Urinalysis

Front 1

first morning SG of urine should be

Back 1

1.015 - 1.025

Front 2

SG of urine during the day should be

Back 2

1.003 - 1.035

Front 3

Hi SG > 1.030 most often suggests

Back 3

dehydration

Front 4

fixed SG (e.g. 1.010) suggests

Back 4

severe renal disease - often when GFR falls b/w 10-20; inability to concentrate the urine

Front 5

causes of turbidity of the urine include

Back 5

crystals
cells

Front 6

normal urine pH

Back 6

5-8

Front 7

causes of acidic urine

Back 7

diarrhea, hi protein diet, starvation, metabolic acidosis

Front 8

alkaline urine is caused by

Back 8

vegetarian diet, vomiting, RTA, resp alkalosis, urea splitting bacteria (produce ammonia)

Front 9

will the presence of urea-splitting bacteria cause alkaline or acidic urine?

Back 9

alkaline -b/c they produce urea

Front 10

how is glu measured in urinalysis

Back 10

enzymatic test (glucose oxidase)

Front 11

how do you measure ketones in the urine?

Back 11

nitroprusside rxn detects acetoacetate and acetone

Front 12

what is the main problem with the ketone test in urinalysis

Back 12

can't detect b-hydroxybutarate - the most important ketone

Front 13

how is blood testted for in urinalysis?

Back 13

detects peroxidase-like activity a/w Hb

Front 14

a positive test for blood in urinalysis indicates the presence of one of which 3 things in the urine?

Back 14

1. hemoglobinuria
2. myoglobinuria (muscle injury)
3. hematuria

Front 15

why do we test for nitrites?

Back 15

indicates the presence of bacteriuria. Humans secrete nitrate. If bacteria with nitrate reductase activity are present, nitrite will be generated

Front 16

what is the test for leukocytes?

Back 16

leukocyte esterase

Front 17

does leukocyte esterase test for the presence of both lysed and intact leukocytes>?

Back 17

yes

Front 18

does urine normally contain bilirubin?

Back 18

no

Front 19

urobilinogen is formed by?

Back 19

bacterial reduction of bilirubin in the intestine

Front 20

what are indications for sending a urine sample for microscopy?

Back 20

leukocyte esterase, Hb, nitrite, protein, OR if the sample is red/cloudy

Front 21

procedure for microscopy of urine?

Back 21

10 mL sample is centrifuged
resuspend sediment in 1 mL
place drop on slide
examine under LPF and HPF

Front 22

is a fine granular cast normal?

Back 22

yes

Front 23

what does a coarse granular cast indicate the presence of?

Back 23

proteinuria, cell degeneration

Front 24

what kind of white blood cells do leukocyte casts usually contain?

Back 24

neutrophils

Front 25

what would you find in a renal tubular epithelial cast? what would its presence indicate?

Back 25

intact/necrotic epithelial cells


renal tubular injury (acute tubular necrosis)

Front 26

what would a broad (waxy) cast indicate? and where are they formed

Back 26

formed in dilated tubules

indicate renal disease

Front 27

Does the following crystal form in acidic/alkaline/mixed pHs: cystine

Back 27

acid

Front 28

Does the following crystal form in acidic/alkaline/mixed pHs: bilirubin

Back 28

acid

Front 29

Does the following crystal form in acidic/alkaline/mixed pHs: sodium urate

Back 29

acid

Front 30

Does the following crystal form in acidic/alkaline/mixed pHs: cholesterol

Back 30

acid

Front 31

Does the following crystal form in acidic/alkaline/mixed pHs: calcium oxalate

Back 31

mixed

Front 32

Does the following crystal form in acidic/alkaline/mixed pHs: hippuric acid

Back 32

mixed

Front 33

Does the following crystal form in acidic/alkaline/mixed pHs: oxalate crystals

Back 33

mixed

Front 34

Does the following crystal form in acidic/alkaline/mixed pHs: triple phosphate (ammonium magnesium phosphate)

Back 34

alkaline

Front 35

Does the following crystal form in acidic/alkaline/mixed pHs: calcium phosphate

Back 35

alkaline

Front 36

Does the following crystal form in acidic/alkaline/mixed pHs: ammonium biurate (thorn apples)

Back 36

alkaline

Front 37

Does the following crystal form in acidic/alkaline/mixed pHs: tyrosine crystals

Back 37

alkaline

Front 38

Does the following crystal form in acidic/alkaline/mixed pHs: indinavir crystals

Back 38

alkaline

Front 39

Does the following crystal form in acidic/alkaline/mixed pHs: pyridium crystals

Back 39

alkaline

Front 40

normal WBC in urine

Back 40

<1

Front 41

normal number of renal rubular epithelial cells

Back 41

<2 / hpf

Front 42

when would you see oval fat bodies in the urine, and what exactly are they?

Back 42

they are lipid-laden renal cells, seen in nephrotic syndrome

Front 43

would finding squamous epitheial cells in teh urine be a concern? why? where do they come from?

Back 43

nope they come from distal urinary tract and female genital tract

Front 44

what three classes of organism would you find in teh urine?

Back 44

bacteria, yeasts, parasites

Front 45

what can be mistaken for casts?

Back 45

fibres (artifacts)

Front 46

what artifact can be mistaken for cells/crystals

Back 46

starch granules

Front 47

what number of bacteria per hpf indicates a significant finding?

Back 47

10 bacteria

Front 48

what # of hyaline or granular casts/lpf is significant?

Back 48

3

Front 49

what # of renal tubular cells/hpf is significant?

Back 49

2

Front 50

would finding cystine crystals be a significant finding?

Back 50

yes

Front 51

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

Back 51

acute glomerulonephritis

Front 52

end stage renal disease would be characterized by:
______ casts
hi/lo/fixed SG

Back 52

broad waxy


fixed SG

Front 53

would you see renal casts in a flower UTI?

Back 53

no

Front 54

if there was a pre-renal cause of kidney problems, would the urine be concentrated or dilute?

Back 54

concentrated (normal)

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