Block 3 Path Exam -- Urinalysis & Synovial Fluid Analysis(#17)

Front 1

What can cause blue-green urine (2)?

Back 1

Pseudomonas
Indicans

Front 2

What can cause brown-black urine (3)?

Back 2

Melanin
Alkaptonuria
Methemoglobin

Front 3

What can cause more acidic urine (3)?

Back 3

High protein diet
Starvation
Acidosis

Front 4

What can cause more alkaline urine (4)?

Back 4

Renal tubular acidosis
Post-prandial state
Bacterial infection
Alkalosis

Front 5

What comprises the majority of normal urinary protein (2)?

Back 5

Albumin
Tamm-Horsfall mucoprotein

Front 6

Where does Tamm-Horsfall protein come from?

Back 6

Normal secretion of renal tubular cells

Front 7

These can cause a transient proteinuria (4)

Back 7

Exercise
Stress
CHF
Seizures

Front 8

These can cause false-positives when testing for proteinuria (2)

Back 8

Highly alkaline urine
Bacterial/blood contamination

Front 9

This can cause false-negatives when testing for proteinuria

Back 9

Excretion of proteins other than albumin

NOTE: proteinuria tests screen for albumin

Front 10

These conditions can result in globulins in the urine (2)

Back 10

Glomerulonephritis
Tubular dysfunction

Front 11

This condition can result in fibrinogen in the urine

Back 11

Severe renal disease

Front 12

These conditions can result in Bence Jones proteins in the urine (2)

Back 12

Multiple Myeloma
Leukemia

Front 13

When will conjugated bilirubin appear in the urine (2)?

Back 13

Liver disease
Biliary obstruction

Front 14

Why can't unconjugated bilirubin be in the urine?

Back 14

NOT water soluble
CANNOT be excreted by the kidney

Front 15

What is the shake test?

What is a positive reading?

Back 15

Test for bilirubin in the urine

Foam turns yellow if positive
White is normal

Front 16

How is urobilinogen produced?

Back 16

Degradation of bilirubin by bacteria in intestine

NOTE: 50% is excreted via intestine, other half via kidney

Front 17

How would urine urobilinogen levels be in Hemolytic disease?

Back 17

Increased

Front 18

How would urine urobilinogen levels be in liver disease?

Back 18

Increased

Front 19

How would urine urobilinogen levels be in biliary obstruction?

Back 19

Low or absent

Front 20

What would the urine bilirubin test be in hemolytic disease?

Back 20

Negative

Front 21

What would the urine bilirubin test be in Hepatic Disease?

Back 21

Could be either negative or positive

Front 22

What would the urine bilirubin test be in biliary obstruction?

Back 22

Positive

Front 23

3 causes of myoglobinuria

Back 23

Muscle trauma
Prolonged coma
Extensive exertion

Front 24

3 things that can cause false negative urine blood test

Back 24

High specific gravity
High protein
Ascorbic acid

Front 25

These can cause a false positive urine blood test

Back 25

Oxidizing agents

Front 26

Leukocyte esterase is found in urine in what situation?

Back 26

UTI

Front 27

Nitrite is found in urine in what situations (2)?

Back 27

Cystitis
Pyelonephritis

Front 28

What are the two most common bacteria that cause GU infections?

Back 28

E. Coli (72%)
Klebsiella/Enterobacter (16%)

Front 29

A microvillus border signifies epithelial cell from where?

Back 29

Proximal tubule

Front 30

A flattened cell signifies epithelial cell from where?

Back 30

Loop of Henle

Front 31

What is the most commonly observed cast?

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

Back 31

Hyaline

Emotional stress
Strenuous exercise

Front 32

What conditions cause WBC casts (3)?

Back 32

Acute glomerulonephritis
Pyelonephritis
Nephrotic syndrome

Front 33

What do RBC casts indicate?

What conditions can cause their presence (4)?

Back 33

Acute inflammatory/vascular disorder in the glomerulus

Acute glomerulonephritis
Renal infarct
Collagen disease
Kidney involvement in bacterial endocarditis

Front 34

What conditions can cause granular casts (2)?

Back 34

Pyelonephritis
Chronic lead intoxication

Front 35

What type of cast is assoc. w/ chronic lead intoxication?

Back 35

Granular cast

Front 36

Cholesterol crystals are seen in what condition?

Back 36

Nephrotic syndrome

Front 37

What pH conditions are abnormal crystals typically seen in?

Back 37

Neutral or acid pH

Front 38

How man RBCs may be seen in a "normal" U/A sample?

Back 38

3-8 RBC/hpf

Front 39

What conditions can result in yeast in the U/A sample (3)?

Back 39

Candida albicans
Diabetes mellitus
Vaginal moniliasis

Front 40

What causes turbid synovial fluid?

Back 40

Leukocytosis

Front 41

Presence of what causes synovial fluid to be milky?

Back 41

Crystals

Front 42

In gout, what are the crystals in synovial fluid made of?

What kind of birefringence do thet show?

Back 42

Monosodium urate

NEGATIVE

Front 43

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

Back 43

"Nypbperp"

---Negative---
Yellow when parallel
Blue when perpendicular

Front 44

What type of crystals are in synovial fluid of pseudogout?

What type of birefringence do they show?

Back 44

Calcium pyrophosphate dihydrate

POSITIVE

Front 45

How do the colors line up in a positively birerfringent sample?

Back 45

Opposite of "Nypbperp"

---Positive---
Yellow when perpendicular
Blue when parallel

Front 46

What in the urine causes it to be sweet or fruity?

Back 46

Ketones

Front 47

If not analyzed promptly, what may happen to urine (2)?

Back 47

pH may rise
(due to bacterial splitting of urea)

Crystals may form

Front 48

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

Back 48

Glomerular source