Urinalysis on the NCLEX
UA components: protein, glucose, ketones, blood, leukocyte esterase, nitrites, casts.
Urinalysis is one of the most ordered tests. NCLEX tests common findings.
Protein
Normally absent. Present in CKD, nephrotic syndrome, pre-eclampsia. Quantify with 24h urine or spot ratio.
Glucose and ketones
Glucose: uncontrolled diabetes. Ketones: DKA, starvation, low-carb diets.
Blood
Hematuria. UTI, stones, trauma, cancer, glomerulonephritis.
Leukocyte esterase + nitrites
Positive in UTI. Nitrites suggest gram-negative bacteria specifically.
Casts
RBC casts = glomerulonephritis. WBC casts = pyelonephritis. Muddy brown granular = ATN. Hyaline casts = nonspecific.
Frequently asked
Sterile pyuria?
WBCs in urine without bacteria. Think TB, fastidious organisms, chemical irritation.
Casts visualization?
Microscopic. Fresh urine. Spun sample.
Quick check
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