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Urine Flashcards

Introduction, Renal function, Urinalysis (physical examination) (66 cards)

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1
Q

A patient presenting polyuria, nocturia, polydipsia, and a low urine specific gravity is exhibiting symptoms of?

A

Diabetes insipidus

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2
Q

The average daily output of urine is

A

1200 mL

Or 1.2 L

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3
Q

An unidentified fluid is received in the lab with a request to det. Wether the fluid is urine or another body fluid. Using routine lab tests, what tests would determine the fluid is most probably urine?

A

Urea and Creatine

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4
Q

A patient with oliguria might progress to having

A

Anuria

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5
Q

Characteristics of recommended urine containers

A
  1. Flat bottom
  2. Made of clear material
  3. A capacity of 50 mL
  4. Disposable
  5. Sterile
  6. Screw-top lids
  7. Bags with adhesive (for pedia)
  8. Individually packaged with secure closures (for Micro)
  9. Large containers for 24-hr urine
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6
Q

the primary inorganic substance found in urine is

A

Chloride

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7
Q

labels for urine containers are

A

placed on the container prior collection

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8
Q

a urine specimen may be rejected by the laboratory for?

A
  1. Spx with unlabeled containers
  2. nonmatching labels with requisition forms
  3. spx. contaminated with feces or toilet papers
  4. containers with contaminated exteriors
  5. Spx of insufficient quantity
  6. Specimens that have been improperly transported
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9
Q

A cloudy spx received in the laboratory may have been preserved using

A

Boric Acid

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10
Q

for general screening, the most frequently collected spx is a

A

Random urine

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11
Q

the primary advantage of the first morning specimen over random spx is that it

A

is more concetrated

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12
Q

if a routine urinalysis and a culture are requested on a catheterized specimen, then:

A

Routine urinalysis

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13
Q

if the patient fails to discard the first specimen when collecting a timed specimen the

A
  • Specimen will be recollected

- Results will be falsely elevated

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14
Q

the primary cause of the unsatisfactory results in an unpreserved routine specimen not tested for 8 hours is

A

Bacterial growth

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15
Q

prolonged exposure of a preserved urine specimen to light will cause

A

Decreased bilirubin

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16
Q

which of the following would be least affected in a specimen that has remained unpreserved at a room temperature for more than 2 hours?

a. urobilinogen
b. ketones
c. protein
d. nitrite

A

c. protein

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17
Q

bacterial growth in an unpreserved spx will

a. dec. clarity
b. inc. bilirubin
c. dec. pH
d. inc. glucose

A

a. dec. clarity

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18
Q

the most sterile spx collected is a

A

suprapubic aspiration

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19
Q

which of the following would not be given to a patient prior to the collection of midstream clean catch spx?

a. sterile container
b. iodine cleanser
c. antiseptic towelette
d. instructions

A

b. iodine cleanser

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20
Q

urine spx collection for drug testing requires the collector to do all of the ff. except:

a. inspect the spx color
b. perform rgt. strip testing
c. read the spx temp.
d. fill out the COC form

A

b. perform rgt. strip testing

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21
Q

the type of nephron responsible for renal concentration is the

A

Juxtaglomerular nephron

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22
Q

the function of the peritubular capillaries is

A

reabsoprtion and secretion

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23
Q

blood flow through the nephron in the ff. order:

A

afferent arteriole - peritubular capillaries - vasa recta - efferent arteriole

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24
Q

filtration of protein is prevented in the glomerulus by

A

the glomerular filtration barrier

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25
the RAAS is responsible for all of the ff. except: a. vasoconstriction of the afferent arteriole b. vasoconstriction of the efferent arteriole c. reabsorbing sodium d. releasing aldosterone
a. vasoconstriction of the afferent arteriole
26
the primary chemical affected by the RAAS is
Sodium
27
the secretion of renin is stimulated by
Macula densa cells
28
the hormone aldosterone is responsible for
Sodium retention
29
the fluid leaving the glomerulus has a specific gravity of
1.010
30
for active transport to occur a chemical
must combine with a carrier protein to create electrochemical energy
31
which of the tubules is impermeable to water
ascending loop of henle
32
glucose will appear in the urine when the
- blood level glucose is 200 mg/dL - Tm for glucose is reached - renal threshold for glucose is exceeded
33
concentration of the tubular filtrate by the countercurrent mechanism depends on all of the following except: a. high salt conc. in the medulla b. water-impermeable walls of the ascending loop of henle c. reabsoprtion of sodium and chloride from the ascending loop of henle d. reabsoprtion of water in the descending loop of henle
d. reabsoprtion of water in the descending loop of henle
34
ADH regulates the final urine conc. by controlling
tubular permeability
35
decreased production of ADH
produces a high urine volume
36
bicarbonate ions filtered by the glomerulus are returned to the blood
- in the PCT - combined with hydrogen ions - by tubular secretion
37
if ammonia is not produced by the DCT, the urine pH will be
Basic
38
write if the ff. substances are exogenous or endogenous 1. B2-microglobulin 2. creatinine 3. Cystatin C 4. 125 I-iothalmate
1. exo 2. endo 3. endo 4. endo
39
the largest source of error in the creatinine clearance test is
improperly timed urine spx
40
given the ff. info. calculate the creatinine clearance: 24-hr urine volume; 1000 mL; serum creatinine 2.0 mg/dL; urine crea 200 mg/dL
69 mL/min
41
creatinine clearance test used to determine the GFR must measure substances that are
neither reabsorbed nor secreted by the tubules
42
performing clearance test using radionucleotides
- eliminates the need to collect urine | - provides visualization of the filtration
43
variables tha MDRD-IDSM estimated creatinine clearance calcuations include all of the ff. except: a. serum crea. b. weight c. age d. gender
b. weight
44
an advantage to using Cystatin C to monitor GFR is that
- it does not require urine collection - it is secreted by the tubules - it can be measured by immunoassays
45
solute dissolved in solvent will
lower the freeaing point
46
substances that may interfere with freezing point measurement of urine and serum osmolality include all of the following except: a. ethanol b. lactic acid c. sodium d. lipids
c. sodium
47
clinical osmometers use NaCl as a reference solution because:
NaCl is partially ionized similar to the composition of a urine
48
the normal serum osmolarity is
275 to 300 mOsm
49
after controlled fluid intake the urine-to-serum osmolarity ratio should be at least
1:1
50
calculate the free water clearance from the ff. results: urine volume in 6 hrs: 720 mL urine osmolarity: 225 mOsm plasma osmolarity: 300 mOsm
+0.5
51
to provide an accurate measure of a renal blood flow, a test substance should be completely
cleared on each contact with functional renal tissue
52
given the ff. data, calculate the effective renal plasma flow urine vol. in 2 hrs: 240 mL urine PAH: 150 mg/dL Plasma PAH: 0.5 mg/dL
600 mL/ min
53
Renal tubular acidosis can be caused by the
inability to produce an acidic urine due to increased production of ammonia
54
tests performed to detect renal tubular acidosis after adminitering an ammonium chloride load include all of the following except: a. urine ammonia b. arterial pH c. Urine pH d. titratable acidity
b. arterial pH
55
Patients with diabetes typically have higher urine output volumes; this is referred to as:
polyuria
56
The glomerular filtration barrier is composed of:
. capillary endothelium, podocytes, and basement | membrane
57
. The glucose renal threshold is 160–180 mg/dL. This | represents the:
. plasma concentration above which glucose is | excreted in the urine
58
Which of these is not a mechanism to maintain blood | pH through the kidney?
excretion of acetic acid
59
Which of these urinary structures is involved in the | countercurrent exchange mechanism?
the vasa recta
60
Aldosterone is involved in the reabsorption of
sodium
61
``` indicate the most appropriate use for the ff. urine collection methods: A. Clean-catch B. Early afternoon C. First morning D. Postprandial E. Random F. Three-glass ```
a. _ screening for infection b. urobilinogen quantitation c. most concentrated specimen d. diabetic screening e. routine analysis f. diagnosis of prostate infections
62
``` Match urine appearance with its listed cause: A. Amber and clear B. Brown and cloudy C. Colorless and clear D. Orange E. Red and clear F. Red and cloudy G. Yellow and clear 7. ________ normal urine appearance 8. ________ concentrated urine 9. ________ very dilute urine 10. ________ medications 11. ________ red blood cells 12. ________ old specimen with RBCs 13. ________ porphyrins ```
7. G 8. A 9. C 10. D 11. F 12. B 13. E
63
Refractive index compares the velocity of light in urine | to the velocity of light in:
Air
64
Which principle is used in the determination of | specific gravity by reagent strip methods?
The pKa of a polyelectrolyte is altered by the urine’s | ionic strength.
65
``` Match urine odor with their causative constituent. A. Fishy B. Fruity C. Fusty D. Pungent E. Sweaty feet F. Syrupy 21. ________ Ammonia 22. ________ Bacteria 23. ________ Butyric acid 24. ________ Hypermethioninemia 25. ________ Ketones 26. ________ Leucine and isoluecine 27. ________ Phenylalanine ```
21. D 22. D 23. E 24. A 25. B 26. F 27. C
66
``` Match urine preservatives with their description: A. Boric acid B. Chorohexidine C. Formalin D. Refrigeration E. Thymol 14. ________ preserves urine sediment 15. ________ most commonly used 16. ________ preserves many constituents 17. ________ culture and sensitivity 18. ________ routine analysis within 72 hours ```
14. C 15. D 16. E 17. A 18. B

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