Clin laboratory 3 Urinalysis

What is the main function of the kidney?

Extract and remove metabolic waste from the blood

What is the microscopic unit of the kidney called?

Nephron

The inner layer of the kidney is the \________ and the the outer layer is called the \_______.

Medulla/ cortex

What are the three phases involved in the urine production?

Filtration, reabsorption, secretion

List the flow chart in order for the urinary system

Afferent arteriole -\> glomerulus -\> bowman's capsule -\> proximal convoluted tubule -\> loop of henle -\> distal convoluted tubule -\> large collecting duct -\> renal pelvis -\> ureter -\> urine is excreted

List the four methods of urine collection:

- free catch (voided sample) - manual expression - catherization - cystocentesis

When performing bladder/manual expression on an animal, what does the bladder feel like?

Slippery water balloon

When should you never try to express an animal's bladder ?

\- Urethral obstruction

\- blocked

\- has a fragile bladder wall

\- abdominal trauma

Which method of collection is used to collect a sterile urine sample from a patient? Therefore it is best Sample to be sent in for a urine \________ and \________.

Cystocentesis / culture and sensitivity

When performing a cystocentesis, an aseptic technique must be used during collection, and once the needle is through the skin you never want to\_______ it.

Redirect

Which method of urine collection is the easiest to obtain, but the sample is often contaminated?

Free catch ( voided sample)

When obtaining a urine sample via free catch, a \__________ sample is best.

Midstream

Which type of urinary catheter is more flexible? Which type is more rigid?

Red rubber/ polypropylene

An increase in red blood cells may be seen in urine collected via:

Manual expression, catherazation, cystocentesis

The final urinalysis should include:

* Patient info
* collection technique
* date and time collected
* Method of preservation ( if used) -
* complete results

How soon should a urinalysis be performed after collection?

30 mins - 1 hr

Refrigeration will preserve most of the components of urine for how long?

6 -12 hours

What can form in the urine sample when it is cool/ cold?

Crystals

What are some cellular changes seen in a urine sample left out at room temperature for an extended period of time?

* Cells deteriorate
* red bloods and cast disintegrate
* bacteria growth will multiply

What are some chemical changes seen in a urine sample left out at room temperature for an extended period of time?

* decrease glucose concentration
* decrease bilirubin concentration -
* increase pH

List the physical properties of urine

urine volume, color, odor, and specific gravity

Polyuria is usually accompanied by \___________ and the urine is diluted with a \________specific gravity.

polydipsia / low

Observing a single urination isn't reliable for estimating urine output so a \________ hour urine volume should be determined.

24

Normal urine is what color?

Yellow to amber

Would concentrated urine be darker or lighter and color? Would delute urine be darker or lighter?

darker/ lighter

Yellow brown or green urine that produces a greenish yellow foam when shaken likely contained what?

bile pigments

What species can have cloudy looking urine normally? Why?

horses and rabbits/ High concentration of calcium carbonate

Name some substances that can cause a urine sample to be cloudy:

rbc's, wbc's, epithelial cells, cast, crystals, mucus, fat, and bacteria

A characteristic sweet or fruity odor to a urine sample indicates the presence of what?

ketones

Which part of a complete urine analysis is used to assess the kidney's ability to concentrate or dilute urine?

specific gravity

What is the name of the instrument used to read a urine specific gravity?

Refractometer

Oliguria causes the urine to be \_________ with a \_______ specific gravity.

concentrated / high

What is the average urine specific gravity for a cat? For a dog?

1.030 / 1.025

Specific gravity gives you important information on the hydration status of a patient so animals are expected to concentrate their urine when \_____________ and dilute it when \____________.

dehydrated/ overhydrated

What is the term used when urine specific gravity is in a range that has not been concentrated or diluted by the kidneys? What is the range?

isosthenuria / 1.008 to 1.012

How are most of the chemical properties of urine measured?

reagent strips

A pH below 7.0 is considered ________ and a ph above of 7.0 is considered ___________.

acidic / alkaline

Herbivores normally have \_______ urine and carnivores normally have \__________ urine.

alkaline / acidic

If the pH of urine is too acidic or too alkaline what can form?

specific crystals or uroliths

Is it normal to find a trace amount of protein in a normal urine sample ?

yes

What is one example of a condition that would be considered prerenal? postrenal? renal?

congestive heart failure / urethral obstruction/ nephritis

Should a normal urine sample contain any glucose?

no

The amount of glucose found in urine depends on what?

* blood glucose levels
* rate of glomerular filtration
* tubular resorption

Fear, excitement, or restraint can cause the release of epinephrine, which then increases the glucose especially in what species?

cats

Ketones are formed during what?

incomplete catabolism/metabolism of fatty acids

What is a common cause of ketouria?

ketoanemia

What medical condition in small animals is ketouria frequently seen in?

diabetes mellitus

What type of billirubin is found in urine? why?

conjugated bilirubin/ Because unconjugated billirubin does not pass the glomerulus into the renal filtrate

Is the presence of urobilinogen in a urine sample considered normal?

yes

What species is it normal to find small amount of bilirubin in their urine? What species is any presence of billirbin in their urine considered abnormal and suggestive of disease?

dogs and cattle / cats, pigs, sheep, horses

Urine being tested for billirubin should never be exposed to what?

light

If I centrifuge a reddish brown urine sample and the reddish color to the urine cleans after centrifugation, it is likely \____________ but if the reddish color remains red after centrifugation it is likely \___________.

hematuria/ hemoglobinuria

What type of urine sample is best for evaluating specific gravity?

early morning or first urine

If I tell you that I read a specific gravity of "ten twenty-three," how would you write those results in a medical record?

1.023

List the chemical properties of urine:

protein, PH, glucose, ketones, bilirubin, blood, leukocytes, urobilinogen

What is myoglobin? What condition can cause myoglobin to be excluded in the urine?

protein found in the muscle / severe muscle damage

Myoglobinuria causes the urine to be what color?

Dark brown to almost black

Since there can be many false positives and false negatives for leukocytes on a reagent strip what must you do to confirm any result?

microscopic examination of urine sediment

How long and at what speed is urine centrifuged for?

3-5mins; 1000-2000 rpm

What does TNTC stand for?

too numerous to count

Increased urine specific gravity can be seen with which of the following:

Decrease water intake, shock, acute renal failure, dehydration

When urine volume is decreased, the specific gravity will be:

increased

With significant dehydration in an otherwise healthy patient, which of the following would likely be seen on a urinalysis and CBC:

An increased urine specific gravity and an increased PCV.

What are red blood cells in the urine confused with ?

fat droplets

When do you see red blood cells in the urine?

-Indicate bleeding somewhere in the urogenital tract -can be seen in females during proestrous, estrous, or after parturition

White blood cells are larger than \________ but are smaller than \______________.

RBC's / epithelial cells

What are the largest cells observed in a urine sediment?

squamous epithelial cells

When do you see transitional epithelial cells?

* Due to sloughing of old cells
* can be seen in urine samples collected via catherizaton -
* can indicate cystitis or pyelonephritis

Transitional epithelial cells contain a small \_______ and are larger in size than \__________.

nucleus; WBC's

What is the smallest epithelial cell observed? And what are they often confused with?

renal epithelial cells / WBC'S

Renal epithelial cells are \_________ found and an increased number of these can indicate\__________ disease or \___________ of the kidney.

rarely; renal tubular; degeneration

Is there a significance behind seeing squamous epithelial cells in urine?

no

What is the most common type of cast seen in animals?

granular casts

Regular casts can be \__________ or \__________.

fine or course

What do epithelial casts indicate?

Seen with acute nephritis or degeneration of the renal tubular epthilieum

What cast contains predominantly neutrophils?

leukocyte cast

What components of urine sediment is spherical in shape, appears dull Gray or greenish yellow in color and contains granules or lobulations ?

WBC'S

What components of a urine sediment is small, round, smooth edged, somewhat refractile, and yellow or Orange and color?

RBC’S

Casts associated with chronic, severe degeneration of renal tubules that can appear smooth and refractal with squared ends are ______ casts.

Waxy

Are waxy casts refractile?

yes

Struvite crystals are also known as?

Triple phosphate crystals or magnesium ammonium phosphate crystals

What do struvite crystals resemble?

coffin lids

Where are amorphous phosphate crystals seen in what kind of urine?

alkaline urine ( depends on pH of urine)

Amorphous urate crystals are seen in what kind of urine?

acidic urine

Amorphous urate crystals can be confused with what?

bacteria

In what animals are calcium carbonate crystals seen?

horses, rabbits, guinea pigs

Calcium carbonate crystals have a \__________ shape.

dumbell

Ammonium Biurate crystals are seen in animals with severe \___________ disease.

liver

Ammoninum biurate crystals resemble what?

thornapples

Calcium oxalate dihydrate crystals are seen in what? What do they look like?

horses and dogs / contain an "X" across the crystal looks like the x box logo

What crystals are seen in animals with ethylenol glycol (antifreeze) toxicity?

Calcium Oxalate monohydrate crystals

Calcium oxalate monohydrate crystals resemble what ?

slat from a picket fence

Sulfonamide crystals are seen in animals being treated w/ \________________.

sulfonamides

Uric acid crystals are seen in what dog breed?

Dalmatians

Leucine crystals are seen in animals with \___________ disease.

liver

Leucine crystals resemble what?

wheel or a pin cushion

Cystine crystals are seen with \_______ tubular dysfunction or \___________ urolithiasis.

renal / cystine

How do cystine crystals look like?

six sided (hexagonal)

Bilirubin crystals are seen in conjunction with \___________?

bilirubinuria

Bilirubin crystals appear as ?

rhomboid plates with needles