Urinalysis Sub-Modules
🔬 Interpretation Fundamentals
Core principles and systematic approach to urinalysis interpretation
- Microscopy Priority: Why microscopy trumps dipstick
- UA Micro vs FeNa: Diagnostic priorities in AKI
- Contamination Challenge: The Olympic sport of clean catch
- Collection Mastery: Practical guidelines
- Key Learning Points: Evidence-based summary
🧪 Dipstick Analysis
Comprehensive dipstick parameters and limitations
- Dipstick Limitations: When chemistry lies
- Complete Analysis: All dipstick parameters
- Individual Parameters: Detailed interpretation
- Additional Tests: Bilirubin, urobilinogen
- Timing Requirements: Collection considerations
🔬 Ancillary Urine Testing
Advanced testing beyond routine dipstick and microscopy
- FeNa Analysis: Pitfalls and proper interpretation
- Urine Eosinophil Testing: Poor test for AIN
- Advanced Microscopy: Phase contrast and polarized light
- Clinical Context: When ancillary tests are useful
- FeNa Calculator: Interactive tool with clinical caveats
🦠 UTI Assessment and Treatment
Comprehensive UTI evaluation, prevention, and evidence-based management
- UTI Detection: Timing is everything (4-hour rule)
- Prevention Strategies: Vaginal estrogen, cranberry, D-mannose evidence
- Asymptomatic Bacteriuria: When NOT to treat
- Mental Status Myth: Debunking UTI-delirium association
- Treatment Guidelines: Evidence-based therapy selection
🧫 Dysmorphic RBCs (Glomerular Hematuria)
Recognize glomerular source of hematuria with thresholds, technique, and pitfalls
- Acanthocytes: Most specific for glomerular origin
- Thresholds: >5% dysmorphic RBCs suggests GN
- Technique: Phase-contrast tips for accuracy
- Referral Cues: When to escalate to GN workup
🩸 RBC Morphology Overview
Isomorphic vs dysmorphic RBCs, casts, and clinical integration
- Isomorphic vs Dysmorphic: Distinguish urologic vs glomerular
- Casts: RBC casts and their significance
- Clinical Context: Integrate microscopy with symptoms
- Pearls & Pitfalls: Avoid common interpretation errors
🎯 Nephrology-Focused Approach
From a nephrology perspective, the urinalysis is far more than a simple screening test. It's a window into kidney pathology that can reveal glomerulonephritis, acute tubular necrosis, interstitial nephritis, and other critical conditions. This modular approach ensures you master both the technical aspects and clinical interpretation needed for excellent patient care.
🔬 Evidence-Based Priority
- Microscopy First: Direct visualization of pathology
- Clinical Context: Symptoms + microscopy + dipstick
- Fresh Specimens: <2 hours for optimal results
- Contamination Awareness: Validity assessment
- Systematic Approach: Consistent interpretation
⚠️ Common Pitfalls
- Dipstick-Only Diagnosis: Missing critical findings
- FeNa Over-Reliance: Multiple confounding factors
- Contamination Ignorance: Treating normal flora
- Timing Issues: Old specimens, wrong collection
- Context Neglect: Not considering clinical picture
🎓 Learning Objectives
- Systematic Interpretation: Step-by-step approach
- Emergency Recognition: RBC casts, severe findings
- Quality Assessment: Valid vs contaminated specimens
- Clinical Integration: Lab + symptoms + examination
- Evidence Application: Current literature and guidelines