Macroscopic Urine Examination Flashcards
physical examination of urine includes:
- urine color
- clarity
- specific gravity
pigment present in urine that gives a yellow color of urine
urochrome
urochrome was named by
Thudichum
pink pigment, is most evident in specimens that have been refrigerated, resulting in the precipitation of amorphous urates. attached to the urates, producing a pink color to the sediment.
uroerythrin
amorphous material in acidic level
amorphous urates
amorphous material in alkaline level
amorphous phosphate
- pigment of amorphous urates
- pigment of amorphous phosphate
- pink
- white
an oxidation product of the normal urinary constituent urobilinogen, imparts an orange-brown color to urine that is not fresh
urobilin
constituent of urobilinogen
urobilin
urine color associated with oxidation of porphobilinogen to porphyrins
red / port wine
urine color associated with melanoma and alkaptonuria
black
_ - oxidation product of the colorless pigment, melanogen, produced in excess when a malignant _ is present
melanin; melanoma
_ metabolite of phenylalanine, imparts a black color to alkaline urine from persons with the inborn-error of metabolism, called alkaptonuria
homogentisic acid
condition which urine color is normal at first but when left standing at RT changed color to black
alkaptonuria
inborn-error of metabolism that produce black urine
alkaptonuria
urine color associated with pseudomonas infection
green
urine color associated with clorets
blue-green
urine clarity with no visible particulates, transparent
clear
urine clarity with few particulates, print easily seen through urine
hazy
urine clarity with print cannot be seen through urine
turbid
urine clarity with many particulates, print blurred through urine
cloudy
urine clarity with precipitate or be clotted
milky
t/f. milky urine is not rare.
false
Semen is only reported when the physician is checking for _
fertility
point of reference
Squamous epithelial cells
condition which sperm goes to urine bladder instead of urethra
retrograde ejaculation
Nonpathologic Causes of Urine Turbidity
SMASFRTV
“smasfortv”
- Squamous epithelial cells
- Mucus
- Amorphous phosphates, carbonates, urates
- Semen, spermatozoa
- Fecal contamination
- Radiographic contrast media
- Talcum powder
- Vaginal creams
Pathologic Causes of Urine Turbidity
RWBYNALL
“rawbynall”
- RBC
- WBC
- Bacteria
- Yeast
- Nonsquamous epithelial cells
- Abnormal Cysts
- Lymph fluid
- Lipids
evaluation of urine concentration
specific gravity
urine with a specific gravity of 1.010
isosthenuric
urine with a specific gravity of <1.010
hyposthenuric
urine with a specific gravity of >1.010
hypersthenuric
specific gravity of most random specimens fall between
1.015 and 1.030
to determine whether specimen concentration is adequate to ensure the accuracy of chemical tests
specific gravity
current urine specific gravity measurement
- refractometer
- osmolality
- reagent strip
specific gravity measurement with a principle of pKa changes in polyelectrolyte by ions present
Reagent strip
specific gravity measurement with a principle of changes in colligative properties by particle number
osmolality
refractometry principle
refractive index
calibration of manual specific gravity measurement for every 1 gram of protein subtract _
0.003
calibration of manual specific gravity measurement for every 1 gram of glucose subtract _
0.004
temperature adjustment in refractometer
none
temperature adjustment in urinometer
Temperature C = 5/9 (F-32)
color microscopic correlations
blood
clarity microscopic correlations
- hematuria vs. hemoglobinuria / myoglobinuria
- pathologic and non pathologic cause of turbidity
(turbid) gross hematuria has _ RBCs
packed-filled
microscopic hematuria has _ RBCs
intact
blood microscopic correlations
RBCs, RBC Casts
protein microscopic correlations
casts, cells
nitrite microscopic correlations
bacteria, wbcs
a true UTI is accompanied by _
WBCs
leukocyte esterase microscopic correlations
wbcs, wbc casts, bacteria
glucose microscopic correlations
yeast
normal urine odor
aromatic
Foul, ammonia-like odor caused by
UTI, bacterial decomposition
Fruity, sweet odor is caused by
Ketones (diabetes mellitus, starvation, vomiting)
Maple syrup urine disease odor
maple syrup
rancid odor is caused by
tyrosinemia
mousy odor is caused by
phenylketonuria
sweaty feet odor is caused by
isovaleric acidemia
cabbage odor is caused by
methionine malabsorption
bleach odor is caused by
contamination
rotting fish “galunggong-like” odor is caused by
trimethylaminuria
urinary pigments that are present when refrigerated
- urochrome
- uroerythrin