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Clinical Microscopy > Chapter 2: Physical & Chemical Examination Of Urine > Flashcards

Chapter 2: Physical & Chemical Examination Of Urine Flashcards

1
Q

Normal urine daily output

A

600 - 2000 mL

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2
Q

Average urine output

A

1200 - 1500 mL

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3
Q

Refers to a decrease in urine output (<400 mL/day)

A

Oliguria

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4
Q

Cessation of urine flow

A

Anuria

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5
Q

Increase in daily urine output (>2.5 L/day)

A

Polyuria

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6
Q

Increase in nocturnal excretion of urine

A

Nocturia

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7
Q

Polyuria + Low SG (Problem with ADH)

A

Diabetes Insipidus

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8
Q

Urine pigments

A

Urochrome, Uroerythrin, Urobilin

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9
Q

How to examine urine color

A

Examine the specimen under a good light source, looking down through the container against a white background

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10
Q

A pink pigment most evident in refrigerated specimens as a result of amorphous urates precipitation

A

Uroerythrin

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11
Q

Oxidation product of urobilinogen and imparts an orange-brown color to urine that is not fresh

A

Urobilin

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12
Q

Main urine pigment in that causes yellow color

A

Urochrome

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13
Q

This substance produces stable yellow foam when specimen is shaken

A

Bilirubin

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14
Q

This is an oxidation product of bilirubin

A

Biliverdin

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15
Q

This also causes yellow foam when shaken but only briefly

A

Phenazopyridine (Pyridium) aka azo-gantrisin compounds

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16
Q

Nitrofurantoin causes urine to produce a color

A

Dark yellow/Amber/Orange

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17
Q

This causes red & cloudy urine

A

Red blood cells

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18
Q

Associated with red & clear urine

A

Hemoglobin & myoglobin

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19
Q

Causes a port-wine color from the oxidation of porphobilinogen

A

Porphyrins

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20
Q

Red plasma + red & clear urine

A

Hemoglobin

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21
Q

Normal color plasma + red & clear urine

A

Myoglobin

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22
Q

Rifampin causes what color of urine?

A

Rifampin

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23
Q

Phenolphthalein, Phenindione, Phenothiazines causes what color of urine?

A

Red

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24
Q

This is a metabolite of phenylalanine that causes brown/black urine

A

Homogentisic Acid

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25
Q

An oxidation product of the colorless pigment Melanogen that causes brown/black urine

A

Melanin

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26
Q

This medication causes brown/black urine

A

Metronidazole

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27
Q

A substance used for gastric fluid analysis (tubeless method) causes what color of urine?

A

Blue (Azure A is the substance)

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28
Q

Phenol derivatives cause urine to appear

A

Black

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29
Q

Phenol in the urine makes urine appear

A

Blue

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30
Q

How to examine urine clarity?

A

Visually examine the specimen in a clear container while holding it in front of a light source

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31
Q

No visible particulates seen in urine, transparent

A

Urine is clear

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32
Q

Few particulates is seen, print easily seen through urine

A

Urine is Hazy

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33
Q

Many particulates in the urine, print is blurred through urine

A

Urine is cloudy

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34
Q

Print cannot be seen through the urine

A

Urine is turbid

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35
Q

Presence of precipitate or clotted urine

A

Milky

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36
Q

No (or rare) visible particles; transparent

A

Clear

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37
Q

Visible particles present; newsprint can be read when viewed through urine tube

A

Hazy/ Slightly cloudy

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38
Q

Significant particulate matter; newsprint is blurred or difficult to read when viewed through the urine tube

A

Cloudy

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39
Q

Newsprint cannot be seen when viewed through urine tube

A

Turbid

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40
Q

What causes uniform turbidity in the urine that cannot be cleared by filtration

A

Bacter

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41
Q

Nonsquamous epithelial cells is a cause for (pathologic/non pathologic turbidity)

A

Pathologic cause of turbidity

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42
Q

Used to measure the concentrating and diluting ability of the kidney in its effort to maintain homeostasis

A

Specific Gravity

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43
Q

Density of solution compared with density of similar volume of water at a similar temp

A

Specific gravity

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44
Q

First function to diminish in renal disease

A

Tubular reabsorption

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45
Q

Normal SG in random urine

A

1.002 - 1.035

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46
Q

Normal SG for 24 hr urine

A

1.015 - 1.025

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47
Q

SG of >1.035 may mean

A

Px body has taken in Radiographic contrast media

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48
Q

Urine with fixed specific gravity of 1.010

A

ISOSTHENURIA

49
Q

Isosthenuria is seen in

A

End-stage renal disease

50
Q

Refers to the comparison of the velocity of light in air with the velocity of light in a solution

A

Refractive index

51
Q

Indirect methods on measuring SG

A

Refractometer (Total Solids Measure), Reagent strip

52
Q

Calibration using distilled water in refractometer

A

1.000

53
Q

Calibration using 3% & 5% NaCl in refractometer

A

3% NaCl: 1.015
5% NaCl: 1.022 +- 0.001

54
Q

Calibration using 9% sucrose in refractometer

A

1.034 +- 0.001

55
Q

This method in SG determination of urine needs temperature correction

A

Urinometer
(Cold subtract 0.001)
(Warm add 0.001)
* for every 3 deg c away from 20 deg c

56
Q

Correction needed for glucose and protein in SG determination in urine

A

SUBTRACT:
0.004 for GLUCOSE
0.003 for PROTEIN

57
Q

Freshly voided urine has what kind of odor?

A

FAINTLY AROMATIC

58
Q

What is the significance of LACK of ODOR in urine

A

Acute Renal Failure w/ Acute Tubular Necrosis

59
Q

Foul, ammonia like odor in the urine suggests

A

Bacterial decomp. suggestive of UTI

60
Q

Fruity, sweet odor in the urine

A

Ketones (DM, starvation and vomiting)

61
Q

Mousy odor of urine

A

Phenylketonuria

62
Q

Rancid odor of urine

A

Tyrosinemia

63
Q

Sweaty feet odor in urine

A

Isovaleric acidemia & glutaric acidemia

64
Q

Methionine malabsorption produces what odor of urine?

A

Cabbage, Hops

65
Q

Rotting fish odor of urine

A

Trimethylaminuria

66
Q

Unusual or pungent smell of urine may indicate?

A

Ingestion of onions, garlic, and asparagus

67
Q

Fill out the following NORMAL Values of Physical Examination of Urine

VOLUME:
COLOR:
TRANSPARENCY:
SPECIFIC GRAVITY:
ODOR:

A

VOLUME: 600 - 2000 mL/day
COLOR: Yellow to amber
TRANSPARENCY: Clear
SPECIFIC GRAVITY: 1.001 - 1.035
ODOR: Faintly aromatic

68
Q

Normal urine pH of a randomly collected specimen

A

4.5 - 8.0

69
Q

This parameter is determined by the concentration of free Hydrogen ions

A

pH

70
Q

pH of first morning urine sample

A

5.0 - 6.0

71
Q

Normal urine pH with normal protein diet

A

4.5 - 6.5

72
Q

Vomiting leads to alkaline or acidic urine

A

Alkaline

73
Q

Renal tubular acidosis leads to alkaline or acidic urine

A

Alkaline urine

74
Q

This is parameter is most indicative of renal disease

A

Protein

75
Q

Major serum protein found in the urine

A

Albumin

76
Q

This is a mucoprotein produced by the renal tubules and forms matrix of all types of casts

A

Tamm-Horsfall protein (Uromucoid/Uromodulin)

77
Q

Normal urine protein value (Quantitative)

A

<10 mg/dL or 100 mg/24 hrs

78
Q

Protein reaching >30mg/dL (300 mg/L)

A

Clinical Proteinuria

79
Q

This are abnormally produced proteins in multiple myeloma and macroglobulinemia

A

Immunoglobulin paraprotein

80
Q

Abnormal protein found in multiple myeloma

A

Bence-Jones protein

81
Q

Significant clinical finding in preeclampsia

A

Proteinuria

82
Q

Glomerulonephritis significant clinical finding

A

Presence of dysmorphic rbc

83
Q

Microalbuminuria in diabetic patients is suggestive of

A

Diabetic nephropathy

84
Q

Microalbuminuria is significant when it drops to ___________ when using quantitative procedures for albumin using a 24 hr urine specimen

A

30-300 mg/24 hrs

85
Q

Albumin excretion rate of _________ is indicative of microalbuminuria

A

20-200 ug/min

86
Q

Normal urine glucose level

A

15 mg/dL

87
Q

Normal urine glucose in fasting state

A

2 - 20mg/dL per 100 mL of urine

88
Q

Positive reaction for clinitest

A

Blue to orange/red positive reaction

89
Q

To prevent pass through phenomenon in clinitest

A

Change urine volume from 5 drops to 2 drops

90
Q

Acetest cannot detect what kind of ketone bodies

A

B-Hydroxybutyric acid

91
Q

Positive result for acetest

A

Purple

92
Q

Parasite than cause hematuria

A

Schistosoma haematobium

93
Q

Cholesterol-lowering statin medication lead to

A

Myoglobinuria

94
Q

Test used to differentiates hemoglobin or myoglobin in urine

A

BLONDHEIM’S test

95
Q

Positive result for ICTOTEST

A

Blue to purple color

96
Q

Urobilinogen excretion peaks

A

Between 2-4 pm (Need early afternoon specimen)

97
Q

1mg/dL is equals to ______ ehrlich urine

A

1 ehrlich unit

98
Q

Positive result for Ehrlich’s test for urobilinogen

A

Cherry red color

99
Q

This is a rapid screening test for urine porphobilinogen

A

Hoesch Test (Inverse Ehrlich)

100
Q

Reagent for Ehrlich test

A

P-dimethylaminobenzaldehyde (PDAB) & Sodium acetate (enhance color reaction)

101
Q

Reagent for Hoesch test

A

Hoesch reagent (Ehrlich reagent dissolved in 6M HCl)

102
Q

This test distinguish the presence of urobilinogen and porphobilinogen in the urine

A

Schwartz-watson differentiation test

103
Q

What is the 11th parameter in the reagent strip

A

Ascorbic acid/Vitamin C

104
Q

Fill in the following normal values for the ff. Parameters

pH:
Protein:
Glucose:
Ketones:
Blood:
Bilirubin:
Urobiliogen:
Nitrite:
Leukocyte Esterase:

A

Protein: 4.5 - 8.0
Glucose: <10 mg/dL
Ketones: Neg
Blood: Neg
Bilirubin:Neg
Urobiliogen: <1 mg/dL
Nitrite: Neg
Leukocyte Esterase: Neg

105
Q

How to store reagent strip

A

Store below 30 deg c; do not freeze

106
Q

This is an green dye that stains nuclear membranes, mitochondria and negatively charged cell membranes

A

Carbocyanine

107
Q

This is an orange dye that stains DNA used in automated urine analyzer

A

Phenathridine

108
Q

This parameter in urine dip-stick is affected by run over

A

pH

109
Q

Principle of glucose reagent strip test

A

Double sequential enzyme reaction

110
Q

Principle of Ketone in reagent strip test

A

Sodium Nitroprusside

111
Q

Principle of pH in reagent strip

A

Double indicator system

112
Q

Principle of specific gravity in reagent strip test

A

pKa change of poly-electrolyte

113
Q

Principle of protein in reagent strip test

A

Protein error of indicator

114
Q

Principle of blood in reagent strip test

A

Pseudoperoxidase activity of Hgb

115
Q

Principle of bilirubin in reagent strip

A

Diazo reaction

116
Q

Principle of Urobilinogen in reagent strip

A

Ehrlich’s reaction

117
Q

Principle of Nitrite in reagent strip

A

Greiss reaction

118
Q

Principle of Leukocyte Esterase

A

Leukocyte Esterase

Clinical Microscopy (4 decks)

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