Collection and Physical Exam of Urine

Question 1

What is first morning collection?

Answer 1

Collecting urine first thing in the morning: most concentrated, higher cellular elements and/or protein

Question 2

What is fasting-second collection?

Answer 2

Urine voided after 8 hours of fasting.

Question 3

What is postprandial-first collection?

Answer 3

Urine voided before a meal and specimen collected 2 hours after eating

Question 4

What does a timed (aka 24 hr collection) collection measure? 5

Answer 4

creatinine
urine urea nitrogen
glucose
sodium
potassium

Question 5

What is midstream clean catch? why preferred?

Answer 5

prefered type of urine collection for bacteria and sensitivity culture/testing. preferred bc there is a reduced incidence of cellular and microbial contamination

Question 6

what happens when urine sits for a long time?

Answer 6

RBCs undergo lysis, urine becomes alkalinized with the preciptation of salts

Question 7

What is the most common urine preservative chemical?

Answer 7

Boric acid

Question 8

what is the preferred way of preserving urine?

Answer 8

regrigeration

Question 9

how soon after collection must testing happen?

Answer 9

two hours

Question 10

What are the 3 parts of a routine urinalysis?

Answer 10

physical exam
chemical exam
microscopic exam

Question 11

What are the 3 aspects of the physical exam? A4SV

Answer 11

Appearance (color, clarity, foam, odor)
Specific gravity
volume

Question 12

What is the pigment that makes urine yellow?

Answer 12

urochrome

Question 13

What pigment may contribute pink/red coloration?

Answer 13

uroeythrin

Question 14

3 pathogenic WHITE color variations. CLP

Answer 14

Chyle (milky body fluid of lymph, fats, FFA’s)
Lipids
Pyuria (many WBC’s)

Question 15

2 non-pathogenic WHITE color variations

Answer 15

phosphates

vaganal creams

Question 16

2 pathogenic YELLOW/ORANGE color variations. LC

Answer 16

liver dysfunction (++urobilin or bilirubin)
Chemotherapy drugs

Question 17

2 pathogenic YELLOW/GREEN color variations. BB

Answer 17

biliverdin

bilirubin

Question 18

5 non-pathogenic YELLOW/ORANGE color variations. CCFVM

Answer 18

carrots (beta carotene)
concentrated urine (dehydration)
Food color
vit. B or C
meds

Question 19

1 non-pathogenic YELLOW/GREEN color variation

Answer 19

asparagus

Question 20

4 pathogenic PINK/RED color variations RHMP

Answer 20

RBC’s
Hemoglobin
Myoglobin
Porphyrin

Question 21

3 non-pathogenic PINK/RED variations BFM

Answer 21

beets
food color
medications

Question 22

1 pathogenic RED/PURPLE color variation. P

Answer 22

Porphyrin

Question 23

5 pathogenic RED/BROWN/BLACK color variations BMMMH/A

Answer 23

bilirubin
methemoglobin
myoglobin
melanin
homogentisic acid/alkpton

Question 24

4 non-pathogenic BROWN/BLACK color variations. IFAM

Answer 24

Iron compounds
Fava beans
Aloe
Meds

Question 25

1 pathogenic BLUE color variation. P

Answer 25

Pseudomonas infection

Question 26

4 non-pathogenic BLUE color variations. VTDM

Answer 26

Vit. B12 Thymole Diuretic Therapy Meds

Question 27

What makes urine white and cloudy?

Answer 27

amorphous phosphates preciptates

Question 28

what makes urine pink and cloudy

Answer 28

amorphous urate precipitate (uroerythrin)

Question 29

What makes urine cloudy?

Answer 29

salts / crystals

Question 30

what makes urine hazy?

Answer 30

mucus

Question 31

what makes urine smoky?

Answer 31

RBC's

Question 32

What makes urine turbid? LBPPE

Answer 32

``` leukocytes bacteria pus proteins epithelial cells ```

Question 33

what makes urine milky? 2

Answer 33

fat or chyle

Question 34

2 pathogenic CLEAR color variations. VdP

Answer 34

very dilute | polyuria (DM or DI)

Question 35

non-pathogenic CLEAR color variation

Answer 35

over-hydrated

Question 36

How would the urine appear if you observed these in it: "varying degrees of casts, cells, crystals/calculi, fat, microorganisms, fecal contaminatation"? Pathogenic or not?

Answer 36

Hazy/cloudy/turbid | pathogenic

Question 37

5 non-pathogenic substances that may create a hazy/cloud/turbid appearance. CCMRPF

Answer 37

``` creams/lotions crystals mucus radiographic dyes powders fecal contamination ```

Question 38

3 pathogenic causes of FOAMY urine

Answer 38

++protein (kidney disease) UTI (pus) Fistula from colon to bladder (fecal cont.)

Question 39

3 non-pathogenic causes of FOAMY urine

Answer 39

Rapid urination ++concentration (dehydration) toilet cleaner

Question 40

cause of "sweet/fruity" odor

Answer 40

ketones (DM)

Question 41

cause of "pungent" odor

Answer 41

bacteria (ammonia, eg UTI)

Question 42

cause of "maple syrup" odor

Answer 42

amino acids (maple syrup urine disease)

Question 43

cause of "musty/mousy" infant urine odor

Answer 43

phenylketonuria

Question 44

cause of "rancid butter/fishy" odor

Answer 44

hypermethioninemia

Question 45

cause of "stronger ammonia" odor

Answer 45

dehydration

Question 46

4 aspects of urine concentration test. SRPO

Answer 46

specific gravity refractive index pKa osmolarity

Question 47

what is specific gravity of urine?

Answer 47

ratio of weight: vol. urine: vol. distilled water

Question 48

What does specific gravity measure?

Answer 48

concentrating and diluting ability of the kidneys

Question 49

What is one of the first functions to be lost in the case of kidney tubular damage?

Answer 49

urine concentration ability

Question 50

What is normal specific gravity range?

Answer 50

1.003-1.035

Question 51

What does the refractive index measure? How?

Answer 51

Specific gravity via the total number of solids (aka how dense) in the urine. By how much light refracts when moving through urine

Question 52

what specifically do pKa strips measure?

Answer 52

Ionic concentration; specific gravity

Question 53

what makes urine more acidic?

Answer 53

increase in specific gravity

Question 54

what does urine osmolality measure?

Answer 54

total solute concentration

Question 55

how are urine osmolality and specific gravity different?

Answer 55

Osmolality measures number of particles in the solution | pKa measures the number and weight of the solutes

Question 56

what is osmolality a better indicator than pKa for?

Answer 56

determining the concentrating and diluting abilities of the kidney

Question 57

Is osmolality usually measured in routine assessments?

Answer 57

no

Question 58

what 3 conditions should osmolality be measured for?

Answer 58

uncontrolled DM nephrotic syndrome assessing hydration status