Physical Examination of Urine Flashcards
1
Q
what must be determined during the physical examination of urine
A
- color
- clarity
- specific gravity
2
Q
what causes the yellow pigment of the urine
A
urochrome
3
Q
who termed the word “urochrome”
A
thudichum in 1864
4
Q
urochrome can be increased in px w/?
A
- increased in thyroid conditions
- increased for those in fasting states
5
Q
urochrome can also be increased when
A
left standing at room temp
6
Q
a pink pigment caused by precipitation of amorphous urates in acidic urine due to refrigeration
A
uroerythrin
7
Q
an oxidation product of urobilinogen which imparts an orange-brown color in a urine that is not fresh
A
urobilin
8
Q
pale yellow urine; increased urine volume; low SG
A
diabetes insipidus
9
Q
pale yellow urine; increased urine volume; high SG; (+) glucose
cause:
A
DM
10
Q
px taking b complex vitamins
color of urine:
A
dark yellow
11
Q
strenuous exercise or first morning urine color of urine:
A
dark yellow
12
Q
Fever and burns
cause and color of urine:
A
dehydration; dark yellow
13
Q
yellow foam when shaken; (+) result for bilirubin
cause; color of urine:
A
Increased bilirubin; dark yellow
14
Q
(-) bile test and possible green fluorescence
cause and color of urine:
A
acriflavine
15
Q
antibiotic administered for urinary tract infections
cause and color of urine:
A
nitrofurantoin; dark yellow
16
Q
drug commonly administered for UTI; orange-yellow urine color
cause:
A
phenazopyridine (pyridium)
17
Q
anticoagulant, orange in alkaline urine, colorless in acid urine
cause and color of urine:
A
phenindione; orange yellow
18
Q
when using phenindione, what is the color of the px when urine pH is alkaline? how about when the pH is acidic?
A
alkaline: orange or orange yellow
acid: colorless
19
Q
anti-inflammatory drug that causes orange yellow urine?
A
sulfasalazine (azulfidine)
20
Q
sulfasalazine (azulfidine) is an anti-inflammatory drug that cause _ urine color?
A
orange-yellow urine
21
Q
colored foam in acidic urine but false negative chemical test in bilirubin
cause and color of urine:
A
biliverdin (due to oxidation of bilirubin); yellow-green
22
Q
positive urine culture
cause and color of urine:
A
p. aeruginosa; green
23
Q
px eats asparagus and turns it into what color of urine (not everybody has this, some px are just genetically disposed of producing this kind of urine color)
A
green
24
Q
an anti-depressant that turns urine into blue green color
A
amitriptyline (elavil)
25
amitriptyline is an antidepressant, it turns urine into what color?
blue green
26
a muscle relaxant that produces blue green color
methocarbamol (robaxin)
27
methocarbamol (robaxin) is a muscle relaxant that cause __ color in the urine
blue green/green brown
28
when ingesting clorets, what would the color of your urine be? *clorets are chewing gums*
blue green
29
when u have bacterial infections or intestinal disorders, your urine may have a distince blue green color. what causes this?
production of indican, an indole byproduct (trytophan is broken down into indican by bacterial overgrowth)
30
when the px has a fistula, they might have what color of urine?
blue green
31
oxidation of phenol leads to what urine color
blue green
32
what anesthetic produces blue green color?
propofol (diprivan)
33
blue diaper syndrome
cause and color of urine?
familial hypercalcemia; blue green
34
non-steroidal anti-inflammatory drugs such as indomethacin (indocin//tivorbex) causes _ color in the urine
blue green
35
Cloudy urine with positive chemical test results for blood
and RBCs visible microscopically
cause and urine color?
pink red
36
what is the cause of cloudy urine with positive chemical test results for blood
and RBCs visible microscopically
rbcs
37
Clear urine with positive chemical test results for blood; intravascular hemolysis
- color?
pink red
38
what is the cause of clear urine with positive chemical test results for blood; intravascular hemolysis
hemoglobin
39
Clear urine with positive chemical test results for blood; muscle damage
color?
pink red
40
what is the cause of clear urine with positive chemical test results for blood; muscle damage
myoglobin
41
people who are genetically susceptible to beets have ___ color of urine
pink red
42
px diagnosed with TB medication such as rifampin have _ color of urine
pink red
43
TB medication that cause pink red urine color
rifampin
44
Cloudy specimen with RBCs, mucus, and clots
menstruation
45
negative result for blood but have portwine color in urine
porphyrins
46
cause of red-brown urine seen in acidic urine after standing; (+) for blood
Methemoglobin (RBC oxidation)
47
when methemoglobin is present, what is the color of the urine
red-brown
48
methemoglobin is formed when there is oxidation of RBCs, give examples on how it is formed?
- acidic urine after standing
49
aside from methemoglobin giving red-brown urine color, give another example
myoglobin
50
a brown black urine is seen in an alkaline urine when standing, what is the cause of this?
homogentisic acid (alkaptonuria)
51
homogentisic acid (alkaptonuria) causes __ urine color
brown black
52
px with malignant melanoma or with excess melanin/melanogen have darkened urine when standing due to the addition of what oxidizers?
- ferric chloride
- sodium nitroprusside
53
when ferric chloride/sodium nitroprusside is added to a urine from px with malignant melanoma, what is the color of their urine?
brown black
54
phenol derivatives might interfere with copper reduction tests and might produce
__ urine color
brown black
55
when using copper reduction test, it is important to not have any ___ or ____ that might cause the urine to have a brown black color
phenol or phenol derivatives
56
color disappears with ferric chloride
antiseptic (argyrol) - brown black urine
57
antihypertensive (methyldopa/levodopa) causes __ urine color
brown black
58
brown black urine color may be observed when using anti-hypertensive medicine such as?
methyldopa and levodopa
59
what medication is used for intestinal and vaginal infections
metronidazole
60
metronidazole is a medication used for intestinal and vaginal infxns, it often causes _ urine color
brown black
61
antimalarial drugs that cause brown black urine
chloroquine and primaquine
62
chloroquine and primaquine are antimalarial drugs that causes ___ urine color
brown black
63
muscle relaxant that can either cause blue green or brown black urine
methocarbamol (robaxin)
64
fava beans, rhubarb or aloe can cause what kind of urine color
brown black
65
large amount of white foam when shaken indicates?
increased protein concentration
66
does the oxidation of urobilinogen to urobilin have yellow foam appearance when shaken?
no (only urine with bilirubin has an appearance of yellow foam when shaken)
67
what is mistaken for bilirubin when it shaken, since it also produces yellow foam?
phenazopyridine (pyridium) or azo-gantrisin
68
intact rbcs (physical appearance)
- red and cloudy
69
hemoglobin and myoglobin (physical appearance)
- red and clear (to distinguish them, look at their plasma)
70
which is cleared rapidly? hgb or mgb
mgb (thats why when distinguishing them through plasma, the plasma appears clear when myoglobin is suspected since it is cleared rapidly)
71
nonpathogenic causes of red urine
- menstruation
- ingestion of highly pigmented food/ medication (beets - red color in alkaline urine; blackberries - red color in acidic urine)
- ingestion of highly pigmented medication (rifampin, phenolphthalein, phenindione, phenothiazines)
72
melanin is an oxidation product of
melanogen (colorless product) produced in excess when a px has malignant melanoma
73
homogentisic acid is a metabolite of
phenylalanine
74
homogentisic acid imparts a black color to alkaline urine from px with inborn error of metabolism called?
alkaptonuria
75
A purple staining may occur in catheter bags and is caused by indican in the urine or a bacterial infection, frequently caused
Klebsiella or providencia species
76
precipitation of amorphous phosphates and carbonates may cause
white cloudiness in an alkaline urine
77
amorphous urates in an acid urine produces ___ due to uroerythrin
pink brick dust/pink pigment
78
urine clarity:
No visible particulates, transparent
clear
79
urine clarity:
Few particulates, print easily seen through urine
hazy
80
urine clarity:
Many particulates, print blurred through urine
cloudy
81
urine clarity:
print cannot be seen through urine
turbid
82
urine clarity:
may precipitate or be clotted
milky
83
clear
no visible particulates, transparent
84
hazy
few particulates, print easily seen through urine
85
cloudy
many particulates, print blurred through urine
86
turbid
print cannot be seen through urine
87
milky
may precipitate or be clotted
88
common pathological turbidity
- rbcs
- wbcs
- bacteria
89
is used to describe urine with an SG of 1.010
isosthenuric
90
is used to describe urine with an SG of above 1.010
hypersthenuric
91
is used to describe urine with an SG of below 1.010
hyposthenuric
92
SG is influenced by
- number of particles
- size of particles
93
determines the concentration of dissolved particles in a specimen by measuring refractive index
refractometry
94
is a comparison of the velocity of light in the air with the velocity of light in a solution
refractive index
95
are temperature corrections necessary when using refractometers
no because the light beam passes through a temperature-compensating liquid before being directed at the specific gravity scale
96
in refractometers, temperature is compensated between
15°C and 38°C
97
how is refractometer calibrated?
- using distilled water; it should give a reading of 1.000 SG
97
in refractometers, corrections for glucose
and protein
glucose : subtract 0.004 for each gram
protein : subtract 0.003 for each gram
98
in refractometer, the calibration is further checked using ___ or _____
- 5% NaCl; 1.022 ± 0.001
- 9% sucrose; 1.034 ± 0.001
99
Results that are abnormally high—above 1.040—are seen in patients who have recently undergone an
IV pyelogram (excretion of the injected radiographic contrast media)
100
High SG above 1.040 is caused by?
- iv pyelogram (radiographic contrast media)
- dextran
- plasma expanders
101
high sg above 1.040 can be measured through ___ or ____
rgt strip (chemical) or osmometry
102
is affected only by the number of particles present
osmolality
103
in osmolality, small molecules primarily ___ and ____ is important in evaluating renal concentration ability
sodium and chloride
104
in osmolality, ___ which is not an important substance will contribute more to the sg than sodium and chloride
urea
105
An _____ is defined as 1 g molecular weight of a substance divided by the number of particles into which it dissociates
osmole
106
glucose contains how many osmole per gram
180 g per osmole
107
nacl contains how many osmole per gram
58.5 g per osmole (29.25g per osmole if dissociated)
108
consists of a weighted float attached to a
scale that has been calibrated in terms of urine specific gravity
urinometer
109
Solute dissolved in solvent causes the following changes in colligative properties:
Lower FV; Higher OB
- freezing point
- vapor pressure
- osmotic pressure
- boiling point
110
The ---- is based on the change in pKa
(dissociation constant) of a polyelectrolyte in an alkaline medium
reagent strip reaction
111
increased sg leads to what changes in the pH?
- lowering of the pH (acid urine)
112
--- is based on the principle that the frequency of a sound wave entering a solution changes in proportion to the density of the solution
Harmonic oscillation densitometry
113
normal urine odor
aromatic
114
bacterial decomposition, urinary tract infection urine odor
foul, ammonia-like
115
Ketones (diabetes mellitus,
starvation, vomiting)
Fruity, sweet
116
Maple syrup urine disease
Maple syrup
117
Phenylketonuria
Mousy
118
Tyrosinemia
Rancid
119
Isovaleric acidemia
Sweaty feet
120
Methionine malabsorption
Cabbage
121
Contamination
Bleach
