Physical Examination of Urine Flashcards
Three things examined during physical examination of urine
Color
Clarity
Specific gravity
Pigment that gives urine its yellow color
Urochrome
Urochrome was named by ________ in the year _______.
Thudichum; 1864
Urochrome is a product of (exogenous/endogenous) metabolism.
Endogenous
TRUE OR FALSE:
Under normal conditions, urochrome is produced at a constant rate.
TRUE
Urochrome (increases/decreases) in urine that stands at room temperature
Increases
A pink pigment that can be observed in refrigerated urine samples
Uroerythrin
Refrigeration of urine samples can cause precipitation of what type of crystals?
Amorphous urates
An oxidation product of the normal urinary constituent urobilinogen which is also present in urine in small quantities.
Urobilin
Urobilin imparts _______ color to urine that is not fresh.
Orange-brown
Indicate the COLOR of urine caused by:
Recent fluid consumption
Colorless
Indicate the COLOR of urine caused by:
Polyuria or diabetes insipidus
Pale yellow
Indicate the COLOR of urine caused by:
Diabetes mellitus
Pale yellow
Indicate the COLOR of urine caused by:
Dilute random specimen
Pale yellow
Indicate the COLOR of urine caused by:
Concentrated specimen
Dark yellow
Indicate the COLOR of urine caused by:
B complex vitamins
Dark yellow
Indicate the COLOR of urine caused by:
Dehydration
Dark yellow
Indicate the COLOR of urine caused by:
Bilirubin
Dark yellow
Indicate the COLOR of urine caused by:
Acriflavine
Dark yellow
Indicate the COLOR of urine caused by:
Nitrofurantoin
Dark yellow
Indicate the COLOR of urine caused by:
Phenazopyridine (Pyridium)
Orange-yellow
Indicate the COLOR of urine caused by:
Phenindione
Orange-yellow
Indicate the COLOR of urine caused by:
Bilirubin oxidized to biliverdin
Yellow-green
Indicate the COLOR of urine caused by:
Pseudomonas infection
Green
Indicate the COLOR of urine caused by:
Amitriptyline
Blue-green
Indicate the COLOR of urine caused by:
Methocarbamol
Blue-green
Indicate the COLOR of urine caused by:
Clorets
Blue-green
Indicate the COLOR of urine caused by:
Indican
Blue-green
Indicate the COLOR of urine caused by:
Methylene blue
Blue-green
Indicate the COLOR of urine caused by:
Phenol
Blue-green
Indicate the COLOR of urine caused by:
Presence of red blood cells
Pink/Red
Indicate the COLOR of urine caused by:
Hemoglobin
Pink/Red
Indicate the COLOR of urine caused by:
Myoglobin
Red/Red-brown
Indicate the COLOR of urine caused by:
Beets
Pink/Red
Indicate the COLOR of urine caused by:
Rifampin
Phenolphthalein
Phenindione
Phenothiazine
Red
Indicate the COLOR of urine caused by:
Menstrual contamination
Red
Indicate the COLOR of urine caused by:
Porphyrins
Port wine
Indicate the COLOR of urine caused by:
Red blood cells oxidized to methemoglobin
Red-brown
Indicate the COLOR of urine caused by:
Homogentisic acid (alkaptonuria)
Brownish black/Black
Indicate the COLOR of urine caused by:
Malignant melanoma
Brownish black/Black
Indicate the COLOR of urine caused by:
Melanin or melanogen
Brownish black/Black
Indicate the COLOR of urine caused by:
Phenol derivatives
Brownish black/Black
Indicate the COLOR of urine caused by:
Argyrol (antiseptic)
Brownish black/Black
Indicate the COLOR of urine caused by:
Methyldopa or levodopa
Brownish black/Black
Indicate the COLOR of urine caused by:
Metronidazole (Flagyl)
Brownish black/Black
Presence of bilirubin may be suspected when urine produces _______ when shaken.
Yellow foam
Note: Normal urine produces small amount of rapidly disappearing foam
Large amount of white foam in urine indicates increased concentration of ________.
Protein
Color and transparency/clarity of urine when red blood cells are present:
Red; cloudy
Color and transparency/clarity of urine when hemoglobin or myoglobin are present:
Red; clear
Presence of myoglobin and hemoglobin both produces red and clear urine. What is one way to distinguish myoglobinuria from hemoglobinuria?
Examining patient’s plasma
Hemoglobinuria: red and clear urine + red plasma
Myoglobinuria: red and clear urine + clear plasma
Stains of purple in urine may also be observed when the patient has a bacterial infection caused by what species?
Klebsiella or Providencia spp.
This is a general term that refers to the transparency or turbidity of urine specimen
Clarity
Precipitation of this type of crystal/s cause a white cloudiness to the urine.
Amorphous phosphates and carbonates
Identify the term used for urine CLARITY/TRANSPARENCY:
No visible particulates, transparent
Clear
Identify the term used for urine CLARITY/TRANSPARENCY:
Few particulates, print easily seen through urine
Hazy
Identify the term used for urine CLARITY/TRANSPARENCY:
Many particulates, print blurred through urine
Cloudy
Identify the term used for urine CLARITY/TRANSPARENCY:
Print cannot be seen through urine
Turbid
Identify the term used for urine CLARITY/TRANSPARENCY:
May precipitate or be clotted
Milky
Identify if the cause of urine turbidity is PATHOLOGIC/NON-PATHOLOGIC:
Squamous epithelial cells
Non-pathologic
Identify if the cause of urine turbidity is PATHOLOGIC/NON-PATHOLOGIC:
Mucus
Non-pathologic
Identify if the cause of urine turbidity is PATHOLOGIC/NON-PATHOLOGIC:
Amorphous phosphates, carbonates, urates
Non-pathologic
Identify if the cause of urine turbidity is PATHOLOGIC/NON-PATHOLOGIC:
Semen
Non-pathologic
Identify if the cause of urine turbidity is PATHOLOGIC/NON-PATHOLOGIC:
Fecal contamination
Non-pathologic
Identify if the cause of urine turbidity is PATHOLOGIC/NON-PATHOLOGIC:
Radiographic contrast media
Non-pathologic
Identify if the cause of urine turbidity is PATHOLOGIC/NON-PATHOLOGIC:
Talcum powder
Non-pathologic
Identify if the cause of urine turbidity is PATHOLOGIC/NON-PATHOLOGIC:
Vaginal cream
Non-pathologic
Identify if the cause of urine turbidity is PATHOLOGIC/NON-PATHOLOGIC:
Red blood cells
Pathologic
Identify if the cause of urine turbidity is PATHOLOGIC/NON-PATHOLOGIC:
White blood cells
Pathologic
Identify if the cause of urine turbidity is PATHOLOGIC/NON-PATHOLOGIC:
Bacteria
Pathologic
Identify if the cause of urine turbidity is PATHOLOGIC/NON-PATHOLOGIC:
Yeast
Pathologic
Identify if the cause of urine turbidity is PATHOLOGIC/NON-PATHOLOGIC:
Nonsquamous epithelial cells
Pathologic
Identify if the cause of urine turbidity is PATHOLOGIC/NON-PATHOLOGIC:
Abnormal crystals
Pathologic
Identify if the cause of urine turbidity is PATHOLOGIC/NON-PATHOLOGIC:
Lymph fluid
Pathologic
Identify if the cause of urine turbidity is PATHOLOGIC/NON-PATHOLOGIC:
Lipids
Pathologic
TRUE OR FALSE:
Clear urine is always normal.
FALSE
Abnormalities may still be found in clear urine which can be examined chemically and/or microscopically.
The specific gravity of plasma filtrate entering glomerulus.
1.010
This term is used to describe urine with a specific gravity of 1.010.
Isosthenuric
Term used to describe urine with a specific gravity below 1.010
Hyposthenuric
Term used to describe urine with a specific gravity above 1.010
Hypersthenuric
Specific gravity of normal random specimens may be from ______ to ______.
1.002 to 1.035
Note: Most random urine specimens have a specific gravity of 1.015 to 1.030
TRUE OR FALSE:
Specimens with specific gravity below 1.002 are most likely not urine.
TRUE
This is the density of a solution compared with the density of a similar volume of distilled water at similar temperature.
Specific gravity
TRUE OR FALSE:
Specific gravity of urine is a measure of the density of the dissolved chemicals in the specimen.
TRUE
Methods used to measure urine specific gravity
Refractometry
Osmolality
Reagent strip
This is the only method used to measure urine specific gravity that requires correcting
Refractometry
Identify the method used to measure urine specific gravity:
Principle: changes in colligative properties by particle number
Osmolality
Identify the method used to measure urine specific gravity:
Principle: Refractive index
Refractometry
Identify the method used to measure urine specific gravity:
Principle: Reagent pKa changes of a polyelectrolyte by ions present
Reagent strip
This is a comparison of the velocity of light in air with the velocity of light in a solution
Refractive index
In refractometry, correction for glucose is calculated by subtracting ______ for each gram of glucose present.
0.004
In refractometry, correction for protein is calculated by subtracting ______ for each gram of protein present.
0.003
TRUE OR FALSE:
In measuring urine specific gravity via refractometry, temperature must also be corrected aside from glucose and protein.
FALSE
Note:
Temperature corrections are not necessary because the light beam already passes through a temperature-compensating liquid prior to being directed at the specific gravity scale.
Temperature is compensated between 15°C to 38°C.
This is used to calibrate refractometer.
Distilled water
These are used to check calibration of refractometer.
5% NaCl or 9% sucrose
Note:
For 5% NaCl, conversion table should read 1.022 +/- 0.001
For 9% sucrose, conversion table should read 1.034 +/- 0.001
This is a previously used method for determining urine specific gravities that consists of a weighted float attached to a scale that has been calibrated in terms of urine specific gravity. The weighted float displaces a volume of liquid equal to its weight.
Urinometry
TRUE or FALSE:
Urinometry is less accurate than refractometry, osmolality, and reagent strip.
TRUE
TRUE OR FALSE:
Specific gravity and osmolality are both affected by number of particles present and their densities.
FALSE
Note:
Specific gravity: affected by number of particles present and the density of particles
Osmolality: affected ONLY by the number of particles present
Substances of interest when evaluating renal concentration ability.
Sodium
Chloride
Urea*
TRUE or FALSE:
Osmolarity of a solution can be determined by measuring a property that is mathematically related to the number of particles in the solution and comparing this value with the value obtained from the pure solvent.
TRUE
Note:
These properties are the colligative properties. Freezing point, boiling point, vapor pressure, and osmotic pressure are examples.
The breakdown of this component gives urine a characteristic ammonia odor.
Urea
Identify possible cause of urine odor:
Fruity, sweet
Ketones
Identify possible cause of urine odor:
Foul, ammonia-like
Bacterial decomposition, urinary tract infection
Identify possible cause of urine odor:
Maple syrup
Maple syrup urine disease (MSUD)
Identify possible cause of urine odor:
Mousy
Phenylketonuria
Identify possible cause of urine odor:
Rancid
Tyrosinemia
Identify possible cause of urine odor:
Sweaty feet
Isovaleric acidemia
Identify possible cause of urine odor:
Aromatic
Normal
Identify possible cause of urine odor:
Cabbage
Methionine malabsorption
Identify possible cause of urine odor:
Bleach
Contamination
TRUE or FALSE:
It is normal for freshly voided urine to have a faint aromatic odor.
TRUE