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Analysis of Urine and Bodily Fluids > Physical Examination of Urine > Flashcards

Physical Examination of Urine Flashcards

1
Q

The ____ gives you an idea what are the results that you can obtain from the chemical and microscopic examination of urine.

A

Physical Examination

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2
Q

The ____ is a rough indicator of the degree of hydration.

A

Urine color

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3
Q

The urine color is a rough indicator of the ____.

A

degree of hydration

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4
Q

The ____ should correlate with the urine specific gravity.

A

Urine color

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5
Q

The urine color should correlate with the ____.

A

urine specific gravity

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6
Q

Low fluid intake = ____ = ____ = ____.

A
  • darker urine color
  • higher amount of solute
  • increased specific gravity
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7
Q

High fluid intake = ____ = ____ = ____.

A
  • lighter urine color
  • lower amount of solute
  • decreased specific gravity
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8
Q

The yellow color of urine is caused by the presence of ____.

A

Urochrome

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9
Q

Urochrome is a product of ____.

A

endogenous metabolism

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10
Q

____ is a product of endogeneous metabolism.

A

Urochrome

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11
Q

____ is produced by the body at a constant rate under normal conditions.

A

Urochrome

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12
Q

The urochrome produced is dependent on the ____.

A

body’s metabolism

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13
Q

TRUE OR FALSE.

Urochrome is decreased when left at room temperature.

A

False

Answer: Increased

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14
Q

Because urochrome is excreted at a constant rate, a dilute urine will be ____.

A

pale yellow

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15
Q

Because urochrome is excreted at a constant rate, a concentrated urine will be ____.

A

dark yellow

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16
Q

____ is a water-soluble pigment.

A

Urochrome

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17
Q

TRUE OR FALSE.

Urochrome is water-insoluble

A

False

Answer: Water-soluble

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18
Q

The rate of production of urochrome depends on the ____.

A

metabolism

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19
Q

The higher the metabolism, the production of urochrome is ____.

A

increased

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20
Q

Is urochrome normally present in the body?

A

Yes, it is excreted in urine.

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21
Q

Why is urochrome water-soluble?

A

Because the urine is made up of water

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22
Q

Examples of instances when metabolism is increased, which will result in increased urochrome

A
  • Hyperthyroidism
  • Fever
  • Starvation
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23
Q

Why are patients with renal disease, failure, or CKD have a yellowish-skin?

A

Since the filtering capacity of their kidneys is damaged, the urochrome is deposited under the subcutaneous fats which causes the pigmentation.

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24
Q

____ is most evident in specimens that have been refrigerated.

A

Uroerythrin

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25
Q

Uroerythrin is most commonly seen in specimens that have been ____.

A

refrigerated

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26
Q

____ deposit in amorphous urates and uric acid crystals.

A

Uroerythrin

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27
Q

____ gives a pink pigment to the sediments.

A

Uroerythrin

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28
Q

What pigment does uroerythrin produce?

A

Pink

Also gives reddish or brick-red crystals

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29
Q

How does uroerythrin give the pink color to the sediment?

A

By attaching to urates

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30
Q

____ forms reddish or brick-red crystals.

A

Uroerythrin

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31
Q

Uroerythrin produces ____ crystals.

A

reddish or brick-red

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32
Q

____ imparts an orange-brown color of urine that is not fresh.

A

Urobilin

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33
Q

What pigment does urobilin produce?

A

Orange-brown

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34
Q

____ is the oxidized form of urobilinogen.

A

Urobilin

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35
Q

____ gives color in feces as stercobilin.

A

Urobilin

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36
Q

Is urobilin a normal constituent of urine?

A

No

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37
Q

Factors affecting urine color

A
  • Amount of substance
  • Urine pH
  • Structural form
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38
Q

Urine Pigments

A
  • Urochrome
  • Uroerythrin
  • Urobilin
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39
Q

Normal Urine Color

A
  • Colorless/Straw
  • Pale Yellow
  • Dark Yellow
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40
Q

Determine the color of Urine

Recent fluid consumption

A

Colorless or Straw

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41
Q

Determine the color of Urine

Lead poisoning

A

Colorless or Straw

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42
Q

TRUE OR FALSE.

A colorless first morning urine specimen is normal.

A

False

Reason: Not normal as it should be concentrated; kidney failure.

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43
Q

Pathological instances when urine is colorless

A
  • Kidney failure (first morning urine specimen is colorless)
  • Lead poisoning
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44
Q

Determine the color of Urine

Diluted random specimen

A

Pale yellow

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45
Q

Determine the color of Urine

Polyuria

A

Pale yellow

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46
Q

Determine the color of Urine

Diabetes mellitus

A

Pale yellow

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47
Q

Determine the color of Urine

Diabetes insipidus

A

Pale-yellow to Colorless/Straw

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48
Q

In ____, glucose and water excretion is increased.

A

Diabetes mellitus

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49
Q

How will you describe the specific gravity of a patient with Diabetes Mellitus?

A

Increased

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50
Q

Why is the specific gravity of patients with Diabetes Mellitus increased?

A

Due to the excretion of glucose

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51
Q

In ____, there is a deficiency in ADH, but increased water excretion.

A

Diabetes insipidus

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52
Q

How will you describe the specific gravity of a patient with Diabetes Insipidus?

A

Decreased

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53
Q

How is diabetes mellitus similar to diabetes insipidus?

A

Both have increased water excretion

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54
Q

How is diabetes mellitus different than diabetes insipidus?

A
  • DM: ↑ Glucose = ↑ SG
  • DI: ↓ ADH = ↓ SG
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55
Q

Determine the color of Urine

Concentrated specimen

A

Dark yellow

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56
Q

Determine the color of Urine

Increased urochrome

A

Dark yellow

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57
Q

Determine the color of Urine

Dehydration

A

Dark yellow

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58
Q

Determine the color of Urine

Strenuous exercise

A

Dark yellow

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59
Q

Determine the color of Urine

First morning urine specimen

A

Dark yellow

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60
Q

Determine the color of Urine

Complex B vitamins

A

Dark yellow

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61
Q

Determine the color of Urine

Bilirubin

A

Dark yellow

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62
Q

Determine the color of Urine

Acriflavine

A

Dark yellow

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63
Q

Determine the color of Urine

Nitrofurantoin

A

Dark yellow

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64
Q

Determine the color of Urine

Good hydration, overhydration, or mild hydration

A

Clear

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65
Q

Determine the color of Urine

Good hydration of mild hydration

A

Pale yellow

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66
Q

Determine the color of Urine

Mild or moderate dehydration; taking vitamin supplements

A

Bright yellow

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67
Q

Determine the color of Urine

Moderate or severe dehydration

A

Orange, Amber

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68
Q

Determine the color of Urine

Severe dehydration or burned patients

A

Tea-colored

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69
Q

Determine the color of Urine

Presence of abnormal pigment bilirubin

A

Dark yellow/Amber/Orange

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70
Q

____ produces a yellow foam when the specimen is shaken.

A

Bilirubin

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71
Q

Bilirubin produces a ____ when the specimen is shaken.

A

yellow foam

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72
Q

The yellow foam produced by bilirubin may contain ____.

A

hepatitis virus

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73
Q

____ also causes yellow foam.

A

Phenazopyridine (Pyridium)

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74
Q

Bilirubin increases when there is a ____.

A

liver problem

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75
Q

____ increases when there is a liver problem.

A

Bilirubin

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76
Q

↑ Bilirubin = ____ color.

A

orange

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77
Q

Normal color of foam in urine

A

White

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78
Q

A large amount of white foam in the urine indicates an ____.

A

increased concentration of protein

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79
Q

Determine the color of Urine

Photo-oxidation of large amount of excreted urobilinogen to urobilin

A

Yellow-orange

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80
Q

TRUE OR FALSE.

A yellow foam appears when photo-oxidation of large amounts of excreted urobilinogen to urobilin occurs.

A

False

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81
Q

Determine the color of Urine

Phenazopyridine

A

Orange-yellow

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82
Q

Determine the color of Urine

Phenindione

A

Orange-yellow

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83
Q

Determine the color of Urine

Sulfasalazine (Azulfidine)

A

Orange-yellow

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84
Q

Determine the color of Urine

Photo-oxidation of bilirubin

A

Yellow-green

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85
Q

The ____ is one of the most common causes of abnormal urine color.

A

presence of blood

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86
Q

____ is the most commonly encountered abnormal urine color.

A

Red

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87
Q

When is the red pigment pathological in urine?

A

If there is glomerular bleeding

88
Q

Determine the color of Urine

Intact RBC

A

Cloudy red or pink

89
Q

Determine the color of Urine

Hemolyzed RBCs

A

Clear red

90
Q

Besides RBCs, ____ also produce a red urine.

A

Hemoglobin and Myoglobin

91
Q

How can we differentiate hemoglobin from myoglobin?

A

Through Plasma Examination Test

Hemoglobin: Red
Myoglobin: Yellow

92
Q

Color of hemoglobin in Plasma Examination Test

A

Red

93
Q

Color of myoglobin in Plasma Examination Test

A

Yellow

94
Q

Hemoglobin or Myoglobin?

Stays in the blood

A

Hemoglobin

95
Q

Hemoglobin or Myoglobin?

Immediately filtered

A

Myoglobin

96
Q

Determine the color of Urine

Oxidation of phorphobilinogen (Porphyrins)

A

Port wine or Burgundy red

97
Q

____ occurs when there is a problem in globin.

A

Thalassemia

98
Q

A ____ causes Thalassemia.

A

problem in globin

99
Q

____ lack the enzyme necessary to convert the pre-cursor substance to become heme.

A

Porphyria

100
Q

____ is a familial disease.

A

Porphyria

101
Q

Porphyria

If there is no enzyme, ____.

A

no heme = ↑ pre-cursor susbtance

102
Q

Determine the color of Urine

Beets

A

Pink or Red

103
Q

Determine the color of Urine

Rifampin, phenolphthalein, pheninedione, and phenothiazines

A

Pink or Red

104
Q

Determine the color of Urine

Ingestion of blackberries

A

Red

105
Q

Determine the color of Urine

Oxidation of hemoglobin to methemoglobin

A

Red-brown

106
Q

____ is a pre-cursor of heme.

A

Porphobilinogen

107
Q

If you will check for hematuria, and the urine specimen submitted is contaminated with menstrual blood, should you accept or reject it?

A

Reject

108
Q

Determine the color of Urine

Pseudomonas infection

A

Green

109
Q

Determine the color of Urine

Asparagus

A

Green

110
Q

Determine the color of Urine

Amitriptyline

A

Blue-green

111
Q

Determine the color of Urine

Methocarbamol (Robaxin)

A

Blue-green

112
Q

Determine the color of Urine

Breath deodorizers such as clorets

A

Blue-green

113
Q

Determine the color of Urine

Indican

A

Blue-green

114
Q

Indican came from ____.

A

indole

115
Q

Indole is converted by bacteria to become ____.

A

Indican

116
Q

____ is responsible for giving an indigo-blue color.

A

Indican

117
Q

↑ organisms = ____ indole.

A

↑

118
Q

Determine the color of Urine

Methylene blue

A

Blue-green

119
Q

Determine the color of Urine

Phenol

A

Blue-green

120
Q

Determine the color of Urine

Propofol

A

Blue-green

121
Q

Determine the color of Urine

Familial hypercalcemia

A

Blue-green

122
Q

Determine the color of Urine

Indomethacin (indocin, tivorbex)

A

Blue-green

123
Q

Determine the color of Urine

Observed among catheterized patients

A

Purple

124
Q

Purple bag syndrome is associated with patients with ____.

A

catheter bags

125
Q

Aside from blue-green color of urine, indican/indole also gives a ____ pigment.

A

Purple

126
Q

Determine the color of Urine

Bacterial infection caused by Klebsiella or Providencia species

A

Purple

127
Q

____ is an oxidation product of melanogen.

A

Melanin

128
Q

____ is a colorless substance that precedes melanin.

A

Melanogen

129
Q

____ is produced in excess when a malignant melanoma is present.

A

Melanogen

130
Q

Determine the color of Urine

Homogentisic acid

A

Black

131
Q

____ imparts a black color to alkaline urine from patients with alkaptonuria.

A

Homogentisic acid

132
Q

In patients with skin cancer, ____ proliferate.

A

melanocytes

133
Q

____ is a substance of the phenyl-alanine-tyrosine pathway of amino acid.

A

Homogentisic acid

134
Q

Determine the color of Urine

Malignant melanoma

A

Black/Brown

135
Q

Determine the color of Urine

Melanin

A

Brown

136
Q

Determine the color of Urine

Phenol derivatives

A

Brown/Black

137
Q

Determine the color of Urine

Argyrol

A

Brown/Black

138
Q

Determine the color of Urine

Methyldopa or levodopa

A

Brown/Black

Levodopa: cola-colored

139
Q

Determine the color of Urine

Metronidazole

A

Brown/Black

140
Q

Determine the color of Urine

Chloroquine and primaquine

A

Brown/Black

141
Q

Determine the color of Urine

Methocarbamol

A

Brown/Black

142
Q

Determine the color of Urine

Fava beans, rhubarb, or aloe

A

Brown/Black

143
Q

Urine color changes with commonly used drugs

Levodopa

A
  • Cola-colored
  • Due to myoglobin
144
Q

Urine color changes with commonly used drugs

Mepacrine (Atabrine)

A

Yellow

145
Q

Urine color changes with commonly used drugs

Methyldopa (Aldomet)

A

Green-brown

146
Q

Urine color changes with commonly used drugs

Metronidazole (Flagyl)

A
  • Darkening
  • Reddish-brown
147
Q

Urine color changes with commonly used drugs

Phenazopyridine (Pyridium)

A
  • Orange-red
  • Acidic pH
148
Q

Urine color changes with commonly used drugs

Rifampin

A

Bright red

149
Q

Urine color changes with commonly used drugs

Riboflavin

A

Bright yellow

150
Q

Normal range of urine volume

A

600 mL - 2000 mL

151
Q

Average range of urine volume

A

1200 mL - 1500 mL

152
Q

Night:Day Ratio

A

1:2 or 1:3

153
Q

Factors that influence urine volume

A
  • Fluid intake
  • Fluid loss from non-renal sources (sweating, vomitting, diarrhea)
154
Q

____ is the decrease in urine output.

A

Oliguria

155
Q

Oliguria amount

A

<400 mL/day

156
Q

Causes of Oliguria

A
  • Nephrotic syndrome
  • Edema
  • Dehydration
157
Q

In order for us to maintain the filtration of blood within the glomerulus, we need ____.

A

constant pressure

158
Q

↓ glomerular pressure = ____ = ____.

A

↓ filtration = ↓ UV

159
Q

Nephrotic syndrome can lead to ____.

A

albuminuria

160
Q

____ is a disease caused by the disruption of the shield of negativity.

A

Nephrotic syndrome

161
Q

Edema occurs due to the ____.

A

accumulation of fluid in the interstitial tissues as a result of no pressure

162
Q

____ is the cessation of urine flow.

A

Anuria

163
Q

Anuria amount

A

<100 mL/day

According to Graff’s textbook

164
Q

Causes of Anuria

A

Urinary tract obstruction (tumor, kidney stones, etc.)

165
Q

Kidney stones are usually formed in the ____.

A

renal pelvis or urinary bladder

166
Q

Composition of Kidney Stones

A
  • Uric acid
  • Cysteine
  • Calcium oxalate
167
Q

____ is the most common, and hardest kidney stone.

A

Calcium oxalate

168
Q

____ is an increase in daily urine volume.

A

Polyuria

169
Q

Amount of polyuria

A
  • Henry’s: 2000 mL/24 hours
  • Strasinger: 2.5 L/day
170
Q

Polyuria is artificially induced by ____.

A

Diuretics, caffeine, or alcohol

171
Q

Diuretics, caffeine, and alcohol all suppress the secretion of ____.

A

ADH

172
Q

Other causes of Polyuria

A
  • Diabetes mellitus
  • Diabetes insipidus
173
Q

____ is the increased noctural excretion of urine.

A

Nocturia

174
Q

Amount of nocturia

A

> 500 mL/night

175
Q

Causes of Nocturia

A
  • Pregnancy
  • Chronic progressive kidney failure
176
Q

The ____ describes the overall visual apperance of a urine specimen.

A

Urine clarity

177
Q

In ____, we will check the presence of particulates.

A

Urine clarity

178
Q

↑ turbid = ____ SG.

A

↑

179
Q

Urine Clarity

No visible particles, transparent

A

Clear

180
Q

Urine Clarity

Few particulates, print easily seen through urine

A

Hazy

181
Q

Urine Clarity

Many particulates, print blurred through urine

A

Cloudy

182
Q

Urine Clarity

Print cannot be seen through urine

A

Turbid

183
Q

Urine Clarity

May precipitate or be clotted

A

Milky

184
Q

Non-pathological causes of Turbidity

A
  • Squamous epithelial cells
  • Mucus
  • Amorphous phosphates, carbonates, urates
  • Semen, spermatozoa
  • Fecal contamination
  • Radiographic contrast media
  • Talcum powder
  • Vaginal creams
185
Q

The presence of squamous cells with bacteria can indicate that the patient has ____.

A

UTI

186
Q

TRUE OR FALSE.

Turbid urine is normal in females before and after menstruation.

A

True

187
Q

The presence of squamous cells and bacilli (G. vaginalis) can indicate that the patient has ____.

A

Bacterial vaginosis

188
Q

Determine if pathologic or non-pathologic cause of turbidity

Squamous epithelial cells

A

Non-pathologic

189
Q

Determine if pathologic or non-pathologic cause of turbidity

Mucus

A

Non-pathologic

190
Q

Determine if pathologic or non-pathologic cause of turbidity

Amorphous phosphates, urates, and carbonates

A

Non-pathologic

191
Q

Determine if pathologic or non-pathologic cause of turbidity

Semen, spermatozoa

A

Non-pathologic

192
Q

Determine if pathologic or non-pathologic cause of turbidity

Fecal contamination

A

Non-pathologic

193
Q

Determine if pathologic or non-pathologic cause of turbidity

Radiographic contrast media

A

Non-pathologic

194
Q

Determine if pathologic or non-pathologic cause of turbidity

Talcum powder

A

Non-pathologic

195
Q

Determine if pathologic or non-pathologic cause of turbidity

Vaginal creams

A

Non-pathologic

196
Q

Pathological causes of Turbidity

A
  • RBCs
  • WBCs
  • Bacteria
  • Yeast
  • Non-squamous epithelial cells
  • Abnormal crystals
  • Lymph fluid
  • Lipids
197
Q

Determine if pathologic or non-pathologic cause of turbidity

RBCs

A

Pathologic

198
Q

Determine if pathologic or non-pathologic cause of turbidity

WBCs

A

Pathologic

199
Q

Determine if pathologic or non-pathologic cause of turbidity

Bacteria

A

Pathologic

200
Q

Determine if pathologic or non-pathologic cause of turbidity

Yeast

A

Pathologic

201
Q

Determine if pathologic or non-pathologic cause of turbidity

Non-squamous epithelial cells

A

Pathologic

202
Q

Determine if pathologic or non-pathologic cause of turbidity

Abnormal crystals

A

Pathologic

203
Q

Determine if pathologic or non-pathologic cause of turbidity

Lymph fluid

A

Pathologic

204
Q

Determine if pathologic or non-pathologic cause of turbidity

Lipids

A

Pathologic

205
Q

RBCs are soluble in ____ acetic acid.

A

2%

206
Q

Lipids are soluble in ____.

A

ether

207
Q

RBCs are soluble in ____.

A

Dilute acetic acid

208
Q

The ____ is an expression of urine concentration in terms of density.

A

Specific gravity

209
Q

Specific gravity is correlated with ____.

A

Clarity and Color

210
Q

The specific gravity of the plasma filtrate entering the glomerulus is ____.

A

1.010

211
Q

The term ____ is used to describe urine with a specific gravity of 1.010.

A

Isosthenuric

212
Q

The term ____ is used to describe urine with a specific gravity below 1.010.

A

Hypostenuric

213
Q

The term ____ is used to describe urine with a specific gravity above 1.010.

A

Hyperstenuric

214
Q

Specific gravity of Urine

A

1.003 - 1.035

215
Q

Average specific gravity of Urine

A

1.015 - 1.030

216
Q

↑ solute = ____ BP.

A

↑ BP

217
Q

↑ solute = ____ FP.

A

↓FP

Analysis of Urine and Bodily Fluids (3 decks)

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