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54 Cards in this Set

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first morning SG of urine should be
1.015 - 1.025
SG of urine during the day should be
1.003 - 1.035
Hi SG > 1.030 most often suggests
dehydration
fixed SG (e.g. 1.010) suggests
severe renal disease - often when GFR falls b/w 10-20; inability to concentrate the urine
causes of turbidity of the urine include
crystals
cells
normal urine pH
5-8
causes of acidic urine
diarrhea, hi protein diet, starvation, metabolic acidosis
alkaline urine is caused by
vegetarian diet, vomiting, RTA, resp alkalosis, urea splitting bacteria (produce ammonia)
will the presence of urea-splitting bacteria cause alkaline or acidic urine?
alkaline -b/c they produce urea
how is glu measured in urinalysis
enzymatic test (glucose oxidase)
how do you measure ketones in the urine?
nitroprusside rxn detects acetoacetate and acetone
what is the main problem with the ketone test in urinalysis
can't detect b-hydroxybutarate - the most important ketone
how is blood testted for in urinalysis?
detects peroxidase-like activity a/w Hb
a positive test for blood in urinalysis indicates the presence of one of which 3 things in the urine?
1. hemoglobinuria
2. myoglobinuria (muscle injury)
3. hematuria
why do we test for nitrites?
indicates the presence of bacteriuria. Humans secrete nitrate. If bacteria with nitrate reductase activity are present, nitrite will be generated
what is the test for leukocytes?
leukocyte esterase
does leukocyte esterase test for the presence of both lysed and intact leukocytes>?
yes
does urine normally contain bilirubin?
no
urobilinogen is formed by?
bacterial reduction of bilirubin in the intestine
what are indications for sending a urine sample for microscopy?
leukocyte esterase, Hb, nitrite, protein, OR if the sample is red/cloudy
procedure for microscopy of urine?
10 mL sample is centrifuged
resuspend sediment in 1 mL
place drop on slide
examine under LPF and HPF
is a fine granular cast normal?
yes
what does a coarse granular cast indicate the presence of?
proteinuria, cell degeneration
what kind of white blood cells do leukocyte casts usually contain?
neutrophils
what would you find in a renal tubular epithelial cast? what would its presence indicate?
intact/necrotic epithelial cells


renal tubular injury (acute tubular necrosis)
what would a broad (waxy) cast indicate? and where are they formed
formed in dilated tubules

indicate renal disease
Does the following crystal form in acidic/alkaline/mixed pHs: cystine
acid
Does the following crystal form in acidic/alkaline/mixed pHs: bilirubin
acid
Does the following crystal form in acidic/alkaline/mixed pHs: sodium urate
acid
Does the following crystal form in acidic/alkaline/mixed pHs: cholesterol
acid
Does the following crystal form in acidic/alkaline/mixed pHs: calcium oxalate
mixed
Does the following crystal form in acidic/alkaline/mixed pHs: hippuric acid
mixed
Does the following crystal form in acidic/alkaline/mixed pHs: oxalate crystals
mixed
Does the following crystal form in acidic/alkaline/mixed pHs: triple phosphate (ammonium magnesium phosphate)
alkaline
Does the following crystal form in acidic/alkaline/mixed pHs: calcium phosphate
alkaline
Does the following crystal form in acidic/alkaline/mixed pHs: ammonium biurate (thorn apples)
alkaline
Does the following crystal form in acidic/alkaline/mixed pHs: tyrosine crystals
alkaline
Does the following crystal form in acidic/alkaline/mixed pHs: indinavir crystals
alkaline
Does the following crystal form in acidic/alkaline/mixed pHs: pyridium crystals
alkaline
normal WBC in urine
<1
normal number of renal rubular epithelial cells
<2 / hpf
when would you see oval fat bodies in the urine, and what exactly are they?
they are lipid-laden renal cells, seen in nephrotic syndrome
would finding squamous epitheial cells in teh urine be a concern? why? where do they come from?
nope they come from distal urinary tract and female genital tract
what three classes of organism would you find in teh urine?
bacteria, yeasts, parasites
what can be mistaken for casts?
fibres (artifacts)
what artifact can be mistaken for cells/crystals
starch granules
what number of bacteria per hpf indicates a significant finding?
10 bacteria
what # of hyaline or granular casts/lpf is significant?
3
what # of renal tubular cells/hpf is significant?
2
would finding cystine crystals be a significant finding?
yes
name the disease characterized by:
macroscopic: decreased urine volume, turbidity, proteinuria, hematuria

microscopic: red cell casts, red cells, neutrophils epithelial cells, sometimes WBC, epithelial cats
acute glomerulonephritis
end stage renal disease would be characterized by:
______ casts
hi/lo/fixed SG
broad waxy


fixed SG
would you see renal casts in a flower UTI?
no
if there was a pre-renal cause of kidney problems, would the urine be concentrated or dilute?
concentrated (normal)

whereas if the rpoblem is acute tubular necrosis, the kidney can no longer concentrate the urine - therefore expect to see dilute urine