3.1 PHYSICAL EXAMINATION OF URINE - COLOR Flashcards
The physical examination of urine includes the determination
of the
urine color, clarity, and specific gravity
The results of the physical portion of urinalysis can confirm or explain findings in what other areas of urinalysis?
Chemical and microscopic areas
Variations in urine color may be due to
normal metabolic functions, physical activity, ingested materials, and Pathological conditions
The yellow color of
urine is caused by the presence of a pigment, which Thudichum named
urochrome
is a product of endogenous metabolism, and under normal conditions, the body produces it at a constant rate.
Urochrome
Caused by recent fluid consumption
Commonly observed with random specimens
Colorless
Pale yellow color causes
Polyuria or diabetes insipidus
Diabetes mellitus
Dilute random specimen
Increased 24-hour volume and low specific gravity with a pale yellow color suggests
Polyuria or diabetes insipidus
Elevated specific gravity and positive glucose test result with a pale yellow color suggests
Diabetes mellitus
Recent fluid consumption with pale yellow color suggests
Dilute random specimen
Dark yellow color of urine possible causes
Concentrated specimen
B complex vitamins
Dehydration
Bilirubin
Acriflavine
Nitrofurantoin
Dark yellow color of specimen that may be normal after strenuous exercise or in first morning specimen means that the sample is
Concentrated specimen
Fever or burns with a dark yellow urine color suggests
Dehydration
Dark yellow urine color with yellow foam when shaken suggests a positive chemical test results for this specific metabolite
bilirubin
Negative bile test results and possible green fluorescence causes dark yellow urine specimen with?
Acriflavine
Antibiotic administered for urinary tract infections that causes dark yellow urine specimen
Nitrofurantoin
Orange-yellow color of urine possible causes
Phenazopyridine (Pyridium)
Phenindione
Sulfasalazine (Azulfidine)
Drug commonly administered for urinary tract infections that causes orange-yellow urine
Phenazopyridine (Pyridium)
Anticoagulant, orange in alkaline urine, colorless in acid urine that causes orang yellow urine
Phenindione
Anti-inflammatory drug that causes orange yellow urine
Sulfasalazine (Azulfidine)
Yellow-green urine possible cause
Bilirubin oxidized to biliverdin
Colored foam in acidic urine and false-negative chemical test results for bilirubin and yellow green urine color indicates that
Bilirubin oxidized to biliverdin
Positive urine culture for this bacteria is the primary cause of green urine
Pseudomonas infection
Possible causes of green urine
Pseudomonas infection
Asparagus
Possible causes of Blue-green urine
Amitriptyline
Methocarbamol (Robaxin)
Clorets
Indican
Methylene blue
Phenol
Propofol
Familial hypercalcemia
Indomethacin (Indocin, Tivorbex)
Antidepressant that causes blue green urine
Amitriptyline
Muscle relaxant, may be green-brown that causes blue green urine
Methocarbamol (Robaxin)
Bacterial infections, intestinal disorders secretes this organic compound that causes blue green urine
Indican
Dye used to check for fistulas which causes the urine to be blue-green
Methylene blue
This compound, when oxidized causes blue green urine
Phenol
Anesthetic that causes blue green urine
Propofol
“Blue diaper syndrome” is an indication of what disease
Familial hypercalcemia
Nonsteroidal anti-inflammatory drug that causes blue green urine
Indomethacin (Indocin, Tivorbex)
Pink Red urine possible causes
RBCs
Hemoglobin
Myoglobin
Beets
Rifampin
Menstrual contamination
Cloudy red urine suggests
RBCs in the urine
Clear pink red urine with positive chemical test results for blood; intravascular hemolysis suggests
Hemoglobin
Clear pink red urine with positive chemical test results for blood; muscle damage suggests
Myoglobin
Alkaline urine of people who are genetically susceptible pink red coloration is caused by
Beets
Tuberculosis medication that causes pink red urine
Rifampin
Cloudy specimen with RBCs, mucus, and clots suggest that the urine is
Contaminated with menstruations
Port wine color of urine is caused by
Porphyrins
Red-brown color of urine may be caused by
RBCs oxidized to methemoglobin
Myoglobin
Seen in acidic urine after standing; positive chemical test result for blood with reed brown coloration indicates
RBCs oxidized to methemoglobin
Brown Black urine may be caused by
Homogentisic acid (alkaptonuria)
Malignant melanoma
Melanin or melanogen
Phenol derivatives
Argyrol (antiseptic)
Methyldopa or levodopa
Metronidazole (Flagyl)
Chloroquine and primaquine
Methocarbamol
Fava beans, rhubarb, or aloe
Seen in alkaline urine after standing; specific tests are available for determining this cause of brown black urine
Homogentisic acid (alkaptonuria)
Urine darkens on standing and reacts with nitroprusside and ferric chloride is caused by
Malignant melanoma
Melanin or melanogen
If the urine is brown black and it Interferes with copper reduction tests this is probably caused by
Phenol derivatives
When the urine is brown black and the Color disappears with ferric chloride, it is probably caused by
Argyrol (antiseptic)
Antihypertensive that caused brown black urine
Methyldopa or levodopa
Darkens on standing, intestinal and vaginal infections cause
Metronidazole (Flagyl)
Antimalarial drugs that causes brown black urine
Chloroquine and primaquine
Muscle relaxant that causes brown black urine
Methocarbamol
Increased amounts of urochrome are produced in patients with what type of conditions?
Thyroid conditions
What happens to urochrome levels in urine that stands at room temperature?
They increase
A dilute urine specimen will appear what color?
Pale yellow
A concentrated urine specimen will appear what color?
Dark yellow
The presence of which pink pigment is most evident in refrigerated urine specimens?
Uroerythrin
What pigment imparts an orange-brown color to urine that is not fresh?
Urobilin
Dark yellow or amber urine may indicate the presence of what abnormal pigment?
Bilirubin
What visual indication suggests bilirubin presence when shaking a urine specimen?
Yellow foam
A large amount of what type of foam indicates increased protein concentration in urine?
White foam
The photo-oxidation of large amounts of excreted urobilinogen produces what color urine?
Yellow-orange
What color does bilirubin impart to urine when photo-oxidized?
Yellow-green
Specimens containing phenazopyridine produce what visual indicator when shaken?
Yellow foam
What is one of the most common causes of abnormal urine color?
Presence of blood
The color of urine may range from red to brown due to what factors?
Amount of blood, pH of urine, length of contact
What causes urine to turn brown when red blood cells remain in acidic urine for several hours?
Oxidation of hemoglobin to methemoglobin
What color and appearance does urine take on when intact red blood cells are present?
Red and cloudy
How can one distinguish between hemoglobinuria and myoglobinuria?
Examining the patient’s plasma
What type of urine appears red due to the oxidation of porphobilinogen?
Urine containing porphyrins
What are nonpathogenic causes of red urine?
Menstrual contamination, ingestion of pigmented foods/medications
Name some medications that can produce red urine.
Rifampin, phenolphthalein, phenindione, phenothiazines
What additional testing is recommended for urine specimens that turn brown or black on standing?
Testing for melanin or homogentisic acid
What condition may lead to an excess production of melanin?
Malignant melanoma
What metabolite causes black color in alkaline urine due to alkaptonuria?
Homogentisic acid
Name some medications that can produce brown or black urine.
Chloroquine, primaquine, levodopa, methyldopa, metronidazole, nitrofurantoin, laxatives with cascara or senna, methocarbamol
What can cause dark-brown urine due to liver and kidney disorders or muscle injury?
Extreme exercise
Which medications may cause blue urine?
Methocarbamol, methylene blue, indomethacin, amitriptyline, propofol
A purple staining may occur in catheter bags and is caused by indican in the urine or a bacterial infection, frequently caused by
Klebsiella or Providencia species