Body Fluids Final

What gets through the glomerulus?

Amino acids, electrolytes, glucose.

What doesn’t get through the glomerulus?

Proteins. Red blood cells, white blood cells. Anything protein bound. Drug metabolites.

What is tubular reabsorption?

Your body taking back what it needs.

What is the renal threshold for glucose?

160 to 180 mg/dL.

What is renal blood pressure regulated by?

RAA system.

What is water reabsorption regulated by?

Antidiuretic hormone.

What would be a possible pathogenic cause for a dark yellow urine?

Possible bilirubin (check for yellow foam).

What would be a pathologic cause for an Amber, brownish-orange icteric urine?

Bilirubin, check for yellow foam.

What would be a pathologic cause for red and cloudy urine?

Hematuria (intact RBCs).

What would be a pathologic cause for red and clear urine?

Hemoglobinuria (hemoglobin in the urine), myoglobinuria (myoglobin in urine).

What would be a pathologic cause for port wine, burgundy urine?

Prophyrins.

What would be a pathologic cause for brown to black urine?

Melanuria (melanin in urine), alkaptonuria (homogentisic acid in urine).

What would be a pathologic cause for blue to green urine?

Pseudomonas infection.

What would be a pathologic cause for white urine?

Lipids and WBCs.

What would be a pathologic cause for purple urine?

Proteus, Klebsiella, Providencia, Morganella infection.

What would be a pathologic cause for pale yellow to colorless urine?

Diabetes insipidus, diabetes mellitus.

How many WBCs are normal in a urine per high powered field?

0-5 WBC.

How many RBCs are normal to see per HPF in a urine?

0-2 RBC.

What type of environment makes a ghost cell?

Very dilute urine. Cell starts to absorb water.

What is the best type of urine sample for routine testing?

First morning specimen because it’s most concentrated.

Most COMMON is random urine.

What causes crenated RBCs?

Fluid around the cell has so much solute in it that it sucks the water out of the cell causing it to crenate.

Best urine for Chemistry?

Timed urine specimen.

Best urine for Microbiology?

Midstream clean catch, suprapubic aspirates, cath urines.

True or false. Uric acid is a breakdown product of nucleic acids.

True.

Patients receiving chemo may have uric acid in their urine. True or false.

True. Due to cell breakdown.

What crystal indicated Ethylene glycol poisoning?

Calcium monohydrate crystals (oval).

Is Triple Phosphate a normal crystal seen in urine?

Yes.

What shape is Calcium Carbonate?

Dumb bell, or peanut shape.

Cystinuria:

Unable to reabsorb Cystine. Accumulates as Cystine crystals. Can cause kidney stones. Acid.

Tyrosine:

“Sea urchins”. Metabolic disorder, inability to metabolizes tyrosine- poor prognosis (if you’re seeing this in an older adult- suspect liver disease). Liver can’t produce amounts of enzyme needed to break down tyrosine anymore due to diseased liver.

Premature infants. Liver not mature enough to produce enzymes needed to breakdown Tyrosine. As infant matures Tyronsinura will go away.

Leucine:

Maple Syrup Urine Disease. Can’t break down.

Liver disease. May not be able to produce enzymes to breakdown Leucine.

Bilirubin Crystals:

Liver disease, bile duct obstructions. Should always have positive bilirubin dipstick.

Cholesterol crystals:

NEPHROTIC SYNDROME. Look for free floating fat droplets. Sample may look milky.

Where are casts formed?

ONLY formed in renal tubules! If there are things trapped in the casts- means something is going on INSIDE the kidney.

True or false. Casts survive better in acid urine.

True.

Epithelial cell casts can only be made of one type of epithelial. True or false.

Renal tubule epithelial cells.

Granular casts can be caused by nonpathogenic reasons. True or false.

True.

Waxy casts can be seen in renal failure. True or false.

True.

What causes Hyaline casts? What will show on the dipstick?

Exercise, stress, dehydration, fever. Protein ±

What causes RBC casts? What will show on the dipstick?

Acute glomerulonephritis, other glomerular disease. + Protein, + blood.

What causes WBC casts? What will show on the dipstick?

Pyelonephritis, inflammatory disorders. + LE, + Protein, ± Blood, Nitrite.

What is Pyelonephritis?

Kidney infection.

What is Acute Glomerulonephritis?

Inflammation of the tiny filters in the kidneys (glomeruli)

What causes Epithelial Casts? What will show on the dipstick?

Acute tubular necrosis.

+ Protein, ± Blood.

What causes Fatty Casts? What will show on the dipstick?

Nephrotic syndrome. Diabetic neuropathy, crush injuries.

+ Protein, ± Blood.

What causes Granular casts? What will show on the dipstick?

Accompanying other pathologic casts. Exercise, stress, dehydration, fever.

± Protein, + Blood.

What causes Waxy casts? What will show on the dipstick?

Chronic renal disease, kidney transplant rejection.

+ Protein, ± Blood.

What causes Broad casts? What will show on the dipstick?

Renal Failure. Dependent on cause of renal failure.