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Aubf Lec > PHYSICAL EXAMINATION OF URINE > Flashcards

PHYSICAL EXAMINATION OF URINE Flashcards

1
Q

encompasses a systematic series of procedures such as physical, chemical, and microscopic examination of urine that are able to be correlated to each other in order to ensure reliable and coherent diagnosis of one’s illness.

A

Routine urinalysis

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2
Q

is a thorough investigation and documentation of urine’s physical characteristics. It is a crucial step in routine urinalysis procedure because it provides preliminary information about the patient’s health status and is used to confirm or to explain findings in the chemical and microscopic areas of urinalysis.

A

Physical examination of urine

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3
Q

The __________ of a certain person reflects his/her hydration status.

A

urine volume

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4
Q

There are several factors that affect urine volume. These factors include:

A

fluid intake
fluid loss from nonrenal sources
variations in ADH
necessity to excrete dissolved substance

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5
Q

VARIATION IN URINE VOLUME IN A DAY:
Oliguria in infants

A

<1ml/kg/hr
<0.5 ml/kg/hour

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6
Q

VARIATION IN URINE VOLUME IN A DAY:
Oliguria in adults

A

<400 ml/day

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7
Q

VARIATION IN URINE VOLUME IN A DAY:
Polyuria in children

A

2.5-3 ml/kg/day

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8
Q

VARIATION IN URINE VOLUME IN A DAY:
Polyuria in adults

A

2.5 L

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9
Q

This parameter in the physical examination of urine is not routinely reported, though it is necessary that distinct odor in urine samples received in the laboratory should be notified to attending physicians for the consideration of metabolic disorders or aminoaciduria.

A

Odor

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10
Q

VARIATIONS OF URINE ODOR
Cause: normal

A

Aromatic

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11
Q

VARIATIONS OF URINE ODOR
Cause: Bacterial decomposition, Urinary Tract Infection (UTI)

A

Foul
Ammonia-like

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12
Q

VARIATIONS OF URINE ODOR
Cause: Ketones (diabetes mellitus, starvation, vomiting)

A

Fruity
sweet

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13
Q

VARIATIONS OF URINE ODOR
Cause: maple syrup urine disease

A

Maple syrup

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14
Q

VARIATIONS OF URINE ODOR
Cause: phenylketonuria

A

Mousy

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15
Q

VARIATIONS OF URINE ODOR
Cause: tyrosinemia

A

Rancid

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16
Q

VARIATIONS OF URINE ODOR
Cause: isovaleric acidemia

A

Sweaty feet

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17
Q

VARIATIONS OF URINE ODOR
Cause: methionine malabsorption

A

Cabbage

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18
Q

VARIATIONS OF URINE ODOR
Cause: contamination

A

Bleach

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19
Q

one parameter used in urinalysis to predict urine concentration and probable dissolved substances present in it

A

Urine color

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20
Q

Urine color

Normal variations are caused by:

A

a. Normal metabolic functions
b. Physical activity
c. Ingested materials
d. Pathologic condition
e. Abnormal variations caused by bleeding
f. Liver disease
g. Infection

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21
Q

pigments that are present urine that gives its normal color.

A

Urochrome
Uroerythrin
Urobilin

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22
Q
  • gives the normal yellow coloration of urine.
  • It is normally excreted at a constant rate, though an increased production is expected in thyroid disorders and fasting states.
  • It also increases when the specimen sits at room temperature.
A

Urochrome

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23
Q

is a pigment that deposits amorphous crystals in urine upon refrigeration. It attaches itself on amorphous crystals’ surface creating a brick dust appearance especially on amorphous urates.

A

Uroerythrin

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24
Q

is a derivative of protoporphyrins that come from RBC catabolism. It provides orange-brown color in older urine specimens.

A

Urobilin

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25
Q

an oxidation product of the normal urinary constituent urobilinogen.

A

Urobilin

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26
Q

LABORATORY CORRELATION OF URINE COLOR

CAUSE: Recent fluid consumption
CLINICAL/ LABORATORY CORRELATIONS: Commonly observed with random specimens

A

Colorless

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27
Q

LABORATORY CORRELATION OF URINE COLOR

CAUSE: Polyuria or diabetes insipidus
CLINICAL/ LABORATORY CORRELATIONS: Increased 24-hour volume and low specific gravity

A

Pale yellow

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28
Q

LABORATORY CORRELATION OF URINE COLOR

CAUSE: D.mellitus
CLINICAL/ LABORATORY CORRELATIONS: Elevated specific gravity and positive glucose test result

A

Pale yellow

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29
Q

LABORATORY CORRELATION OF URINE COLOR

CAUSE: dilute random specimen
CLINICAL/ LABORATORY CORRELATIONS: Recent fluid consumption

A

Pale yellow

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30
Q

LABORATORY CORRELATION OF URINE COLOR

CAUSE: concentrated specimen
CLINICAL/ LABORATORY CORRELATIONS: May be normal after strenuous exercise or in first morning specimen

A

Dark yellow

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31
Q

LABORATORY CORRELATION OF URINE COLOR

CAUSE: B complex vitamins

A

Dark yellow

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32
Q

Causes colorless urine

A

Recent fluid consumption

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33
Q

Causes pale yellow urine

A

Polyuria or diabetes insipidus
Diabetes mellitus
Dilute random specimen

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34
Q

Causes dark yellow urine

A

Concentrated specimen
B complex vitamins
Dehydration
Bilirubin
Arcriflavine
Nitrofurantoin

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35
Q

Causes orange-yellow urine

A

Phenazopyridine (Pyridium)
Phenindione
Sulfasalazine (Azulfidine)

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36
Q

Cause yellow-green urine

A

Bilirubin oxidized to biliverdin

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37
Q

Causes green urine

A

Pseudomonas infection
Asparagus

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38
Q

Causes blue-green urine

A

Amitriptyline
Methocarbamol (Robaxin)
Clorets
Indican
Methylene blue
Phenol
Propofol
Familial hypercalcemia
Indomethacin (Indocin Tivorbex)

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39
Q

Causes pink red urine

A

RBCs
Hemoglobin
Myoglobin
Beets
Rifampin
Menstrual contamination

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40
Q

Causes port wine urine

A

Porphyrins

41
Q

Causes red-brown urine

A

RBCs oxidized to methemoglobin
Myoglobin

42
Q

Cause brown black urine

A

Homogentisic acid (alkaptonuria)
Malignant melanoma
Melanin or melanogen
Argyrol (antiseptic)
Methyldopa or levodopa
Metronidazole (Flagyl)
Chloroquine and primaquine
Methocarbamol
Fava beans, rhubarb, or aloe

43
Q

It pertains to the clarity or turbidity of a urine specimen

A

Transparency

44
Q

True or false:

Normally, a urine has a clear transparency or clarity

45
Q

True or false:

Decrease in clarity or increase in turbidity is not always associated to a renal disease or metabolic pathologies

46
Q

➔ View the urine against a white background using adequate room lighting
➔ View through a newspaper print

A

Urine Clarity Determination

47
Q

URINE CLARITY PARAMETER

No visible particulates, transparent

48
Q

URINE CLARITY PARAMETER

Few particulates, print easily seen through urine

49
Q

URINE CLARITY PARAMETER

Many particulates, print blurred through urine

50
Q

URINE CLARITY PARAMETER

Print cannot be seen through urine

51
Q

URINE CLARITY PARAMETER

May precipitate or be clotted

52
Q

can result in urine that is hazy but normal.

A

Presence of : squamous epithelial cells and mucus, particularly spx from women

53
Q

frequently develop a thick turbidity caused by precipitation of amorphous phosphates, carbonates, and urates.

A

Refrigerated specimens

54
Q

Produce a white precipitate in urine with an alkaline pH

A

Amorphous phosphates and carbonates

55
Q

produce a precipitate in acidic urine that resembles pink brick dust due to the presence of uroerythrin.

A

amorphous urates

56
Q

A. Hazy female specimens with squamous epithelial cells and mucus

B. Bacterial growth in
unpreserved specimens

C. Refrigerated specimens with precipitated amorphous phosphates and urates

D. Contamination; fecal talc, semen, vaginal creams, IV contrast media

A

NON PATHOLOGIC TURBIDITY

57
Q

A. Most common: RBCs, WBCs, bacteria

B. Nonsquamous epithelial cells, yeast

C. Abnormal crystals

D. Lymph fluid

E. Lipid

A

PATHOLOGIC TURBIDITY

58
Q

is determined by the concentration of free H+ ion present in urine sample. As H+ ion increases, pH decreases making the urine acidic while as H+ ion decreases, pH increases bringing alkalinity to urine sample.

59
Q

The lung excretes ___________through respiration, while the kidney reclaims and generates bicarbonate and secretes ammonium ions.

A

carbon dioxide

60
Q

is responsible for the bulk of the bicarbonate reabsorption/generation, while the distal tubule provides the remaining function.

A

proximal renal tubule

61
Q

may be produced through ingestion of meat, fruits such as cranberries and various pharmacologic agents (ammonium chloride, methionine and methenamine mandelate).

A

Acidic urine

62
Q

may be produced after the ingestion of fruits and vegetables (citrus fruits), following a meal ( the so-called alkaline tide), taking medications (Sodium bicarbonate, potassium citrate and acetazolamide).

A

alkaline urine

63
Q

Normal urine pH in random sample

64
Q

Normal urine pH in first morning urine sample

65
Q

Normal urine pH in Nnormal protein diet sample

66
Q

Normal urine pH in Unpreserved Urine

67
Q

is useful in the evaluation of urine concentration.
● It can determine if the specimen is concentrated enough to provide reliable screening results.

A

Specific gravity

68
Q

● It is known as the density of a solution compared with the density of an equal volume of distilled water at the same temperature.
● It is influenced by the number and size of particles present

A

Specific gravity

69
Q

URINE SPECIFIC GRAVITY

Hyposthenuric

Isosthenuric

Hypersthenuric

Random specimen

Normal Range

A

<1.010

1.010

> 1.010

1.015-1.025

1.023

70
Q

● It is a conventional means to measure urine’s specific gravity

● less accurate than the other methods, it is a simple method that can be done in basic laboratory.

A

Urinometer

71
Q

The major limitation of using a urinometer to measure specific gravity is…

A

it requires a large volume of specimen

72
Q

Determines the concentration of dissolved particles in a specimen by measuring refractive index.

A

Refractometer

73
Q

a comparison of the velocity of light in the air with the velocity of light in a solution.

A

Refractive index

74
Q

measures velocity of light in air versus velocity of light in a solution. The concentration of urine changes the velocity and angle at which the light passes through the solution.

A

Refractometer

75
Q

The __________ in the refractometer determines the angle that light is passing through the urine and converts angle to calibrated viewing scale

76
Q

It is a way of determining the urine specific gravity through sound waves of specific frequency that is generated at one end of the tube and as the sound waves oscillate through urine, their frequency is altered by the density of the specimen

A

Harmonic Oscillation Densitometry

77
Q

most convenient and most commonly used means of measuring specific gravity in many laboratories worldwide.

A

Reagent Strip

78
Q

is based on the change in pKa (dissociation constant) of a polyelectrolyte in an alkaline medium

A

reagent strip reaction

79
Q

True or false:

The releasing of H ions is directly proportional to the number of ions in the solution. The more hydrogen ions released, the lower is the pH.

80
Q

Macroscopic hematuria

A

Red turbid
Red cloudy

81
Q

Microscopic hematuria

A

Red color
Clear urine

82
Q

Blodhein’s test

3.2g Ammonium sulfate + urine = red precipitate
2.8g Ammonium sulfate + urine = clear

A

Hemoglobinuria

83
Q

Blodhein’s test

3.2g Ammonium sulfate + urine = red color, no precipitate
2.8g Ammonium sulfate + urine = clear

A

Myoglobinuria

84
Q

Urinometer:
In every 3C increase in temp. add?

A

0.001 in SG

85
Q

Urinometer

In every 3C<20C, subtract?

86
Q

Refractometer

Unless protein is present, subtract?

87
Q

Refractometer

Unless glucose is present, subtract?

88
Q

Evident pigment when the urine is unpreserved

89
Q

Most famous urine pigment

90
Q

Normal color of urine

A

Pale yellow-datk yellow

91
Q

Urine color of TB immunocompromised-HIV patient

92
Q

Presence of __________ causes the urine coffe-black appearance

A

Methemoglobin

93
Q

Parameters that measures how concentrated the urine

A

Specific gravity
Color
Clarity

94
Q

Most reliable parameter that measures the concentration of urine

A

Specific gravity

95
Q

Which method of measuring SG is prone to interferences?

A

Urinometer

96
Q

Advantage of using refractometer

A

Smaller volume of urine is used
No temperature calibration

97
Q
  • metabolite will crystallize
  • indicating presence of UTI
A

Amphicilin & sulfonamide crystals

98
Q

A contaminant from plastic containers

99
Q

Presence of leucine tyrosine and bilirubin crystals are indication of what?

A

Liver damage

Aubf Lec (4 decks)

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