UA (lec 1) Flashcards Preview

Q3 Clin LAB Test 1 (UA, Na, K, CMP) > UA (lec 1) > Flashcards

Flashcards in UA (lec 1) Deck (53)
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1
Q

Abnormal urine colors?

A

red/brown = blood or Hgb

dark brown/black = bile/bilirubin

2
Q

Causes of turbid urine? (7)

A
crystal precipitate
bacteria/yeast
WBC/RBC
mucus
squamous epithelial cells
sperm/prostatic fluids
lipids
3
Q

Causes of abnormal urine odors? (4)

A

UTI
ketone bodies
smoke
AA disorders

4
Q

Dipsticks test for what? (10)

A
pH
Specific Gravity
Glucose
Ketones
Protein
Blood
Nitrite
Leukocyte Esterase
Bilirubin
Urobilinogen
5
Q

pH normal range?

A
  1. 5 - 8.0
  2. 5 - 5.5 = acidic
  3. 5 -8.0 = alkaline
6
Q

Specific Gravity (SG) is what?

Normal range?

A

measure comparing urine to pure H2O (solutes),
water = 1.0

1.003 - 1.035

7
Q

SG tells us?

A

kidney ability to concentrate/dilute urine

8
Q

Isosthenuria is?

A

inability of kidney to concentrate urine,

SG fixed at 1.010

9
Q

Normal Urine volume/24 hrs?

Oliguria =

Anuria =

Polyuria =

A

500 - 2000 cc

Oliguria = < 500 cc

Anuria = < 100 cc

Polyuria = excessive w/ SG = 1.0 - 1.002

10
Q

Glucose in urine?

A

abnormal in urine

plasma glucose threshold = 150 - 180 mg/dL ,
excess spills into urine

11
Q

Glucose dipstick ranges?

A

Trace - 4+

12
Q

(P) causes of false negatives for urine glucose?

A
ascorbic acid (vit C)
aspirin
13
Q

Ketones result from?

3 kinds?

A

incomplete fat metabolism when carb stores ↓

acetoacetic acid
acetone
β-hydroxybutyrate

14
Q

(P) causes Ketones in urine?

A

acidosis (DM, starvation, pregnancy)

15
Q

Normal urine protein level?

A

< 150 mg/24hrs

16
Q

Protein dipstick ranges?

A

trace - 4+

small, mod, large

17
Q

Urine protein levels affects by SG how?

A

High SG = (P) false high protein level

Low SG = (P) false low protein level

18
Q

(P) causes of false positive urine protein?

A

high pH
hematuria
high SG
pyridium (UTI painkiller)

19
Q

Microalbuminuria is?

Normal level is?

A

level of albumin in urine below detection of dipstick (< 300mg/24h) BUT above upper limit for normal (30mg)

<30mg albumin/gram urinary creatinine

20
Q

Microalbuminuria may indicate? (5)

A
early diabetic nephropathy,
exercise,
fever,
cystitis,
CHF
21
Q

Best test for Microalbuminuria?

A

10 - 24 hr collection

or 1st void

22
Q

Proteinuria may indicate?

A

kidney dx (glomerular capillary leakage of protein)

23
Q

Proteinuria tx?

A

BP management (SBP <120)
ACE inhibitors
low protein diet

24
Q

Dipstick detection of blood:
will show + for what 3 things?

Sensitivity?

A

RBC, Hgb (RBC lysis), myoglobin (mm breakdown)

sensitivity:
5 - 10 RBCs
0.05 - 0.3 mg/dL Hgb

25
Q

Abnormal range for RBCs?

A

> 3 RBC/hpf

26
Q

Blood dipstick ranges?

A

trace - 4+

small, mod, large

27
Q

Urine Nitrate test for?

Normal results should be?

A

bacteria capable of reducing nitrates

negative

28
Q

(P) causes for false negatives of urine nitrites?

A

urine in bladder < 4hrs (no time to reduce)
nitrate-deficient diet
bacteria w/o necess enz

29
Q

Urine Leukocyte Esterase (LE) tests for?

Can detect as low as?

Sensitivity?

A

leukocytes

5 WBCs/hpf

80% in dx UTI,
higher if + LE and + nitrites

30
Q

(P) causes of false positive urine LE?

A

vaginal contamination

trichomonads

31
Q

LE dipstick ranges?

A

trace - 4+

small, mod, large

32
Q

Bilirubin/Urobilinogen (U) excreted how?

What causes presence in urine?

A

in stool

liver dx

33
Q

Dipstick results for Bilirubin/Urobilinogen?

A

(U) negative

34
Q

RBC sediment abnormal level?

RBCs appear as?

A

> 3 RBCs/hpf

refractile disks,
(P) crenated (shrunken) appearance if hypertonic urine

35
Q

(P) causes of ↑ RBCs?

A
UTI
renal or lower UT trauma
kidney stones
glomerular damage
nephrotoxins
vaginal contamination
36
Q

(C) causes of ↑ RBCs in old people?

A

kidney dx
CA
BPH

37
Q

Approach to red/brown urine:

red sediment?

red supernatant + positive heme dip?

  • >
    • clear plasma?
  • >
    • red plasma?

red supernatant + negative heme dip?

A

see slide 41

red sediment = blood

red supernatant + positive heme dip = Mgb or Hgb

  • >
    • clear plasma = Mgb
  • >
    • red plasma = Hgb

red supernatant + negative heme dip = diet, meds, etc

38
Q

WBCs in urine abnormal level?

Next step?

A

> 5 WBC/hpf
10-20 suspicious UTI
= 20 indicates UTI

C&S

39
Q

Appearance of WBCs in urine?

A

lobed nuclei,

refractile cytoplasmic granules

40
Q

U/A w/ reflex C&S is?

A

tells lab to run C&S if U/A suggests infection

41
Q

Renal Tubular/Transitional Epithelial Cells present in large #s if?

A

tubular degeneration

42
Q

If Lipiduria, Renal Tubular/Transitional Epithelial Cells contain?

A

oval fat bodies

43
Q

Oval Fat Bodies are?

A

degenerated tubular cells w/ refractile-appearing lipid

configured in “maltese cross”

seen w/ hyperlipidemia

44
Q

↑ # of Squamous Epithelial Cells (U) indicates?

A

contaminated specimen

45
Q

Urine Casts are?

A

clumps of cells formed in distal convoluted tubule or collecting duct

** NOT formed in proximal convo tube or loop of Henle

46
Q

Hyaline Casts made of?

Appearance?

A

mucoprotein from tubule cells (benign, common)

very pale, slighly refractile

47
Q

RBC Casts cause by? (2)

A

glomerular injury

glomerulonephritis (assume this until proven otherwise)

48
Q

WBC Casts (U) caused by?

A
acute pyelonephritis (upper kidney)
"pie alone a fright us"
49
Q

Renal Tubular Cell Casts suggest?

A

tubular epithelium injury

50
Q

Granular Casts from?

A

broken-down renal tubular cell casts

51
Q

Waxy Casts from?

Appearance?

A

broken-down renal tubular cell casts

sharp edges w/ cracks

52
Q

Most reliable test for infection?

A

Urine Cx

53
Q

Colony level consistent w/ infection?

A

> 100k colonies/ml