Quiz 1 - Urinalysis

why take urinalysis?

Many disorders can be detected early secondary to identifying substances spilling into urine, excess levels of substances are often excreted via urine

What are the 3 components of a urinalysis?

Physical/visual exam, biochemical exam, and microscopic exam

What do you look for in the physical/visual exam of the urinalysis?

Colour, clarity, odor

How is “normal urine” described in the physical/visual exam?

Clear and pale yellow without strong odour

What can colourless, straw, pale yellow urine indicate?

Normal, diabetes mellitus, or hyperhydration

What can dark yellow, amber, or orange urine indicate?

Dehydration, bilirubin, dietary factors, drugs

What can yellow-green or yellow-brown urine indicate?

Dehydration or bilirubin

What can green or blue-green urine indicate?

Pseudomonas infection, drugs, clorets

What can pink or red urine indicate?

Bleeding in urinary tract, beets, rhubarb, menstrual contamination

What can brown or black urine indicate?

Oxidized blood, drugs, genetic disorders

What can transparent urine indicate?

Normal or diabetes mellitus

What can cloudy/turbid urine indicate?

WBC, RBC, bacteria, mucus, fat, infection

What can urine smelling of ammonia indicate?

Dehydration, liver disease, kidney disease

Urine of someone with kidney disease will be _____ in ammonia and _____ in urea

High; high

Urine of someone with liver disease will be _____ in ammonia and _____ in urea

High; low

What can musty smelling urine indicate?

Phenylketonuria

What can maple syrup/sweet smelling urine indicate?

Maple syrum urine disease (high in BCAAs)

What can fruit-like, strong, sweet, acetone smelling urine indicate?

Diabetic ketoacidosis

How is urinary volume/output measured?

24 hour collection

What urine output is considered polyuria?

>2000ml/24h

What conditions are associated with polyuria?

Diabetes insipitus, diabetes mellitus, potassium depletion

What urine output is considered nocturia?

>500ml at night

What conditions are associated with nocturia?

Prostate disease and diabetes mellitus

What urine output is considered oliguria?

<600ml/24h

What is associated with oligouria?

Dehydration

What urine output is considered anuria?

No urine production

What substances are screened in the biochemical exam of urinalysis?

Leukocyte esterase, nitrite, urobilinogen, pH, blood, specific gravity, ketones, bilirubin, and glucose

What does the leukocyte esterase test detect?

Presence of abnormal WBC

What does a positive nitrate test indicate?

Presence of significant number of infection causing bacteria

What is indicated by elevated urobilinogen indicate?

Hepatic disease and hemolytic disease

What is protein test most sensitive to?

Albumin

What is the consistent presence of protein an early indicator for?

Renal disease

What does pH measure?

Hydrogen ion concentration

What is the healthy range for urinary pH?

4.5-8.5

What can strongly influence urinary pH?

diet

What does blood urinary test detect?

Presence of intact of hemolyzed RBCs and free hemoglobin

Why may ketones be present in urine?

Increased breakdown of fat; ketoacidosis in diabetes

What is a positive urine bilirubin test indicative of?

Liver disease; often early indicator of acute hepatitis

What may positive urine glucose test indicative of?

High serum glucose (diabetes) or decreased tubular reabsorption of glucose

What is the normal value of a urinary bilirubin test?

Negative

What is the normal value of a urinary blood test?

Negative

What is the normal value of a urinary glucose test?

Negative

What is the normal value of a urinary ketone test?

Negative

What is the normal value of a urinary leukocyte esterase test?

Negative

What is the normal value of a urinary specific gravity test?

1.005-1.025

What is the normal value of a urinary nitrite test?

Negative

What is the normal value of a urinary protein test?

Negative

What is the normal value of a urinary urobilinogen test?

0.2-1.0EU

What does a specific gravity urine test indicate?

How concentrated the urine is/the kidney’s ability to concentrate urine

What are specific gravity urine tests?

Comparison of amount of substances dissolved in urine compared to pure water

If there is no substance present in urine, what would it’s specific gravity number be?

1.0

What is low specific gravity characteristic of?

Diabetes insipidus, acute tubular necrosis, or pyelonephritis

What is fixed specific gravity characteristic of?

Chronic glomerulonephritis with severe renal damage

What is high specific gravity characteristic of?

Nephrotic syndrome, dehydration, acute glomerulonephritis, heart failure, liver failure, or shock

What is a positive leukocyte esterase characteristic of?

Urinary tract infection

What is pyuria?

Presence of WBC in urine

What is a positive urinary nitrite test characteristic of?

Urinary tract infection

What is often the cause of proteinuria?

Primary or secondary renal disease

What is the first protein to be excreted in renal disease conditions?

Albumin

What is proteinuria?

Protein in the urine

What is hematuria?

Blood in urine

What should you do if a patient has hematuria?

Send to MD to evaluate for UTI, kidney disease, bleeding disorder, kidney stone, or prostatitis

What is ketouria commonly associated with?

Diabetes mellitus when lack of glucose results in metabolizing of fat for energy, or starvation

What does the presence of bilirubin in urine indicate?

Liver disease or early indicator of acute hepatitis

What does increased levels of urobilinogen indiate?

Non-obstructuve liver or hemolytic disease

What is glucosuria?

Glucose found in urine

What is glucosuria associated with?

Diabetes or hyperglycemia

What is the microscopic examination in urinary testing?

Urine sediment is examined for cells, crystals, and casts