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AAB MT Exam Chem Urinalysis & Body
Fluids
What consists of the gross renal anatomy? - Answer- Kidneys, Ureters, Bladder, and Urethra What is the anatomy of the Nephron? - Answer- Glomerulus. proximal convoluted tubule, descending Loop of Henle, Ascending Loop of Henle, distal convoluted tubule, and collecting duct. What are the 3 primary functions of the kidneys? - Answer- Glomerulur Filtration, Tubular Reabsorption, and Tubular Secretion True or False: Cells are filtered through the glomerulus? - Answer- False What is the GFR? - Answer- Volume of blood filtered per minute. What does the glomerulus filter? - Answer- The Blood The fluid that is filtered from the blood in the glomerulus travels to where? - Answer- The nephron The proximal convoluted tubule reabsorbs what? - Answer- Sodium, Potassium, Bicarbonate, and Water. The proximal convoluted tubule secretes what? - Answer- Hydrogen Ions, Urea, Creatinine, and Uric Acid. What is the primary function of the Loop of Henle? - Answer- To reabsorb water, sodium, and chloride. What is the function of aldosterone in the Distal Convoluted Tubule? - Answer- To increase Sodium re-absorption. Where is aldosterone produced? - Answer- In the adrenal cortex Where is the final site for urine concentration? - Answer- Collecting Duct
What is the function of antidiuretic hormone? - Answer- To act on the collecting ducts and stimulate water reabsorption. Where is antidiuretic hormone stored? - Answer- The Posterior Pituitary What is produced by the kidney? - Answer- Renin, Prostaglandins, and Erythropoietin. The kidney is the target tissue for what? - Answer- Aldosterone and Antidiuretic Hormone What is the most preferred urine collected? - Answer- First morning specimen What is the most common urine specimens? - Answer- Random Specimens First morning urine specimens must be examined when? - Answer- Within 1 hour of collection What happens to a urine sample after one hour? - Answer- The bacteria multiplies, false positives for Nitrate, pH becomes alkaline, casts disintegrate, and red cells are lysed. The physical examination of urine includes? - Answer- Color, appearance, odor, and specific gravity. Urine color, correlates with what? - Answer- Concentration Dark yellow urine is ___________________? - Answer- Concentrated Light yellow urine is _______________? - Answer- Diluted What makes urine yellow? - Answer- Urochrome What causes a dark yellow/amber/orange color in urine? - Answer- Concentration, bilirubin, and pyridium What causes urine to be red in color? - Answer- Hemoglobin and red blood cells. What causes urine to be blackish brown? - Answer- Homogentistic Acid Urine appearance may be reported? - Answer- Clear, Hazy, Cloudy, or Turbid What are common causes of hazy, cloudy, or turbid urine specimens? - Answer- Bacteria, hematuria, mucus, or amorphous crystals. A freshly voided urine should have what type of odor? - Answer- Aromatic Oder
What analytes are commonly examined during the chemical examination of urine? - Answer- pH, Glucose, Protein, Ketones, Nitrite, Leukocyte esterase, Bilirubin, Urobilinogen, and Hemoglobin. What is the normal pH range for urine? - Answer- 4.5-8.0 pH What is the principle for the urine pH strip test? - Answer- Double indicator system What is the renal threshold for glucose? - Answer- 160-180 mg/dL Does normal urine contain glucose? - Answer- No Glucose is often present in the urine of patients with? - Answer- Diabetes mellitus What is the principle for the urine glucose strip test? - Answer- Double enzymatic reaction What enzymes are in the glucose strip test for urine? - Answer- Peroxidase and Glucose oxidase Clinitest should be performed on who? - Answer- Newborns Why should Clinitest be used in a routine analyses of a newborn's urine? - Answer- Because it can detect galactose (as well as other sugars) What are ketones? - Answer- The breakdown products of lipids. Ketones are normally ___________ in urine. - Answer- Absent Ketones may appear in the urine due to? - Answer- Weight loss, Starvation, and diabetes mellitus What is the principle of the reagent strip test for urine Ketones? - Answer- Sodium Nitroprusside Reaction What does the protein reagent strip measure in urine? - Answer- Albumin True or False: Normal urine is free of proteins. - Answer- True What can cause a false positive for proteins in urine? - Answer- An alkaline pH What test method is used to confirm the presence of protein in urine? - Answer- Sulfosalicyclic Acid What is the principle behind the urine protein reagent strip test? - Answer- Protein error of indicators
A Gram-negative bacillus (e.g. E. coli) can reduce nitrate to what? - Answer- Nitrite True or False: Gram-positive bacillus (Staphyl, Strep, Entero) is unable to reduce nitrate to nitrite. - Answer- True What is the principle for the reagent strip test for Nitrite? - Answer- Griess's Reaction What can cause false negatives in the reagent strip test for urine nitrite? - Answer- Inadequate incubation of urine in bladder A positive esterase urine test indicates? - Answer- White Blood cells in the urine When are WBCs typically seen in urine? - Answer- During an infection A purple color in the urine esterase test is? - Answer- Positive (WBCs present) What is Bilirubin? - Answer- A breakdown product of hemoglobin degradation. Is urine bilirubin present in pre-hepatic jaundice? - Answer- No Increased amounts of urobilinogen occurs during? - Answer- Pre-hepatic Jaundice Urine bilirubin and urobilinogen increases during what disease state - Answer- Hepatic Jaundice What is an example of post hepatic jaundice? - Answer- Bile duct obstruction Increased urine bilirubin and normal urobilinogen levels indicate? - Answer- Post hepatic Juandice What is the principle for the urine bilirubin reagent strip test? - Answer- The Diazo Reaction What is urine bilirubin broken down to? - Answer- Urobilinogen Where is Uroblininogen produced? - Answer- The intestines (bacteria breaks down Bilirubin) What is urobilinogen broken down to? - Answer- Urobilin Urobilin causes the stools to be what color? - Answer- Brown What reagent is used in the urine urobilinogen strip test? - Answer- p- dimethylaminobenzaldehyde (Ehrlich)
Transitional epithelial cells originated from? - Answer- Lining cells for the renal pelvis, ureters, bladder, and upper portion of urethra. Renal tubular epithelial cells are almost ___________ clinically significant. - Answer- Always Where do the Renal tubular epithelial cells originate from? - Answer- Proximal and Distal convoluted tubules. What is the cause of renal tubular epithelial cells in urine? - Answer- Tubular necrosis, acute pyelonephritis, rejection of a transplant, and acute glomerulonephritis. When are oval fat bodies observed in urine? - Answer- Nephrotic syndrome Describe the appearance of oval fat bodies? - Answer- Highly retractile RTE cells contain fat and form maltese cross under polarized light. When is bacteria in urine clinically significant? - Answer- In the presence of WBCs (indicating an infection) What fungi can be present in urine? - Answer- Budding yeast and branching mycelium. Patients with diabetes mellitus and vaginal yeast infections may have what in their urine? - Answer- Budding yeast cells or mycelium What are four parasites found in the urine? - Answer- Trichomonas vaginalis, Enterobius vermicularis, Strongyloides stercoralis, and Schistosoma haematobium. This urine parasite has a pear shaped flagellate? - Answer- Trichomonas vaginalis This urine parasite has a bread shaped ova and results from fecal contamination? - Answer- Enterobius vermicularis This rhabdiform larvae appears in urine contaminated with feces? - Answer- Strongyloides stercoralis This urine parasite is commonly known as a blood fluke? - Answer- Schistosoma haematobium If urine has casts in it, the protein test should be? - Answer- Positive Red blood cell's casts appear in the urine during? - Answer- Acute Glomerulonephritis and strenuous exercise
A urine with Red blood cell casts should be positive for? - Answer- Protein and occult blood What infection would cause white blood cell casts to appear in the urine? - Answer- Acute pyelonephritis and acute interstitial nephritis When WBC casts are noted in the urine, what other tests should be positive? - Answer- Protein and esterase Bacterial casts in urine occur in patients with? - Answer- Pyelonephritis If bacterial casts are noted in the urine, what other tests should be positive? - Answer- Protein and nitrite When can granular casts be seen in the urine? - Answer- Stress, strenuous exercise, acute glomerulonephritis, and pyelonephritis Why are waxy casts clinically significant? - Answer- Because the urine stopped flowing in the nephrons, chronic glomerulonephritis, and chronic renal failure. When are fatty casts noted in the urine? - Answer- Nephrotic syndrome and Tubular necrosis Fatty casts should correlate with what other urine test? - Answer- Positive protein test and oval fat bodies. Broad casts are seen in the urine of what conditions? - Answer- Chronic renal failure and chronic glomerulonephritis Broad casts in the urine should correlate with what other urine tests? - Answer- Positive protein test and waxy casts. What three crystals are normally found in the acid urine? - Answer- Uric acid crystals, Amorphous urate crystals, and Calcium oxalate crystals. Describe a uric acid crystal. - Answer- Rhombic, rosette, needle-shaped crystal that birefringent under polarized light. Uric acid crystals in the urine may be correlated with which diseases? - Answer- Gout, leukemia, and Lesch-Nyhan syndrome Describe an amorphous urate crystal. - Answer- Ambiguous distribution with pink sedimentation due to uroerythrin. What is the clinical significance of amorphous urate crystals? - Answer- None
What are the chemical findings in acute pyelonephritis? - Answer- Positive protein, nitrite, and leukocyte esterase. What are the microscopic findings in acute pyelonephritis? - Answer- WBCs, WBC casts, bacteria, and RBCs. What are the chemical findings for acute glomerulonephritis? - Answer- Positive for protein, blood, and an increased specific gravity. What are the microscopic findings for acute glomerulonephritis? - Answer- RBCs, WBCs, RBC casts, and granular casts.
