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Mercy CLS 3: Urinalysis > 2. Physical exam > Flashcards

2. Physical exam Flashcards

1
Q

4 parts of physical exam

A
  • color
  • clarity
  • specific gravity
  • odor (not reported)
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2
Q

RBC presentation in fresh acidic urine

A

yellow (normal color), pink, red
as RBCs lyse, it turns brown/black

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3
Q

RBC presentation in fresh alkalkine urine

A

red-brown
hemoglobin oxidation to methemoglobin is promoted by high pH

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4
Q

gives normal yellow color

A

urochrome

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5
Q

give increased production of urochrome

A

thyroid conditions
fasting states
urine sitting at room temp

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6
Q

3 pigments in normal urine

A
  • urochrome
  • uroerythrin
  • urobilin
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7
Q

normal pink pigment

A

uroerythrin

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8
Q

explain brick dust

A

amorphous urates precipitate in refrigeration and uroerythrin attaches, producing “brick dust”

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9
Q

normal orange-brown pigment to non-fresh urine

A

urobilin

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10
Q

urobilin is a product of…

A

oxidation of the normal urinary constituent urobilinogen

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11
Q

large white foam

A

↑ protein

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12
Q

dark yellow/amber + yellow foam

A

bilirubin
may contain hepatitis

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13
Q

yellow-orange + white foam

A

photooxidation of large amounts of urobilinogen to urobilin

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14
Q

yellow-green + colored foam

A

photooxidation of bilirubin to biliverdin (rare)

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15
Q

neon orange + yellow foam

A

phenazopyridine drug (azo)
UTI pain medication

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16
Q

bright yellow urine

A

vitamins (riboflavin)

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17
Q

red urine + cloudy

A

hematuria
intact cells

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18
Q

red urine + clear

A

hemoglobin OR myoglobin

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19
Q

red urine + clear + red plasma

A

hemoglobin from in vivo RBC lysis

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20
Q

red urine + clear + clear plasma

A

myoglobin from breakdown of skeletal muscle

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21
Q

fresh brown urine

A

glomerular bleeding

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22
Q

port wine urine

A

porphyrins
metabolic problem or lead poisoning

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23
Q

nonpathogenic reasons for red/brown urine

A

menstrual contamination
beets
medication

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24
Q

brown/black urine = for blood

A

melanin or homogentisic acid

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25
Q

sign of melanoma

A

oxidation of melanogen –> melanin in the urine, turns black over time

26
Q

sign of alkaptonuria

A

homogentisic acid, a metabolite of phenylalanine
black color to alkaline urine

inborn error of metabolism

27
Q

causes of blue/green urine

A
  • bacterial infections (Pseudomonas)
  • breath deodorizers
  • medications
  • collection bags
28
Q

print easily seen through urine

A

slightly cloudy/hazy

29
Q

print blurred through urine

A

cloudy

30
Q

print cannot be seen through urine

A

turbid

31
Q

precipitate/clotted urine

A

milky

32
Q

nonpathogenic turbidity

A

women: epithelial cells, mucus
mucus
semen
fecal contamination
radiographic contrast media
talcum powder
vaginal creams

33
Q

how does urine precipitate in the fridge depending on if it’s acidic or alkaline?

A

ACIDIC
pink precipitate
amorphous urates
soluble in NaOH, disappear upon heating

ALKALINE
white precipitate
amorphous phosphates + carbonates
soluble in acetic acid

34
Q

less frequent pathogenic causes of turbidity (besides RBC, WBC, bacteria)

A
  • nonsquamous epithelial cells (transitional, renal)
  • yeast
  • crystals
  • lymph fluid
  • lipids/fat
35
Q

define specific gravity

A

density of a solution compared with the density of a similar volume of distilled water (SG 1.000) at a similar temperature

36
Q

specific gravity is influenced by…

A

number of particles and size of particles

37
Q

specific gravity tells us about the kidney’s ability to…

A

selectively reabsorb essential chemicals and water from the glomerular filtrate

38
Q

normal specific gravity

A

1.002 - 1.035

39
Q

causes of low SG

A

diuretics (alcohol, caffeine, medications); HTN, pyelonephritis, DI, protein malnutrition

40
Q

causes of high SG

A

dehydration, proteinuria, glycosuria, eclampsia

41
Q

causes false high SG

A

radiographic contrast dye

42
Q

SG of plasma filtrate entering glomerulus

A

1.010

43
Q

SG = 1.010

A

isosthenuric

44
Q

SG < 1.010

A

hyposthenuric

45
Q

SG > 1.010

A

hypersthenuric

46
Q

measures refractive index

A

refractometer

47
Q

Each g/dL of protein present, the SG is increased by…

A

0.003

48
Q

Each g/dL of glucose present, the SG is increased by ——-

A

0.002

49
Q

more representative measure of renal concentrating ability—only depends on number of particles present, not size

A

osmolality
measures colligative property of sample

50
Q

used to measure osmolality
2 methods

A

osmometer
freezing point depression method
vapor pressure method

51
Q

SG measure on the dipstick is based on…

A

pKa, dissociation constant

52
Q

indicator on dipstick for SG

A

bromothmol blue

53
Q

how do you correct for falsely high SG results on the refractometer?

A

use the dipstick SG measure

54
Q

reagent test strip SG results are especially useful for…

A

assessing the ability of the kidneys to handle water and ionic solutes when glucose or protein is also present in the urine, or contrast media

55
Q

odor

Ammonia/strong, foul

A

bacterial infection

56
Q

odor

sweet/fruity

A

ketones

57
Q

odor

Strong, maple syrup odor

A

Maple Syrup Disease

58
Q

odor

mousy

A

Phenylketonuria

59
Q

odor

rancid

A

Tyrosinemia

60
Q

odor

sweaty feet

A

Isovaleric acidemia

61
Q

odor

cabbage

A

Methionine malabsorption

62
Q

odor

bleach

A

Contamination

Mercy CLS 3: Urinalysis (10 decks)

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