BRUNZEL CHAPTER 5 (Foam And Clarity)

Question 1

If a normal urine specimen is shaken or agitated sufficiently, a____ foam can be forced to develop at its surface that readily dissipates on standing.

The characteristics of urine foam — namely, its color, ease of formation, and the amount produced-are modified by the presence of____ and ____

Answer 1

white

protein and bilirubin.

Question 2

Moderate to large amounts of_______ in urine cause a stable white foam to be produced when the urine is poured or agitated.

Similar to_______, the foam that develops is thick and long lasting.

In addition, a larger volume of foam is easily produced by agitation of this urine compared with urine in which protein is not present.

Answer 2

protein (albumin)

egg albumin

Question 3

When_____ is present in sufficient amounts, the foam if present will be characteristically yellow.

This coloration may be noticed when the urine is being processed and the physical characteristics recorded.

Although not definitive, this distinctive yellow coloration of the foam provides preliminary evidence for the presence of ______.

Answer 3

bilirubin

Question 4

Most substances that intensify or change the color of urine do not alter the color or characteristics of the urine foam.

In other words, despite significant changes in urine color, the foam, if forced to form by agitation, remains_____ and readily dissipates.

Answer 4

white

Question 5

______ characteristics noted in the physical examination are not reported in a routine urinalysis;

instead, they serve as preliminary and supportive evidence for the presence of______and abnormal amounts of_____ in the urine.

These suspected substances must be detected and confirmed during the _____\before either substance is reported.

Answer 5

Foam

bilirubin; protein

chemical examination

Question 6

_____, along with color, describes the overall visual appearance of a urine specimen.

It is assessed at the same time as urine color and refers to the transparency of the specimen.

Answer 6

Clarity

Question 7

Often called________, clarity describes the cloudiness of the urine caused by suspended particulate matter that scatters light.

Answer 7

turbidity

Question 8

In health, a freshly voided “clean catch” urine specimen is usually_____.

Answer 8

clear

Question 9

If precautions are not taken, particularly with female patients, to eliminate potential contamination from the skin or from vaginal secretions, a normal specimen can appear_____.

Likewise, if a specimen is handled improperly after collection, bacterial growth can cause the specimen to become _____.

Answer 9

cloudy

Question 10

Precipitation of solutes dissolved in urine, most commonly______ and______, can cause a normal urine specimen to appear cloudy.

Answer 10

amorphous urates and phosphates

Question 11

_______ and ______ produce a white or beige precipitate and are present only in alkaline urine.

Answer 11

Amorphous phosphates and carbonates

Question 12

In acidic urine, a pinkish precipitate (“brick dust”) results from the deposition of uroerythrin on_______ and_______ crystals.

Answer 12

amorphous urate; uric acid crystals

Question 13

Indirectly, the color of the precipitate indicates whether a urine pH is_____ (pink) or____ (white, beige)

Answer 13

acid

alkaline

Question 14

On close inspection of the particulate matter in urine, a specific component may be evident.

Most often noted are red blood cells and small blood clots.

Similarly, the excretion of fat or lymph, although rare, should be suspected in urine that appears_____ or _____

Answer 14

opalescent or milky.

Question 15

______ provides a rapid quality check for microscopic examination- that is, a cloudy urine specimen should have significant numbers of components present when viewed microscopically.

Answer 15

Urine clarity

Question 16

Substances that reduce urine clarity can be categorized as______ or _____.

Answer 16

pathologic or nonpathologic

Question 17

Principally, those substances considered nonpathologic are contaminants or normal urine components.

______ and ____are considered to be urine contaminants because they are not derived from the urinary tract; rather, they use it as a coveyance.

Answer 17

Spermatozoa and prostatic fluid

Question 18

_______present in the urine after an x-ray procedure are iatrogenic and are not indicative of disease.

Answer 18

Radiographic contrast media

Question 19

The presence of many _____ or ______usually indicates improper collection of the urine specimen.

Answer 19

squamous epithelial cells or fecal material

Question 20

Pathologic conditions, however, such as a fistula between the bladder and the colon, can also result in the presence of fecal material in urine, which causes a persistent_______

Answer 20

urinary tract infection.

Question 21

Pathologic substances in urine indicate (3)

Answer 21

(1) deterioration of the barrier normally separating the urinary tract from the blood

(2) a disease process

(3) a metabolic dysfunction

Question 22

For example, the presence of _____in urine indicates damage to the urinary tract.

At times the site of injury can be localized, as with the presence of dysmorphic red blood cells, which are highly indicative of_______ damage, or with the presence of red blood cells in casts, which indicate_______ or______.

Answer 22

red blood cells

glomerular

glomerular or tubular origin

Question 23

______in urine indicate an inflammatory process somewhere in the urinary system.

Answer 23

White blood cells

Question 24

Although bacteria are the most common cause of______, other agents can produce inflammation without bacteriuria.

Answer 24

urinary tract infection

Question 25

In fresh urine, the presence of ***bacteria, white blood cells, and casts*** indicates an infection of the_________, whereas the presence of ***bacteria and white blood cells without pathologic casts*** implies a________.

Answer 25

upper urinary tract (e.g., renal pelvis, interstitium) lower urinary tract infection (e.g., bladder, urethra)

Question 26

In contrast,_____ and _____ although agents of infection, commonly originate from a vaginal infection and often are contaminants when present in the urine specimen of a female. Regardless of their origin, these organisms are routinely reported when observed during the microscopic examination of a urine specimen.

Answer 26

yeast and trichomonads