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Diagnostic M.'s Sara Peer mentor > Urinalysis > Flashcards

Urinalysis Flashcards

(57 cards)

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1
Q

What are the types of Urine specimens that can be collected?

A 
Random or spot urine 
Clean catch urine
Straight catheter specimen
Indwelling catheter specimen
Suprapubic specimen
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2
Q

What do we evaluate when performing Urinalysis (UA)?

A

Physical examination of urine
Chemical testing of urine
Microscopic examination of urine

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3
Q

What other tests can be performed on urine?

A

Urine culture and sensitivities (C&S)

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4
Q

What are the indications for urinalysis?

A

Diagnostic screening
Monitoring or renal disease or metabolic disease
S/S of urinary tract diseases
S/S of urinary tract infection = abdonminal pain, back pain, dysuria, hematuria, urinary frequency
S/S of infection including fever and leukocytosis

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5
Q

What is looked at on physical examination of urine?

A

Color
Appearance
Specific gravity

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6
Q

What is normal urine color due to?

A

Urochrome

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7
Q

What can cause urine to be red?

A 
Beets
Hemoglobinuria
Blood
Propofol
Chemotherapy
Ex-lax
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8
Q

What can cause urine to be orange?

A

Vitamin C
Rifampin
Phenazopyridine

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9
Q

What can cause urine to be green?

A

Asparagus
Propofol
Utis
Methylene Blue

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10
Q

What can cause urine to be blue?

A

Methylene blue
Indomethacin
Blue diaper syndrome

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11
Q

What can cause urine to be purple?

A

Utis in patient with catheters

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12
Q

What can cause urine to be brown?

A

Fava bean
Levodopa
Metronidazole
Hepatobiliary disease

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13
Q

What can cause urine to be black?

A

Alkaproteinuria

Melanoma

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14
Q

What is the specific gravity of urine and what is it measured by?

A

Density of urine

A Refractom eter test

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15
Q

What does a urine dipstick test?

A 
Specific Gravity
pH
Leukocyte esterase
Blood
Nitrate
Ketones
Bilirubin
Urobilinogen
Protein
Glucose
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16
Q

At what level of blood glucose will a positive glucose test be seen on urine dipstick?

A

> 180

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17
Q

What are the normal findings on a urine dipstick?

A 
Clear
Yellow
Aromatic odor
4.6-8.0 pH
0.8 protein
1.005-1.030 specific gravity
neagtive leukocyte esterase
None nitrates, ketones, bilirubin, or glucose
0.01-1 urobilinogen
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18
Q

Proteins in urine…

A

proteinuria

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19
Q

WBCs in urine…

A

pyuria

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20
Q

Blood/RBCs/hemoglobin in urine…

A

hematuria vs. hemoglobinuria

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21
Q

Ketones in urine…

A

ketonuria

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22
Q

Bilirubin in urine…

A

bilirubinemia

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23
Q

Glucose in urine…

24
Q

What can be seen within urine specimens?

Study These Flashcards
A 
Urine sediment including:
Cells
Casts
Crystals
Other
25
What cells may possibly in urine?
RBCs WBCs Squamous epithelial cells
26
What are squamous epithelial cells in urine an indication of?
contamination of specimen
27
What are casts?
Cylindrical particles formed from coagulated proteins in renal tubules
28
What are the types of casts?
``` Hyaline cast RBC cast WBC cast Waxy cast Muddy-brown granular cast Fatty cast ```
29
What are hyaline casts associated with?
Non-specific Heavy exercise Diuretics
30
What are RBC casts associated with?
Glomerulonephritis | Vasculitis
31
What are WBC casts associated with?
Acute pyelonephritis | Tubule interstitial nephritis
32
What are waxy casts associated with?
Advanced renal failure
33
What are muddy-brown granular casts associated with?
nephrotic syndrome
34
What are normal urine microscopic findings?
``` No crystals or casts 0-4 per low power field WBCs < 3 RBCs No RBC casts Less than 15-20/hpf squamous epithelial cells ```
35
What are urinalysis indicators of infection?
``` Bacteria Leukocyte esterase positive WBCs > 10 Nitrate positive RBCs pH increased ```
36
What are the two categories of urine culture?
``` Quantitative = colony count evaluation Qualitative = presence of bacteria ```
37
What are the diagnostic indications for lumbar puncture?
CNS infections Inflammatory processes Subarachnoid hemorrhage Cytologic and protein analysis
38
What are therapeutic indications for lumbar puncture?
Deliver medications | Relieve symptoms of a few specific causes of increased ICP
39
What are the Contraindications for Lumbar puncture?
``` Local skin infection Suspected mass lseion Raise ICP Bleeding Diathesis Coagulopathy = platelet count less than 50,000; platelet dysfunction; INR greater than 1.4 Poor patient cooperation ```
40
What is in a Lumbar puncture kit?
Sterile procedure | Four tubes collected labeled 1-4 and order of collection is important
41
Where would you do a lumbar puncture?
L3-L4 or L4-L5
42
What are the four tubes for CSF testing?
Tube 1 = Collect Cell Count and differential Tube 2 = Glucose and protein Tube 3 = Culture and gram stain Tube 4 = Cell count and diferential
43
Why are there two tubes that collect for cell count and differential?
Because RBCs would be higher due to trauma from puncture at beginning of procedure Last tube would be more correct for RBC count
44
What must the patient do after lumbar puncture and why?
Lay flat so fluid can normalize and so they don't get a spinal HA
45
If a CSF infection is suspected, what would you get?
Cell count and differential Glucose Protein Gram stain, culture, PCR
46
What must you consider if CSF infection suspected?
``` AFB or TB PCR Cryptococal antigen and india ink Fungal culture VDRL Lyme Antibody PCR for viruses (EBV, HSV, CMV, VZV, HHV6 ```
47
What would you find on CSF analysis if the infection is bacterial?
``` > 30 pressure Turbid appearance > 1 protein < 2.2 Glucose 60-90% positive gram stain < 0.4 Glucose-CSF: Serum ratio > 500 WCC 90% PMN ```
48
What would you find on CSF analysis if infection if viral?
``` Normal or mildly increased pressure Clear appearance < 1 protein Normal Glucose and Gram stain > 0.6 Glucose-CSF: Serum ratio < 1000 WCC Monocytes: 10% have > 90% PMN and 30% have > 50% PMN ```
49
What would occur if traumatic puncture happens?
``` Low CSF pressure Duration of bleeding with decrease when CSF is withdrawn Clotting will be present Repeat lumbar puncture is not bloody Clear fluid when centrifuged ```
50
What would occur if Subarachnoid hemorrhage happens?
``` High CSF pressure No change in color when CSF is wthdrawn Absent clotting Blood if repeated lumbar puncture Xanthochromia if centrifuged ```
51
What are the indications for synovial fluid analysis?
Joint pain Joint swelling Joint Effusion Must take context of clinical history and presentation
52
What is looked at on synovial fluid analysis?
``` Appearance Viscosity Cell count Cell differential Crystal analysis Culture and sensitivity (infection) Cytology (if malignancy suspected) ```
53
What are the characteristics of normal synovial fluid?
``` Transparent Clear High viscosity < 200 WBC.mm3 < 25% Polys ```
54
What are the characteristics of non-inflammatory synovial fluid?
``` Transparent Yellow High viscosity 100-2000 WBC/mm3 < 25% polys ```
55
What are the characteristics of Inflammatory synovial fluid?
``` Transparent Yellow Low viscosity 2000-10000 WBC/mm3 > 50% polys ```
56
What are the characteristics of Septic Synovial fluid?
``` Opaque Yellow/Dirty Variable viscosity > 80000 WBC/mm3 > 75% Polys ```
57
What are the characteristics of Hemorrhagic synovial fluid?
``` Bloody Red Variable viscosity 200-2000 WBC/mm3 50-75% polys ```

Diagnostic M.'s Sara Peer mentor (27 decks)

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