Urinary- Urinalysis

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Urinary- Urinalysis
2015-08-26 19:56:56
vetmed urinary UA

vetmed UA
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  1. What are the pros to mid-stream free catch collection of urine? (6)
    free, easy, client can perform, low risk to patient, no effect on USG/ketones/glucose, good screen for hematuria
  2. What are the cons to mid-stream free catch collection of urine? (2)
    contamination by distal urinary tract with bacteria/protein/WBCs/cellular debris, tough in cats and some female dogs
  3. What are the pros to catheterization for urine collection? (3)
    easy in male dogs, less risk of contamination by distal urinary tract, can completely empty bladder easily
  4. What are the cons to catheterization for urine collection? (5)
    requires sedation in female dogs and all cats, may damage urethra, need for sterile technique, can potentially introduce cells/protein/blood to sample, will artificially increase epithelial cell numbers
  5. What are the pros of cystocentesis for urine collection? (4)
    relatively easy, quick, minimal risk of contamination, well tolerated
  6. What are the cons of cystocentesis for urine collection? (5)
    can have blood contamination with traumatic stick, risk for patients with thrombocytopenia/ coagulopathies/weak bladder wall, challenging in obese/pollakiuric animals, seeding of TCC, rare vasovagal response in cats
  7. What does pollakiuric mean?
    patient with irritated voiding (urinates even when bladder is nearly empty)
  8. How do you prepare urine that has been refrigerated for UA?
    warm to room temp
  9. What does intermittent pigmenturia indicate? What disorder is this associated with?
    erythrocyte fragility; PFK deficiency
  10. In what species is the urine normally turbid?
    horses and rabbits
  11. What is the only portion of the UA that provides info about renal function?
    specific gravity
  12. What factors can artificially affect SG?
    (increase) dehydration, (decrease) excessive drinking, fluids, diuretics
  13. SG is a(n) _________ marker of renal dysfunction than BUN and creatinine.
  14. What are 4 factors that can cause a false increase in SG?
    turbid urine, glucosuria, proteinuria, pre-injected with contrast
  15. The SG of young puppies is _______ than in adults because...
    lower; it takes time to establish the concentration gradient
  16. What does isosthenuria indicate?
    >66% renal damage
  17. PU/PD is usually driven by ________.
  18. What 6 parameters can veterinarians use on the human urine dip sticks?
    pH, protein, glucose, ketones, occult blood, bilirubin
  19. Carnivores have ________ urine pH than herbivores.
    lower (more acidic)
  20. Urine may become more basic  by _________, such as __(2)__.
    urease-producing bacteria; Staph and Proteus
  21. Urine pH may be decreased by... (4)
    increased protein catabolism, acidosis, paradoxical with alkalosis, meat diet
  22. Urine pH may be increased by...(6)
    decreased protein catabolism, alkalosis, cystitis, RT storage, plant-based diet, post-prandial alkaline tide
  23. Protein dip sticks are most sensitive to ________.
  24. False positive protein dipstick reactions may occur due to _________.
    alkaline urine
  25. False negative protein dipstick reactions may occur due to ________.
    acid or dilute urine
  26. What are the categories of proteinuria?
    pre-glomerular, glomerular, post-glomerular
  27. What are the potential causes of pre-glomerular proteinuria? (2)
    functional/physiologic, serum protein overload
  28. What are physiologic causes of pre=glomerular proteinuria? (6)
    strenuous exercise, seizures, fever, extreme temperatures, stress, venous congestion
  29. When tubular resorptive capacity for certain proteins is exceeded when serum concentration of these proteins becomes abnormally increased.
    pre-glomerular proteinuria
  30. If the sediment is active and proteinuria is mild to moderate, consider... (2)
    inflammatory renal disease or disease of the lower urinary tract/genital tract.
  31. Post-glomerular proteinuria can be associated with... (3)
    tubular disease, hemorrhage or inflammation distal to the tubules
  32. What re causes of tubular proteinuria?
    acute renal failure, primary tubular disease, chronic tubulointerstitial disease
  33. Proteinuria caused by disruption of the normal filtration barrier.
    glomerular proteinuria
  34. Persistent proteinuria in the absence of hyperglobulinemia, hemolysis, or muscle damage is highly suggestive of...
    glomerular disease
  35. 5 causes of glomerular proteinuria.
    glomerulonephritis, membranous glomerulopathy, amyloidosis, glomeruloscleorsis, hereditary nephritis
  36. Glucose is almost completely resorbed in the ___________.
    proximal tubule
  37. False positive glucose can arise from...(2)
    peroxide and hypochlorite
  38. False negative glucose can arise from...(3)
    refrigerated urine, vitamin C, formaldehyde
  39. Causes of glucouria. (4)
    diabetes mellitus (most common by and far), stress/excitement, chronically sick cats in the absence of hyperglycemia, renal tubular disease
  40. Glucosuria and normoglycemia indicates...
    proximal tubular problem
  41. What ketones are detected by the dip stick?
    acetoacetate, acetone
  42. Causes of ketonuria. (5)
    diabetic ketoacidosis, starvation, glycogen storage disease, high fat/low carb diet, persistent hypoglycemia
  43. Positive occult blood dipstick cannot differentiate b/w...
    RBCs, hemoglobin, myoglobin
  44. Hemoglobinuria is caused by....(2)
    immune-mediated hemolysis, intravascular hemolysis
  45. _________ urine may produce red cell lysis and positive occult blood dip stick.
    dilute or alkaline
  46. Urine bilirubin may be normal in _________ but is NEVER normal in ________.
    dogs; cats
  47. Causes of bilirubinuria. (3)
    hemolysis, liver disease, extrahepatic biliary obstruction
  48. Urine sediment MUST be performed on ___________.
    fresh samples
  49. 12 causes of hematuria on urine sediment.
    genital tract contamination, trauma, urolithiasis, neoplasia, inflammatory disease, idiopathic feline cystitis, systemic disease, renal infection, parasites, renal pelvic hematoma, strenuous exercise
  50. Describe how timing of blood in urine can localize source of blood.
    blood at beginning, coming from urethra; blood at end, blood settled w/i bladder
  51. WBCs on urine sediment are indicative of...
  52. Clumps of WBCs on urine sediment may suggest...
    infectious organisms as the cause of inflammation
  53. WBCs on sediment can be caused by inflammation that is caused by...
    infection or sterile inflammation (therefore, follow with culture)
  54. Large amounts of bacteria present in urine sediment from urine collected by __(2)__ strongly suggests UTI, especially if there is concurrent pyuria.
    cystocentesis, catheterization
  55. Squamous epithelial cells observed in urine sediment suggest...
    usually normal urine
  56. Transitional epithelial cells on urine sediment are derived from __________.
    the renal pelvis to the urethra
  57. _________ are transitional cells with tapered ends that are thought to have arrived from the renal pelvis.
    Caudate cells
  58. What is particularly indicative of transitional cell carcinoma?
    rafts/clumps of transitional epithelial cells on urine sediment
  59. Transitional epithelial cells can only be determined to have originated from the renal tubules when...
    present in casts
  60. Casts are formed in the _________ and are thus of ________.
    distal nephron; localizing value
  61. Casts are formed by...
    the precipitation of protein and cellular material because of maximal acidity, highest solute conc, and lowest flow rate in the distal nephron
  62. Pure protein precipitates of Tamm-Horsefall mucoproteins.
    hyaline casts
  63. What are 4 causes of hyaline cast formation?
    strenuous exercise, dehydration, oliguria, proteinuria associated with renal disease
  64. White cell or pus cellular casts are suggestive of _________.
  65. RBC cellular casts may be seen with... (3)
    acute glomerulonephritis, renal trauma, violent exercise
  66. Renal epithelial cellular casts occur with... (2)
    acute tubular necrosis, pyelonephritis
  67. Course and fine granular casts represent...
    degeneration of cells in other casts or precipitation of filtered plasma proteins
  68. The final stage of degeneration of granular casts that suggest chronic intrarenal stasis.
    waxy casts
  69. Mineral solubility in urine is dependent upon... (3)
    urine pH, temperature, SG
  70. Crystals that can be found in normal urine. (3)
    struvite, amorphous phosphates, oxalates
  71. Crystals found in acidic urine. (3)
    uric acid, calcium oxalate, cystine
  72. Crystals found in alkaline urine. (5)
    struvite, calcium phosphate, calcium carbonate, amorphous phosphate, ammonium biurate
  73. What type or crystals are common and normal in equine urine?
    calcium carbonate
  74. Urate crystals can be associated with... (3)
    congenital defects, liver disease, porto-systemic shunts
  75. Struvite stones are associated with... (2)
    normal urine, some urinary stones in dogs and cats
  76. What type of crystals are associated with ethylene glycol toxicity?
    Calcium oxalate monohydrate crystals
  77. What crystals are associated with stone formation?
    struvite (cats and dogs), calcium oxalate monohydrate (cats), cystine
  78. When are crystals a significant finding?
    in patients who are known stone-formers, patients with lower urinary tract signs, male cat with history of obstruction, persistent/significant crystalluria, urate or cystine crystals