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43 Cards in this Set
- Front
- Back
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Indication for Urinalysis
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To detect Renal & Metabolic diz
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Abnormal Elements found in Urine
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RBC, WBC, Urinary tract Cells & Casts from diseased Kidneys
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Best Noninvasive urine sample
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Freshly voided-mid stream in AM.
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Indication for 24 hr urine sample
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Na, Ca, Uric acid, Creatinine, Lead, Toxicology screening
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Physical Chtz of Urine
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Color, Odor, Cloudiness/Turbidity, Vol;
Red/Brown=Blood in urine Fruity Smell=Diabetes; Foul Smell=UTI Cloudy=Alkaline Ave vol=1500+/-500 ml Polyuria=Increased Urine>2500 ml Oliguria=Decreased urine<500 ml Anuria=No urine |
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Indications for QUICK screening of urine via DIPSTICKS
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Specific Gravity, pH, Glucose, Hb, Protein, Bilirubin
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Urine Specific Gravity / SG
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1.003-1.030
High SG=DM, dehydration Low SG=Diabetes insipidus, Lack of ADH, Glomerularnephritis |
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Urine pH
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Slightly acidic ie. 6
Dxs- Renal & Resp diz, Met diz Low pH=Acidosis, Diabetes, Dehydration, COPD High pH=Alkalosis, UTI, Hyperventilation, Chronic renal fail |
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What is the SINGLE MOST important indication of renal diz?
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Persistent Proteinuria; normally glomerulus prevents this.
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Causes of Proteinuria
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Due to strenuous Exercise or Kidney diz (Nephritis, Glomerulonephritis, Polycystic Kidney diz,TB & Cancer of Kidneys)
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Glycouria & its causes
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Glucose in the urine; mostly due to DM, but also in MI, Brain injury
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Ketones & ketoneuria
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A byproduct of FAT metabolism in the absence of CHO; presence of ketones in urine is ketoneuria.
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MOST important diz in which KETONURIA occurs?
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DM
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Causes of Ketoneuria
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Starvation, DM, excessive ETOH, high FAT-low-CHO diet, Vomiting, Diarrhea
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Diff bet Hematuria & Hemoglobinuria
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Hematuria=RBCs in the urin; it occurs due to Renal diz, Infectious dizs, Trauma of U/Tract
Hemoglobinuria=presence of FREE Hb in urine; occurs due to hemolytic anemia, transfusion rexn, poisoning & burns |
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Bilirubinuria
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BIlirubin in urine; occurs due to overproduction of Bilirubin or Liver not removing bilirubin from portal circulation
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What is the Most SENSITIVE test to determine impaired Liver fxn?
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Urobilinogen; a colorless compound formed in the intestines by the reduction of bilirubin
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Nitrite & its Significance
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A salt or ester of Nitrous Acid; indicates UTI via Gr-ve bacteria
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Esterase & Leukocyte Esterase
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Esterase is a substance released by WBCs in urine;
Leukocyte Esterase is a urine test to look for white blood cells and other signs associated with infection |
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Pyuria
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Presence of significant number of WBCs in urine= UTI
5 WBC/high power field of microscope is normal |
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A significant bacterial culture
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>=100,000 bacteria/ml
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What are Urinary Casts?
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Urinary casts are tube-shaped particles made up of Proteins, WBCs, RBCs, and kidney cells. They develop in kidney structures called tubules;
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Types of Urinary Casts?
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Hyalin; Cellular; Fatty; Granular; Waxy
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Significance of Hyaline casts in urine
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Proteinuria; usually caused by dehydration, exercise, or diuretic medicines
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Significance of Cellular casts in urine
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Reflect damage to the tubules; seen in renal tubular necrosis, viral disease
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Granular casts' significance
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Nonspecific; may be found in many different kidney disorders
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Urine Crystals
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Small crystals of different types, eg. Uric acid ; Cholesterol; cystine; amorphous; triple phosphate; lucine & tyrosine; sulfadiazine crystals
Cystine & uric acid=acidic urine Phosphate & oxalate=alkaline urine |
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Tests for UTI
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+ve WBCs; Nitrite; Leukocyte esterase; blood
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Symptoms of Pyelonephritis
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Acute onset of Fever; chills; dysuria; frequency; flank or groin pain
Also WBCs casts & ESR>30mm/hr indicate pyelonephritis |
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S/sx of Glomerulonephritis
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Hematuria; proteinuria; Edema; HTN; decreased GFR
Oftenly it is associated with Strep infection |
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S/Sx of Nephrotic syndrome
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Excretion of >3.5g protein/day in urine; hypoalbuminemia; edema
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S/Sx of Acute Renal Failure
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Abrupt reduction in renal fxn w/ elevated BUN & Creatinine
Usually associated w/ Oliguria (<400ml/day) |
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PSA & its indication
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Prostate-Specific Antigen; <2.5 ng/ml;
used to assess/monitor prostate CA, BUT Digital Rectal Exam is the PRIMARY TEST for prostate CA; wait 48hrs after prostate Palpation to get blood sample (it stimulates PSA production) |
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Normal Value for BPH (benign prostate hyperplasia)
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4-8 ng/ml;
>8 ng/ml=Prostate CA |
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Acid Phosphatase significance
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A grp of phosphatase enzymes found in prostate gland & semen; most active @pH of 5; its elevation indicates metastasized prostate CA;
Normal value<2.5 ng/ml |
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Most common Reportable STD
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Chlamydia trachomatis; 3 types of samples-
Urethral; Cervical & Rectal samples Urine specimen is more sensitive & not painful |
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What is Syphilis &Tests for Syphilis?
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Infectious STD; Non-Treponemal antigen tests are :-VDRL; RPR; STS; ART; these are +ve for Syphilis or False +ve
Treponemal antigen tests are:- FTA-ABS; MHA-TP; they Confirm syphilis |
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Vaginal Yeast infection
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NOT an STD; caused by candida albicans (white, itchy, cottage cheese like vaginal discharge); KOH prep kills bacteria leaving "branched budding yeast"
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Trichomoniasis AKA "Trich"
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A parasitic STD caused by Trichomonas vaginitis (yellow-green, foamy, bad smelling vaginal discharge); saline wet mount shows "mobile trichomonads"
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Bacterial Vaginosis
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NOT an STD; it is a change in the normal vaginal bacteria (thick-milky, fishy odor discharge); Saline-wet mount shows "Clue cells"
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Indication of Cervical Smears
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Precancerous & CA of uterine cervix
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Causes of Cervical Intraepithelial Neoplasia {CIN}
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Human Papilloma Virus; PAP smear will dx it, BUT final Dx is done by OB/GYN using Colposcopy
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Tests for Prostate CA
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PSA; BPH; Acid Phosphatase; Digital Rectal Exam
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