Physical Exam Flashcards
Physical properties of urine
Color
Clarity
Specific gracity
Normal color of urine
Yellow
color of urine is due to (3)
Urochrome
Urobilin
Uroeythrin
chemical primarily responsible for the yellow color of urine
Urochrome
Urine clarity
Clear
Hazy
Cloudy
Turbid
Milky
Urine clarity
No visible particulates
Clear
Urine clarity
Transparent
Clear
Urine clarity
Few particulates
Hazy
Urine clarity
Few particulates, print easily seen through urine
Hazy
Urine clarity
Many particulates
Cloudy
Urine clarity
Print blurred
Cloudy
Urine clarity
Print cannot be seen
Turbid
Urine clarity
Precipitation is present
Milky
How can you say that the urine is milky
Presence of precipitation or clot
Ways in measuring specific gravity
- refractometer
- urinometer
- harmonic oscillation densitometry
- reagent strip
Refractometer measures
Refractive index
What does refractometer particularly determines
Concentration of dissolved particles
Determines concentration of dissolved particles by measuring refractive index
Refractometer
T/F In refractometer, temperature correction is necessary
False
Refractometer requires correction for
Glucose and protein
Principle of refractometer
Refractive index
Principle: Changes in colligative properties by particle number
Osmolality
Principle: pKa changes of a polyelectrolyte by ions present
Reagent strip
Calibrator for refractometer
Potassium sulfate
Distilled water
5% NaCl
9% sucrose
Specific gravity of potassium sulfate
1.015
Specific gravity of distilled water
1.00
Specific gravity of 5% NaCl
1.022
Specific gravity of 9% sucrose
1.034
1.034
9% sucrose
Two types of refractometer
Handheld
Digital
Consists of a weighted float attached to a scale that has been calibrated in terms of urine specific gravity
Urinometer
When using urinometer, how much volume of urine is needed
50 mL
When using urinometer, for every ___ Degrees increase, add _____
3 degrees, 0.001
Subtract ___ for each gram% of protein present
0.003
Subtract ___ for each gram% of glucose present
0.004
Calibrating temp of urinometer
20 degrees
Less accurate method for specific gravity
Urinometer
Principle: frequency of a sound wave entering a solution changes in proportion to the density of the solution
Harmonic oscillation densitometer
It is affected only by number of particles
Osmolality
More representative measure of renal concentrating ability can be obtained by measuring ___
Osmolarity
Effect of 1 mole of solute in freezing point
Normal pure water: 0
Lowered 1.86
Effect of 1 mole of solute in boiling point
Normal: 100 degrees
Raised 0.52
Effect of 1 mole of solute in vapor pressure
Normal: 2.38 mm/Hg
Lowered 0.3 mm/Hg
Effect of 1 mole of solute in osmotic pressure
Normal: 0
Increased 1.7
As the specific gravity increases, the indicator changes from ___ through shades of ____ to ____
Blue to green to yellow
Specific gravity acidic
1.030
Intervals for specific gravity
0.005
Indicator of specific gravity
Bromthymol blue
normal yellow color of urine is produced by
Urochrome
presence of bilirubin in a urine specimen produces a
Yellow foam when shaken
The presence of a pink precipitate in a refrigerated speci- men is caused by
Uroerythrin
Microscopic examination of a clear urine that produces a white precipitate after refrigeration will show
Amorphous phosphate
strong odor of ammonia in a urine specimen could indicate
Old spx
This pigment is high in thyroid conditions
Urochrome
This pigment is evident in refrigerated spx
Uroerythrin
Pigment produced by urobilin
Orange brown
Orange brown pigment
Urobilin
This pigment states a not fresh urine
Urobilin
What analyte is present with Amber urine
Bilirubin
White foam appears when shaken, which analyte is present
Protein
What color:
Phenindione
Orange yellow
What color: pyridium
Orange yellow
What causes orange yellow urine
Pyridium
Phenindione
What color
Bilirubin oxidized to biliverdin
Yellow green
What causes a yellow-green color
Bilirubin oxidized to biliverdin
Pseudomonas inf causes what urine color
Green
Green colored urine may be due to
Pseudomonas inf
Asparagus
What color
Amitriptyline
Blue-green
What color
Methocarbamol (Robaxin)
Blue green
What color
Indican
Blue green
Familial hypercalcemia is known as ____ it makes the urine color ____
Blue diaper syndrome
Blue
What causes pink urine
RBC (hematuria)
What color
Hematuria
Pink
Most common abnormal urine color
Red
What color
Beets
Red
What color
Rifampin
Red
Describe the urine of px with hemoglobinuria
Clear red
Urine of px with hematuria
Cloudy red / pink
How to differentiate hemoglobin from myoglobin
Red plasma = hemoglobin
Clear plasma = myoglobin
When the urine became acidic, rbc can be oxidized to ____ which turns the urine to color ____
Methemoglobin
Red brown
Color of porphyrins
Port wine
What analyte is present with port win urine
Porphyrins
What analyte is present with port win urine
Porphyrins
Color of urine of px with babesia
Red
Homogentisic acid causes ___ urine
Black
Melanin or melanoma causes ____ urine
Black
Homogentisic acid is a metabolite of ___
Phenylalanine
Color of urine of px with alkaptonuria
Yellow to black
B complex vitamin causes ___ urine
Dark yellow
Clarity of a freshly voided normal urine
Clear
Largest cell found in urine
Squamous epithelial cells
Pathologic or Non pathologic
Squamous epithelial cells
Non
Pathologic or Non pathologic
Fecal contam
Non
Pathologic or Non pathologic
Talcum powder
Non
Pathologic compound seen in immunocompromised px
Yeast
Pathologic compound seen in px infected with Wuchereria bancrofti
Lymph fluid
Lipids
Lymph fluid and lipids are found in px infected with
Wuchereria bancrofti
Pathologic or Non pathologic
Fecal with fistula
Pathologic
Causes a sand- like appearance urine
Amorphous phosphates, carbonates, urates
Radiographic contrast media causes the specific gravity of urine to (increase or decrease)
Increase
1.055 to 1.065
Amorphous phosphate, carbonates, and urates precipitate at what temp
Ref temp
Amorphous phosphate and carbonate causes white precipitation at what pH
Alkaline
What causes white precipitation at alkaline pH
Amorphous phosphate and carbonate
This causes pink dust at acidic pH
Amorphous urate
Amorphous urate causes pink dust precipitate at what pH
Acidic
Specific gravity of random urine
1.002 to 1.035
Unit of density
Mass per unit volume
Unit of specific gravity
None
Direct method for specific gravity
Urinometer
Harmonic Oscillation Densitometer
Indirect method for specific gravity
Reagent strip
Refractometer
Direct or indirect
Urinometer
Direct
Direct or indirect
Harmonic oscillation densitometer
Direct
Disadvantage of urinometer
Less accurate
Requires large volume
In every one grams/dL of glucose, you subtract ____
0.004
Calibrating temp for urinometer
20 C
Specific gravity
Isosthenuric
1.010
SG
Hyposthenuric
<1.010
SG
Hypersthenuric
> 1.010
Specific gravity of 1.010
Isosthenuric
Specific gravity of < 1.010
Hyposthenuric
Normal odor of urine
Aromatic
Odor of px with UTI
Foul ammonia
Foul ammonia is due to
UTI
Fruity sweet odor can be due to
Ketones
DM
Urine odor of px with ketones
Fruity, sweet
Tyrosinemia causes ___ odor
Rancid
What causes rancid urine
Tyrosinemia
What causes sweaty feet odor
Isovaleric acidemia
Isovaleric acidemia causes what odor
Sweaty feet
Cabbage odor is caused by
Methionine malabsorption
Methionine malabsorption turns the urine to smell ___
Cabbage like
Contamination causes ___ odor
Bleach
Bleach like odor is caused by
Contamination
Fecaloid smell is due to
Fistula
Fistula causes what odor
Fecaloid
Putrid odor is caused by
Necrosis
Odor of urine in px with necrosis
Putrid or extreme foul
Dried celery odor is caused by
Butyric hydroxic acid
Oast house disease
Odor of urine in px with oast house disease
Dried celery odor
Tea colored urine is caused by
Myoglobinuria
Which formed elements can be insoluble when diluted acetic acid is added
WBC
