clin chem 2

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clin chem 2
2012-07-12 10:40:30

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  1. Uranalysis
    • determines the function of kidneys and other organs
    • ie pancreas-glucose
    • liver-bilirubin
  2. Hematuria
    Rbcs in urine, red-reddish brown & cloudy
  3. causes of hematuria
    inflammation, trauma, urolithiasis, neoplasia, coagulopathy, rough collection technique
  4. Hemoglobinuria
    Hgb in urine, red-reddish brown transparent, usually paired with hemolytic plasma
  5. causes of Hemoglobinuria
    AIHA, incompatible blood transfusion, toxins/ venom, rbc parasites (mycoplasm)
  6. Myoglobinuria
    red-reddish brown transparent, clear plasma, occurs with muscle cell lysis
  7. causes of myoglobinuria
    rhabdomyolysis (monday morning sickness) , cushing injuries, muscle exertion, heat stoke, electric shock, snake bite,
  8. bilirubinuria
    dark yellow orange, yellow brown green, stains fingers, caused by excessive hemolysis, hepatobiliary obstruction, liver dz
  9. what does it mean if urine smells like ammonia
    may indicate cystitis due to urease (+) bacteria (urease converts urea back to ammonia)
  10. sweet or fruity smelling urine
    may indicate sudomonas or ketones due to Dm
  11. what may foam indicate
    increased protein
  12. what does USG evaluate?
    renal tubular fx and how well they respond to adh, how well they reabsorb h2o into the bloodstream
  13. USG may flucuate with?
    hydration status
  14. norm USG in the dog
  15. USG range that worries us
    1.008-1.012 or 1.015 in cats because it becomes isosthinuric urine
  16. what does it mean if USG stays withing bad range?
    fixed usg= 2/3-3/4 of the nephrons are non-functional=Renal Failure

    h20 not being reabsobed and nephs not responding to ADH
  17. reasons for decreased usg
    • (more h2o less stuff)
    • urine is pale and dilute
    • pyometra, DI (lack adh), cushings, diuresis from drugs, iv fluids, renal failure, increase in fluid intake
  18. reasons for increased USG
    dehydration, acute renal shutdown (oleguria (scanty)) shock, DM (urine is palebut increased usg bc of dissolved glucose causeing a hypertonic solution) 
  19. Sulfosalicylic acid test
    determination of protein in urine

    cloudier=more protein
  20. Epithelial cells
    • reported in #/hpf
    • squamous
    • transitional
    • renal
  21. Squamous
    • Found: distal 1/3 of urethra, vag, vulva, and prepuce
    • looks: larges ep. cell in urine, cornflake, clustered or single, nucleus siz of an rbc
    • Signif: Norm in mild amounts dep. on collection method
  22. Transitional ep. cells
    • Found: line the bladder, ureters, renal pelvis, and prox. parts of the urethra
    • looks: round pear or caudate shape, large nucleus, granular, larger than wbc
    • Signif:can be norm may be increased w/ inflam, urolithiasis, neoplasia, trauma
    • Ect: more common in cysto
  23. Leukocytes in Urine
    • #/hpf
    • <5=normal, mostly segs, look 1.5-2x bigger than rbc
    • indicate inflam. usually hand in hand with bacteria

    Blocked toms will have increased WBC but no bacteria
  24. RBcs in urine
    • #/hpf, <5 is norm, more if using cysto, catherter, or manual extraction
    • appearance will vary with usg and ph
    • increased usg=hypertonic=crenated rbc
    • decreased usg=hypo=swollen rbc or bursts (ghost cells with no hgb)

    • alkaline ph destoyes rbcs
    • acidic ph preserves rbcs
  25. mucus threads
    large amount is norm in horses due to mucus glands in the renal pelvis and ureters
  26. Bacteria in urine
    bact. with no wbc usually indicateds contamination, gram stain sediment, report reaction and shape (purp. pos)
  27. Granular precipitates
    • amorphous phosphates if urine is alkaline
    • amorphous urates when urine is acidic

    "bladder sludge"
  28. Triple phosphate
    • Stuvite or ammonium magnesium phosphate crystas (amp)
    • form in alkaline to slightly acidic urine normal in horses cats and dogs
    • may indicate urolythiasis
    • look like coffin lids, colorless

    tx: acidify urine through diet
  29. Calcium oxilate
    • acidic to slighty alkaline
    • norm in dogs cats, ocassionally in horses
    • may indicate Urolithiasis or Ethylene Glycol tox.
    • monohydrate=colorless dumbell
    • dihydrate-more common colorless envelopesq
  30. hippuric acid
    • always pathologic and indicate ethelyne glycol toxicity
    • look like picket fence posts
  31. Calcium carbonate crystals
    most common in horses yellow brown dumbell shape or round with radial striations (reason horses urine is cloudy mixed iwth mucus)
  32. Bilirubin crystals
    spiky yellow gold needles can be norm in dogs increased # indicates liver dz
  33. ammonium biurate/ urate
    • thron apple, brown
    • common in dalmations and primates due to increaed excreation of uric acid in urine
    • if found in animals other than Dal. and primates, can indicate portosystemic shunt and liver dz
  34. cystine crystals
    • six sided stop sign, flat and colorless
    • never norm. idicates congenital inability to metabolize certain ammino acids
    • common in daushunds
  35. tyrosine and lucine
    • usually seen together never normal, indicates liver dz usually sever
    • Tyro-long cluster of spiky needles
    • leucine-grapfruit or wheel
  36. Uric acid crystals
    • looks like chips of broken glass
    • norm. in dalmations
    • form as urine is allowed to stand or if temp flucuates, little clinical significance
  37. Cholesterol crystals
    • flat colorless transparent stair step
    • can be norm or may indicate sever kidney disease rarely seen
  38. micro eval
    centrifuge 5-10ml  in conical tube or 1-1.5ml of urine in bullet centrifuge at 1500 rpm/3-5min or use statspin