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Diagnostic methods > Urinanalysis > Flashcards

Urinanalysis Flashcards

1
Q

Normal urine color is due to?

A

Urochrome

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2
Q

Red urine color is due to?

A
  • beets,
  • blood,
  • chemotherapy;
  • ex-lax → laxative, seen when people have eating disorder
  • hemoglobinuria,
  • propofol(used when people of colonoscopy),
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3
Q

Orange urine

A
  • Vit. C
  • Rifampin
  • Phenazopyridine
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4
Q

Green Urine

A
  • Asparagus
  • Propfolol
  • Utis
  • Methylene blue → agent to used to reverse toxicities of some agents
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5
Q

Purple Urine

A

uti patients with catheters

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6
Q

Brown Urine

A

fava beans,
levodopa,
metronidazole,
hepatobiliary disease

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7
Q

Black Urine

A

alkaprotienuria, melanoma

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8
Q

What is the name of the test called when you physically test the urine on a refractometer ? What does it test for?

A

Specific Gravity-test for the concentration of solutes of the urine– a really conc. urine will have a increased specific gravity

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9
Q

What does the chemical analysis dipistick test for?

A

Chemical analysis (dipstick)

Holy God Kate Loves NAPS

  • Heme (Blood)
  • Glucose
  • Ketones
  • Leukocyte esterase
  • Nitrate
  • Albumin (protein)/urobilinogen/bilirubin
  • pH
  • Specific Gravity
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10
Q

Serum glucose >180 results in?

A

Serum glucose >180 results in spilling

glucose into urine

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11
Q 
Normal findings?
Appearance 
Color 
Odor 
pH 
Protein Specific gravity
A 
clear
Yellow (amber) 
Aromatic 
4.6-8.0 0-8 mg/dL 
1.005– 1.030
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12
Q 
Normal findings?
Leukocyte esterase 
Nitrates 
Ketones
Bilirubin 
Urobilinogen Glucose
A 
negative
none
none 
none 
0.01-1 Ehrlich unit/mL none
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13
Q

The term for glucose in the urine?

A

glycosuria

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14
Q

What are casts?

A

“mold” like a cast, from inside renal tubule (solid), tells you if some disease is in the kidney

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15
Q

Findings of calcium oxalate in the urine would be represented of ?

A

Nephrolithiasis

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16
Q

Findings of uric acid in the urine would be represented of ?

A
  • TLS (tumor lysis syndrome)→ really agressive chemo so the dead tumor cells will be in the urine
  • hyperuricosuria
17
Q

Findings of Magnesium Ammonium Phophosphate in the urine would be represented of ?

A

staghorn calculi

18
Q

Findings of Cystine in the urine would be represented of ?

A

cystinuria

19
Q

What of cells would you find in a urine microscopic exam?

A
  • RBCs (Hematuria)
  • WBCs (Pyuria)
  • Transitional Epithelial→ bladder cells
  • Renal Tubular epithelial cells
  • Squamous epithelial cells→ contamination
20
Q

IF you find • Squamous epithelial cells it is an indicator of ?

A

contamination

21
Q

Casts are?

A

cylindrical particles formed

from coagulated proteins in renal tubules

22
Q

What are the different kind of casts you can find and what does each mean? ( 6 types of casts)

A

Hey Ryan, Wait, Wanna FM

Hyaline Cast -non specific, heavy
exercise, diuretics

• RBC Cast –glomerulonephritis, vasculitis

• WBC cast –acute pyelonephritis, tubule
interstitial nephritis

  • Waxy cast –Advanced renal failure
  • Fatty Cast –nephrotic syndrome

• Muddy-brown granular cast -acute
tubular necrosis

23
Q

What are normal finding each category in the urine?

  • Crystals
  • Casts
  • WBCs
  • RBCs
  • RBC Casts
  • Squamous Epi
A
  • none
  • none
  • 0-4 per low power field (lpf)
  • <3
  • none
  • Less than 15-20/hpf
24
Q

Urinalysis Indicators of Infection ?

A 
• Bacteria 
• Leukocyte Esterase positive 
• WBCs > 10 
• Nitrate positive 
• RBCs → can be caused by inflammation
• Ph increased (can indicate
infection)
25
Q

Urine culture

Quantitative vs. Qualitative difference?

A

• Quantitative
→ Colony count evaluation
• Qualitative
→ Presence of bacteria

26
Q

Lumbar puncture indications?

A 
Diagnostic:
• CNS infections
• Inflammatory Processes
• Subarachnoid hemorrhage
• Cytologicand protein analysis (ex: malignant cells getting into CSF-ex: Lymphoma)

Therapeutic:
• Deliver medications
• Relieve symptoms of a few specific causes of increased ICP (ex: hydrocephalus)

27
Q

What would be C/I’s of reasons why you shouldn’t preform a lumbar puncture

A 
• Local Skin Infection
• Suspected mass lesion 
• Raised ICP 
• Bleeding Diathesis 
• Coagulopathy
→ Platelet count less than 50,000
→ Platelet dysfunction
→  INR greater than 1.4 
• Poor Patient Cooperation
→ pt. can't stay in fetal position
28
Q

Describe the equipment involved in lumbar puncture?

A 
Spinal needle 
• Three way stopcock 
• Manometer 
• Connecting Tube 
• Four Specimen Tubes 
• Local Anesthesia 
• Syringes and needles for local anesthesia 
• Sterile Gloves 
• Antiseptic Solution
29
Q

Where do you inject a lumbar needle and what is important about the collection of the CSF?

A 
Collection:
• Four tubes labeled #1-4
→ normally shouldn't be blood in tuber number 4
• Order of collection is important
• L3 –L4
• L4 -L5

→ less chance of spinal cord injury in these spots

30
Q

How much CSF do you collect in each tube and do you do with each tube?

A

Four Tubes • Collect approx. 4-8 ml total.
• Tube 1 –Collect Cell Count and Differential
• Tube 2 –Glucose and Protein
• Tube 3 –Culture and Gram Stain
→ *** cultures only check for bacteria
• Tube 4 –Cell Count and Differential

**Cultures

31
Q

What tests should you consider if you suspect a CSF infection?

A 
Consider:
• AFB or TB PCR
 • Cryptococalantigen and indiaink 
• Fungal culture 
• VDRL 
• Lyme Antibody 
• PCR for Viruses (EBV, HSV, CMV, VZV, HHV-6)
32
Q

If there is blood in all four tubes you should suspect ?

A

subarachnoid hemorrhage→

bleeding between the arachnoid and the Pia matter

33
Q

Subdural hematoma (SDH) occurs because of

A
  • result of the countercoup injuries

- result of venous bleeding stretching of bridging veins

34
Q

Bacterial vs. Viral : CSF analysis

Appearance?

Glucose?

Gram Stain?

A

Appearance:
B: Turbid
V: Clear

Glucose:
B: <2.2
→ bacteria will eat the sugar so it will be low
V: Normal

Gram Stain:
B: Positive
V: Normal

35
Q

Subarachnoid Hemorrhage vs. Traumatic Tap:

  • CSF pressure?
  • Duration of bleeding?

-Centrifugation?

A

CSF Pressure:
TP: Low
SH: High

Duration of when CSF is withdrawn:
TP: Decreases when CSF is withdrawn→ will normally see blood in 1st tube b/c you stuck a needle into their back
SH: No change in color when CSF is withdrawn→ blood in all 4 tubes

Centrifugation:
TP: clear fluid
SH: Xanthochromia

36
Q

Synovial Fluid Analysis Indications?

A
  • Joint pain • Joint swelling • Joint effusion

* Must take context of clinical history and presentation

37
Q

Synovial Fluid Analysis

A

look at picture on desktop

38
Q

Physical analysis of urine looks at

A

color
appearance
specific gravity

39
Q

What are the two parts to complete an urinalysis

A

Chemical tests

Sediment tests (microscopic)

Diagnostic methods (11 decks)

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