipstick

A

glucose

bilirubin

ketones

blood

pH

protein

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24
Q

T/F glucose can be present in urine in health puppies

A

true

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25
T/F cold urine falsely elevates glucose
false: decreases it
26
renal threshold for dogs -glucose
180 mg/dL
27
renal threshold for cats - glucose
280 mg/dL
28
renal threshold for horses - glucose
180 mg/dL
29
renal threshold for cattle - glucose
100 mg/dL
30
5 main causes of hyperglycemic glucosuria
Diabetes mellitus – glucose Hyperadrenocorticism – cortisol Drugs – dextrose, glucocorticoids, progesterone Postprandial (P just ate) Acute pancreatitis
31
3 main causes of normoglycemic glucosuria
Transient stress Reversible tubular damage: drugs, hypoxia, infection, toxins Cats with urethral obstruction
32
T/F more than 20% of normal dogs have 1+ bilirubin
true: – Has low renal threshold – Canine PCT can conjugate Hgb & excrete bilirubin
33
T/F Expect bilirubinuria before bilirubinemia
true: – 2+ bilirubin & USG 1.020 – more concerned – 2+ bilirubin & USG 1.040 – less concerned
34
in any species other than dogs bilirubinuria is
ABNORMAL
35
bilirubinuria can be indicative of
liver disease bile duct onstruction hemolysis
36
what causes false negatives [bilirubin}
Old sample Light exposure Nitrites Ascorbic acid
37
what are they true ketones
acetoacetic acid and acetone
38
T/F ketones are present in normal animals
False
39
Question, what kind of bear is best?
black bear
40
Fact, bears eat beets
Bears, beets, "Battlestar Galactica."
41
which ketones are detected on dipstick
Acetoacetic acid & acetone – NOT β-hydroxybuterate
42
what it the predominant form of ketones in ruminants
β-hydroxybuterate | – Expect β-OHB in bovine ketosis & pregnancy toxemia in ewes
43
when do you get ketonuria
Negative energy balance DKA Insulinoma
44
what can blood on the dipstick indicate
Hgb, Mgb or RBCs – RBCs lyse & release Hb – Bleach causes a F(+) reaction
45
if blood on the dipstick is due to hematuria:
Clears with centrifugation Speckled pattern if low-grade
46
causes of hematuria
Trauma, infection, inflammation, infarction, calculi, neoplasia, coagulopathy
47
if blood on the dipstick is due to hemoglobinuria
1. Urine supernatant NOT clear after centrifugation – still red colored 2. No RBCs found in sediment
48
causes of hemoglobinuria
intravascular hemolysis – Serum will be pink/red – Patient will be anemic
49
T/F myoglobinemia is visible
false
50
what leads to the release of myoglobin
Myocyte damage – ↑ AST & CK – muscle-origin on biochemical profile – Urine supernatant red
51
normal urine pH of Dogs and Cats
6.5 – 7.5 * carnivores/omnivores
52
normal urine pH of Horses and Cattle
7.5 – 8.5 * herbivores
53
renal tubular dysfunction leads to...
paradoxically alkaline urine
54
alkaline pH caused by
Urinary Tract Infections (UTI) - urea splitting bacteria Low protein diets Respiratory alkalosis, Metabolic alkalosis Alkalinizing drugs
55
what hinders interpretation of urine pH
pigmenturia
56
examples of urea splitting bacteria
Proteus Pseudomonas Staphylococcus
57
causes of acidic pH
High protein diets: Carnivores/omnivores; herbivores on milk Respiratory and Metabolic Acidoses Hypochloremic metabolic alkalosis + severe dehydration Hypokalemia (K/H exchanger) Furosemide
58
which protein is primarily detected on dipstick
albumin
59
which proteins is the dipstick insensitive to
Bence Jones proteins Globulins
60
causes of proteinuria
‒ Pre-renal: Fever, hypertension, seizures, IV ‒ Renal: Glomerulonephritis, renal tubular injury ‒ Post-renal: Hemorrhage, infection
61
what should be ruled out with a positive protein reaction
hemorrhage (RBCs in sediment) UTI/Cystitis (BacT and WBCs on sediment) Intravascular hemolysis-hemoglobinurea (animal will be anemic)
62
proteinuria caused by renal disease
1. Blood reaction will be negative (usually) 2. Sediment will likely have casts 3. Measure a UPCR **Proteinuria with nothing in the sediment is most often indicative of glomerular disease**
63
T/F trace to 1+ protein is a normal finding in concentrated urine for dogs
true (remember 1+ bilirubin is also normal in dogs)
64
T/F proteinuria with dilute urine is a problem
true
65
Sulphosalicylic Acid Test (SSA)
Used to confirm dipstick protein results Reacts with albumin, and also reacts adequately with globulins / Bence-Jones proteins
66
what does a discrepancy between SSA and dipstick indicate
there is protein other than albumin in the urine See glob and BJ proteins with certain neoplasms- multiple myeloma and B cell tumors
67
urine sediment preparation
1. Mix urine and transfer a standarized volume to a conical test tube 2. Centrifuge at low speed for 5 minutes 3. Decant urine without disrupting the sediment; leave a small amount of urine for sediment resuspension 4. Gently agitate the vial to resuspend the sediment 5. Transfer a drop to a glass slide and place a coverslip 6. Lower the condenser on your microscope 7. Examine the entire coverslip, especially the edges
68
source of caudate cells
renal pelvis
69
renal cells
renal tubules
70
squamous epithelial cells
‒ Largest ‒ Thin ‒ Often transparent ‒ Angular or folded
71
significance of squamous epithelial cells
Seen in free catch urine Rarely pathologic
72
transitional epithelial cells
‒ Round ‒ Vary in size ‒ Found individually or in clusters
73
significance of transitional epithelial cells
Seen with hyperplasia associated with inflammation Seen in transitional cell tumors (benign and malignant)
74
caudate cells
cone-shaped significance: pyelonephritis
75
renal cells
‒ Small ‒ Cuboidal to round ‒ Basal to central nuclei ‒ Found individually and in small groups or rows ‒ Seen with renal tubular injury: infectious, toxic, and ischemic injury
76
what are crenated RBCs
they are the pissed off cats of the RBC world- when urine has been stored or USG >1.025 (unhappy environment)
77
when do you see RBC lysis
USG
78
significance of RBCs in sediment
hemorrhage, inflammation
79
WBCs on sediment
1.5-2x larger than RBCs Light gray, granular texture Often visualize nucleus Cannot easily differentiate in unstained preps
80
significance of WBCs
inflammation (infectious and noninfectious-stones)
81
when can you see start to see bacteria on sediment
‒ >10,000 rods/ mL ‒ >100,000 cocci/ mL
82
T/F air-dired wright stained is a better detector of bacteria
true
83
T/F there is no standard method for reporting bacteria
true
84
T/F bacteria spin down with centrifugation
false
85
other infectious agents include
dioctophyma renale capillaria ovum yeast and fungal hyphae (immunosuppressed) - candida spp Dirofilaria immitis
86
transitional cell carcinoma
Extremely difficult to diagnose and differentiate from inflammation- send it to a clinical pathologist!!!! Normal transitional epithelial cells can be very variable in size
87
T/F free lipid droplets are common in cats
true
88
when can lipid presence have pathologic significance
renal tubular injury
89
Struvite crystals
Most common crystal in dogs and cats Formation is favored in neutral to alkaline pH
90
significance of struvites
Can be found in clinical normal patients Urease-positive bacteria promote formation (↑urine pH)
91
bilirubin crystals
Orange to copper granules Usually present in small bundles
92
significance of bilirubin crystals
dogs: low number in highly concentrated urine is normal Abnormal in all other species: ICTERUS - r/o pre-hepatic - hemolysis (EVH) - r/o hepatic/ post-hepatic - hepatobiliary disease
93
calcium carbonate
‒ Large spheres with radial striations ‒ Variably sized ‒ Colorless to yellow-brown (can cause brown-tinged urine in ↑↑↑ #s)
94
significance of calcium carbonate
NORMAL in horses, rabbits, guinea pigs, and goats No reports in canine or feline urine.
95
calcium oxalate dihydrate
NORMAL in domestic animals Storage artifact Pathologic: - Miniature Schnauzers are predisposed to calcium oxalate urolithiasis - Increased calcium excretion due to hypercalcemia (e.g. hyperparathyroidism) - Acute renal fialure
96
calcium oxalate monhydrate
Can be seen in healthy animals (esp horses) Can be seen in animals with: ‒ Oxalate urolithiasis ‒ Hypercalciuric or hyperoxaluric disorders ‒ ETHYLENE GLYCOL TOXICOSIS (RARE)

RUSVM Clin Path (11 decks)

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