Chapter 4 - Physical Examination of Urine Flashcards
1
Q
Normal range for urine volume (24 hours)
A
600-2000 mL
2
Q
Average normal range for urine volume (24 hours)
A
1200 - 1500 mL
3
Q
Night urine output (volume)
A
<400 mL
4
Q
Day:night ratio of normal urine volume
A
2-3:1
5
Q
Container capacity for UA
A
50 mL
6
Q
Required volume of a urine specimen for routine UA
A
10-15 mL (avg of 12 mL)
7
Q
Causes of polyuria
A
DM, DI, diuretics, nervousness, increased fluid intake
8
Q
How to diff DI from DM
A
SG
9
Q
What is the SG for DI? (Inc or dec)
A
Dec
10
Q
expected SG for DM px (inc or dec)
A
Inc
11
Q
Urine volume considered as polyuria
A
> 2000 mL / 24 hrs
12
Q
Decreased urine volume
A
Oliguria
13
Q
Urine vol considered as oliguria
A
<500 mL/day (Henry’s)
<400 mL/day (Strasinger)
14
Q
Complete cessation of urine flow
A
Anuria
15
Q
Nocturia is defined as excretion of _____ (urine volume) at night
A
More than 500 mL
16
Q
Cause of nocturia
A
Pregnancy
17
Q
Oliguria or anuria: renal diseases
A
Oliguria
18
Q
Oliguria or anuria: toxic agents
A
Anuria
19
Q
Oliguria or anuria: decreased renal blood flow
A
Anuria
20
Q
Oliguria or anuria: dehydration
A
Oliguria
21
Q
Oliguria or anuria: renal calculi or tumor
A
Oliguria
22
Q
Oliguria or anuria: complete obstruction of stones / tumors
A
Anuria
23
Q
Rough indicator of the degree of hydration
A
Urine color
24
Q
Normal urine color
A
Colorless to deep yellow
25
Most common abnormal urine color
Red / red brown
26
Urine color should correlate with what parameter
Urine SG
27
How do you examine urine color?
Look down through the container against a white background
28
Color and SG expected for the urines of persons with low fluid intake
Dark yellow, high urine SG
29
Color and SG expected for the urines of persons with high fluid intake
Pale yellow, low urine SG
30
Urine pigment that is color pink and may deposit in amorphous urates and uric acid crystals
Uroerythrin
31
Pigment in urine that imparts an orange brown color to a urine that is not fresh
Urobilin
32
Color of urobilin
Dark yellow / orange
33
Major pigment of urine
Urochrome
34
Color of urochrome
Yellow
35
Urochrome is _____ (increased or decreased) during fever, starvation and thyrotoxicosis
Increased
36
Lab correlations of urine color: carotene
Dark yellow
37
Lab correlations of urine color: Bilirubin
Orange
38
Lab correlations of urine color: biliverdin
Yellow green / yellow-brown
39
Lab correlations of urine color: Pseudomonas infection
Green
40
Lab correlations of urine color: Indican
Blue-green
41
Lab correlations of urine color: phenol
Blue-green
42
Lab correlations of urine color: hematuria
Pink / red
43
Lab correlations of urine color: porphyrins
Portwine, burgundy, purplish red
44
Lab correlations of urine color: methemoglobin (acidic urine)
Brown, black
45
Lab correlations of urine color: phenazopyridine (pyridium)
Orange
46
Lab correlations of urine color: homogentisic acid (alkaline urine)
Brown, black
47
Lab correlations of urine color: fever
Amber
48
Lab correlations of urine color: first morning specimen
Dark yellow
49
Lab correlations of urine color: polyuria
Pale yellow
50
Lab correlations of urine color: recent fluid comsumption
Colorless
51
Lab correlations of urine color: Dilute random specimen
Pale yellow
52
Lab correlations of urine color: strenuous exercise
Dark yellow
53
Lab correlations of urine color: burns
Amber
54
Lab correlations of urine color: dehydration
Amber
55
Lab correlations of urine color: rifampin
Pink / red
56
Lab correlations of urine color: beets
Pink / red
57
Lab correlations of urine color: methyldopa / Levodopa
Brown, black, cola-colored
58
Lab correlations of urine color: Myoglobin
Pink / red
59
Lab correlations of urine color: melanin (upon air exposure)
Brown, black
60
Lab correlations of urine color: chlorophyll
Blue-green
61
Lab correlations of urine color: amitriptyline
Blue-green
62
Lab correlations of urine color: nitrofurantoin
Orange
63
Lab correlations of urine color: menstrual contam
Pink, red
64
Lab correlations of urine color: methylene blue
Blue-green
65
Lab correlations of urine color: metronidazole (Flagyl)
Brown, black
66
Lab correlations of urine color: hemoglobinuria
Pink / red
67
Lab correlations of urine color: oxidized bilirubin
Yellow-green / yellow-brown
68
Tea-colored urine is associated with the presence of?
Bilirubin
69
Presence of yellow foam in the urine suggests?
Bilirubin
70
Urine color changes with commonly used drugs: levodopa (Tx: Parkinsonism)
Cola-colored (red then brown, alkaline)
71
Urine color changes with commonly used drugs: mepacrine [atabrine] (antimalarial, Tx: Giardiasis)
Yellow
72
Urine color changes with commonly used drugs: methyldopa [aldomet] (antihypertensive drug)
Green-brown
73
Urine color changes with commonly used drugs: Metronidazole (Flagyl) (Tx: Trichomoniasis)
Darkening, red-brown
74
Urine color changes with commonly used drugs: phenazopyridine [pyridium] (Tx: UTI)
Orange-red, acid pH
75
Urine color changes with commonly used drugs: riboflavin [multivitamins]
Bright yellow
76
Urine color changes with commonly used drugs: rifampin (Tx: TB)
Bright orange-red
77
How should you observe the transparency or clarity of urine?
Thoroughly mix spn, examine under light source, view through a newspaper print
78
Grade the urine clarity: few particulates, print easily seen through urine
Hazy
79
Grade the urine clarity: many particulates, print blurred through urine
Cloudy
80
Grade the urine clarity: may precipitate or be clotted
Milky
81
Grade the urine clarity: print cannot be seen through the urine
Turbid
82
Grade the urine clarity: no visible particulates, transparent
Clear
83
Identify the following causes of urine turbidity whether they are pathologic or nonpathologic
1. RBCs
2. Amorphous urates
3. Fecal contam
4. Lymph fluid (chyluria)
5. Lipids
6. Bacteria
7. Squamous epithelial cells
1. Patho
2. Nonpatho
3. Nonpatho
4. Patho
5. Patho
6. Patho
7. Nonpatho
84
```
Lab correlations in urine turbidity:
(Matching type) (may have multiple answers)
1. Amorphous urates
2. Amorphous phosphates
3. Carbonates
4. RBCs
5. Uric acid crystals
6. Radiographic contrast media
7. Lipids
8. Spermatozoa
9. Lymphatic fluid
10. WBCs
11. Bacteria
12. Yeast
13. Chyle
```
a. Acidic urine
b. Akaline urine
c. Soluble in ether
d. Soluble with heat
e. Soluble in dilute acetic acid
f. Insoluble in dilute acetic acid
1. A, D
2. B, E
3. B, E
4. E
5. A, D
6. A
7. C
8. F
9. C
10. F
11. F
12. F
13. C
85
Determine the associated odor:
1. Normal
2. Acute tubular necrosis
3. PKU
4. DM
5. UTI
6. Tyrosinemia
7. Cystine disorder
8. Trimethylaminuria
9. Ingestion of asparagus
10. Methylmercaptan
1. Aromatic
2. Odorless
3. Mousy / musty
4. Fruity
5. Foul / ammoniacal
6. Rancid butter
7. Sulfur
8. Rotting fish
9. Pungent
10. Pungent
86
Determine the associated odor:
1. Ketones
2. Vomiting
3. MSUD
4. Glutaric acidemia
5. Oasthouse syndrome
6. Hawkinsuria
7. Methionine malabsorption
8. 3-hydroxy-3-methylglutaric aciduria
9. Multiple carboxylase deficiency
10. Ingestion of onions and garlic
1. Fruity, sweet
2. Fruity, sweet
3. Caramelized sugar, curry, maple syrup
4. Sweaty feet, acrid
5. Cabbage, hops
6. Swimming pool
7. Cabbage, hops
8. Cat urine
9. Tomcat urine
10. Pungent
