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urine composition Flashcards

(73 cards)

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1
Q

normal urines clarity

A

clear and transparent

-look once it is mixed

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2
Q

urine turbidity

A

pathological - UTI or kidney disease

non-pathological- mucous, squamous epi cells, urates

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3
Q

normal urine odor

A

not a strong odor

can smell ammonia in older urine as bacteria break down urea to ammonia

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4
Q

other urine smells

A

fruity- diabetes due to ketones

maple syrup- seen in maple syrup urine disease

mousy odor- PKU due to presence of phenylpyruvic acid in urine

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5
Q

non pathological urine turbidity

A

mucous
squamous epi cells
standing at RT
refrigeration
semen
fecal contamination
etc.

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6
Q

pathological turbidity

A

RBCs
WBCs
bacteria
non-squamous epithelial cells
yeast
crystals
lymph fluid
lipids

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7
Q

urine specimen collection RULES

A
  1. bring to lab within 2 hours; if not should refrigerate or add preservative
  2. needs to be sterile for culture; doesn’t have to really for urine analysis
  3. if both ordered, do culture first
  4. should bring to RT before testing !!
  5. don’t forget to mix before testing as formed elements will sink
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8
Q

substances found in urine

A

96% water and other solutes
urea
creatinine - muscle breakdown
vitamins, drugs, hormones
formed elements

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9
Q

random specimen

A

most common
has most junk in it

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10
Q

best specimen

A

first morning specimen - most concentrated
see most formed elements

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11
Q

need to determine what in first morning specimen

A

orthostatic proteinuria

protein present due to pressure on renal vein

-increased amounts throughout the day

should be no protein in morning and present later in day

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12
Q

midstream urine

A

part you want to collect

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13
Q

catheterized specimen

A

should see no bacteria since bladder is sterile
-any growth is significant
-transitional cells

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14
Q

suprapubic aspiration

A

needle is inserted through abdomen into the bladder (surgical procedure)

sterile

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15
Q

24 hour urine specimen

A

used to detect the amount of protein seen in 24 hours so used to access EXACT amount of protein present

-kidney damage can be seen
-void first urine and start

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16
Q

boric acid

A

preservative for formed elements but may interfere with pH

gray tubes
-keeps down bacterial growth
-interfere with drug testing

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17
Q

chlorhexidine

A

preservatives
-very common
-keeps down bacterial growth, but preserve glucose
-red/yellow tubes

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18
Q

refrigeration

A

does not interfere with chemical testing
-more formed elements = kinda bad

kills trichomonas- look like WBCs when dead

-most common method of non chemical preservation

-needs to be RT before analyzed

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19
Q

Glomerular diseases

A

does damage to glomeruli
-immune complexes that deposit on glomular basement membrane
-complement does damage

“glomerulonephritis”

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20
Q

normal urine volume

A

1200-1500

can be as low as 600mL

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21
Q

decrease in volume

A

oliguria

dehyrdation, burns, vomitting

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22
Q

glomularnephritis

A

sterile inflammatory process that affects glomerular

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23
Q

common findings in glomularnephritis

A

blood !!! protein and casts

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24
Q

anuria

A

almost no urine flow

severe kidney damage or decreased blood flow to kidney

-kidney function totally depends on amount of blood flowing to kidney

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25
polyuria
increase in volume seen most commonly in diabetes or when taking diuretics or caffeine intake or decrease of ADH
26
nocturia
increases of urine at night -elders or pregnancy
27
normal color of urine
yellowish due to urochrome pigment
28
refrigerated urines
uroerythrin -pinkish pigment that can attach to amorphous urates giving pink or brick dust appearance
29
what gives brownish color to urine
urobilin -older urine -breakdown product of bilirubin
30
amber or orange urine
seen with sulfa drugs or in cases where bili present in urine -if bili present may see yellow foam when shaken
31
red urine
present with hemoglobinuria or hematuria or when on period
32
dark red/ brownish urine
myoglobin serum will remain yellow
33
port wine color
porphyria heightened when placed in light
34
brown or black urine color
cases of alkaptonuria due to presence of homogentisic acid -may be darker when acidic and Hgb converted to methemoglobin
35
blue or green urine
due to presence of medication or dyes -some cases infection of pseudomonas aeruginosa
36
common findings in glomularnephritis in urine
blood, protein, casts
37
cause of untreated Beta strep A seen in children urine has protein, dysmorphics RBCs, and RBC casts can be reversible
acute poststreptococcal
38
rapidly progressive glomerulohpritis
more permanent damage immune complexes circulating in bloodstream seen in autoimmune diseases destory the kidney see high protein levels, low GFR, increase in FDP, cryoglobulins
39
IgA nephropathy
berger's disease MOST common cause of glomerular nephritis IgA falling on kidney blood seen in urine
40
renal glycosuria
inherited can't reabsorb glucose from tubules not related to diabetes
41
diagnosis of renal glycosuria
normal blood sugar but increase sugar in urine
42
nephrotic syndrome
increase of permeability of glomerular membrane due to shield of negativity; damage to small blood vessels that filter -higher molecular compounds can pass through
43
nephrotic syndrome seen in urine
massive protein >3.5 more lipids in urine- oval bodies fatty casts renal tubular cells macro or micro hematuria
44
symptoms of nephrotic syndrome
edema foamy urine weight gain tiredness
45
consequences of nephrotic syndrome
high BP increased cholesterol and triglycerides blood clots infections can be primary or secondary disease
46
interstitial disorders
infections of urinary tract frequent urination burning increase WBC (pyuria)!!!, protein, blood MOST COMMON INTERSTITIAL: UTI
47
acute pyelonephritis
infection of upper urinary tract -untreated UTI WBC casts in urine !!!!! (beyond UTI) usually don't have permanent kidney damage BACK PAIN
48
chronic pyelonephritis
congenital urinary structural defect permanent kidney damage can see granular, waxy, broad casts with increase protein
49
acute renal failure
-sudden suppression of kidney function
50
prerenal
decreased blood flow to kidney burns, surgery volume lower reversible
51
renal
most cases can result from glomerular, tubular, interstional disease destruction of renal tubules may see cellular and granular casts
52
post renal
obstruction in urine WBC, RBC casts
53
chronic renal failure
progressive loss of renal function loss of function is irreversible see isosthenuric kidneys - SG 1.010 kidney lost ability to concentrate -increased BUN and creatinine levels waxy casts -- worst
54
uremia
increased urea in blood accompanied by kidney failure !!!!! burr cells kidney failure is the difference between this and azotemia!
55
blood smear for uremia
abnormal RBCs in smear burr cells urea serum: 6-20
56
azotemia
increased urea in blood doesn't associated with kidney failure
57
glomerular filtration tests
basically measures filtering capacity of gomeruli have to find a substance that isn't reabsorbed or secreted by tubules
58
creatinine clearance test
known for measuring GFR- gold standard rate kidney can remove creatinine from the blood
59
disadvantage at looking for creatinine
muscle wasting disease elders eating a lot of meat bacteria can break down
60
creatinine testing important
24 hour timed collection milliliters per minute -need to convert from hours to min
61
shorten formula for creatinine clearance
C= u x v / P u=urine creatine v= urine volume per min p= plasma or serum creatinine normal values 90-120 /min decreased= kidney disease
62
modification of diet in renal disease
is age dependent, gender dependent and ethinic
63
inulin testing
another way to measure GFR exogenous test -adminster inulin thorughout test not secreted/ absorbed by tubules
64
2 tests that may not detect early renal failure
creatinine and inulin
65
non-clearnace testing for GFR Cystatin C testing
monitor and screen GFR once kidney disease diagnosed -immunoassay filtered by glomerulus and reabsorbed by renal tubules = none returns to blood circulation
66
BUN and creatinine testing
determine kidney function ratio- 10:1-20:1
67
BUN increased bc
high protein diet GI bled
68
creatinine to be skewed
muscle mass/ loss eating a lot of meat
69
microalbumin testing
screen diabetic nephoronpathy small amounts of albumin -not used to diagnose diabetes, but associated
70
microalbumin 24 hr urine should be
less than 30/ per day
71
microalbumin random urine
>30 albumin is abnormal
72
beta 2 microglobin testing
better marker of reduced renal tubular function than of glomerular function -passes through glomeruli and reabsorbed -none found in urine when reabsorption decreased, urine values increase
73
renal blood flow
PAH test- para- aminohippuric acid test measure amount of blood flowing through kidney if this is abnormal than tubular and glomerular will also be abnormal -need something that can be completely removed from blood everytime

urinalysis composition (1 decks)

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