Zaman 10-16-07 Urine Part 2

Front 1

Fat globules appear in the urine most often with the
_______ syndrome; these are neutral fats
(triglycerides) and cholesterol.

Back 1

nephrotic

Front 2

Lipiduria can also be present in patients who have
sustained __________

Back 2

skeletal trauma with fractures to major long
bones or the pelvis.

Front 3

_____ odor in urine from patients with acute renal failure suggests
acute tubular necrosis rather than prerenal failure.

Back 3

Lack of

Front 4

Production of more than 2000 mL of urine in 24 hours
is termed ______;

Back 4

polyuria

Front 5

nocturia is excretion of more than 500 mL of urine at night with a specific gravity of ________

Back 5

less than 1.018.

Front 6

Pathologic states that result in excess renal fluid loss/urine excretion can be divided into three groups.

Back 6

1. Defective Hormonal Regulation
2. Defective Renal Salt/Water
3. Osmotic Diuresis.

Front 7

_____ is the excretion of less than 500 mL of urine
per 24 hours, and anuria is the near complete
suppression of urine formation.

Back 7

Oliguria

Front 8

So-called _______ is the shifting of intravascular
fluids to extracellular spaces not normally filled with fluid.

Back 8

third spacing

Front 9

Urines of low sg are called _______ (<1.007).

Back 9

hyposthenuric

Front 10

(Alkaline?/acidic?) urine may be induced by use of a diet high in certain fruits and vegetables, especially citrus fruits.

Back 10

alkaline

Front 11

Alkaline?/Acidic? urine may be produced by a diet high in meat protein and
with some fruits such as cranberries or drugs.

Back 11

Acidic

Front 12

Tamm–______ glycoprotein (uromucoid), secreted by
distal tubular cells and cells of the ascending loop of
Henle, is 1/3 third or more of the total normal protein
loss.

Back 12

Tamm-Horsfall

Front 13

Does a dipstick detect globulin protein?

Back 13

no, only albumin

Front 14

How do we detect globulins in urine?

Back 14

acid precipitation methods detect all proteins

Front 15

________ proteinuria is usually less than 0.5 g/day, and
can be seen in dehydration CHF, cold exposure, and fever.

Back 15

Functional

Front 16

Proteinuria is apparently related to an exaggerated
lordotic?/kyphotic? position and may result from renal congestion
or ischemia.

Back 16

lordotic

Front 17

Define minimal, moderate, and heavy proteinuria

Back 17

Minimal Proteinuria (< 1.0 g/day).
Moderate Proteinuria (1.0-4.0 g/day)
Heavy Proteinuria (> 4 g/day).

Front 18

pyelonephritis proteinuria type

Back 18

minimal

Front 19

_______-type proteinuria may be found in the vast
majority of renal diseases, as well as nephrosclerosis,
multiple myeloma, and toxic nephropathies.

Back 19

Moderate

Front 20

nephrotic syndrome type of protein loss

Back 20

heavy

Front 21

A ______ pattern proteinuria occurs with Fanconi's
syndrome, cystinosis, Wilson's disease, and
pyelonephritis, and with RT rejection.

Back 21

tubular

Front 22

Proteinuria associated with MM macroglobulinemia, and lymphomas.

Back 22

Bence Jones .

Front 23

Reagent strip method can only detect what sugar

Back 23

Glucose

It does not react with lactose, galactose, fructose, or
reducing metabolites of drugs.

Front 24

Fructose is identified by ______ chromatography.

Back 24

thin-layer

Front 25

Lactose is identified by ______ chromatography

Back 25

thin-layer

Front 26

In ketonuria, the three ketone bodies present in the
urine are

Back 26

acetoacetic (diacetic) acid (20%), acetone
(2%), and 3-hydroxybutyrate (about 78%)

Front 27

The antihypertensive drugs ______
give positive ketonuria results.

Back 27

methyldopa and captopril

Front 28

____-test will detect 5-10 mg of acetoacetic acid per
deciliter of urine and 20-25 mg acetone per deciliter of
urine.

Back 28

Acetest

Front 29

_______ ferric chloride test measures acetoacetic acid.
However, ferric chloride methods are not very specific
and the sensitivity is low, about 25-50 mg/dL.

Back 29

Gerhardt

Front 30

Free hemoglobin is readily filtered by the glomeruli,
and can be subsequently reabsorbed by proximal
tubular cells where it can be catabolized into _____
and ________.

Back 30

ferritin

hemosiderin

Front 31

When there is acute destruction of muscle fibers
(rhabdomyolysis) as with trauma, ______ is released,
rapidly cleared from blood, and excreted in the urine
as a red-brown pigment.

Back 31

myoglobin

Front 32

What helps distinguish
myoglobinuria from hemoglobinuria?

Back 32

The serum measurements and history

Front 33

Comment on serum in the setting of myoglobinuria

Back 33

Serum is clear and has a markedly elevated creatine kinase (CK), aldolase, and a normal haptoglobin level.

Front 34

_____ is a breakdown product of hemoglobin that is
formed in the reticuloendothelial cells of the spleen,
liver, and bone marrow.

Back 34

Bilirubin

Front 35

______ bilirubin (or indirect bilirubin) is
water insoluble and therefore unable to pass through
the glomerular barrier of the kidney.

Back 35

unconjugated

Front 36

Excretion
of bilirubin is enhanced by alkalosis?/acidosis?

Back 36

alkalosis

Front 37

Bilirubinuria is associated with yellow-brown to
greenish brown urine that may have a _______ foam,
elevated serum bilirubin (conjugated), jaundice, and
pale-colored feces.

Back 37

yellow

Front 38

In congenital hyperbilirubinemias, bilirubin will appear
in the urine in the Dubin–Johnson and the Rotor
types, and is not present with ______ disease or
________ disease.

Back 38

Gilbert's

Crigler–Najjar

Front 39

What bacterium is unable to reduce nitrate to nitrite?

Back 39

Enterococcus

Front 40

Methods for Examining Urine Sediment

Back 40

Brightfield Microscopy
Phase-Contrast Microscopy
Polarized Microscopy
Quantitative Counts

Front 41

Normal opening adult pressure of CSF is ___? mm H20 in
the lateral decubitus position with the legs and neck in
a neutral position.

Back 41

90-180

Front 42

Up to ___? mL of CSF may normally be removed.

Back 42

20

Front 43

If the Opening Pressure > 200 mm H2O in a relaxed patient, no
more than __? mL should be withdrawn.

Back 43

2.0

Front 44

The CSF specimen is usually divided into _____ serially
collected sterile tubes:

Back 44

three

Front 45

CSF:
High sensitivity, high specificity for what?

Back 45

Bacterial, tuberculous, and fungal meningitis

Front 46

Experienced observers may be able to detect cell
counts <50 cells/μL with the unaided eye by observing for _____'s effect.

Back 46

Tyndall

Front 47

Viscous CSF may be encountered in patients with

Back 47

metastatic mucin-producing adenocarcinomas,
cryptococcal meningitis due to capsular polysaccharide,
or liquid nucleus pulposus resulting from needle injury
to the annulus fibrosus.

Front 48

______ commonly refers to a pale pink to
yellow color in the supernatant of centrifuged CSF,
although other colors may be present:

Back 48

Xanthochromia

Front 49

Viral-induced neutrophilia usually changes to a
lymphocytic _____ within 2-3 days.

Back 49

pleocytosis

Front 50

In early bacterial meningitis, the proportion of PMNs
usually exceeds 60%.
However, in about 1/4 of cases of early ____ meningitis
the proportion of PMNs also exceeds 60%.

Back 50

viral

Front 51

A suggested criterion for eosinophilic meningitis is 10%
eosinophils.
______ invasion of the CNS is the most common
cause worldwide.

Back 51

parasitic

Front 52

________ immitis is a significant cause of CSF
eosinophilia in endemic regions of the United States

Back 52

Coccidioides

Front 53

A mixed cell pattern (monos, lymphs) without
________ is characteristmeningoencephalitis.

Back 53

neutrophils

Front 54

Joint fluid aspiration (AKA)

Back 54

arthrocentesis

Front 55

tube top color for SF

Back 55

green

Heparin

Front 56

Transudates?/Exudates? are usually bilateral owing to systemic
conditions leading to increased capillary hydrostatic pressure or decreased plasma oncotic pressure.

Back 56

Transudates

Front 57

Transudates?/Exudates? are more often unilateral, associated with
localized disorders that increase vascular permeability
or interfere with lymphatic resorption.

Back 57

Exudates

Front 58

Light's criteria for having exudative pleural effusion

Back 58

(1) pleural fluid/serum protein ratio greater than 0.5
(2) pleural fluid/serum lactate dehydrogenase (LD) ratio
greater than 0.6
(3) pleural fluid LD level greater than two-thirds of the
serum upper limit of normal

Front 59

CEA is probably the most useful single marker for

Back 59

adenocarcinomas,

Front 60

Many of the recommended laboratory tests described
for pleural fluid also pertain to _______ effusions.

Back 60

pericardial

Front 61

Pericardial effusions are most often caused by viral
infection, _______ being the most common.

Back 61

enterovirus

Front 62

Ascites is the pathologic accumulation of
excess fluid in the peritoneal cavity. Up to 50
mL of fluid is normally present in this
________-lined space.

Back 62

mesothelial

Front 63

Etiology of Transudative Peritoneal effusions

Back 63

Congestive heart failure
Hepatic cirrhosis
Hypoproteinemia (e.g., nephrotic syndrome)

Front 64

Etiology of Exudative Peritoneal effusions

Back 64

Infections
Primary bacterial peritonitis
Secondary bacterial peritonitis (e.g., appendicitis, bowel rupture)
Tuberculosis
Neoplasms
Hepatoma
Lymphoma
Mesothelioma
Metastatic carcinoma
Ovarian carcinoma
Prostate cancer
Trauma
Pancreatitis
Bile peritonitis (e.g., ruptured gallbladder)

Front 65

Etiology of Chylous Peritoneal effusions

Back 65

Chylous effusion
Damage to or obstruction of thoracic duct (e.g., trauma, lymphoma, carcinoma,
tuberculosis and other granulomas [e.g., sarcoidosis, histoplasmosis, etc.], parasitic
infestation)