AUBF Macroscopic Urine Examination Flashcards
Gives yellow color of urine (Thudichum)
Urochrome
most evident in refrigerated, precipitation of amorphous urates, produces pink color to the sediment. (acidic)
Uroerythrin
oxidation product of the normal urinary constituent urobilinogen, imparts an orange-brown color to urine that is not fresh
Urobilin
Urine color:
oxidation of porphobilinogen to porphyrins
Problems in enzymatic steps (heme synthesis): porphyrias
Red/Port Wine color
oxidation of melanogen (colorless pigment) to melanin - produce in excess
Melanoma
homogentisic acid (metabolite phenylalanine) - imparts a black color to alkaline urine from person with inborn metabolism
Alkaptonuria
Clinical Laboratory Correlation:
Random urine specimen
Cause: Recent fluid consumption
Colorless
Clinical Laboratory Correlation: Increased 24 hour volume and low specific gravity
Elevated specific gravity and positive glucose test result
Recent fluid consumption
Pale yellow
Causes:
Polyuria or diabetes insipidus
Diabetes mellitus
Dilute random specimen
Pale yellow
Clinical Laboratory Correlation:
May be normal after strenuous exercise or in first morning specimen
Fever or bums
Yellow foam when shaken and positive chemical test results for bilirubin
Negative bile test results and possible green
fluorescence
Antibiotic administered for urinary tract infections
Dark yellow
Causes of Dark Yellow color of urine
Concentrated specimen
B complex vitamins
Dehydration
Bilirubin
Acriflavine
Nitrofurantoin
Clinical/Laboratory Correlation:
Drug commonly administered for urinary tract infections
Anticoagulant. orange in alkaline urine. colorless in acid urine
Orange-Yellow
Causes of orange-yellow urine
Phenazopyridine (pyridium)
Phenindione
Cause of yellow green urine
Bilirubin oxidized to biliverdin
Causes of Green Urine
Pseudomonas infection
Causes of Blue Green Urine
Amitriptyline
Methocarbamol (Robaxin)
Clorets
Indican
Methylene blue
Phenol
Causes of Pink urine
RBCs
Clinical/Laboratory Correlation
Colored foam in acidic urine and false negative chemical test result for biliburin
Yellow-Green
Clinical/Laboratory Correlation
Positive urine culture
Green
Clinical/Laboratory Correlation
Antidepressant
Muscle relaxant. may be green-brown
None
Bacterial infection, intestinal disorders
Fistulas when oxidized
color
Blue- Green
Clinical/Laboratory Correlation
Cloudy urine with positive chemical test results for blood and RBCs visible microscopically
Color
Pink
Clinical/ Laboratory
Urine darkens on standing and reacts with
nitroprusside and ferric chloride
Interfere with copper reduction tests
Color disappears with ferric chloride
Antihypertensive
Darkens on standing. intestinal and vaginal infections
Black
Causes of Black urine color
Malignant melanoma
Melanin or melanogen
Phenol derivatives
Argyrol (antiseptic)
Methyldopa or levodopa
Metronidazole (Flagyl)
Urine clarity
No visible particulate
clear
Clarity:
Few particulates, print easily seen through urine
Hazy
Urine clarity:
Many particulates, print blurred through urine
Cloudy
Clarity:
Print cannot be seen through urine
Turbid
Clarity:
May precipitate or be clotted
Milky
Non-pathologic cause of urine turbidity:
Squamous epithelial cells
Mucus
Amorphous phosphates, carbonates, urates
Semen, sperm protozoa
Fecal contamination
Radiographic contrast media
Talcum powder
Vaginal creams
Pathologic cause of urine turbidity
RBCs
WBCs
Random urine sample specific gravity
1.015-1.030
Specific gravity of radiographic contrast media (cholesterol correlation)
1.040
Specific gravity of water
1.000
Isosthenuric: SG
1.010
Hyposthenuric: SG
<1.010
Hypersthenuric: SG
> 1.010
Principle of Refractometry
Refractive index
Principle: Changes in colligative properties by particle number
Osmolality
CALIBRATION OF MANUAL SPECIFIC GRAVITY MEASUREMENT: Refractometer and Urinometer difference
Temperature: 5-9 deg C (F: -32) - Urinometer
Temperature (no adjustment) - refractometer
Both:
For every 1g protein, subtract 0.003
For every 1g of glucose, subtract 0.004
Macroscopic screening color significance:
Blood
Macroscopic screening clarity significance:
Hematuria
Hemoglobinuria
Myoglobinuria
Macroscopic screening blood significance:
RBCs, RBC Cast
Macroscopic screening protein significance:
Casts, Cells
Macroscopic screening Nitrite significance:
Bacteria, WBCs
Macroscopic screening Leukocyte Esterase significance:
WBCs, WBC Cast, Bacteria
Macroscopic screening Glucose significance:
yeast
Analyte that decreases in unpreserved urine
Clarity
Glucose
Ketones
Bilirubin
Urobilinogen
RBCs, WBCs, Casts
Trichomonas
Analyte that increases in an unpreserved urine
Odor
pH
Nitrite
Bacteria
Color change in an unpreserved urine
Modified, Darkened
Cause of color change in urine
Oxidation and reduction of metabolites
Cause of clarity change in urine
Bacterial growth and precipitation of amorphous material
Cause of glucose change in urine
Glycolysis and bacterial use
Cause of ketone changes in urine
Volatilization and bacterial metabolism
Cause of change in bilirubin level
Exposure to light/photo oxidation to biliverdin
Cause of change in urobilinogen
Oxidation to urobilin
Causeof RBCs, WBCs, Casts changes in urine
Disintegration in dilute alkaline urine
Cause of trichomonas changes in urine
Loss of motility, death
Analyte that increases in unpreserved urine
Odor
pH
Nitrite
Bacteria
Cause of odor change in unpreserved urine
Bacterial multiplication causing breakdown of urea and ammonia
Cause of ph change in unpreserved urine
Breakdown of urea to ammonia by urease-producing bacteria/loss of CO2
Cause of nitrite changes in urine
multiplication of nitrate reducing bacteria
Cause of change in bacteria in an unpreserved urine
Multiplication
Not part of routine urine analysis
Odor
Normal odor of urine
Aromatic
Foul ammonia-like odor cause
Bacterial decomposition, UTI
Fruity and sweet odor cause in urine
Ketones (DM, Starvation, Vomiting)
Maple syrup odor cause
MSUD
Mousy odor cause of urine
Phenylketoneuria (PKU)
Rancid odor cause
Tyrosinemia
Sweaty feet odor cause
Isovaleric Acidemia
Cabbage odor cause
methionine malabsorption
bleach odor cause
contamination
rotting fish odor cause
galunggong-like odor, trimethylaminuria