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Clinical Pathology 1
Quiz A
93
Veterinary Medicine
Undergraduate 1
09/21/2013

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Cards

Term
What is the primary function of the Urinary system?
Definition
to remove waste products from the blood
Term
what is the urinalysis method?
Definition
  • cheap
  • non invasive
  • get important info. about urinary tract 
  • useful indicator of renal function
  • errors may occur beacuase it is easy
Term
What does Urinalysis depend on?
Definition
quality of sample and observational skills of the person performing the analysis
Term
What does a complete urinalysis include?
Definition
  1. Gross examination
  2. USG
  3. Biochemical analysis
  4. Sediment examination 
Term
Examples of preanalytical errors of urinalysis
Definition
  • sample contamination at collection
  • Incorrect storage of urine
Term
Examples of analytical errors of urinalysis
Definition
  • Improper procedure
  • Inability to recognize structures 
Term
Example of postanalytical error of urinalysis
Definition
incorrect/inaccurate documentation
Term
When do you use urinalysis
Definition
  1. evaluation of the urinary tract
  2. screening process
  3. geriatric screening
  4. pre-anaesthetic screening 
Term
Methods of collecting Urine
Definition
  1. voided sample
  2. manual expression
  3. catheterized sample
  4. cystocentiesis 
Term
What is the Voided sampling method?
Definition
  • clean and not sterile
  • no trauma
  • increased amount of bacteria and cells
  • caught medstream because the urine will be less contaminated
  • don't use this method for bacterial cultures 
Term
What is the manual Expression method?
Definition
  • must be careful of the bladder
  • increased amount of bacteria and cells
  • clean and not sterile
  • caught midstream
  • only used when patient is asleep because they have no muscle tone
  • don't do if patient is blocked
  • don't use for bacterial cultures 
Term
What is the Catheterization method?
Definition
  • use a sterile syringe
  • increased amount of RBC's
  • caught midstream
  • may or may not have bacterial culture
  • this method isn't usually used
  • female patients must be sedated 
Term
What is the Cystocentesis method?
Definition
  • increased amount of RBC's
  • no bacteria because the bladder is steriale
  • urine culture
  • sterile technique
  • take sample directly from bladder 
Term
What problems arise if you get your urine sample from the floor or table top?
Definition
the urine may contain bacteria and/or cleaning solvents
Term
can you use urine collected from the floor or table top?
Definition
only if the collection method is documented, but you can't use it for chemical analysis
Term
Can collection methods impact the results of urinalysis?
Definition
  • yes
  • microscopic findings are influenced by bacteria, epithelial cells and other introduced methods from collection method
Term
Is it good to find WBC's and bacteria in a urine sample?
Definition
no, it indicates that the kidneys aren't working properly
Term
Quality Control for Urine samples
Definition
  1. proper collection/storage
  2. proper identification
  3. proper procedure
  4. no expired reagents
  5. tightly sealed containers
  6. controls available (chem sticks: in water they are negative and there are bacteria on the sticks)
  7. standard volume of 3mL 
Term
What is the informaiton you need to provide for urine samples?
Definition
  • time urine was collected
  • method of collection (effects what is seen)
  • not any medications (effects chemical tests)
  • time urinalysis was performed (must be within 30min to 1 hr) 
Term
What is on the lable of the container that the urine sample is in?
Definition
  • animal name (both first and last)
  • animal number
  • owner name
  • collection method
  • collection time 
Term
collection containers for urinalysis
Definition

clean, dry, opaque and properly labelled

 

Term
urinalysis collection container if used for bacteria culture?
Definition
sterile and collection method indicated
Term
Why preserve urine?
Definition
  • it is a volatile environment and changes as soon as it exits the body
  • the best results of urinalysis is asap 
Term
time of collection
Definition

first morning sample is ideal

Term
Why refridgerate?
Definition
  • if sample not analyzed in 30 mins and a preserve called formalin (saves sedament) is added (but for only 6-12 hrs) 
  • before analyzing allow urine to warm up to room temperature otherwise chemical tests and sediment can be altered
  • gently invert to distribute any formed elements
Term
What happens when urine is cold?
Definition
reaction time is longer, get crystals, USG is all messed up, etc...
Term
Leaving Urine at room temperature
Definition
  • makes the sample useless
  • bacteria begins to grow
  • increases pH (causes a decreases in cellular components)
  • increases turbdity
  • decreases glucose and bilirubin
  • disintegration of casts, red blood cells, cyrstals
  • bacteria eat glucose 
Term
GROSS examonation of urine
Definition
  • involves all observations made without a microscope or chemical tests/reagents 
Term
What are the 5 observations of GROSS examination?
Definition
  1. volume
  2. colour
  3. turbidity
  4. odor
  5. foam (doesn't happen any more) 
Term
What is observation of Volume during GROSS examinations?
Definition
  • 24 hr collection to assess volume
  • things to look for
    • micturition
    • anuria
    • oliguria
    • polyuria
    • pollakiuria
    • polydipsia 
Term
micturition
Definition
to urinate
Term
anuria
Definition
no pee = may be problem with kidney, etc...
Term
aliguria
Definition
decreased output of uring (peeing less than normal)
Term
polyuria
Definition
increased output
Term
pollakiuria
Definition
urge to pee, but only tinkle (i.e.: small infrequent urination)
Term
polydipsia
Definition
increased drinking
Term
What are 7 factors that affect urine output?
Definition
  1. fluid intake
  2. external losses
  3. environmental conditions
  4. food (can vs dried)
  5. activity level (the more active the patient, the more they drink)
  6. species (some urinate more than others)
  7. animal size 
Term
What colours may you observe during GROSS examinations?
Definition
  • colorless to pale yellow
  • dark yellow to orange
  • yellow
  • yellow green
  • red to red brown to brown/black
  • blue 
Term
What affects the colour of urine?
Definition
  • drugs
  • food
  • disease
  • medication
Term
what does the colour of urine indicate?
Definition
  • clear/pale yellow = normal
  • the darker the urine the more concentrated 
  • hydrations status
Term
pigmenturia
Definition
abnormal color of urine
Term
what does the colour of urine depend on
Definition
concentration of the urine
Term
Urine with a red to brown color indicates?
Definition
  1. hematuria
  2. hemoglobinuria
  3. myoglobinuria

 

  • centrifuge to determine cause
  • check plasma color
Term
RBC's in urine
Definition
  • heavy and sink to bottom
  • indicate bleeding

 

Term
hematuria
Definition
  • intact RBC in urine = problem
  • nemerous RBC's
  • clear plasma color
Term
hemoglobinuria
Definition
  • hemoglobin in urine
  • RBC's break down and release hemoglobin in urine
  • plasma color is key
  • red/pink plasma color
Term
myoglobinuria
Definition
  • muscle break down
  • always dark brown
  • clear plasma color 
Term
what types of turbidity (i.e. how clear is the urine) are observend during  GROSS examinations?
Definition
  • clear = normal fresh urine in cats and dogs
  • slightly cloudy
  • moderatelly cloudy
  • cloudy/opaque/turbid
  • milky
  • flocculent 
Term
Turbidity
Definition
  • species dependent
  • asses cause by examining sedament under a microscope
  • a dog with strubite crystals have turbid urine
  • turbid urine is normal for horses, rats, rabbits, etc... becasue calcium carbonate is common in their urine
  • the less you can see through the urine, the more turbid it is 
Term
What types of odour can be observed during GROSS examinations?
Definition
  • normal smell
  • strong/concentrated
  • sweet/fruity (may indicate a diabetes)
    • caused by ketones (when body can't use glucose and breaks down fat cells)
  • foul/ammonia
    • caused by urease
  • dark yellow = very strong
  • green = extreally storng and usually indicates a UTI 
Term
Foam observation during GROSS examinations?
Definition
  • indicates presence of proteins in urine = not good
  • presistent foam may indicates a proteinuria 
  • types
    • white
    • green = bilirubin
  • the longer it lasts, the more protein present
Term
What is the Urinalysis Technique?
Definition
  1. perform macroscopic examination (color, turbidity, odour)
  2. perform chemical reagent tests
  3. centrifuge the sample
  4. determine specific gravity using supernotant
  5. evaluate sediment
  6. before refridgerating uring performe macro examination and chemical tests. 
Term
What is Urine specific Gravity (USG)?
Definition
  • measures concentrating and diluting ability of kidneys
  • measures the amount of solutes in urine and depends on the number and type of solute. 
Term
What effects USG?
Definition
hydration status of patient
Term
what are 2 types of solutes that can overestimate USG?
Definition
blucose & protein because they bend the light
Term
name 1 solute that will not effect USG?
Definition
Crystals, etc...
Term
what happens to an animal that is overhydrated?
Definition
diahrrea, vomit, etc...
Term

what can cause overhydration?

 

Definition
get too much fluid through IV
Term
what does diabetes do in an animal?
Definition
increases thrust, therefore may overhydrate them
Term
High USG =
Definition
more solutes, less water
Term
how do you get a dilute USG?
Definition
drinking a lot of water
Term
USG for normal animals depends on?
Definition
  1. eating/drinking habits
  2. temperature of environment (i.e. if hot, fluids are lost and more water is drunk)
  3. collection time (morn. sample = more concentrated because there is little to no fluids being taken in) 
Term
Are ther always solutes in urine?
Definition
yes
Term
examples of why there may be solutes in urine?
Definition
  • kidneys absorb what they can handle and flush out the excess
  • eat too much sugar, kidneys will flush out excess in urine
  • kidneys have a renal threshhold
  •  
Term
What is the USG in the morning if kidneys are functioning?
Definition
USG is concentrated
Term
Why use USG?
Definition
  • to determine wether the kidneys are functioning properly
  • determine hydration status
  • differentiate between diseases such as diabetes insipidus & diabetes mellitus
Term
osmolality
Definition
takes all particles into consideration
Term
diapetes insipidus
Definition
  • not only based on USG
  • inability of kidney to conserve water
  • Dilute USG
  • lower than expected USG
Term
diabetes mellitus
Definition
  • not only based on USG
  • high USG
  • lots of glucose in sample 
Term
USG when dehydrated
Definition
Through the roof
Term
USG range for Canine?
Definition
1.015-1.045 (1.030)
Term
USG range for Feline?
Definition
1.035-1.065 (1.035)
Term
2 ways to measure USG?
Definition
  1. refractometer
  2. urinometer 
Term
when do you use either the refractometer or urinometer?
Definition
before or after centrifugation because there is little effect on USG from solutes that settle out after centrifuging
Term
When measuring USG?
Definition
  • Be consistent
  • always note turbidity, temperature and refractometer type
  • if fairly turbulent then cnetrifuge first 
Term
acute renel disease
Definition
brand new renal ineffeciencies and presence of protein
Term
trace amount of protein in dog urine
Definition
its ok
Term
trace amount of protein in cat urine
Definition
kidneys threshhold exceded and not functoning
Term
what is the working part of the kidney
Definition
nephron
Term
how much of the nephron can the kidney loose and still function?
Definition
2/3
Term
what is common when animals are 7 yrs and older
Definition
kidney failure
Term
what happens when animals go in shock?
Definition
not as much blood goes through the kidney
Term
polydipsia
Definition
  • excessive drinking
  • excessive urine output
  • dilutes USG
  • the more water, the more solute and therefore the higher the USG 
Term
chronic renal failure
Definition
  • will see signs (driking more and peeing more)
  • only 1/3 of nephron left 
Term
anuria
Definition
peeing more
Term
what causes an increased USG?
Definition
  • dehydration
  • fluid loss
  • increased excretion of urine solutes
  • shock
  • diabetes mellitus
  • acute renal disease
  • certain drugs 
Term
what causes a decreaed USG?
Definition
  • polydipsia
  • fluids
  • chronic renal failure
  • diabetes insipidus
  • any diseases which kidneys cannot reabsorb water 
Term
hyposthenuria
Definition
  • disease process occuring
  • low USG
  • USG = 1.008 or less 
Term
hypersthenuria
Definition
  • high USG
  • USG for a dog = greater than 1.030 
  • USG for a cat = greater than 1.035
Term
isosthenuria
Definition
  • give or take water, don't effect USG range
  • fixed USG
  • kidneys not concentrating or diluting
  • USG range = 1.008-1.012 
Term
Polyuria
Definition
excessive urine output
Term
polydipsia
Definition
excessive drinking
Term
oliguria
Definition
limited/decreased urine output
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