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Flashcards in Urinalysis Deck (37):
1

What is used to analyze sediment in urine? The supernatant?

sed = light microscopy
sup = dipstick

2

Wy is the urine centrifuged?

to produce supernatant and urinary pellet

3

Specific gravity is determined by:

number and weight of solutes

4

Osmolality is determined by:

ONLY the number of solutes

5

Specific gravity is NOT a marker of how concentrated a sample is when:

abnormal numbers of heavy solutes are present in urine (e.g. contrast dye)

6

What are the specific gravity and osmolality of a maximum dilute urine sample?

1.002
50-100 mOsm/kg

7

In metabolic acidosis, urine pH is less than:

5.3

8

Urine pH >7.5-8.0, suggests:

UTI with urea splitting bacteria (such as proteus)

9

How does hyperglycemia cause glycosuria?

increases filtered load to greater than the reabsorptive capacity of proximal tubule

10

What does glycosuria in the presence of normal blood glucose (renal glycosuria) imply?

PT dysfunction

11

When are ketones often present?

fasting, DKA, and AKA

12

How do increased plasma ketoanions lead to ketonuria? How is ketonuria diagnosed?

filtered load exceeding proximal tubular reabsorptive capacity

Dipstick specific for acetone and acetoacetate

13

Elevated levels of plasma conjugated bilirubin lead to:

urinary excretion

14

_______ bilirubin is water soluble, which ______ bilirubin is insoluble.

Conjugated
Unconjugated

15

Which type of bilirubin will NOT be present in urine?

unconjugated-- non water sol

16

Nitrite is (present/absent) in normal urine.

absent

17

Positive nitrite suggests:

UTI with nitrate reducing bacteria
(gram negative)

*Gram negative bacteria = most common uropathogens

18

What is leukocyte esterase and how is it measured in urine?

Produced by neutroohils, and positive, when there are increased numbers of neutrophils in the urine

Dipstick (detects a neutrophil-specific leukocyte esterase)

19

What is normal excretion of protein?

<150 mg/day

20

What is Glomerular Proteinuria associated with?

increased permeability for protein in the glomerular capillary wall
(especially albumin)

21

What test detects all protein in the urine?

Sulfosalicylic acid test

22

How and where are low molecular proteins filtered and normally reabsorbed? What if they are not reabsorbed?

pinocytosis
proximal tubule

proximal tubular dysfunction

23

What is overflow proteinuria? What will you see via urine dipstick?

1. Excess production of low molecular weight proteins
2. increased filtered load exceeds reabsorptive capacity of PT

dipstick test:
positive for sulfosalicylic acid
negative for albumin

24

What is a "spot" urine sample?

ratio of urine protein over creatinine (both measured as mg/dl) in a “spot” urine sample

**reliable estimate of quantitative proteinuria

25

Urine dipstick is normally (positive/negative) for blood.

negative

26

Most common cause of positive dipstick for blood is:

presence of rbc’s in urinary sediment

27

Dipstick tests are sensitive to:

free hemoglobin and myoglobin
RBC

28

What are 5 characteristics of renal hematuria?

1. Dipstick positive
2. RBC’s in sediment, some dysmorphic
3. RBC casts
4. Absence of clots
5. Often associated with proteinuria

29

What are 3 characteristics of non-renal hematuria that are different from renal hematuria?

1 .no RBC cats
2. no proteinuria
3. no abn shaped RBCs

30

Describe urinary WBC's:

Granular cytoplasm
irregular nucleus
“glitter cells” (in polarized light?)

31

What conditions will you see urinary WBC's in?

1. UTI
2. pyelonephritis
3. allergic interstitial nephritis
4. intense glomerulonephritis

32

Urinary casts represent precipitates of:

protein forming in the lumen of tubules

33

Where is Tamm-Horsfall protein formed, and what does it do?

by thick ascending limb of Henle cells

forms the matrix of all casts

34

What are the only normal casts?
What type of cast contains cellular debris?

hyaline

granular

35

Lipiduria is (present/absent) in normal urine.

absent

36

What is lipiduria associated with? What causes it?

heavy proteinuria (nephrotic syndrome

presence of lipoproteins

37

What features of lipiduria may be noted using polarizing light?

Maltese crosses
oval fat bodies
fatty casts