Urinalysis 1-30

Front 1

routine urinalysis includes

Back 1

Gross examination of the specimen
Microscopic examination of the urine sediment
Biochemical analysis

Front 2

typically, the most important abnormalities are:

Back 2

Changes in urine volume
Proteinuria
Glycosuria
Hematuria
Abnormal urinary sediment
Abnormal bacteriologic findings

Front 3

describe the normal findings for the following and what could cause an abnormality:
1. color

Back 3

normally clear and straw colored. Most common causes of abnormal color are drugs; however, changes in color could be due to abnormal accumulation of endogenous metabolites (e.g., bilirubin, hemoglobin, myoglobin, porphyrins, etc.)

Front 4

describe the normal findings for the following and what could cause an abnormality:
1. clarity

Back 4

normally, the urine is clear – without turbidity (cloudiness or haziness). Microscopic examination of a urine sediment (sample of centrifuged “pellet” of the urine specimen) is absolutely required in cases of turbidity. Turbidity can be due to precipitation of solutes in the urine or possibly due to cells / cellular debris. Urates precipitate in acidic urine; phosphates in alkaline urine.

Front 5

describe the normal findings for the following and what could cause an abnormality:
1. pH

Back 5

normally, the urine is slightly acidic (pH 4.5 – 7.5). A urine specimen that represents the first void of the day is typically slightly more acidic, due to retained CO2 during the nighttime sleep. Proteinuria may render the urine acidic. Postprandial urine specimens tend to be more alkaline, due secretion of HCl into the stomach. The most common cause of an alkaline urine is bacteria.

Front 6

describe the normal findings for the following and what could cause an abnormality:
1. specific gravity

Back 6

Specific gravity between 1.002 and 1.035. If sp gr is not > 1.022 after a 12 hour period without food or water, renal concentrating ability is impaired and the patient either has generalized renal impairment or nephrogenic diabetes insipidus. In end-stage renal disease, sp gr tends to become 1.007 to 1.010.

urine over 1.035 is either contaminated or has very high levels of glucose

Front 7

describe the normal findings for the following and what could cause an abnormality:
1.

Back 7

normal urine contains less that 100mg/L of protein.

Front 8

describe the normal findings for the following and what could cause an abnormality:
1. glucose

Back 8

normal urine does not contain glucose, as all filtered glucose typically should be reabsorbed in the proximal tubules. Glucose oxidase used in many urinalysis dipstick tests may yield a false-negative result in the presence of high enough amounts of ascorbic acid (vitamin C) or ketones, which inhibit the glucose oxidase test.
glycosuria = diabetes mellitus/insipidus

Front 9

describe the normal findings for the following and what could cause an abnormality:
1. blood

Back 9

not normally in urine. abnormal numbers in urine can indicate glomerular damage, tumors eroding urinary tract, kidney trauma, urinary tract stones, renal infarct, acute tubular necrosis, upper & lower URTI, nephrotoxins & physical stress (may also be from menstruation in women)
dysmorphic RBC's suggest glomerular disease

pyuria = >2 leukocytes in urine specimen field.. indicates upper or lower URTI

Front 10

what does the presence of squamous epithelial cells in urine indicate?

Back 10

possible contamination of specimen w/skin flora

Front 11

where do urinary casts form?

Back 11

in distal convoluted tubule or collecting duct
(NOT PCT or loop of Henle)

Front 12

what conditions favor protein cast formation?

Back 12

low flow rate
high NaCl concentration
low pH
(favors protein denaturation & precipitation)

Front 13

describe what the following type of casts are and what they indicate:
1. hyaline cast
2. RBC cast
3. WBC cast
4. granular cast
5. waxy cast

Back 13

1. composed of mucoprotein secreted by tubule cells, seen in healthy pts and diseased
2. RBCs sticking together, indicative of glomerulonephritis or severe tubular damage
3. accumulation of WBCs, indicative of acute pyelonephritis, may also indicate glomerulonephritis. also indicate inflammation of kidney
4. cellular cast that remained in nephron for a long time, derived from renal tubular cell casts.. broad casts indicate damaged & dilated tubules (seen in end-stage chronic renal failure)
5. ellular cast that remained in nephron for an even longer time, derived from renal tubular cell casts.. broad casts indicate damaged & dilated tubules (seen in end-stage chronic renal failure)

Front 14

what is telescoped urinary sediment?

Back 14

RBCS
WBC
oval fat bodies
all types of casts
- found in equal profusion, caused by either lupus nephritis, malignant hypertension, diabetic glomerulosclerosis, & rapidly progressive glomerulonephritis

Front 15

what crystals are commonly seen in healthy pts? which one is very uncommon?

Back 15

common- oxalate, triple phosphate
uncommon- cystine crystals, could indicate congenital cystinuria in neonates or severe liver disease
leucine crystals = severe liver disease or maple syrup urine disease