PHYSICAL EXAMINATION OF URINE

Question 1

Normal volume range (24 hours)

Answer 1

600 to 2,000 mL (0.6 to 2 L)

Question 2

Average volume range (24 hours)

Answer 2

1,200 to 1,600 mL (1.2 to 1.6 L)

Question 3

Night urine output

Answer 3

<400 mL

Question 4

Day:Night ratio

Answer 4

2-3:1

Question 5

Container capacity (UA)

Answer 5

50 mL

Question 6

The volume required for routine UA

Answer 6

10 - 15 mL (Average: 12 mL)

Question 7

Increased urine volume

Answer 7

Polyuria

Question 8

Volume considered to be polyuria

Answer 8

> 2,000 mL/24 hours (in adults - Henry)
2.5 L/Day (in adults - Strasinger)
2.5 - 3.0 mL/kg/day (in children)

Question 9

Decreased urine volume

Answer 9

Oliguria

Question 10

Volume considered to be oliguria

Answer 10

<500 mL/24 hours (in adults - Henry)
<400 mL/Day (in adults - Strasinger)
<1 mL/kg/hr (in infants)
<0.5 mL/kg/hr (in children)

Question 11

Complete cessation of urine flow

Answer 11

Anuria

Question 12

Volume considered to be anuria

Answer 12

<100 mL/24 hours (Graff)

Question 13

Excretion of more than 500 mL of urine at night

Answer 13

Nocturia

Question 14

Any increase in urine excretion

Answer 14

Diuresis

Question 15

Difference of polyuria in Diabetes Insipidus and Diabetes mellitus

Answer 15

Diabetes insipidus - low specific gravity
Diabetes mellitus - high specific gravity

Question 16

Roiugh indicator of the degree of hydration; should correlate with urine S.G.

Answer 16

Urine color

Question 17

Best way to examine urine color:

Answer 17

1. Examine the specimen under a good light source
2. Look down through the container against a white background

Question 18

Major pigment of urine

Answer 18

Urochrome

Question 19

Derived form melanin metabolism; May deposit in amorphous urates and uric acid crystals; gives the urine a pink color

Answer 19

Uroerythrin

Question 20

Dark yellow/ orange-brown; derived from oxidation of colorless urobilinogen; Present in old specimens

Answer 20

Urobilin (Dark yellow/orange-brown

Question 21

lab correlation of urine color:

Pale yellow

Answer 21

Polyuria (DM, DI) dilute random specimen

Question 22

lab correlation of urine color:

Dark yellow/ Amber

Answer 22

Concentrated specimen: strenuous exercise, dehydration, fever, burns
First morning specimen
Excessive urobilin, bilirubin, CAROTENE

Question 23

lab correlation of urine color:

Orange
Orange-yellow

Answer 23

Bilirubin (yellow foam)
Phenazopyridine (Pyridium) - used to treat UTI

Question 24

“tea-colored urine”

Answer 24

Bilirubin (yellow foam)

Question 25

lab correlation of urine color: Green

Answer 25

Pseudomonas infection asparagus B vitamins PHENOL

Question 26

lab correlation of urine color: Blue-green

Answer 26

Chlorophyll Clorets, PHENOL Indican, Blue-diaper syndrome

Question 27

lab correlation of urine color: Pink Red

Answer 27

RBCs Hemoglobin Myoglobin porphobilin RIFAMPIN FUCHSIN Beets Menstrual contamination

Question 28

lab correlation of urine color: Cloudy/smokey red urine

Answer 28

presence of RBCs (hematuria)

Question 29

lab correlation of urine color: Clear red urine

Answer 29

Hemoglobin Myoglobin

Question 30

lab correlation of urine color: Portwine

Answer 30

Porphyria

Question 31

lab correlation of urine color: Brown Black

Answer 31

Methemoglobin (acidic urine) Homogentesic acid (alkaline urine): Alkaptoniuria Melanin (upon exposure to air)

Question 32

lab correlation of urine color: Milky white

Answer 32

Pyuria/Leukocyturia (increased WBCs)

Question 33

What should the MT do before determining the urine clarity?

Answer 33

Thoroughly mix the specimen

Question 34

Best way to determine urine clarity

Answer 34

Examine the specimen while holding in front of a light source and mus be viewed through a NEWSPAPER PRINT

Question 35

Few particulates, print easily seen through urine

Answer 35

Hazy

Question 36

Many particulates, print blurred through urine

Answer 36

Cloudy

Question 37

Print cannot be seen through urine

Answer 37

Turbid

Question 38

May precipitate or be clotted

Answer 38

Milky

Question 39

Nonpathologic causes of urine:

Answer 39

1. Squamous epithelial cells (increased in females) 2. Amorphous urates (pink sediment) 3. Amorphous phosphates & carbonates (white or beige precipitate) 4. Vaginal cream, semen, fecal contamination, radiographic contrast media, talcum powder

Question 40

Pathologic causes of urine:

Answer 40

1. RBCs, WBCs 2. Bacteria (uniform turbidity not cleared by acidification or filtration) 3. Yeasts (increased in DM) 4. Nonsquamous epithelial cells 5. Abnormal crystals, Lymph fluid (chyluria), lipids

Question 41

Laboratory correlations in urine turbidity: Acidic urine

Answer 41

Amorphous urates Radiographic contrast media

Question 42

Laboratory correlations in urine turbidity: Alkaline urine

Answer 42

Amorphous phosphates Carbonates

Question 43

Laboratory correlations in urine turbidity: Soluble in heat

Answer 43

Amorphous urates Uric acid Crystals

Question 44

Laboratory correlations in urine turbidity: Soluble in Dilute Acetic Acid

Answer 44

RBCs Amorphous phosphates Carbonates

Question 45

Laboratory correlations in urine turbidity: Insoluble in Dilute Acetic Acid

Answer 45

WBCs Bacteria Yeast Spermatozoa

Question 46

Laboratory correlations in urine turbidity: Soluble in Ether

Answer 46

Lipids Lymphatic fluid Chyle

Question 47

Normal urine odor

Answer 47

Aromatic, faintly, distinct/fragrant

Question 48

Acute tubular necrosis urine odor (acute renal failure)

Answer 48

Odorless

Question 49

UTI urine odor

Answer 49

Foul, ammoniacal, pungent

Question 50

Fruity, sweet urine odor

Answer 50

Ketones( Diabetes Mellitus, starvation, vomiting)

Question 51

Caramelized sugar, curry, maple syrup

Answer 51

Maple syrup urine disease (MSUD)

Question 52

Mousy, musty, barny

Answer 52

Phenylketonuria (PKU)

Question 53

Rancid butter

Answer 53

Tyrosinemia

Question 54

Sweaty feet, acrid

Answer 54

Isovaleric acidemia, glutaric acidemia

Question 55

Menthol-like

Answer 55

Phenol-containing medications

Question 56

Bleach

Answer 56

Specimen adulteration or container contamination

Question 57

Cabbage hops

Answer 57

Methionine malabsorption (Oasthouse disease)

Question 58

Sulfur, rotten egg

Answer 58

Cystine disorder

Question 59

Rotting fish

Answer 59

Trimethylaminuria

Question 60

Pungent, fetid

Answer 60

Ingestions of onions, garlic & asparagus (methyl mercaptan), UTI (Brunzel)

Question 61

Swimming pool

Answer 61

Hawkinsinuria

Question 62

Cat urine

Answer 62

3-hydroxy-3-methylglutaric aciduria

Question 63

Tomcat urine

Answer 63

Multiple carboxylase deficiency