Flashcards in Urine Studies Deck (59):
1
urinalysis can be used to diagnose
renal or urinary tract disease
monitor renal or urinary tract disease
detect metabolic or systemic disease (DM)
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cystocentesis
remove fluid from the bladder using a suprapubic catheter
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first morning specimen
pt. gets specimen first thing in the morning
must use a preservative
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random urine specimen
obtained during the day w/o pt prior notice
-drug testing
-most common
5
timed urine collection
pt collects all urine over a period of 24 hours
-does not include the first morning void (would include urine produced during the night)
-proteinuria
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urine for culture and sensitivity
examines bacteria, sterile, midstream collection, cultured w/in one hour of collection (doesn't usually happen)
-avoids contamination and cell lysis
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cloudy urine indicates
presence of WBC, RBC, bacteria
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pale yellow to amber urine indicates
urochrome (a pigment which is a product of bilirubin metabolism)
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red urine indicates
pt is bleeding, dark red (from the kidneys)
bright red (from bladder)
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dark yellow urine indicates
bilirubin
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specific gravity
measures kidney's ability to conc the urine
-weight is compared to weight of distilled water
-value is affected by amt of solutes, volume, hydration
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low specific gravity indicates
diabetes insipidus
chronic renal diseases (diminished conc ability)
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renal threshold
180mg/dl
point at which kidneys start allowing sugar through
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anti-diuretic hormone
in posterior pituitary, keeps your body from diuresing (urinating)
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high specific gravity indicates
DM
excessive water loss (dehydration)
increased secrection of ADH (urine is concentrated)
lots of solute in the urine
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urine osmolality
number of particles in a unit of solution-correlates w/specific gravity but not the same thing
normal is 50-1200 mOsm/kg
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pH
normal is 4.6-8.0 (avg is 6.0)
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low pH (acidic)
acidosis, diet high in cranberries
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high pH (basic)
some bacteria, UTI
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protein
no protein should be in the urine
measured negative (-) to 4+
qualitative check
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proteinuria indicates
glomerular injury (allows proteins, albumin, to seep into filtrate)
if pos for protein, should f/u with 24 hr specimen
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proteinuria indicates also
preeclampsia-HTN, edema, proteinuria
eclampsia
diabetes -decreased renal flow
glomerulonephritis
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blood
measured negative (-) to 4+
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hematuria
bleeding w/i the urinary tract may be gross or microscopic
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positive microscopy needs to have
3-5 RBC per high power field
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hematuria indicates
cystitis (most common cause of hematuria)
glomerulonephritis
cancer
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false positive on a heme test could be caused by
beets
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microscopy
looking at urine under the microscope
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glucose
normally negative
positive is 100-2000 mg/dl
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glucose in urine indicates
possible diabetes (unless pregnant)
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ketones in urine
normally negative
positive reported as 1+ to 4+
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ketone (definition)
byproduct of fatty acid catabolism
used as energy source when glucose cannot be used
breakdown of muscle
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ketonuria indicates
poorly controlled DM (insulin resistance)
hyperglycemia
diabetic ketoacidosis
alcoholic ketoacidosis
starvation
high protein diets
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bilirubin
breakdown product of hemoglobin
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urobilinogen
bilirubin that has been transformed by the kidney
-water soluble
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urobilinogen increase indicates
hemolysis
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leukocyte esterase
screens for WBC
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positive leuk esterase indicates
UTI
-may be contaminated by vaginal discharge
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nitrites
gram negative bacteria takes nitrates and turns them into nitrites
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positive nitrites indicates
UTI with a gram negative bacteria
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microscopic examination can note
RBC, WBC, epithelial cells (squamous, renal tubular)
crystals (indicates stone formation) varies w/ dz and pH
42
most common cause of a urinary stone
calcium oxalate
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uric acid crystals
crystals in acidic urine indicates gout
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calcium oxalate
crystals in acidic urine composes kidney stones (envelopes)
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calcium phosphate
crystals in alkaline urine
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lots of epithelial cells indicate
contamination from vagina or penis
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triple phosphate
coffin lids a/w stones, chronic cystitis
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casts
formed in DCT
form when overproduction of cells, and conc of Na+, decreased urine flow
cells in the form of whatever area it came out of
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hyaline cast
protein cast
strenuous excercise or dehydration
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cellular cast
abundance of red or white blood cells
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granular cast
cellular or protein material that has been broken down
-renal disease
-strenuous excersize
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fatty cast
overproduction of lipids
oval fat bodies
within cellular cast
-nephrotic sydrome
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waxy cast
cell or hyaline cast that has been present for a long time and has broken down
diminished flow
-long term kidney disease
-diabetic nephropathy
-malignant HTN
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epithelial cast
may be squamous cell or renal tubule
-renal tubular indicates glomerulonephritis
-from bladder indicates tumor, infection or polyps
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WBC cast
found in infections
-pyelonephritis
-inflammatory nephritis (lupus)
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RBC cast
found in disruption of blood/urine barrier
indicates membrane damage (glomerulonephritis)
57
conjugated bilirubin
bilirubin that has passed through the liver and is now water soluble
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unconjugated bilirubin
bilirubin that has not passed through the liver and is fat soluble
59