PHYSICAL EXAMINATION OF URINE

Question 1

body’s state of hydration

Answer 1

URINE VOLUME

Question 2

URINE VOLUME

influenced by:

Answer 2

o fluid intake
o fluid loss from non-renal sources
o variations in ADH secretion
o need to excrete increased amount of dissolved solids

Question 3

URINE VOLUME

Normal Range (24 hours):

Answer 3

600-2000 ml

Question 4

URINE VOLUME

Average (24 hours) :

Answer 4

1200-1500 ml

Question 5

OLIGURIA in infants

Answer 5

< 1 ml/kg/hr

Question 6

OLIGURIA in children

Answer 6

< 0.5 ml/kg/hr

Question 7

OLIGURIA in adults

Answer 7

< 400 ml/day

Question 8

ANURIA VOLUME

Answer 8

< 100 ml/day

Question 9

POLYURIA VOLUME

Answer 9

 >2.5 L/day
 2.5-3 ml/kg/day

Question 10

NOCTURIA VOLUME

Answer 10

more than 500 ml of urine at night

Question 11

Normal night urine output:

Answer 11

<400 mL

Question 12

OLIGURIA CAUSES

Answer 12

 Dehydration
 Renal diseases
 Renal calculi or tumor

Question 13

ANURIA CAUSES

Answer 13

 Complete obstruction (stones, tumors)
 Toxic agents
 Decreased renal blood flow

Question 14

POLYURIA CAUSES

Answer 14

 Increased fluid intake
 Diuretics, nervousness
 Diabetes mellitus
 Diabetes insipidus

Question 15

NOCTURIA CAUSES

Answer 15

 Pregnancy

Question 16

 Related with insulin

Answer 16

DIABETES MELLITUS

Question 17

 The kidneys excrete increased amounts of water to remove the dissolved glucose

Answer 17

DIABETES MELLITUS

Question 18

 ↑ SPECIFIC GRAVITY

Answer 18

DIABETES MELLITUS

Question 19

 Related with ADH

Answer 19

DIABETES INSIPIDUS

Question 20

 The water needed for adequate body hydration is not reabsorbed

Answer 20

DIABETES INSIPIDUS

Question 21

 ↓ SPECIFIC GRAVITY

Answer 21

DIABETES INSIPIDUS

Question 22

should correlate with urine specific gravity

Answer 22

URINE COLOR

Question 23

specimen should be examined under a good light source, looking down through the container against a

Answer 23

white background

Question 24

Normal Urine Color:

Answer 24

straw, pale yellow, light yellow, yellow, dark yellow and amber

Question 25

 Major pigment

Answer 25

Urochrome (Yellow)

Question 26

 Production is directly proportional to metabolic rate

Answer 26

Urochrome (Yellow)

Question 27

 Excreted at a constant rate as a product of endogenous metabolism

Answer 27

Urochrome (Yellow)

Question 28

 Increased in thyrotoxicosis, fever, starvation

Answer 28

Urochrome (Yellow)

Question 29

 May deposit in amorphous urates and uric acid crystals

Answer 29

Uroerythrin (Pink)

Question 30

 Imparts an orange brown color to a urine that is not fresh

Answer 30

Urobilin (Dark yellow/Orange)

Question 31

 Oxidation product of urobilinogen

Answer 31

Urobilin (Dark yellow/Orange)

Question 32

 Recent fluid consumption

Answer 32

Colorless

Question 33

 Polyuria, dilute random specimen

Answer 33

Pale yellow

Question 34

 Concentrated specimen

Answer 34

Dark yellow

Question 35

 Strenuous exercise

Answer 35

Dark yellow

Question 36

 First morning specimen

Answer 36

Dark yellow

Question 37

 Carotene

Answer 37

Dark yellow

Question 38

 Dehydration

Answer 38

Amber

Question 39

Fever

Answer 39

Amber

Question 40

Burns

Answer 40

Amber

Question 41

 Bilirubin: Yellow foam

Answer 41

Orange

Question 42

: Viscous urine with orange foam

Answer 42

Orange  Phenazopyridin (Pyridium)

Question 43

Acriflavin

Answer 43

Orange

Question 44

 Biliverdin (oxidized bilirubin)

Answer 44

Yellow-green, Yellow-brown

Question 45

 Pseudomonas infection

Answer 45

Green

Question 46

 Amitriptyline, Methocarbamol, Cloets, Methylene blue, Phenol, Chlorophyll

Answer 46

Blue-green

Question 47

: Hematuria

Answer 47

Pink, Red  RBCs (Cloudy/smoky red)

Question 48

 Hemoglobin (Clear red): Intravascular hemolysis

Answer 48

Pink, Red

Question 49

 Myoglobin (Clear red/reddish-brown, colacolored): Rhabdomyolysis

Answer 49

Pink, Red

Question 50

Beets

Answer 50

Pink, Red

Question 51

 Porphyrins

Answer 51

Burgundy/Purplish red

Question 52

 Methemoglobin (acidic urine)

Answer 52

Brown, Black

Question 53

 Homogentisic acid (alkaline urine): Alkaptonuria

Answer 53

Brown, Black

Question 54

 Melanin (upon air exposure)

Answer 54

Brown, Black

Question 55

Phenol derivative

Answer 55

Brown, Black

Question 56

 Phenol derivative, Argyrol, Methyldopa/Levodopa, Metronidazole (Flagyl)

Question 57

 results from the IN VIVO BREAKDOWN of RBCs

Answer 57

HEMOGLOBIN

Question 58

 results from BREAKDOWN OF SKELETAL MUSCLES

Answer 58

MYOGLOBIN

Question 59

 Cola-colored

Answer 59

Levodopa

Question 60

Mepacrine

Answer 60

 Yellow

Question 61

 Green-brown

Answer 61

Methyldopa

Question 62

 Reddish brown

Answer 62

Metronidazole

Question 63

 Orange-red

Answer 63

Phenazopyridine

Question 64

Rifampin

Answer 64

Pink, Red  Bright orange-red

Question 65

 Bright yellow

Answer 65

Riboflavin

Question 66

 refers to transparency or turbidity of a urine specimen

Answer 66

URINE CLARITY

Question 67

 evaluated by visually examining a mixed specimen in a clear container while holding it in front of a light source; view through a newspaper print

Answer 67

URINE CLARITY

Question 68

URINE CLARITY  commonly used terminologies:

Answer 68

clear, hazy, cloudy, turbid, milky

Question 69

 No visible particulates, transparent

Answer 69

Clear

Question 70

 Few particulates, newsprint easily seen through urine

Answer 70

Hazy

Question 71

 Many particulates, newsprint is blurred through urine

Answer 71

Cloudy

Question 72

 Newsprint cannot be seen

Answer 72

Turbid

Question 73

 May precipitate or clot

Answer 73

Milky

Question 74

Nonpathologic CAUSES OF URINE TURBIDITY

Answer 74

 Squamous epithelial cells  Amorphous urates  Amorphous phosphates & carbonates (white precipitate)  Vaginal cream, semen and fecal contamination  radiographic contrast media  talcum powder

Question 75

Pathologic CAUSES OF URINE TURBIDITY

Answer 75

Nonsquamous Crystals Lymph fluid Lipids

Question 76

ACIDIC URINE

Answer 76

 Amorphous urates  Radiographic ocntrast media

Question 77

ALKALINE URINE

Answer 77

 Amorphous phosphates  Carbonates

Question 78

SOLUBLE WITH HEAT

Answer 78

 Amorphous phosphates  Uric acid crystals

Question 79

SOLUBLE WITH DILUTE ACETIC ACID

Answer 79

 RBCs  Amorphous phosphates  Carbonates

Question 80

INSOLUBLE WITH DILUTE ACETIC ACID

Answer 80

 WBCs, Bacteria, Yeasts, Spermatozoa

Question 81

SOLUBLE WITH ETHER

Answer 81

 Lipids, Lymphatic fluid, Chyle

Question 82

 Normal Odor

Answer 82

Aromatic

Question 83

 Acute tubular necrosis

Answer 83

Lack of Odor

Question 84

 Bacteria, UTI

Answer 84

Foul/ammonia-like

Question 85

 Ketones (DM, starvation, vomiting)

Answer 85

Fruity/sweetish

Question 86

 Ingestion of asparagus, garlic, eggs, onion

Answer 86

Mercaptan/pungent

Question 87

 Recto-vesical fistula

Answer 87

Fecaloid

Question 88

 Contamination

Question 89

 Maple Syrup Urine Disease

Answer 89

Maple syrup

Question 90

 Phenylketonuria

Answer 90

Mousy

Question 91

 Trimethylaminuria

Answer 91

Rotting fish

Question 92

 Tyrosinemia

Answer 92

Rancid

Question 93

 Methionine malabsorption

Answer 93

Cabbage/hops

Question 94

 Isovaleric and glutaric acidemia

Answer 94

Sweaty feet

Question 95

 Cystine disorder

Answer 95

Sulfur/rotten egg odor

Question 96

 determined to evaluate the kidney’s ability to selectively reabsorb essential substances and water from the filtrate

Answer 96

URINE SPECIFIC GRAVITY

Question 97

 detects possible dehydration or abnormalities in ADH

Answer 97

URINE SPECIFIC GRAVITY

Question 98

 density of urine compared with the density of a similar volume of distilled water at a similar temperature

Answer 98

URINE SPECIFIC GRAVITY

Question 99

 NORMAL SG (random urine):

Answer 99

1.003 – 1.035

Question 100

 Isosthenuria:

Answer 100

1.010

Question 101

 Hyposthenuria:

Answer 101

< 1.010

Question 102

 Hyperstenuria:

Answer 102

> 1.010

Question 103

 Not a urine (except DI):

Answer 103

< 1.003

Question 104

 Radiographic contrast media:

Answer 104

>1.040

Question 105

DIRECT METHODS

Answer 105

1. Urinometery/Hydrometry 2. Harmonic Oscillation Densitometry

Question 106

INDIRECT METHODS

Answer 106

1. Refractometer 2. Reagent Strip

Question 107

 Less accurate than the other methods and is not recommended by CLSI

Answer 107

Urinometery/Hydrometry

Question 108

 Requires 10 to 15 ml urine (major disadvantage)

Answer 108

Urinometery/Hydrometry

Question 109

 Calibration: Potassium sulfate (K2SO4) solution – SG reading should be 1.015

Answer 109

Urinometery/Hydrometry

Question 110

 Calibration temperature is 20°C

Answer 110

Urinometery/Hydrometry

Question 111

 Based on the principle that the frequency of a sound wave entering a solution changes in proportion to the density of the solution

Answer 111

Harmonic Oscillation Densitometry

Question 112

 Results are linear up to a specific gravity of 1.080

Answer 112

Harmonic Oscillation Densitometry

Question 113

 Measures the refractive index to determine the concent ration of dissolved particles

Answer 113

Refractometer

Question 114

 Requires a small volume of urine sample and temperature corrections are (compensated between 15° to 38°C)

Answer 114

Refractometer

Question 115

 Provides a convenient method for routine urinalysis

Answer 115

Reagent Strip

Question 116

 Principle: Change in pKa (acid dissociation c onstant) of a polyelectrolyte

Answer 116

Reagent Strip

Question 117

 Bromthymol blue (indicator) on the reagent pad measures the change in pH

Answer 117

Reagent Strip

Question 118

Nitrofurantoin

Answer 118

Orange

Question 119

Phenindione

Answer 119

Orange

Question 120

menstrual contamination

Answer 120

Pink, Red

Question 121

Rifampin

Answer 121

Pink, Red

Question 122

Argyrol

Answer 122

Burgundy/Purplish red

Question 123

Methyldopa/Levodopa

Answer 123

Burgundy/Purplish red

Question 124

Metronidazole (Flagyl)

Answer 124

Burgundy/Purplish red