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48 Cards in this Set

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What can cause blue-green urine (2)?
Pseudomonas
Indicans
What can cause brown-black urine (3)?
Melanin
Alkaptonuria
Methemoglobin
What can cause more acidic urine (3)?
High protein diet
Starvation
Acidosis
What can cause more alkaline urine (4)?
Renal tubular acidosis
Post-prandial state
Bacterial infection
Alkalosis
What comprises the majority of normal urinary protein (2)?
Albumin
Tamm-Horsfall mucoprotein
Where does Tamm-Horsfall protein come from?
Normal secretion of renal tubular cells
These can cause a transient proteinuria (4)
Exercise
Stress
CHF
Seizures
These can cause false-positives when testing for proteinuria (2)
Highly alkaline urine
Bacterial/blood contamination
This can cause false-negatives when testing for proteinuria
Excretion of proteins other than albumin

NOTE: proteinuria tests screen for albumin
These conditions can result in globulins in the urine (2)
Glomerulonephritis
Tubular dysfunction
This condition can result in fibrinogen in the urine
Severe renal disease
These conditions can result in Bence Jones proteins in the urine (2)
Multiple Myeloma
Leukemia
When will conjugated bilirubin appear in the urine (2)?
Liver disease
Biliary obstruction
Why can't unconjugated bilirubin be in the urine?
NOT water soluble
CANNOT be excreted by the kidney
What is the shake test?

What is a positive reading?
Test for bilirubin in the urine

Foam turns yellow if positive
White is normal
How is urobilinogen produced?
Degradation of bilirubin by bacteria in intestine

NOTE: 50% is excreted via intestine, other half via kidney
How would urine urobilinogen levels be in Hemolytic disease?
Increased
How would urine urobilinogen levels be in liver disease?
Increased
How would urine urobilinogen levels be in biliary obstruction?
Low or absent
What would the urine bilirubin test be in hemolytic disease?
Negative
What would the urine bilirubin test be in Hepatic Disease?
Could be either negative or positive
What would the urine bilirubin test be in biliary obstruction?
Positive
3 causes of myoglobinuria
Muscle trauma
Prolonged coma
Extensive exertion
3 things that can cause false negative urine blood test
High specific gravity
High protein
Ascorbic acid
These can cause a false positive urine blood test
Oxidizing agents
Leukocyte esterase is found in urine in what situation?
UTI
Nitrite is found in urine in what situations (2)?
Cystitis
Pyelonephritis
What are the two most common bacteria that cause GU infections?
E. Coli (72%)
Klebsiella/Enterobacter (16%)
A microvillus border signifies epithelial cell from where?
Proximal tubule
A flattened cell signifies epithelial cell from where?
Loop of Henle
What is the most commonly observed cast?

What can cause its presence in U/A sample (2)?
Hyaline

Emotional stress
Strenuous exercise
What conditions cause WBC casts (3)?
Acute glomerulonephritis
Pyelonephritis
Nephrotic syndrome
What do RBC casts indicate?

What conditions can cause their presence (4)?
Acute inflammatory/vascular disorder in the glomerulus

Acute glomerulonephritis
Renal infarct
Collagen disease
Kidney involvement in bacterial endocarditis
What conditions can cause granular casts (2)?
Pyelonephritis
Chronic lead intoxication
What type of cast is assoc. w/ chronic lead intoxication?
Granular cast
Cholesterol crystals are seen in what condition?
Nephrotic syndrome
What pH conditions are abnormal crystals typically seen in?
Neutral or acid pH
How man RBCs may be seen in a "normal" U/A sample?
3-8 RBC/hpf
What conditions can result in yeast in the U/A sample (3)?
Candida albicans
Diabetes mellitus
Vaginal moniliasis
What causes turbid synovial fluid?
Leukocytosis
Presence of what causes synovial fluid to be milky?
Crystals
In gout, what are the crystals in synovial fluid made of?

What kind of birefringence do thet show?
Monosodium urate

NEGATIVE
How do the colors line up in a negatively birefringent sample?
"Nypbperp"

---Negative---
Yellow when parallel
Blue when perpendicular
What type of crystals are in synovial fluid of pseudogout?

What type of birefringence do they show?
Calcium pyrophosphate dihydrate

POSITIVE
How do the colors line up in a positively birerfringent sample?
Opposite of "Nypbperp"

---Positive---
Yellow when perpendicular
Blue when parallel
What in the urine causes it to be sweet or fruity?
Ketones
If not analyzed promptly, what may happen to urine (2)?
pH may rise
(due to bacterial splitting of urea)

Crystals may form
Dysmorphic RBCs are suggestive of what source?
(meaning, where in the nephron)
Glomerular source