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Urine 1 Flashcards

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1
Q

signs and symptoms to order a UA

A 
frequent urination
inability to urinate
polydipsia (excessive thirst)
polyphagia (excessive hunger)
physicals and wellness screening
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2
Q

what percent of CO perfuse the kidneys every minute?

A

25%

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3
Q

what are kidneys involved in the production of?

A

erythropoitin, renin

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4
Q

erythropoitin

A

a hormone that stimulates RBC production

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5
Q

rening

A

an enzyme for controlling blood pressure

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6
Q

routine UA consists of

A

physical properties
chemical proerties
microscopic properties

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7
Q

functional unit of the kidney is?

A

nephron

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8
Q

how many nephrons are there per kidney? What does a nephron consist of?

A

1 million

proximal convoluted tubule, loop of Henle, descending and ascending limb, distal tubule, collecting duct

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9
Q

what is the oldest lab procedure?

A

UA

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10
Q

when does the glomerular filtrate become urine?

A

after it leaves the distal convoluted tubule

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11
Q

what are the prinicple solutes of urine?

A 
urea
sodium
chloride
potassium
creatinine
uric acid
ammonia
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12
Q

the body excretes approximately __g of dissolved material in 24 hours. how much of it is urea?

A

60 grams

1/2 is urea

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13
Q

what is urine composed of?

A

95% water and 5% dissolved solids

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14
Q

average daily volume of urine?

A

1200-1500ml

normal range is 600-2000ml/day

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15
Q

polyuria

A

> 2000ml/24hours

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16
Q

polyuria can be due to

A

diabetes mellitus
diabetes insipidus
large fluid intake
diuretics

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17
Q

oliguria

A

<500mL/24hours

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18
Q

oliguria can be due to

A 
renal tubule dysfunction
end stage renal disease
obstruction
edema
dehydration
diarrhea
vomiting
shock
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19
Q

anuria

A

abscence of urine

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20
Q

anuria can be due to

A

renal failure
obstruction
heart attack

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21
Q

what specimen is the best for urinalysis

A

early morning urine

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22
Q

how should you catch urine?

A

clean area

start stream, then catch midstream

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23
Q

how soon should you test urine?

A

within 30 minutes at room temp

within 4 hours if referigerated

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24
Q

what is the most common and convienent urinalysis

A

random sample

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25
what is the best urinalysis?
24 hour sample with preservative
26
what happens to urine as it sits out if it is unpreserved?
``` color becomes darker turbidity increases odor is more foul smelling pH increases glucose, ketones, bilirubin and urobilinogen decrease nitrites and bacteria increase RBCs lyse WBCs and casts disintegrate ```
27
what does urine color depend on?
degree of hydration and concentration
28
what is the normal color of urine?
straw to amber (light yellow to dark yellow)
29
red/dark brown urine means?
found with excessive hemoglobin, RBC, myoglobin | (ex)menses, UTI, malignancy, prostate, etc
30
what consistutes as "smoky urine"
yellow urine+red blood= smoky urine
31
orange urine is found with
dehydration from fever, vomiting, certain foods (rhubarb, vit. c, carrots), medications, etc
32
bright yellow urine is found with
excessive vitamin B intake
33
black urine is found with
alkaptonuria | malignant melanoma
34
do people pee black urine?
no, if it sits long enough, then it turns black
35
what is alkaptonuria?
a disease where you can't process amino acids ochronosis- lack of homoegentistic oxidase discs are calcified
36
what color is associated with liver problems?
brownish yellow/brownish green/greenish yellow, yellowish green may also be referred to as dark yellow
37
what should you check if you suspect liver problems?
bilirubin, urobilinogen | may also see jaundice of skin and sclera
38
milky urine is associated with?
hyperlipidemia
39
clear urine
normal
40
slightly hazy urine
usually normal (check sediment, if negative then insignificant
41
cloudy urine
may be pus, bacteria, RBCs, spermatozoa | if associated with crystals, usually insignificant
42
turbidity
how clear the urine is
43
hazy/cloudy urine
usually due to infection
44
frothy urine
assoicated with proteins | if yellow froth- billirubin
45
what do they need to do if there is a change in turbidity
need to look microscopically at urinary sediment
46
specific gravity
evaluates kidney's ability to concentrate urine
47
what is an early sign of kidney disease
inability to concentrate urine
48
what is the nomal SpG for an adult
1.015-1.035
49
what do we compare the weight of urine to?
distilled water
50
what do we use to measure the SpG?
urinometer/refractometer or dipstick
51
hyposthenuria
low specific gravity
52
hypersthenuria
high SpG
53
isosthenuria
fixed SpG at 1.010 same as protein free plasma and signifies end stage of renal failure ONLY if they consistently have an SpG of 1.010
54
what does increased specific gravity indicate?
``` concentrated urine proteinuria glucosuria dehydration (fever, vomiting, diarrhea) decreased renal blood flow (heart failure, renal artery stenosis) ```
55
what does decreased specific gravity mean?
``` dilute urine decreased concentration overhydration glomerulonephritis pyleonephritis diabetes insipidus renal failure ```
56
when is the odor of the urine concerning?
foul, fishy (UTI) fruity, sweet (diabetes mellitus/ketosis) feces odor (asparagus, enterobladder fistula)
57
what is important to know when using dipsticks?
need to be precise in timing
58
urine pH often indicates?
renal or lung disease
59
normal pH range
4.5-7.5
60
acidic pH
<7
61
alkaline pH
>7
62
urine becomes alkaline as it stands due to?
bacterial growth and breakdown of urea
63
normal blood pH
7.35-7.45
64
how do we maintain normal pH
primarily through reabsorption of sodium and secretion of hydrogen and ammonium oins
65
what diets are typically acidic?
high in animal products
66
what diet is typically alkaline
citrus fruits and vegetables
67
what situations usually have acidic pH?
respiratory acidosis (emphysema) metabolic acidosis (diabetic ketoacidosis) diabetes mellitus large amounts of meats and cranberries
68
what situations usually have alkaline pH?
respiratory alkalosis metabolic alkalosis UTI diet high in vegetables and citurs fruits
69
what is the most common bacteria to cause UTI?
e coli

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