Urinalysis

Front 1

main solute in urine?

Back 1

Urea (50%)

Front 2

normal volume for urine daily output?

Back 2

output is 1200-1500 ml, but normal is considered 600-2000 ml per day

Front 3

oliguria?

Back 3

decrease in urine output (less than 400ml/day)
-seen in dehydration due to diarrhea, vomiting, excessive sweating, severe burns

Front 4

Anuria?

Back 4

cessation of urine flow
-seen in kidney damage or a decreased blood flow to kidneys

Front 5

Polyuria?

Back 5

an increase in daily urine volumes (more than 2.5 L /day).
-diabetes mellitus and insipidus
-ADH suppressors, diuretics, caffeine or alcohol

Front 6

Nocturia?

Back 6

an increase in nocturnal excretion of urine

Front 7

What does thymol do in urine preservation?

Back 7

-preserves glucose and sediments
-inhibits bacteria and yeast

Front 8

What does boric acid do in urine preservation?

Back 8

-preserves protein and formed elements
-inhibits bacterial growth for 24 hours

Front 9

What does formalin do in urine preservation?

Back 9

-preserves sediments and formed elements

Front 10

What does acetic acid do in urine preservation?

Back 10

-bactericidal, used for aldosterone, catecholamines, corticosteroids, cortisol, estrogens, metanephrines

Front 11

most common form of urine collection?

Back 11

random

Front 12

First morning void collection?

Back 12

first morning collection that has sat in bladder for more than 8 hours.
-useful for evaluating increased protein, chemicals and formed elements and also for pregnancy testing

Front 13

2 hour collection useful for?

Back 13

monitoring insulin in diabetic patients
-glucose levels tested and compared to blood results

Front 14

12 or 24 hour timed collection ends with what?

Back 14

empty bladder

Front 15

midstream clean catch?

Back 15

-eliminates bacteria contamination
-patient is cleansed before collection
-represents true elements from bladder and kidneys

Front 16

medulla?

Back 16

inner layer of the kidney

Front 17

renal pelvis function?

Back 17

-receives urine from the calyces and transfers it to the ureter

Front 18

what happens at the cortex?

Back 18

site of plasma filtration

Front 19

papilla?

Back 19

located in the medulla, contains papillary ducts that empty into the calyx

Front 20

nephron?

Back 20

functional unit of the kidney
-important for formation and final composition of urine

Front 21

3 processes of urine formation?

Back 21

-Plasma (glomerular) filtration
-Reabsorption of certain components by renal tubules
-secretion of selective components by renal tubules

Front 22

3 layers of the glomerulus?

Back 22

-capillary epithelium membrane (contains pores that increase permeability, but don't allow large molecules)
-Trilayer basement membrane (restricts passage of large molecules)
-Podocytes (finger like structures that create filtration slits, covered with negative charge)

Front 23

low sodium in plasma = water retention decresed and....

Back 23

-decrease blood volume and pressure
-renin is secreted to produce angiotensin
-vasodilation of afferent, constriction of efferent, reabsorption of sodium, release of aldosterone

Front 24

high sodium in plasma = water retention increased and...

Back 24

-increase blood volume and pressure
-renin secretion inhibited
-sodium excretion is enhanced

Front 25

active reabsorption?

Back 25

-involves a carrier protein to move against gradient (requires energy)

Front 26

passive reabsorption?

Back 26

-requires no energy, substance is moved based on area of concentration (low to high or high to low)

Front 27

where are the locations where water is reabsorbed?

Back 27

-all parts of the nephron except the ascending loop of henle

Front 28

maximal reabsorptive capacity (Tm)

Back 28

-when the filtrate concentration reaches its maximum concentration and the substance begins to spill into the urine
-the plasma conc. has reached its renal threshold!

Front 29

final site of urine concentration?

Back 29

collecting duct/tubule

Front 30

increased ADH?

Back 30

-increases permeability to water
-results in low volume of concentrated urine

Front 31

decreased ADH?

Back 31

-decreases permeability to water
-results in high volume of dilute urine

Front 32

normal blood pH?

Back 32

7.35 - 7.45

Front 33

3 mechanisms for renal acid-base regulation?

Back 33

-hydrogen ion secretion and biocarbonate reabsorption
-hydrogen ion secretion and formation of titratable acids
-hydrogen ion secretion and the formation of ammonium ions

Front 34

isothenuric?

Back 34

specific gravity of 1.010

Front 35

hyposthenuric?

Back 35

specific gravity less than 1.010

Front 36

hypersthenuric?

Back 36

specific gravity more than 1.010

Front 37

normal urine color? pigments involved?

Back 37

-yellow
-pigment called urochrome
-uroblin (orange to brown)
-uroerythrin (pink color)

Front 38

non-pathological causes of increased urine turbidity?

Back 38

-improper collection
-improper storage
-ppt of amorphous urates or phosphates
-sperm
-feces or mucous
-contrast media
-powders or lotions

Front 39

pathological causes of increased urine turbidity?

Back 39

-RBCs
-WBCs
-bacteria
-renal epithelial cells
-yeast
-indicates disease or metabolic dysfunction

Front 40

significance of urine foam?
increased?

Back 40

-increases mean moderate to large amounts of protein
-increased bilirubin makes yellow foam

Front 41

what is specific gravity?
affected by?

Back 41

-density or mass of the solutes per volume of solution.
-affected by mass (size) and number of particles

Front 42

urinometer?

Back 42

-weighted glass float to determine density
-no longer used, inaccurate

Front 43

densitometry?

Back 43

-uses sound waves in direct way to measure specific gravity

Front 44

reagent strip measures SG....how?

Back 44

indirectly
-detects only ionic particles

Front 45

osmolality? affected by what?

Back 45

-Preferred method
-concentration of solution expressed in osmoles of solute per kilogram of solvent
-only affected by number of particles present

Front 46

freezing point osmometer?

Back 46

-sample vibrated to produce crystals
-heat of fusion produced
-temp change is measured
-conveted to miliosmoles and compared

Front 47

vapor pressure osmometer?

Back 47

-measures the dew point

Front 48

causes of abnormal urine odor?

Back 48

-bacterial metabolism
-pus
-protein decay
-certain foods

Front 49

diabetes mellitus tastes?
diabetes insipidus tastes?

Back 49

-sweet
-tasteless

Front 50

solutes that distinguish urine from other fluids?

Back 50

-urea
-creatinine

Front 51

specific gravity of plasma ultrafiltrate as it leaves glomerulus?

Back 51

1.010

Front 52

importance of free water clearance?

Back 52

-represents kidneys ability to respond to the body's state of hydration

Front 53

clinical significance of creatinine clearance?

Back 53

-determines degree of nephron damage in known renal disease
-monitor effectiveness of treatments
-determine feasibility of administering meds

Front 54

if tubular reabsorption is decreased, what happens to beta2 microglobulin levels in urine and plasma?

Back 54

-levels in urine increase
-levels in plasma remain the same

Front 55

beta 2 microglobulin increased in plasma indicates?

Back 55

-reduced GFR

Front 56

levels of cystatin C increase means what?

Back 56

-reduced GFR

Front 57

significance of microalbumin test?

Back 57

-appears in early diabetic nephropathy (aids in detection and treatment)
-marker of cardiovascular morbidity and mortality in diabetics

Front 58

testing for renal blood flow and tubular secretion involves what acid and test?

Back 58

-p-aminohippuric acid
-PAH test

Front 59

PAH test?

Back 59

volume of plasma flowing thru the kidney determines the amount of PAH secreted in the urine

Front 60

importance of measuring titratable acids and urinary ammonias?

Back 60

-if tubular secretion becomes compromised, body has hard time maintaining proper acid-base balance, body becomes acidic

Front 61

proteinuria?

Back 61

increased protein in the urine
-more than 30 mg/dl

Front 62

pre-renal protein?

Back 62

-not caused by renal disease
-affects plasma before it reaches the kidney
-acute phase reactants
-hemoglobulin, myoglobin, bence jones proteins

Front 63

renal proteinuria?

Back 63

-associated with renal disease
-glomeruler proteinuria
-tubular proteinuria
-orthostatic proteinuria
-microalbuminuria

Front 64

post-renal protein?

Back 64

-protein that occurs in the urine after it has passed into the lower urinary tract
-bacterial or fungal infections
-contamination from menstration or sperm
-prostatic fluid

Front 65

hematuria?

Back 65

-intact RBCs
-cloudy or smokey urine
-color varies depending on amount of cells present

Front 66

hemoglobinuria?

Back 66

-lysed RBCs
-clear red or brown urine
-hemolyzed plasma

Front 67

myoglobinuria?

Back 67

-red-brown urine
-normal plasma

Front 68

main damage in glomerular disorders?

Back 68

-affect other organs in the body with the glomerulus being affected secondarily
-typically immune disorders in which increased immunoglobulin or antibody-antigen complexes form and deposit in the glomerulus membranes

Front 69

tubular function affected by?

Back 69

-damage to tubules
-inherited disorders

Front 70

most frequently encountered tubular disorder?

Back 70

Fanconi Syndrome

Front 71

whats the difference between cystitis and pyelonephritis?

Back 71

WBC casts will be present in pyelonephritis (upper UTI), not present in cystitis (bladder infection)

Front 72

difference between polarized and phase?

Back 72

polarized light vibrates in only one direction or plane

Front 73

normal RBCs per hpf? WBCs?

Back 73

0-3
0-8

Front 74

normal casts per hpf? epithelial cells? bacteria and yeast?

Back 74

0-2 hyaline casts
-few epithelial
-negative, negative

Front 75

what causes crenated RBCs?

Back 75

-concentrated (hypertonic) urine
-lose water and shrink

Front 76

what causes ghost RBCs to be seen?

Back 76

-dilute (hypotonic) urine
-RBCs absorb water, swell, lyse

Front 77

what does dysmorphic RBCs indicate?

Back 77

-glomerular bleeding or damage
-or menstruation contamination or strenuous exercise

Front 78

what/where are clue cells found?

Back 78

bacterial vaginosis
-squamous cells covered with small coccobacillus Gardenella

Front 79

RTE cells indicate?

Back 79

-tubular injury or necrosis

Front 80

what are oval fat bodies and what do they indicate?

Back 80

-RTE cells that absorb lipid
-signifies: nephrotic syndrome causing damge to glomerulus, tubular necrosis, diabetes mellitus, trauma to bone marrow

Front 81

name the 5 acidic crystals?

Back 81

-uric acid
-amorphous urates
-sodium urates
-calcium oxalate

Front 82

name the 5 alkaline crystalls?

Back 82

-amorphous phosphates
-calcium phosphate
-triple phosphate
-ammonium biruate
-calcium carbonate

Front 83

3 crystals that signify liver disorder?

Back 83

-leucine
-tyrosine
-bilirubin

Front 84

3 abnormal crystals?

Back 84

-cysteine
-cholesterol
-radiographic dye

Front 85

overflow disorders?

Back 85

a disruption in the normal metabolic pathway
-renal tubules unable to reabsorb causing metabolic substances to appear in urine

Front 86

newborn screening test?

Back 86

-inborn errors of metabolism need to be treated at birth
-heal stick infant before leaving hospital

Front 87

amino acid primary disorders?

Back 87

-tubular reabsorption is disrupted due to enzyme deficiancy or defective in metabolic pathway

Front 88

amino acid secondary disorders?

Back 88

-induced by liver disease or general tubular dysfunction

Front 89

most common inborn error of metabolism?

Back 89

phenylketonuria