Test 4 Urinalysis

Ch.8-17

Renal Disease has 3 forms:

Glomerular, Tubular, Interstitial

Glomerular diseases

Acute glomerulonephritis, Nephrotic syndrome

Acute glomerulonephritis can cause:

Lab findings:

Edema, Hematuria, Fever, Strep. in children

Cloudy; red urine, RBC casts, increased proteinuria

Nephrotic syndrome

Lab findings:

Heavy proteinuria, RTE cells, Oval fat bodies

Tubular Disorders

Acute tubular necrosis, Hereditary/ Metabolic

Acute tubular necrosis

Lab findings:

Shock, Trauma

Damaged RTE cells with other casts, mild proteinuria, hematuria

Hereditary/ Metabolic disorders

Fanconi syndrome, Alport syndrome, Uromodulin kidney disease, Diabetic nephropathy, Nephrogenic diabetes inspidious, renal glycosuria

Interstitial disorders

Acute pyelonephritis, Chronic pyelonephritis, Acute interstitial nephritis, cystitis

Cystitis

UTI, renal calculi

Acute pyelonephritis

Lab findings:

back pain, polyuria, burning upon urination

WBC casts, bacteria

Chronic pyelonephritis

Lab findings:

permanent damage to renal tubules

granular, waxy, broad casts

Acute interstitial nephritis

Lab findings:

allergic reactions to medication

WBC casts without bacteria

Renal failure

increased BUN, azotemia, granular, waxy, broad casts

Acute renal failure

Chronic renal failure

can be reversible, pre-renal, renal, and post-renal

end-stage renal disease

Renal lithiasis

formation of renal calculi, large and staghorn stones, calcium oxalate and phosphate, hematuria

Most glomerular disorders are caused by _______ disorders.

Immunologic disorders

The heavy levels of proteinuria and oval fatty casts are seen with:

Nephrotic syndrome

Ischemia frequently produces:

Acute renal tubular necrosis

A disorder associated with polyuria and low specific gravity is:

Nephrogenic Diabetes Insipidus

The only protein produced by the kidney:

Uromodulin

The presence of damaged RTE cells and casts is an identification of:

Acute Tubular Necrosis

Differentiation between cystitis and pyelonephritis is aided by the presence of:

WBC casts

The presence of WBC’s and WBC casts without bacteria is indicative of:

Acute Intersitial Nephritis

The most common component of renal calculi is:

calcium oxalate

Urinalysis for a patient with severe back pain being evaluated for renal calculi would be most beneficial if it showed:

A. Heavy proteinuria

B. Low specific gravity

C. Uric acid crystals

D. Microscopic hematuria

D. Microscopic hematuria

Damage to the glomerulus can result in all of the following except:

A. cellular infiltration

B. Deposition of amyloid materials

C. Deposition of immune complexes

D. increased infiltration of electrolytes

D. increased infiltration of electrolytes

The common cause of end-stage renal disease is ________.

Diabetic nephropathy

The finding of red cell casts is associated with:

Acute glomerulonephritis

Waxy casts and broad casts are most likely seen in:

Chronic renal failure

Overflow disorders cause

disruption of normal metabolic pathway and “inborn error of metabolism”

Porphyrinuria

port wine color in urine and staining of teeth

A disease that causes large amounts of branched chain amino acids to be excreted in urine:

maple syrup urine disease (MSUD)

MSUD amino acids

Leucine, Isoleucine, Valine

Hart-nup disease

finding of a “blue diaper” is indicative

Lesch-Nyan disease

the presence of “orange sand” in an infants diaper

Melanuria

dark color of urine; increased melanin in urine

Alkaptonuria

“brown-stained” diapers

False positive clinitest

Cystinuria

increased amounts of amino acid cystine in urine

5-HIAA

increased serotonin levels in urine

Isovuleric has the smell of cabbage in urine

True or False?

True

CSF collection tubes

1. Chemistry, 2. Hematology, 3. Microbiology

CSF is produced in ________ and flows through the ________.

The choroid plexus and Subarachnoid space

The most rapid diagnosis of CSF is

Gram Stain

Cryptococcal meningitis is detected by what type of gram stain?

India Ink

Functions of CSF:

Remove metabolic waste, Supply nutrients to CNS, Protect brain and spinal cord.

Substance presence in CSF are controlled by:

Blood-brain barrier

Xanthrochromia is caused by:

Immature liver function, RBC degradation, Elevated CSF protein

CSF WBC count is diluted with

Acetic acid

Increased Eosinophils is a detection of

parasitic infection

Increased Neutrophils is detection of

Bacterial infection

Increased Lymphocytes is detection of

Viral infection

Pleocytosis of neutrophils and lymphocytes found in CSF is detection of

Meningitis

Oligoclonal bands in CSF and not serum is detection of

Multiple sclerosis

WBC normal levels in CSF

0-5

Semen volume

2-5 mL

Semen Viscosity

pours in droplets within 60 min

Semen pH

7.2-8.0

Sperm concentration

greater than 20 million/ mL

Sperm count

greater than 40 million/ ejaculate

Sperm motility

greater than 50% within an hour

Sperm quality

greater than 2.0

Semen contains Acid Phosphate (ACP)

True or False?

True

The major component of semen is

Fructose

The first portion of semen specimen is not collected, semen analysis will have:

decreased sperm count

Synovial fluid Characteristics

high viscosity

ultra filtrate plasma

amniotic fluid is kept in what kind of bottle

a dark bottle

What kind of stain do you use to determine a fecal WBC?

Methylene blue

Upper GI tract blood appears

Black and tarry

Transudates

transports; disrupts balance in regulation of fluid filtration and reabsorption

Exudate

produced by conditions that involve membranes

Diffusion

accumulation of fluid

For needle aspiration, thorocentesis is from what cavity?

pleural