Physical Examination of Urine Flashcards
Enumerate the Physical Characteristics of Urine:
Color
Clarity
Odor
Taste
Foam
Volume
Concentration
In the evaluation of urine physical characteristics it is recommended to view through a clear container
TRUE OR FALSE
TRUE
Clear containers either plastic or glass.
What may this describe?
Can be inverted; a vortex can be used to mix the specimen (for the urine to be well-distributed all throughout).
A well-mixed specimen
Main determinant of body’s state of hydration.
Urine Volume
Characterized by decreased urine output.
Dehydration
Reabsorbs water retention in the body; prevents water to be excreted in the urine.
ADH also called Arginine Vasopressin
Waste products and solutes are released from the blood to the urine.
TRUE OR FALSE
TRUE
Of the approximate renal blood flow of 100 mL/min, only an average of 1 mL/min is excreted as urine.
TRUE OR FALSE
FALSE
the approximate renal blood flow is not 100 mL/min, its 120mL/min
____% of our blood passes through the renal artery, which will later on be filtered by the kidney.
25%
if an average of 1 mL/min is excreted as urine.
what may a value of 0.3mL/min imply?
Dehydration
if an average of 1 mL/min is excreted as urine.
what may a value of 15mL/min imply?
Excessive hydration
The kidneys excrete 2 – 3x more urine at night than it will during the day.
TRUE OR FALSE
FALSE
The kidneys excrete 2 – 3x more urine during the day than it will at night.
Night-and-Day Volume Ratio of Urine
1:2 to 1:3
Day-and-Night Volume Ratio of Urine
2:1 to 3:1
Normal Daily Urine Output
600 – 2000 mL
Average Daily Urine Output
1200 – 1500 mL
This derangement is characterized by an increase in daily urine output.
Polyuria
This derangement is characterized by an decrease in daily urine output.
Oliguria
Name this derangement
Possible Causes:
o (1) Increased fluid intake;
o (2) Nervousness;
o (3) Diabetes Mellitus;
o (4) Diabetes Insipidus;
o (5) Diuretics (e.g., alcohol, coffee, etc.).
Polyuria
Name this derangement
Possible Causes:
o (1) Decreased fluid intake;
o (2) Excessive water loss;
o (3) Calculi or tumors of the kidney.
Oliguria
increased urine excretion (>1800 mL/day).
Diuresis
Increased urine output at night.
Nocturia
Name this derangement
Possible Causes:
o (1) Increased fluid intake at night;
o (2) Reduction in bladder capacity;
o (3) Chronic progressive renal failure.
Nocturia
Can be caused by pregnancy (placenta occupies the space in the bladder), old age, or enlarged prostate.
Reduction in bladder capacity
Loss of circadian rhythm in the kidney.
Chronic progressive renal failure.
Absence of urine output; complete cessation of urine output
Anuria
<100 mL/day in 2 – 3 consecutive days in spite of high fluid intake is a product of?
Anuria
Name this derangement
Possible Causes:
o (1) Decreased renal blood flow;
o (2) Serious kidney damage;
o (3) Urinary tract obstruction.
Anuria
Both are characterized by High urine output (polyuria)
DIABETES MELLITUS AND DIABETES INSIPIDUS
Diabetes characterized by Decreased/defective insulin
DIABETES MELLITUS
Diabetes characterized by High concentration of glucose in the urine
DIABETES MELLITUS
Diabetes characterized by Decreased/defective ADH
DIABETES INSIPIDUS
Diabetes characterized by Diluted urine
DIABETES INSIPIDUS
Diabetes characterized by an increased Specific Gravity
DIABETES MELLITUS
Diabetes characterized by decreased Specific Gravity
DIABETES INSIPIDUS
Roughly indicates the degree of hydration; should be correlated with specific gravity. Affected by concentration
Urine Color
Describe the observation
Pale yellow: Diluted urine
Properly hydrated
Describe the observation
Dark yellow: Concentrated urine
Dehydrated
Describe the observation
Almost colorless or straw → pale or light yellow
NORMAL
The yellow urine pigment
Urochrome
Lipid soluble (does not dissolve in water); named by Thudichum in 1864.
Urochrome
Produced at a constant rate via endogenous metabolism; present in plasma.
Urochrome
Imparts the normal yellow color in urine.
Urochrome
Increased in thyroid conditions, fasting state, and prolonged urine standing at room temperature.
Urochrome
The urine pigment that resembles Pink brick dust
UROERYTHRIN
Attaches to urates as a result of amorphous urates precipitation in an acid urine.
UROERYTHRIN
Urine pigment most evident in refrigerated specimens.
UROERYTHRIN
the dark yellow/orange urine pigment
UROBILIN
Oxidation product of normal urinary urobilinogen.
UROBILIN
Imparts an orange-brown color to urine that is not fresh.
UROBILIN
Hemoglobin degrades → bilirubin → urobilinogen.
UROBILIN
Interpret the pathologic cause of this urine color
Colorless to pale yellow
Diabetes mellitus and diabetes insipidus.
Interpret the pathologic cause of this urine color
Dark yellow, amber, orange
- Bilirubinuria
- Biliverdin
- Excess urobilin
Interpret the pathologic cause of this urine color
Blue, green
- Indican (product of tryptophan metabolism)
- Pseudomonas infection
Interpret the pathologic cause of this urine color
Pink, red
- Hematuria
- Hemoglobinuria
- Myoglobinuria
Interpret the pathologic cause of this urine color
Brown, black
- Methemoglobinuria (oxidized hemoglobin; brown)
- Alkaptonuria
- Melanuria
metabolic disorder wherein homogentisic acid accumulates in the urine; upon alkalinization, this imparts the color black in the urine
Alkaptonuria
Increased indican in the urine = indicanuria; seen in what condition?
Hartnap Syndrome (Blue Diaper Syndrome)
Produces pyocyanin and pyoverdine.
Pseudomonas infection
Interpret the non-pathologic cause of this urine color
Colorless to pale yellow
Recent fluid consumption or diuresis
Interpret the non-pathologic cause of this urine color
Dark yellow, amber, orange
- Acriflavine
- Phenazopyridine (Pyridium)
- Carotene
- Warfarin (Coumadin)
- Riboflavin (vitamin) /Nitrofurantoin
- Phenindione
Interpret the non-pathologic cause of this urine color
Blue, green
- Amitriptyline
- Methocarbamol
- Methylene blue
- Phenol
- Clorets
- Azure A
Interpret the non-pathologic cause of this urine color
Pink, red
- Beets (alkaline/acid urine)
- Rifampin (anti-TB drug)
- Menstrual contamination
- Blackberries
- Phenolphthalein
- Phenolsulfonphthalein
- Phenothiazines
- Senna (laxative; Carcasa)
Interpret the non-pathologic cause of this urine color
Brown, black
- Levodopa
- Methyldopa
- Metronidazole
- Argyrols
- Phenol derivatives
used in Diagnex Blue Test, which tests for gastric fluid and the presence of HCl
Azure A
Urine has a lot of intact RBCs, which gives the smoky or cloudy red urine
Hematuria
High amounts of hemoglobin in the urine; degraded RBCs and their cell membranes.
Hemoglobinuria:
Myoglobin is present in the skeletal muscles; keeps oxygen in the muscles.
Myoglobinuria
Wherein: Hemoglobin and myoglobin are both present as clear, red urine.
A by-product of heme synthesis; imparts a portwine red-purple color
Porphyrin
Came from the oxidation of porphobilinogen/porphyrinogen, a by-product of heme synthesis.
Porphyrin
When one has melanoma, the excess melanin will be excreted in the urine.
Melanuria
Upon air exposure/standing of urine (environment turns alkaline), this will present a black color.
Melanuria
color of urine that may occur in catheter bags
Violet
This color of urine may indicate the ff
o (1) Indican;
o (2) Klebsiella infection;
o (3) Providencia infection.
Violet