key: cord-0049849-lwr87iab authors: Wu, Alan H.B. title: Urinalysis and stool testing date: 2020-09-11 journal: Self-Assessment Q&A in Clinical Laboratory Science, III DOI: 10.1016/b978-0-12-822093-1.00028-4 sha: 38494ede139d068abb8086eb08a5dfdde2e87e24 doc_id: 49849 cord_uid: lwr87iab nan . What is the normal threshold for excretion of glucose into the urine? a. 65 mg/dL b. 110 mg/dL c. 126 mg/dL d. 180 mg/dL e. 250 mg/dL 16. Which of the following disorders can produce a negative urine bilirubin and positive urobilinogen? a. hepatic cirrhosis b. hemolytic anemia c. urolithiasis d. alcoholism e. liver cancer 17. Which of the following is true regarding the sensitivity of the urine protein dipstick? a. measures all urine proteins equally b. most sensitive to albumin c. most sensitive to free light chains d. results correlate to microalbumin testing e. good agreement with quantitative urine protein analysis 18. Which of the following is false regarding hematuria and hemoglobinuria? a. hemoglobinuria can result from hematuria b. most common causes of hematuria are related to kidney diseases c. the dipstick is sensitive to both hemoglobin and myoglobin d. hemoglobinuria occurs when the transferrin binding capacity has been exceeded e. hematuria can be caused by drugs such as aspirin, warfarin, and heparin 19. Usually the urine and blood pH are abnormal in the same direction. For which of the following is there a discrepancy between urine pH and blood pH? a. lactate acidosis b. diabetic ketoacidosis c. hyperventilation d. chronic obstructive pulmonary disease e. renal tubular acidosis 20. Which of the following is not associated with a positive leukocyte with a negative nitrite in the urine? a. the leukocyte can be falsely positive due to skin contamination b. some microorganisms do not produce nitrite c. nitrites are produced by bacteria but are not increased due to inflammation Waxy casts are broad and are found in tubules when there is urinary stasis and atrophy. Ringsrud KM. Casts in the urine sediment Granular casts form from white and red cell casts as a result of aggregation of mucoproteins. Ringsrud KM. Casts in the urine sediment Retrograde ejaculation is a disorder whereby semen the bladder instead of exiting out of the penis. Retrograde ejaculation Candida fungus are yeast and can cause itching, pain and is caused by infections to the upper or lower urinary track. It occurs in women more often than men. The arrow indicates the presence of budding yeast. Kauffman CA, et al. Candida urinary tract infections-diagnosis This structure is a diatom, a single cell algae found in ocean water and soils. Its presence could indicate ingestion of seawater as seen in drownings The renal threshold for reabsorption of glucose is between 160 and 180 mg/dL, above which results in glycosuria. Ferrannini E. Learning from glycosuria In patients with bleeding there is an overload in the liver's ability to conjugate bilirubin and high serum bilirubin unconjugated. Due to its insolubility, conjugated must be bound to albumin and is not excreted into urine The urine protein dipstick largely reacts to albumin but cannot measure low levels of albumin, such as in early diabetic nephropathy and is not useful for Bence Jones proteins detection. Gaugarum R, et al. The accuracy of urine dipsticks as a screening test for proteinuria in hypertensive disorders of pregnancy Hemoglobinuria occurs when binding capacity of haptoglobin, not transferring is exceeded. Difference between hematuria and hemoglobinuria In renal tubular acidosis, there is an inability of the kidneys to secrete acids into the tubules leading to alkaline urine and a systemic acidosis Renal tubular acidosis High leukocytes indicate infection or inflammation along the urinary tract. Nitrites are produced by some bacterium. Nitrites are used as an adulterant