Urine 2

Question 1

what type of UTIs require concurrent car?

Answer 1

upper UTI

Question 2

what type of UTI is most common?

Answer 2

lower UTI

Question 3

acidic urine usually creates what kind of stones?

Answer 3

xanthine
cysteine
uric acid

Question 4

alkaline urine usually creates what kind of stones?

Answer 4

calcium carbonate
calcium phosphate
magnesium phosphate

Question 5

dipsticks are mainly sensitive to?

Answer 5

albumin

Question 6

how is albumin reported

Answer 6

negative
trace
1+
2+
3+
4+

Question 7

what is normal for albumin in the urine?

Answer 7

normal- negative, trace (>150mg/day)

Question 8

protein uria is used synonymously with?

Answer 8

albuminuria

Question 9

protein uria is a primary indicator of?

Answer 9

renal disease

Question 10

positive dipstick test needs to be confirmed with?

Answer 10

sulfosalicylic acid test

Question 11

when doing an SSA, what does the tech check for?

Answer 11

the amount of turbidity

Question 12

what do protein s in the urine indicate?

Answer 12

stress or dysfunction

physiological or pathological in etiology

Question 13

proteinuria because of kidney disease usually indicates?

Answer 13

upper UTI
diabetes
glomerulonephritis
nephrotic syndrome
preclampsia
trauam

Question 14

what can lead to protein uria

Answer 14

strenuous exercise
exposure to cold (shivering)
large abdomen (pregnancy, preclampsia)
dehydration
febrile illness

Question 15

what do you do if you suspect proteinuria but they exercise?

Answer 15

have them not exercise for a few days, then take another UA

do NOT sign their sports physical

Question 16

orthostatic proteinuria

Answer 16

patient displays normal urine when supine and protein uria standing

Question 17

what do you do for orthostatic protein uria?

Answer 17

have them lie down for 1 hour and recheck urine, may be exaggerated lumbar lodosis, which leads to renal congestion

Question 18

orthostatic proteinuria is more common in?

Answer 18

adolescents

Question 19

preclamsia may become severe with?

Answer 19

headache, visual changes, liver enlargement, severe proteinuria, intrauterine growth retardation, convulsions, coma, etc

Question 20

proteinuria could be from?

Answer 20

intense exercise
heart conditions
CNS lesions
blood disorders
drug therapy
systemic disorders (diabetes)
collagen disorders (lupus, scleroderma)
septicemia (microorganisms in blood)
nephrotic syndrome
multple myeloma

Question 21

nephrotic syndrome

Answer 21

+4 protein in urine
urine may appear frothy
they have severe edema around the eyes

Question 22

nephrotic syndrome is associated with?

Answer 22

toxins
bee stings
severe infections
polycystic kidney

Question 23

what should always be run on those with +4 protein?

Answer 23

Bence Jones test

Question 24

when should a bence jones test be considered?

Answer 24

if there is suspected muliple myeloma

Question 25

what is multple myeloma

Answer 25

malignant proliferation of plasma cells (a type of WBC)

Question 26

what are bence jones proteins?

Answer 26

kappa or lambda light chain part of immunoglobulins that get into the urine

Question 27

what test do you order to look for bence jones proteins?

Answer 27

urine protein electrophoresis urine immunofixation boil, chemicals, immunoelectrophoresis

Question 28

will a routine urinalysis detect bence jones proteins?

Answer 28

no

Question 29

what are some symptoms of muliple myeloma?

Answer 29

nausea, confusion, polyuria (hypercalcemia renal insufficiency) fatigue (anemia, renal insufficiency) bone pain (bone lysis, pathological fx) bleeding (thrombocytopenia) infections (immune deficiency) neurological complaints (path fx) confusion, dizziness, blurred vision (hyperviscosity)

Question 30

describe the process of finding out if someone has bence-jones proteins.

Answer 30

+SSA test, -dipstick test | M spike in protein electrophoresis of blood and urine

Question 31

CRAB

Answer 31

``` signs of multiple myeloma C- calcium (elevated) R- (renal failure/dysfunction) A- anemia B- bone lesions ```

Question 32

how do you determine between osteoporosis, lytic mets or multiple myeloma?

Answer 32

history/clnical presentation old films if not helpful, do labs (CBC, ESR, C-RP, BCP, UA)

Question 33

if the labs look like lytic mets, what happens next?

Answer 33

bone scan MRI biopsy

Question 34

if the labs look like multiple myeloma, what happens next?

Answer 34

protein electrophoresis of blood and urine skeletal survey MRI of anything that looks weird or is painful biopsy

Question 35

are bone scans indicated with multiple myeloma?

Answer 35

no

Question 36

what will you see in a patient that you suspect may have multple myeloma?

Answer 36

unexplained anemia kidney dysfunction high ESR high serum protein (raised immunoglobulin)

Question 37

serum free light chain assay

Answer 37

another test that can be useful in diagnosis and monitoring of patient's response to treatment

Question 38

serum protein electrophoresis (SPEP)

Answer 38

measures the amount of M-protein in serum

Question 39

urine protein electrophoresis (UPEP)

Answer 39

measures the amount of M-protein in urine

Question 40

immunofixation electrophoresis

Answer 40

measures the type of M-protein in serum and urine

Question 41

MGUS

Answer 41

Monoclonal Gammopathy fo Undetermined Significance

Question 42

Dx criteria of MGUS

Answer 42

serum M protein <3g/dL bone marrow plasma cells <10% no CRAB

Question 43

dx criteria | of smoldering multiple myeloma

Answer 43

serum M protein >3g/dL bone marrow plasma cells >10% no CRAB

Question 44

dx criteria of multiple myeloma

Answer 44

serum M protein >3g/dL bone marrow plasma cells >10% CRAB