Urinalysis - More than you ever wanted to know about pee. No, seriously. Flashcards by Lauren Leyland

Q

Urine needs to be looked at within what period of time?

A

1 hour

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Q

What are 3 methods for urine collection?

A

midstream clean catch
catheterization
suprapubic bladder aspiration

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Q

What’s one thing that indicates you did NOT get a clean catch?

A

squamous cells present in urine

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Q

What should be the timing/specifics for a urine collection for:

screening, evaluation for infection

A

random midstream clean catch

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Q

What should be the timing/specifics for a urine collection for:

pregnancy

A

first morning urine

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Q

What should be the timing/specifics for a urine collection for:

glucose testing/DM monitoring

A

2 hr post-prandial

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Q

What should be the timing/specifics for a urine collection for:

gestational diabetes

A

glucose tolerance test + blood samples

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Q

What should be the timing/specifics for a urine collection for:

protein

A

24 hr collection

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Q

What should be the timing/specifics for a urine collection for:

bacterial culture

A

catheterization

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Q

What should be the timing/specifics for a urine collection for:

prostatic infection

A

three-glass collection

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Q

What should be the timing/specifics for a urine collection for:

bladder urine for bacterial culture

A

suprapubic aspiration

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Q

orange urine

A

pyridium

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Q

green urine

A

pseudomonas

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Q

pink/red

A

RBCs, hemoglobin, myoglobin

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Q

Normal urine pH

Average urine pH

A

Normal: 4.5 - 8.0

Average: 5.0 - 6.0

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Q

What happens to the pH of urine as it stands around on your lab counter?

A

becomes more alkaline

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Q

What is the significance of a urine pH of 9?

A

Urine never gets to pH of 9. Means you need to re-do the test.

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Q

Acidic urine or alkaline urine?

UTI with E. coli

A

acidic

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Q

Acidic urine or alkaline urine?

starvation, DKA

A

acidic

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Q

Acidic urine or alkaline urine?

Proteus or Pseudomonas

A

alkalotic

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Q

Acidic urine or alkaline urine?

CKD

Study These Flashcards

A

alkalotic

Q

Range of values of specific gravity

Study These Flashcards

A

1.005 - 1.030

Q

specific gravity is usually (directly, inversely) related to amount of urine produced

Study These Flashcards

A

inversely

low urine volume, high specific gravity

high urine volume, low specific gravity

Q

Dilute urine has a (high, low) specific gravity

Study These Flashcards

A

low

High or low specific gravity? diabetes insipidus

low

High or low specific gravity? DM

high

High or low specific gravity? CHF

high

What biochemical marker is used to monitor DM?

ketones

What biochemical marker could be used in hemolytic anemia?

urobilinogen - increased

What biochemical marker would be decreased if bile ducts are obstructed?

urobilinogen - decreased

What is the main cause of glycosuria?

DM

What protein is checked for in a standard urinalysis?

albumin

What level of protein in the urine has a 90% sensitivity for significant renal injury?

3+ / 300 mg/dL

Proteinuria \> 2000mg/24hrs usually indicates what?

glomerular problem

Proteinuria \> 3500mg/24 hrs usually indicates what?

nephrotic syndrome

What is the difference between hemoglobinuria and hematuria?

Hemoglobinuria: when conditions outside the urinary tract results in extensive destruction of erythrocytes -\> hemoglobin is filtered through glomerulus Hematuria: whole RBCs

What if urine is cherry red but no RBCs are found in urine?

myoglobinuria

What is the usefulness of leukocyte esterase?

It is useful if tested in conjunction with nitrites - if both leukocyte esterase and nitrites are present, highly sensitive and specific for UTI

What is the downside to nitrites being useful in diagnosing UTI?

Bacteria need time to produce the nitrites - urine needs to sit in the bladder for a few hours….but if you have a UTI you probably have urinary frequency!

What if you see DYSMORPHIC RBCs?

glomerular problem!

What is this and what does it signify?

Red cell casts. Usually means glomerulus involvement. CURRENT 2014

What is this and what does it signify?

Renal tubular epithelial cell cast seen in renal tubular injury. CURRENT 2014

What is this and what does it signify?

Pigmented granular cast seen in acute tubular necrosis. CURRENT 2014

What is this and what does it signify?

Hyaline cast - notice the parallel sides, tubular shape with rounded edge, and colorless appearance. (Univ. of Delaware) May occur normally after exercise, or may be pathologic.

What is this and what does it signify?

Red cell casts. Usually means glomerulus involvement. PKM lecture

What is this and what does it signify?

White cell casts * May form in the presence of acute infectious process of the kidney such as pyelonephritis * Inflammatory disorders such as lupus nephritis or interstitial nephritis may also cause white cell cast formation PKM lecture

What is this and what does it signify?

Waxy cast - broad, brittle, and irregularly shaped STASIS in the tubules...anuric or oliguric PKM lecture

What are these and what do they signify?

Triple phosphate crystals coffin lid shape **Can form when urine sits around on the counter** Also may indicate infection with a urea-splitting organism like Proteus (not common) PKM lecture

What are these and what do they signify?

Oxalate crystals double pyramid In abundance, may mean ethylene glycol poisoning PKM lecture

What are these and what do they signify?

Uric acid crystals Variety of shapes and colors Leukemia, gout, other stuff PKM lecture

What are these and what do they signify?

Cystine crystals hexagon shape cystinuria

What are these and what do they signify?

Tyrosine crystals significant liver disease PKM lecture