Urinalysis Flashcards by Francette Llorin

Basic structural and functional unit of kidney

Nephron

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Order of urine formation

Glomerulus > pct > loop of henle > dct > collecting duct > calyx > renal pelvis

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Alter urine concentration

Pct, LH, dct & collecting duct

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Highly permeable to water

Ascending loop of henle

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Renal blood flow

Renal artery > afferent arteriole > glomerulus > efferent arteriole > peritubular capillaries > vasa recta > renal vein

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Resembles a sieve and located within the bowman’s capsule

Glomerulus

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1st function to be affected in renal disease

Tubular reabsorption

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Renal threshold for glucose

160 to 180 mg/dL

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Major site of reabsorption of plasma subs.

PCT

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Regulates water reabsorption in dct and cd

ADH/vasopressin

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ADH deficiency

Diabetes insipidus

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ADH excess

SIADH

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Regulates sodium reabsorption

Aldosterone

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2 major functions of tubular secretion

Elimination of waste products; regulation of the acid-base balance

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Inability to produce an acid urine; hydrogen ions are not excreted in the urine

Renal tubular acidosis

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Used to evaluate glomerular filtration

Clearance tests

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Oldest clearance test

Urea

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Most common clearance test

Creatinine

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Gold standard in clearance test

Inulin

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Used to evaluate tubular reabsorption

Concentration tests

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Obsolete test(tubular reab): when px is deprived of fluid for 24hours, urine SG is then measured.

Fishberg test (SG should be >/= 1.026)

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Obsolete test(renal reab): Compare day & night urine in terms in volume & sg

Mosenthal test

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Commonly used test in tubular reabsorption that is influenced by the number & specific gravity of particles in solution

Specific gravity

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Commonly used test in tubular reabsorption that is influenced by the number of particles in a sol’n

Osmolarity

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Tests in tubular secretion & renal blood flow

PAH (p-aminohippuric acid) test, PSP (phenolsulfonphtalein) test

Urine composition

95-97% water, 3-5% solids

Type of urine: For routine and qualitive UA

Random/occasional/single

Type of urine: ideal spx for routine and preg test (HCG)

First morning

Type of urine: for evaluation of orthostatic proteinuria

First morning

Type of urine: for diabetic screening/monitoring

2-hour postprandial

Type of urine: optional with blood samples in gtt

Glucose tolerance

Type of urine: collected at specific time intervals to compare conc'n of subs in urine with its concentration in the blood (used in the diagnosis of diabetes)

Fractional specimen

Type of urine: for routine & bacterial culture

Midstream clean catch

Type of urine: for bacterial culture

Catheterized

Type of urine: bladder urine for anaerobic bacterial culture and urine cytology

Suprapubic aspiration

Type of urine: use of soft, clear plastic bag with adhesive

Pediatric spx

Type of urine: for prostatic infection

Three-glass technique

Type of urine: begin and end the collection period with an empty bladder

24-hr

True or false: 24-hr spx requires preservative

True

Type of urine: for addis count

12-hr

Type of urine: for urobilinogen

Afternoon (2-4pm)

The process that provides documentation of proper sample identification from the time of collectuion to the receipt of lab results

Chain of custody

Required urine volune in drug spx collection

30-45 mL (60 mL container capacity)

Increased changes in unpreserved urine

PH, bacteria, odor, nitrite

Least affected parameter

Protein

Normal range of urine volume (24 hrs)

600-2000 mL

Average urine volume

1 200-1 500 mL

Night : Day ratio of urine volume

1:2 to 1:3

Volume required in urinalysis

10 to 15 mL (average 12mL)

Specific gravity of DM

⬆️ SG

Specific of DI

⬇️ SG

Increased urine volume

Polyuria

Decreased urine volume

Oliguria

Complete cessation of urine flow

Anuria

Excretion of more than 500 mL of urine at night

Nocturia

Causes of oliguria

Dehydration, renal calculi or tumor

Causes of anuria

Complete obstruction (stones, carcinomas), toxic agents, dec. renal blood flow

Causes of nocturia

Pregnancy

Rough indicator of the degree of hydration

Urine color

True or false: urine color shouldn't correlate with urine SG

False

Major pigment of urine

Urochrome

Color of urochrome

Yellow

Color of uroerythrin

Pink

Color of urobilin

Dark yellow/orange

May deposit in amorphous urates & uric acid crystals

Uroerythrin

Imparts an orange-brown color to urine that is not fresh

Urobilin

Color of urine that is correlated with strenous exercise

Dark yellow

Color of urine that is correlated with fever and burns

Amber

Color of urine that is correlated with pseudomonas infection

Green

Color of urine that is correlated with porphyrins

Portwine

Pathologic causes of urine turbidity

Rbcs, wbcs, bacteria, yeast and nonsquamous epithelial cells, abnormal crystals, lymph fluids, lipids

Normal odor of urine

Aromatic

Fruity odor

Ketones, DM

Cabbage odor

Methionine malabsorption

Rotting fish

Trimethyl aminuria

Swimming pool odor

Hawkinsinuria

Odorless

Acute tubular necrosis

Principle of glucose

Double sequential enzyme reaction

Principle of Bilirubin

Diazo reaction

Principle of ketones

Sodium nitroprusside reaction (Legal's test)

Principle of Specific gravity

pKa change of polyelectrolyte

Principle of pH

Double indicator system

Principle of Protein

Protein error of indicator / Sorensen's

Principle of Blood

Pseudoperoxidase of Hgb

Principle of urobilinogen

Ehrlich's reaction

Principle of Nitrite

Greiss reaction

Principle of Leukocyte

Leukocyte Esterase

Principle of Rgt strip

Reflectance photometry

This is influenced by the number and size of particles in a solution

Specific gravity

Normal specific gravity of random urine specimen

1.003 to 1.035

SG of Isosthenuria

1.010

SG of Hyposthenuria

<1.010

SG of Hypersthenuria

>1.010

Calibration temp of Urinometer

20degC

Rgt of Sg in rgt strip

Bromthymol blue

Important in the identification of crystals and determination of unsatisfactory specimens

Normal pH of random urine specimen

4.5 to 8

pH of first morning specimen

5.0 to 8.0

pH of unpreserved specimen

9.0

Reagents in pH

Methyl red(pH4.0-6.0), Bromthymol Blue(pH6.0-9.0)

Most indicative of renal disease

PROTEIN

Protein produces what in urine when shaken?

White foam

Major serum protein found in the urine

Albumin

Pink sediment in an acidic urine

Amorphous urates

Four-sided flat plates/lemon-shaped crystal

Uric acid

Enveloped/pyrimidal shaped crystal

Calcium oxalate (dihydrate)

Oval/dumbell shaped crystal

CaOx (monohydrate)

Cigarette-butt shaped crystal

Calcium sulfate

"Thorny apples" crystals

Ammonium biurate

Coffin-lid shaped crystals

Triple phosphate

Flatplates thin prisms in rosette form

Calcium phosphate

Dumbell shaped with formation of gas

Calcium carbonate

Staircase pattern

Cholesterol

Colorless to yellow needles

Tyrosine

Concentric circles & radial striations

Leucine

clumped needles or granules with bright yellow color

Bilirubin

"Arrow head" shaped

Sulfonamide

Colorless needles

Ampicillin

Urinalysis Flashcards

(118 cards)