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18 Cards in this Set
- Front
- Back
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"Urinalysis" can mean which three 4 forms of analyzing the urine?
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Dipstick
Chemical analysis Specific gravity/osmolality Microscopy |
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o Across which 6 parameters does the urine dipstick typically screen?
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o pH, glucose, ketones, nitrite, leukocyte esterase, heme, albumin
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o The urine dipstick can detect the presence of which protein?
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o Albumin and only albumin
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o What might a urine pH above 7.5 – 8 indicate?
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o UTI with a urea-splitting organism
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o What pH should the urine be in a patient with acidosis?
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o Below 5.5
o A pH above 5.5 in this setting suggests an impairment in the acidification process, due most often to one of the forms of renal tubular acidosis |
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o What might the presence of nitrite in the urine indicate?
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o Presence of bacteria
o Dietary nitrate, not nitrite, is normally excreted in the urine o If bacteria are present and there is adequate contact time (as in a specimen obtained when the patient first voids in the morning), then urinary nitrate can be partially converted to nitrite |
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o What is specific gravity?
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Weight of solution in question / weight of equal volume of pure water
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o What is the specific gravity of plasma?
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1.010
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o What is the difference between specific gravity and osmolality?
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Specific gravity is dependent not only on the number of solute particles but also their individual weights. Osmolality is purely an expression of the number of solute particles and is independent of the weight of those particles.
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Urine that has the same osmolality as plasma is called....
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Isothenuric
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Name three categories of "things" you examine on urine microscopy.
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1) Casts
2) Cells 3) Microorganisms |
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What are casts?
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• Casts are aggregates of precipitated protein or cells that form within the tubular lumen
• Because they form within the lumen they have a cylindrical shape and regular margins that conform to the shape of the tubular lumen |
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What component do all casts have in common?
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• Organic matrix composed of Tamm-Horsfall mucoprotein (THMP), also known as uromodulin
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Casts can be divided into which two broad categories?
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• Hyaline and cellular casts
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What are hyaline casts?
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• Casts composed entirely of the THMP matrix
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What are cellular casts?
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• Casts that contain cells in addition to THMP matrix
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What is the significance of cellular casts?
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• They identify the kidney as the source of the cells
• For example, white cells can enter the urine at any site in the urinary tract, from the kidney to the bladder to the ureter. However, the presence of white cell casts indicates inflammation in the kidney itself. |
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A urine sample is found to contain white cell casts. What is the source of the white cells?
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• The kidney
• White cell casts indicate inflammation in the kidney |
