Physical Examination

Question 1

Describe normal urine color?

Answer 1

Pale yellow, yellow, amber

Question 2

What causes the yellow color of urine?

Answer 2

Urochrome pigment

Question 3

What is Urochrome a product of?

Answer 3

endogenous metabolism, it is produced at a constant rate under normal conditions

Question 4

The amount of Urochrome produced depends on?

Answer 4

The body’s metabolic state, with increased amounts produced in thyroid / fasting conditions

Question 5

T/F: because urochrome is excreted at a constant rate the intensity of the yellow color in a freash specimen can give a rough estimate of urine concentration.

Answer 5

True

Question 6

What two additional pigments are present in urine in smaller quantities?

When are these colors most evident?

Answer 6

• Uroerythrin (pink pigent)
  
  • most evident in refridgerated specimens
• Urobilin (orange-brown)
  
  • oxidation product of urobilinogen, orange-brown color in urine that is not fresh.

Question 7

What is an abnormal pigment in urine?

Answer 7

Bilirubin

Question 8

If a specimen has yellow foam on top it indicates the prescence of?

Whit foam indicates?

Answer 8

• Bilirubin
• Protein

Question 9

The thick orange pigemnt that interferes with chemical tests is the use of what medication used to treat UTIs?

Answer 9

Pyridium or Azo-ganstrin

Question 10

Besides RBCs, what two other substances produce red urine?

Answer 10

• Hemoglobin
• Myeoglobin

Question 11

How is hemoglobinuria distinguished from myeoglobinuria?

Answer 11

Examining plasma

Hemoglobin = red plasma

myeglobin = clear plasma

Question 12

What medications cause brown/black urine? (4)

Answer 12

• levodopa
• methlydopa
• phenol derivatives
• metrondoazole (flagyl)

Question 13

Homogenstic acid a metabolite of phenylalanine imparts a black color to urine from persons with?

Answer 13

inborn error of metabolism, alkoptonuria

Question 14

Blue/green urine is usualy caused by?

Answer 14

• bacterial infection by Pseudomonas species and instestinal tract infections increasing indican.
• Breath doedorizers (clorets) cause green
• medications robaxin, methylene blue and elavil cause blue pee
• specimen collection bags from hospital patients can have purple staining caused by klebsiallea or provendencia species

Question 15

1. Amphorus phosphates in alkaline urine produce what color precipitates?
2. Amphorus urates in acidic urine produce what color precipitates?

Answer 15

1. pink
2. white

Question 16

Describe pathologic causes of urine TBD? (4)

Answer 16

• RBCs - non sq. eithelial cells
• WBCs - abnormal crystals
• Bacteria - lymph fluid
• Yeast - lipids

Question 17

What is the specific gravity of the filtrate entering the glomerulus?

Answer 17

1.010 (isothenuric)

Question 18

Normal SG range?

Answer 18

1.002 - 1.035

most specimens fall between 1.015 - 1.030

Question 19

What is the reagent strip reaction based on?

Answer 19

• Is based on the change in pKa (dissociation constant) of a poly electrolyte in an a lkaline medium.
• The poly electrolyte ionizes, releasing H+ ions in proportion to the number of ions in solution.
• The higher the concentration of urine , the more H+ ions realeased therfore lowering the pH.

Question 21

Reagent strip abnormalities over 1.040?

Answer 21

seen in patients recently undergoner a pyelogram

Question 22

A recfratometer measures refractive index.

1. Are temperature corrections necessary?
2. What are the corrections for glucose and protein?

Answer 22

1. No
2. subtract 0.003 for each gram of glucose and 0.004 for each gram of protein