Powerpoint urinalysis ripley (3)
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Powerpoint urinalysis ripley (3)
Transcript of Powerpoint urinalysis ripley (3)
Urine Related Terms
Anuria Dysuria Glycosuria Hematuria Hypersthenuria Hyposthenuria Isosthenuria
Ketonuria Nocturia Polyuria Pyuria
Urine Collections
Random Urine Specimen First morning specimen Midstream Clean-Catch Catheterized Suprapubic Aspiration
Urine Preservation
The Urinalysis
Inspection Chemical Testing Microscopic exam
Inspection
Color Urochrome pigment Color is concentration dependent
Appearance Specific Gravity
Color
Cause Laboratory Correlation
ColorlessStrawPale
Yellow
Recent fluid consumption
Polyuria or Diabetes insipidus
or diabetes mellitus
Commonly observed with random specimen Increased 24-hour volume Elevated specific gravity and positive
dip test for glucose
Dark yellow
Amber Orange
Concentrated specimen
DehydrationBilirubinCarrots or vitamin
APyridiumNitrofurantoin
May be normal after exercise or in a first morning specimen
Yellow foam when shaken and positive test for bilirubin
Drug given for urinary tract infectionsDrug given for urinary tract infection
Yellow-green
Yellow-brown
Bilirubin oxidized to biliverdin
Rhubarb
Colored foam in acidic urine false negative tests for bilirubin
Seen in acidic urine
Green Blue-green
Pseudomonas infection
Amitriptyline
CloretsMethylene Blue
Positive urine culture Antidepressant Used in tube feedings in ICU to look for
aspiration
Color
Cause Laboratory Correlation
PinkRed
Red Blood Cells
HemoglobinMyoglobinBeetsRhubarb
Cloudy urine with positive dip test for blood and RBC's microscopically Clear urine positive dip test for blood and no RBC's microscopically Clear urine with positive dip test for blood and no RBC's microscopically
Brown Red Blood cells oxidized to methemoglobin
Myoglobin
Methyldopa
Metronidazole
Positive test for blood Seen in acidic urine Positive test for blood
Antihypertensive
Antibiotic
Inspection
Color Urochrome pigment Color is concentration dependent
Appearance Specific Gravity
Chemical Testing
Chemical Testing
pH Protein Glucose Ketones Blood- Red blood cells, myoglobin and hemoglobin Bilirubin (Conjugated) Urobilinogen Nitrite Specific Gravity Leukocytes
Microscopic Examination
Epithelial Cells Squamous Cells-lining of the vaginal and lower portion
of the male and female urethras Transitional cells- lining of the bladder, renal pelvis,
and upper urethra Renal Tubular Cells
Red Blood Cells White Blood Cells Crystals Bacteria, Fungus and Protozoa Casts
CastsType Origin Clinical Significance
Hyaline Tubular secretion of Tamm Horsfall protein that aggregates into fibrils
GlomerulonephritisPyelonephritisChronic Renal DiseaseCongestive heart failureStress and ExerciseNormal
Red Blood Cell Red blood cells in Tamm Horsfall proteins
GlomerulonephritisStrenuous Exercise
White blood Cell WBC in Tamm Horsfall protein PyelonephritisAllergic Interstitial nephritis
Epithelial Cell Tubular cells attatched to Tamm Horsfall protein
Renal Tubular nephritis
Granular Disintegration of white cells, bacteria, urates, tubular cells
Stasis of urineUrinary tract infectionStress and exercise
Waxy Hyaline casts Stasis of urine
Fatty Renal tubular cellsOval fat bodies
Nephrotic syndrome
Broad Casts Formed in collecting ducts Extreme stasis of urine flow
Common Crystals
Crystal pH Color Appearance
Uric Acid Acid Yellow-brown
Rosettes
Amorphous Urates
Acid Brick dust or yellow brown
Crud
Calcium Oxalate
Acid/neutral
(alkaline)
Colorless Envelopes
Amorphous phosphates
Alkaline
Neutral
Colorless
Crystal pH Color Appearance
Triple Phosphate
Alkaline Colorless Coffin lids
Calcium Carbonate
Alkaline Colorless Dumbbells
Cystine Acid Colorless 6 sided
Cholesterol Acid Colorless Notched Plates
Microscopic Examination
The Loch Ness Monster
You’ve Got to Look to See It!
Squamous Epithelial Cells
Red Blood Cells
Red Blood Cells
Red Blood Cells
Transitional Cells
White Blood Cells
White Blood Cells
Budding Yeast
Yeast with Hyphae
Cystine Crystal
Cystine Crystals
Calcium Oxalate Crystals
Calcium Oxalate and Calcium Carbonate Crystals
Triple Phosphate Crystals
Triple Phosphate Crystals
Uric Acid Rosette
Birefringent Uric Acid Crystals
Amorphous Urates
Contrast Crystals
Casts
White Blood Cell Clump
White Blood Cell Cast
White Blood Cell Cast
Red Blood Cell Cast
Red Blood Cell Cast
Hyaline Cast with Red Cells Around
Brown Muddy Granular Casts
Lipid Droplets
Maltese Crosses of Lipid Droplets
A 24 year old female presents with dysuria and a low grade temperature. What would you expect to see on the dip stick?
A. pH 6, 3+ protein, Leukocytes +2
B. pH 8.0, Leukocytes +3, Nitrite +
C. pH 6, +3 Blood
D. pH 6, glucose +3, ketones +2
Cystitis- Urinary Tract Infection
35 year old female with Temp 102, BP 98/63 mmHg, ill appearing, CVA tendernessDip pH 5.5, Leukocytes +3,
What treatment would you start?
A.Lithotripsy for a stone
B.Steroids following a renal biopsy
C.An IV antibiotic
D.A statin for hyperlipidemia
24 year old male presents with severe flank pain radiating to the scrotumUA: blood +1, What would you expect to see on microscopy?
A.
B.
C.
12 year old male presents with leg swelling and feeling bad. Mom notes he had a sore throat one week ago.BP 148/98mmHg, Tonsils are mildly erythematous, legs have trace edemaUA: blood+3Microscopic
Which diagnosis is most likely?
A. Diabetes B. Fibromuscular Dysplasia with hypertension C. Post Streptococcal Glomerulonephritis
34 year old admitted yesterday following a motorcycle accident. Due to multiple injuries he had significant blood loss, required a prolonged surgery and had systolic blood pressures of 60-70 mmHg for more than 8 hours.
You are consulted because his initial creatinine on admission was 0.8 mg/dl it has risen to 1.9mg/dl today.
UA dip stick large blood micro 0-1 RBC
What is the most likely diagnosis?
A.Interstitial Nephritis B.Focal Segmental GlomeruloscerosisC.Acute Tubular Necrosis- RhabdomyolysisD.Contrast Nephropathy
