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Urinalysis and Body fluids > Urinalysis > Flashcards

Urinalysis Flashcards

(192 cards)

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1
Q

pH method

A

double indicator

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2
Q

what does the double indicator method for pH contain?

A

methyl red

bromthymol blue

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3
Q

false high pH

A

bacterial growth

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4
Q

clinical significance of high pH

A 
veg diet
Met / Resp alkalosis
Renal tubular acidosis
vomiting
old specimen
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5
Q

clinical significance of low pH

A

protein diet
met / Resp acidosis
DM
dehydration

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6
Q

glucose method

A

double sequential

glucose oxidase then peroxidase

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7
Q

glucose false +

A

bleach

peroxide

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8
Q

glucose false -

A 
ascorbic acid
prolonged storage
high ketones and SG
acetoacetic acid
salicylates
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9
Q

clinical significance of glucose

A 
DM
pancreatitis
acromegaly
cushings
fanconi
renal disease
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10
Q

bilirubin method

A

diazo

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11
Q

what type of bilirubin is being detected in the urine strip

A

conjugated (only kind that is in urine)

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12
Q

false + bilirubin

A

drug induced color change

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13
Q

false - bilirubin

A

ascorbic acid

high nitrate, storage

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14
Q

clinical significance of bilirubin

A

hepatitis, cirrhosis, other liver disorders, biliary obstruction

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15
Q

urobilinogen method

A

ehrlichs / diazo

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16
Q

false - urobilinogen

A

formalin
storage
light exposure

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17
Q

clinical significance of urobilinogen

A

early detection of liver disease, liver disorders, hemolytic disorders

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18
Q

protein method

A

error of indicators

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19
Q

protein reagent

A

tetra-bromophenol blue

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20
Q

false + protein and why

A 
high pH (overwhelm acid buffer)
color
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21
Q

false - protein

A

protein other than albumin

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22
Q

protein clinical significance pre renal

A

intravascular hemolysis
muscle injury
APR
MM

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23
Q

protein clinical significance renal

A

diabetic nephropathy
strenuous exercise
dehydration
hypertension

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24
Q

protein clinical significance post renal

A

LUTI

injury trauma

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25
ketone method
nitroprusside reaction
26
false + ketone
color | levodopa
27
false - ketone
storage ascorbic acid
28
ketone clinical significance
``` diabetic acidosis starvation malabsorption/pancreatic disorders strenuous exercise vomiting AA ```
29
rbc method
pseudoperoxidase
30
false + rbc
menses microbial peroxidase soaps/detergent
31
false - rbc
ascorbic acid | high SG
32
clinical significance rbc
renal calculi glomerulonephritis pyelonephritis trauma
33
clinical significance hemoglobin
transfusion reaction hemolytic anemia burns infections
34
clinical significance myoglobin
muscular trauma coma convulsions alcoholism
35
wbc method
leukocyte esterase | cleave ester = aromatic + diazo salt
36
false + wbc
color vaginal contamination soap / detergent
37
false - wbc
high glucose, protein, SG | drugs
38
nitrate method
diazo reaction | sulfanilamide
39
false + nitrate
color | storage
40
false - nitrate
ascorbic acid | acid pH
41
wbc clinical significance
bacterial UTI inflammation of tract screening of urine culture specimens trich / chlamydia / yeast
42
nitrate clinical significance
cystitis | pyelonephritis
43
tests with false - due to ascorbic acid
``` glucose bilirubin ketones rbc nitrate ```
44
tests with false + due to soaps / detergent
wbc rbc glucose
45
false + SG
high protein, ketones | lactic acid
46
false - SG
high glucose, urea | acidic pH
47
clinical significance of high SG
renal tubular dysfunction
48
clinical significance of low SG
dilute urine
49
order of urine strip tests
``` glucose bilirubin ketone SG blood pH protein urobilinogen nitrite wbc ```
50
direct method of SG
urinometer
51
indirect methods of SG
refractometer | strip
52
what does the urinometer test measure?
solutes, glucose, protein
53
for what variables does the urinometer have to be corrected for
temperature | large amount of glucose and protein
54
what is the refractometer method testing?
ratio of velocity of light in solution vs velocity of light in air
55
is the degree of refraction proportional or inveresly proportional in the refractometer method?
proportional
56
what factors can affect the refractometer method?
protein and glucose
57
what does the strip test method detect?
only ionic solutes
58
confirmatory test for protein and principle
``` SSA cold precipitation (turbidimetric) ```
59
false + SSA
any substance precipitated by acid
60
is SSA or the strip more sensitive?
strip
61
confirmatory test for glucose and principle
clinitest | benedicts copper reduction
62
what does it mean if: | + clinitest and neg strip
sugar other than glucose present or strip interference
63
confirmatory test for ketones and principle
acetest | diacetic acid and acetone
64
what does it mean if: | + strip, - acetest
false +
65
confirmatory test for bilirubin and principle
ictotest | p-nitrobenzene-diazonium-p-toluenesulfonate
66
what is more sensitive: ictotest or strip?
ictotest
67
confirmatory test for urobilinogen and principle
ehrlichs | para-dimethylaminobenzaldehyde
68
how do you differentiate between hemoglobin and myoglobin in urine
chemical pad 2.8 g ammonium sulfate to urine= hgb precipitated myoglobin stays in supernatant test supernatant
69
what are the normal crystals in acidic urine?
uric acid amorphous urates calcium oxalate
70
what are the normal crystals in alkaline urine?
``` amorphous phosphates triple phosphate calcium phosphate ammonium biurate calcium carbonate ```
71
clinical significance of uric acid crystals
gout / leukemia patients under chemo
72
clinical significance of calcium oxalate
``` clumps = renal calculi mono= ethylene glycol ```
73
amorphous with pink sediment
urates
74
amorphous with white sediment
phosphates
75
crystals soluble in alkali
uric acid | amorphous urates
76
crystals soluble in dilute HCL
calcium oxalate
77
crystals soluble in dilute acetic acid
amorphous phosphates calcium phosphates triple phosphates
78
crystals soluble in acetic acid with heat
ammonium biurate
79
crystals soluble in gas from acetic acid
calcium carbonate
80
abnormal crystals
``` cystine cholesterol leucine tyrosine bilirubin sulfonamides ampicillin ```
81
clinical significance of cystine crystals
cystinuria
82
clinical significance of cholesterol crystals
nephrotic syndrome
83
liver disorder crystals
leucine tyrosine bilirubin
84
cystine crystals soluble in what?
ammonia
85
cholesterol crystals soluble in what?
chloroform
86
lecuine crystals soluble in what?
hot alkali
87
tyrosine crystals soluble in what?
alkali / heat
88
bilirubin crystals soluble in what?
acetic acid HCL NaOH
89
sulfonamides crystals soluble in what?
acetone
90
bacteria CS and source
UTI | bladder
91
squamous cells CS and source
N/A | vagina / urethra
92
tubular cells CS and source
tissue destruction, catheterization, heavy metals, hemoglobin/myoglobinuria, viral infections, pyelonephritis proximal and distal convoluted tubules
93
described tubular cells
rectangular, columnar, round, oval, cuboidal | eccentric nucleus
94
describe transitional cells
spherical, caudal | central nucleus
95
transitional cell CS and source
few = normal, clumps= carcinoma | renal pelvis, calyces, ureters, bladder, male urethra
96
yeast CS and source
DM, immunocompromised, UTI, vaginitis | contaminant
97
trichomonas CS and source
vaginal inflammation | vagina
98
oval fat bodies CS and source
nephrotic syndrome, DM, tubular necrosis | kidney (RTE cells that absorbed lipids)
99
glitter cell CS and source
wbc in alkaline/hypotonic urine, granules move | kidney
100
ghost cell CS and source
dilute/alkaline urine RBC swell and lose hgb | kidney
101
red cells CS and source
renal ut disease, extrarenal disease, trauma, strenuous exercise, renal stone, cystitis kidney
102
white cells CS and source
all renal disease and inflammation, UTI, cystitis, fever, strenuous exercise kidney
103
significance of red urine
``` hgb rbc myoglobin porphyrin beets fuschin ```
104
significance of red-brown urine
hgb rbc myoglobin
105
significance of AMBER urine
bilirubin biliverdin urobilin
106
significance of yellow-orange urine
bilirubin urobilin pyridium
107
significance of bright yellow urine
vitamin c
108
significance of dark yellow urine
concentrated bilirubin urobilin
109
significance of brown-black urine
methmeglobin homogentisic acid melanin
110
significance of blue urine
indican
111
significance of green urine
old | pseudomonas
112
significance of port wine urine
porphyrin
113
``` findings in DM for: polyuria polydipsia SG Glucose Ketones ```
``` polyuria present polydipsia present SG increased Glucose increased Ketones increased ```
114
``` findings in DI for: polyuria polydipsia SG Glucose Ketones ```
``` polyuria present polydipsia present SG low Glucose Normal Ketones Normal ```
115
defect in DM
low insulin production
116
defect in DI
low ADH (decreased Water absorption)
117
Following findings are consistent with what condition: increased BUN:Creat mild proteinuria and blood increased RBC, WBC, RTE, RBC casts
acute glomerulonephritis
118
``` Following findings are consistent with what condition: Mod elevated protein and blood low and fixed SG RBC WBC all casts RTE ```
chronic glomerulonephritis
119
Following findings are consistent with what condition: marked protein, blood, oval fat bodies increased casts, RTE, RBCs
nephrotic syndrome
120
``` Following findings are consistent with what condition: protein blood WBC and nitrate WBC RBC casts (bacterial, WBC, granular) RTE ```
acute pyelonephritis
121
``` Following findings are consistent with what condition: protein WBC low SG WBC casts (granular, waxy, broad) glucosuria ```
chronic pyelonephritis
122
``` Following findings are consistent with what condition: protein blood WBC nitrate bacteria RBC transitional cells ```
cystitis
123
Following findings are consistent with what condition: cytotoxic antibody against glomerular membrane viral respiratory infections proteinuria RBC casts hematuria
Goodpasture syndrome
124
Following findings are consistent with what condition: granuloma producing inflammation of small blood vessels ANCA hematuria proteinuria RBC casts elevated BUN:creat
Wegeners
125
Following findings are consistent with what condition: children after upper respiratory infections mild to heavy proteinuria hematuria RBC casts
Henoch-Schonlein
126
``` Following findings are consistent with what condition: RTE cell damage mild proteinuria hematuria RTE cells RTE cell casts ```
acute tubular necrosis
127
Following findings are consistent with what condition: tubular dysfunction glycosuria mild proteinuria
Fanconi
128
Bilirubin and urobilinogen levels in prehepatic conditions
bili- N | uro- increased
129
Bilirubin and urobilinogen levels in hepatic conditions
bili- positive | uro- increased / N
130
Bilirubin and urobilinogen levels in posthepatic conditions
bili- positive | uro- decreased / absent
131
what are the only analytes that increase in urine on standing?
bacteria nitrate pH
132
what factors must be present for cast formation? | protein, pH, solutes, flow rate
protein- Tamm Horsfall (increased under stress and exercise) pH- acidic solutes- Na and Ca flow rate- stasis
133
mousy odor
phenylketonuria
134
rancid odor
tyrosinemia
135
sulphur odor
cystinuria
136
what cast can be seen with: protein blood
hyaline
137
CS of hyaline casts
``` glomerulonephritis pyelonephritis chronic renal disease CHF stress and exercise diabetic nephropathy ```
138
what cast can be seen with: rbc (strip) protein blood
RBC
139
rbc cast CS
glomerulonephritis | strenuous exercise
140
what cast can be seen with: wbc protein LE +
WBC
141
wbc cast CS
pyelonephritis | acute interstitial nephritis
142
``` what cast can be seen with: WBC LE + nitrate + protein bacteria ```
bacterial
143
bacterial cast CS
pyelonephritis
144
what cast can be seen with: protein RTE
epithelial
145
epithelial cast CS
renal tubular damage
146
``` what cast can be seen with: protein cell casts RBC WBC ```
granular
147
granular cast CS
glomerulonephritis pyelonephritis stress and exercise
148
``` what cast can be seen with: protein cell casts granular casts RBC WBC ```
waxy
149
waxy cast CS
stasis of urine flow | chronic renal failure
150
what cast can be seen with: protein free fat droplets oval fat bodies
fatty
151
fatty cast CS
nephrotic syndrome toxic tubular necrosis DM crush injuries
152
``` what cast can be seen with: protein WBC RBC granular casts waxy casts ```
broad
153
broad casts CS
extreme urine stasis | renal failure
154
what reacts with sodium nitroprusside in the ketone strip reaction
acetoacetic acid
155
what is the greiss reaction
nitrite at acid pH react with aromatic amine and forms a diazo salt
156
what is the normal creatinine level in urine
1.2 mg/24hrs
157
what is the functional unit of the kidney
nephron
158
what is renin released in response to
decreased blood volume, arterial pressure, sodium vascular hemorrhage increased potassium
159
aldosterone function
stimulate kidney to retain sodium and water increase extracellular fluid increase BP normalize potassium levels
160
what is the initial ultrafiltrate specific gravity>?
1.010
161
what is the SG of isothenuric urine
1.010
162
what does it mean if a urine has a specific gravity of 1.010 or less?
renal tubular damage
163
where does urine concentration begin
descending and ascending loop of henle
164
RAAS pathway
Renin - angiotensin- angiotensin II- ADH and Aldosterone, and vasoconstriction of efferent and vasodilation of afferent arteriole
165
where does ADH originate from
hypothalamus
166
where does ADH act on and what does it do
distal convoluted tubule | Na reabsorption
167
where does aldosterone originate from
adrenal cortex
168
where does aldosterone act on and what does it do
collecting duct | water reabsorption
169
what does the vasoconstriction and vasodilation of the arterioles cause
Na reabsorption in proximal convoluted tubule
170
where is Na reabsorbed
proximal convoluted tubule ascending loop of henle distal convoluted tubule
171
what is lesch nyhan syndrom
purine disorder with massive excretion of urinary uric acid crystals
172
heme synthesis pathway
``` delta ALA Porphobilinogen Uroporphyrinogen Coproporphyrinogen Protoporphyrin Heme ```
173
what heme precursors are associated with acute intermittent porphyria
Delta ALA | PORpho
174
what heme precursors are associated with cutaneous symptoms
UR COP PROTO
175
elevated ALA / PORph condition
acute intermittent porphyria | Lead-ALA only
176
elevated URO condition
Porphyria cutanea tarda | Congenital erythropoietic porphyria
177
elevated COPro condition
congenital erythropoietic porphyria | variegate porphyria
178
elevated Proto condition
erythropoietic protoporphyria
179
in what porphyria conditions will the urine fluoresce
porphyria cutanea tarda congenital erythropoietic porphyria variegate porphyria erythopoietic protoporphyria
180
symptoms of porphyrias
photosensitivity pale port wine urine psychiatric symptoms
181
most common porphyria
porphyria cutanea tarda
182
watson schwartz principle
PBG will react with Ehrlichs reagent to form red color
183
watson schwartz differentiation
add chloroform to separate PBG and UBG
184
color in top layer (chloroform layer) watson schwartz
UBG
185
color in bottom layer watson schwartz
PBG
186
what contributes to SG but not osmolality and why
protein | osmolality- all substances that dissolve in urine (urea, uric acid, glucose, salts)
187
microalbumin strip principle
formation of a copper creatinine complex
188
false - microalbumin strip
ascorbate | EDTA
189
false + microalbumin
hemoglobin | drugs
190
what does it mean if: + glucose = clinitest
true glycosuria | clinitest should not be used to confirm positive glucose
191
creatinine clearance formula
U x V / P x 1440 (min / 24 hours)
192
how to correct for body surface area in creatinine clearance formula
creat clear x 1.73 / area

Urinalysis and Body fluids (1 decks)

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