Foam + Clarity Flashcards
If a normal urine specimen is shaken or agitated sufficiently, a white 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 (2)
protein and bilirubin.
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.
protein (albumin)
egg albumin
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 defin-itive, this distinctive yellow coloration of the foam provides preliminary evidence for the presence of _____.
bilirubin
_______ noted in the physical examination are not reported in a routine urinalysis; instead, they serve as preliminary and supportive evidence for the presence of bilirubin and abnormal amounts of protein in the urine.
These suspected substances must be detected and confirmed during the chemical examination before either substance is reported.
Foam characteristics
______, 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.
Clarity
Often called______, clarity describes the cloudiness of the urine caused by suspended particulate matter that scatters light.
turbidity
In health, a freshly voided “clean catch” urine specimen is usually_____.
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______.
clear
cloudy
cloudy
Precipitation of solutes dissolved in urine, most commonly (2), can cause a normal urine specimen to appear cloudy.
amorphous urates and phosphates
(2) produce a white or beige precipitate and are present only in alkaline urine.
Amorphous phosphates and carbonates
In acidic urine, a pinkish precipitate (“brick dust”) results from the deposition of________.
uroerythin on amorphous urate and uric acid crystals
Indirectly, the color of the precipitate indicates whether a urine pH is acid (_____) or alkaline (_____)
pink
white, beige
On close inspection of the particulate matter in urine, a specific component may be evident.
Most often noted are (2)
Similarly, the excretion of (2), although rare, should be suspected in urine that appears opalescent or milky.
Urine clarity provides a rapid quality check for microscopic examination -that is, a cloudy urine specimen should have significant numbers of components present when viewed microscopically.
red blood cells and small blood clots.
fat or lymph
(2) are considered to be urine contaminants because they are not derived from the urinary tract; rather, they use it as a conveyance.
Spermatozoa and prostatic fluid
_______present in the urine after an x-ray procedure are iatrogenic and are not indicative of disease.
Radiographic contrast media
The presence of many (2) usually indicates improper collection of the urine specimen.
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 urinary tract infection.
squamous epithelial cells or fecal material
Pathologic substances in urine indicate (3)
For example, the presence of red blood cells in urine indicates damage to the urinary tract.
(1) deterioration of the barrier normally separating the urinary tract from the blood
(2) a disease process
(3) a metabolic dysfunction
At times the site of injury can be localized, as with the presence of dysmorphic_______, which are highly indicative of glomerular damage, or with the presence of red blood cells in casts, which indicate glomerular or tubular origin.
_______in urine indicate an inflammatory process somewhere in the urinary system.
red blood cells
White blood cells
Although______ are the most common cause of urinary tract infection, other agents can produce inflammation without it.
bacteria
In fresh urine, the presence of (3) indicates an infection of the upper urinary tract (e.g., renal pelvis, interstitium),
whereas the presence of (3-1) implies a lower urinary tract infection (e.g., bladder, urethra).
bacteria, white blood cells, and casts
bacteria and white blood cells without pathologic casts
In contrast, (2) although agents of infection, commonly originate from a vaginal infection and often are contaminants when present in the urine specimen of a female
yeast and trichomonads
Crystals:
• (found in alkaline urine) → Produce a white or beige precipitate.
• (found in acidic urine) → Form a pinkish “brick dust” precipitate due to the presence of uroerythrin.
Amorphous phosphates and carbonates
Amorphous urates and uric acid crystals
The color of the precipitate indirectly indicates urine pH:
• Pink (acidic urine) →_____ deposits on urates.
• White/beige (alkaline urine) →_____ and _____
Uroerythrin
Phosphates and carbonates.
• They are often present in urine due to skin contamination, especially in improperly collected specimens.
• A large number of these cells suggests poor collection technique rather than a disease process.
Epithelial Cells
External Contaminants:
• (4) may accidentally mix with the urine sample, making it appear cloudy.
• _____ can enter urine due to improper collection, but if persistent, it may indicate a pathologic fistula between the bladder and the colon.
Talc, lotions, creams, or powders
Fecal material
