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Lecture 9
Urinalysis and Fluids
| Question | Answer |
|---|---|
| What are some causes of a low specific gravity <1.010 | diabetes insipidus, renal disease, diuretics, excessive water intake |
| what are some causes of a high specific gravity >1.010 | dehydration, proteinuria, diabetes mellitus, dye, heart failure, liver disease |
| what are some causes of a pH <7.0 | high protein diet, starvation, acidosis |
| what are some causes of a pH >7.0 | renal tubular acidosis, post-prandial, alkalosis, bacterial infection |
| What level of protein loss is seen with nephrotic syndrome | more than 5 g/day |
| why would there be albumin in the urine | exercise, stress, pregnancy, infection, glomerulonephritis, newborn |
| why would there be globulins in the urine | glomerulonephritis or tubular dysfunction |
| why would there be hemoglobin in the urine | hematuria or hemoglobinuria |
| why would there be fibrinogen in the urine | severe renal disease |
| why would there be nucleoproteins in the urine | WBCs in the urine epithelial cells in the urine |
| why would there be bence jones proteins in the urine | multiple myeloma or leukemia |
| why would there be glucose in the urine | diabetes, heavy meal, stress, impaired tubular reabsorption, Fanconi's syndrome, advanced tubular renal disease |
| why would there be ketones in the urine | diabetic ketonuria, insulin dosage, excessive carbohydrate loss, starvation |
| what would there be myoglobin in the urine | muscle trauma, prolonged coma, extensive exertion |
| why would there be leukocyte Esterase in the urine | urinary tract infection |
| why would there be nitrites in the urine | cystitis, pyelonephritis |
| what does it mean when there are a large number of epithelial cells in the urine sample | not a clean catch urine |
| what are the requirements for cast formation | acid condition, high salt concentration, reduced urine flow, protein |
| what is the most commonly observed cast | hyaline |
| what is the etiology of hyaline casts | emotional stress or strenuous exercise |
| What do white cell casts indicate | acute glomerulonephritis, pyelonephritis, nephrotic syndrome |
| what do red cell casts indicate | acute glomerulonephritis, renal infarction, collagen disease, kidney involvement in subacute bacterial endocarditis |
| what do granular casts indicate | pyelonephritis or chronic lead intoxication |
| what do fatty casts indicate | tubular inflammation adn degeneration or chronic renal disease |
| When do you see cystine crystals | cystinosis |
| when do you see cholesterol crystals | nephrotic syndrome |
| when do you see bilirubin crystals | liver disease and jaundice |
| when do you see leucine crystals | liver disease |
| when do you see tyrosine crystals | liver disease |
| When do you see eosinophils in the urine | AIN, chronic pyelonephritis, IgA nephropathy, post-streptococcal glomerulonephritis, renal allograft rejection |
| What does it mean when you see bacteria without PMNs | contamination |
| what does it mean when you see yeast in the urine | candida albicans, diabetes mellitus, vaginal moniliasis |
| what are common urine parasites | trichomonas vaginalis, enterobus vermicularis, schistosome haematobium |
| What does it mean when there is xanthrochromia of the synovial fluid | indicates blood has been present for some time |
| what does it mean if the synovial fluic is green | bacterial infection |
| what does it mean when synovial fluid has >90% neutrophils | bacterial infection |
| what does it mean when there are lymphocytes in synovial fluid | nonseptic inflammation |
| what does it mean when there are monocytes in the synovial fluid | normal |
| what does it mean when there are eosinophils in the synovial fluid | parasite, metastatic disease, rheumatoid arthritis |
| what crystals are common in gout | monosodium urate crystals |
| what is the shape of gout monodsodium urate crystals | needle like |
| when gout crystals are parallel to the axes of a red compensator what color are they? perpendicular? | when parallel they are yellow when perpendicular they are blue |
| What crystals are present with Pseudo Gout | calcium pyrophosphate dihydrate crystals |
| what color are pseudo gout crystals when perpendicular to the red compensator | blue when parallel and yellow when perpendicular |