Download MLS Unit 2 Test Questions: Kidney Function and Urine Analysis and more Exams Nursing in PDF only on Docsity!
MLS Unit 2 Test Questions With
Complete Solutions
basic kidney functions - filtration (based on molecular weight) reabsorption secretion the kidneys regulate... - pH concentration of chemicals water/electrolyte balance blood pressure the kidneys detoxify and eliminate waste including... - urea ammonia salts any metabolites from drugs major function of the cortex - filtration major function of the medulla - collection of filtrate nephron - functional unit of the kidney site of electrolyte exchange, water reabsorption, waste secretion renal blood flow - heart -> aorta -> renal artery -> afferent arteriole -> glomerular capillaries -> efferent arteriole-> peritubular capillaries -> renal vein -> inferior vena cava -> heart basement membrane is permeable to ... - water
solutes glucose basement membrane is not permeable to ... - cells proteins fats all substances that are not allowed to pass through the basement membrane return to circulation via the ___________ - efferent arteriole glomerular space - collection point for glomerular filtrate daily 18L of filtered plasma is converted into a urine volume of... - .5 - 1 L proximal convoluted tubule - site at which most of the tubular reabsorption occurs renal threshold - amount that can be reabsorbed by the proximal tubule/ kidney filtrate traveling down the Loop of Henle... - becomes more concentrated because water is being reabsorbed filtrate traveling back up the Loop of Henle ... - becomes less concentrated because solutes are being taken out the only point in the whole process of secretion/reabsorption where water can't go out of the tubules is - ascending loop
first morning urine collection - when you will get the most concentrated sample postprandial urine collection - urine collection after something happens ex: glucose tolerance test, after taking meds fasting urine collection - no food for 8-12 hours, water OK timed urine collection - every so often, or 24 hour collection supra-pubic aspirate - needle through abdomen freezing urine - OK for drug/chemistry, bad for UA refrigerating urine - best method for cell preservation, may cause solutes to precipitate chemically preserving urine - uses boric acid, best/most expensive method to preserve urine increases that occur in unpreserved urine - bacteria, crystals, pH yeast decreases that occur in unpreserved urine - cells, glucose, casts turbid urine - cloudy or milky urine, not see through at all red urine - beets, porphyris (RBC breakdown product), blood
brown urine - blood, bilirubin bright orange urine - medications (azo, cystex) green urine - supplements pink urine - polyphyrins black urine - melanin blue urine - methylene blue-drug ingredient for bladder discomfort non pathogenic causes for cloudy urine - refrigeration, menstruation, dirty catch, contamination pathogenic causes for cloudy urine - infection, UTI, bacteria, cells, casts supravital stain - stains all components of a UA sample Gram stain - classifies bacteria into gram-positive or gram- negative hansel stain - identifies urinary eosinophils (allergies!) detects fatty casts fat stains - Sudan III Oil Red O RBC normal range - 0-2/hpf
bacteria chemical test - nitrite bacteria reporting - plus system squamous epi cell normal range - up to 5/hpf, up to few squamous epi cell significance - dirty catch squamous epi look alikes - artifacts squamous epi cell reporting - few, moderate, many transitional epi cells normal range - up to 2/hpf, rare transitional epi cells significance - bad cath transitional epi chem test - none transitional epi reporting - rare, occ, few, moderate, many /hpf renal epithelial appearance - smaller than transitional epithelial cells, larger than WBCs renal epi cells significance - kidney infection, kidney function issues, tubular damage renal epithelial cells normal range - negative yeast normal range - negative
yeast significance - rarely comes from urinary tract, could indicate vaginal yeast infection/contamination yeast chem test - KOH preps (potassium hydroxide removes all cellular components but fungal elements) look for glucose on dip yeast reporting - present or neg yeast look alikes - RBCs sperm normal range - negative sperm chem test - protein on dip sperm look alikes - WBCs, artifacts, mucus fat normal range - negative fat significance - 1. increased permeability of basement membrane
- increased blood lipids raises red flags for nephrotic syndrome fat chemical test - expect protein and other chemicals on dip due to increased permeability fat confirmatory tests - fat stains ( Sudan III and Oil Red O) maltese cross pattern (indicates cholesterol)
waxy cast red blood cell cast fine granular cast coarse granular cast yeast hyaline cast clue cells
squamous epithelial cell renal epithelial cell transitional epithelial cell casts that are critical values wbc cast rbc cast wbc cast significance pyelonephritis - infection of the tubules, area surrounding the tubules renal tubular cast significance tubular damage RARE white blood cell cast
uric acid crystals calcium oxalate crystals calcium oxalate crystal significance comes from ascorbic acid aka vitamin C calcium phosphate crystal appearance can appear in "sheets" or "plates" that look like squamous epis appear in alkaline urine calcium phosphate crystals amorphous phosphate crystals same look as amorphous urates, alkaline urine triple phosphate crystals "coffin lids" found in alkaline urine
ammonium biurate crystal significance pH increase due to incorrect handling UTI found in alkaline urine Ammonium biurate crystals "sprouty potatoes" crystals of metabolic origin tyrosine, cystine, leucine seen most in fresh, acidic urine found in rare conditions w high blood concentrations of the amino acid tyrosine crystals colorless to yellow-brown needles "fireworks" cystine crystals significance cystinuria - causes kidney stones cystine crystals colorless hexagons
bilirubin crystals orange/ yellow-brown needles "fuzzy balls" starch glass fragments very defined edge
