Physical Examination of Urine Flashcards
Normal range for 24 hours of urine
“600-2000 mL”
Average 24 hr urine
“1200-1500 mL”
Night urine output
“<400 mL”
Day night ratio of urine
“2 - 3:1”
Container capacity of urine
“50 mL”
Amount required for routine UA
“10-15 mL (for urinometry and reagent strip)”
> 2000 mL/24 hrs of urine in adults (Henry)
2.5 L/day in adults (Strasinger)
Polyuria (increased urine volume)
Polyuria amount in children
2.5-3.0 mL/kg/day (in children)
Decreased urine volume in adults output (oliguria)
’< 500 mL/24 hrs (Henry);
‘< 400 mL/day (Strasinger)”
Oliguria in infants
’ <1 mL/kg/hr
Oliguria in children
< 0.5 mL/kg/hr
Complete cessation of urine flow amount (anuria)
< 100 mL/24 hrs
Increased urine output for night amount (nocturia)
> 500 mL of urine at night; S.G < 1.018
Any increase in urine excretion
Diuresis
Causes of polyuria
Increased fluid intake
Diuretics, nervousness
Diabetes mellitus
Diabetes insipidus
Difference between diabetes mellitus and diabetes insipidus in urine
Increased S.G in diabetes mellitus (increased glucose threshold)
Causes of decreased urine output
Dehydration, renal diseases, renal calculi, or tumor
Causes of anuria
“Complete obstruction (stones, tumors); Toxic agents; Decreased renal blood flow”
Diuresis causes
Excessive water intake (polydipsia); Diuretic therapy; Hormonal imbalance; Renal dysfunction, drug ingestion
Urine color should correlate with
Urine S.G
Normal color of urine
Colorless to deep yellow
Abnormal color of urine
“Red/Red brown (most common)”
Diabetes mellitus color of urine and S.G
“Colorless; Increased S.G”
Urine color determination should be examined at
“Under good light source; Look down through the container against white background”
Major pigment of urine; Lipid soluble (end product of endogenous metabolism)
“Urochrome”
Urochrome is increased in
“Thyrotoxicosis, fever, starvation, fasting”
Pink or red color in urine; Derived from melanin metabolism; Deposits amorphous urates and uric acid crystals
“Uroerythrin”
Dark yellow/orange brown color; Derived from an oxidation process; Present in old specimens
“Urobilinogen”
Recent fluid consumption urine color
“Colorless”
Polyuria (DM, DI), dilute random specimen color
Pale yellow
Concentrated specimen, strenuous exercise, dehydration, fever, burns
First morning urine specimen
Excessive urobilin, bilirubin, carotene color of urine
Dark yellow or amber
Yellow foam in urine indicates
“Bilirubin”
Tea colored urine is seen with
“Bilirubin”
Phenazopyridine (pyridium - UTI treatment) causes what urine color
“Orange/orange-yellow urine with orange foam”
Biliverdin presence causes what urine color
“Yellow green”
Pseudomonas infection, asparagus, B vitamins, phenol causes what urine color
“Green”
Chlorophyll, clorets, phenol, indican, blue diaper syndrome (familial hypercalcemia, Hartnup disease) urine color
“Blue-green”
Cloudy/Smoky red color of urine is seen in
“Hematuria (presence of RBCs)”
Clear red color in urine indicates
“Hemoglobinuria”
Myoglobin color in urine
“Clear-red/reddish brown/cola-colored/tea colored”
Pink or Red color in urine is caused by
“RBC, Hemoglobin, Myoglobin, Porphobilin, Rifampin, fuchsin, Beets”
Anti-Tb drug causes urine color
“Red/Pink color (Rifampin)”
Beets causes red color in what urine pH
“Alkaline”
Blackberries causes red color in what urine pH
“Acidic”
Burgundy/Purplish red, Portwine color of urine is due to
Porphyrin
Purple color of urine is caused by
“Indican (Klebsiella or Providencia infection)”
Brown/Black color of urine is caused by
“Methemoglobin (acidic)
Homogentisic acid (alkaline)
Alkaptonuria; Melanin (upon air exposure)
Cola-colored = fava beans, rhubarb, or aloe”
Pyuria/Leukocyturia (increased WBCs) causes what urine color
“Milky white”
Drugs that cause pale, diuresis in urine
“Ethyl alcohol”
Drugs that cause yellow color in urine
“Mepacrine (Atabrine), Fluorescein sodium”
Drugs that cause bright yellow urine
“Riboflavin (multivitamins)”
Drugs that cause orange-yellow urine
“Phenindione, Sulfasalazine (Azulfidine), Azo-gantrisin compounds”
Drugs that cause blue-green color
“Amitriptyline, Methocarbamol (Robaxin), Methylene blue, Indomethacin (Indocin, Tivorbex), Propofol (Diprivan)”
Drugs that cause brown/black urine color
“Phenol derivative, Argyrol, Methyldopa/Levodopa, Metronidazole (Flagyl), Methocarbamol, Nitrofurantoin, Chloroquine, Primaquine, Cascara/Senna”
Drugs that cause red urine color
“Phenolphthalein, Phenindione, Phenothiazines, Desferal, Paraflex”
Urine clarity determination is achieved by
“Thoroughly mixing the sample;
Examine sample in front of a light source;
View through newsprint paper”
Clarity of no visible particulates and transparent
“Clear”
Few particulates, print is EASILY seen through urine
“Hazy”
Many particulates, print blurred through the urine
“Cloudy”
Print cannot be seen through urine
“Turbid”
Clarity may be precipitate or clotted
“Milky”
Nonpathologic cause of urine turbidity
Some Amazing Animals Visit Sam’s Farm To See Reach Cows
Some = Squamous cell epithelial (females)
Amazing = Amorphous urates
Animals = Amorphous phosphates and carbonates
Visit = Vaginal cream
Sam’s = Semen
Farm = Fecal contamination
To = Talcum powder
Reach = Radiographic contrast media
Cows = Contrast media
Pink sediment in urine is caused by
“Amorphous urates”
White or beige precipitate in urine is caused by
“Amorphous phosphates and carbonates”
Pathologic cause of turbidity in urine
Real Wizards Bring Nightmares After Little Bizarre
Real = RBCs
Wizards = WBCs
Bring = Bacteria
Nightmares = Nonsquamous epithelial cells
After = Abnormal crystals
Little = Lymph fluid (chyluria)
Bizarre = Lipids
Bacteria: uniform turbidity not cleared by acidification or filtration
Laboratory correlations of acidic urine
“Amorphous urates, radiographic contrast media”
Laboratory correlations of alkaline urine
“Amorphous phosphates, carbonates”
Laboratory correlations of urine that is soluble with heat
“Amorphous urates, uric acid crystals”
Laboratory correlations of soluble with dilute acetic acid
“RBCs, amorphous phosphates, carbonates”
Laboratory correlations of insoluble in dilute acetic acid
“WBCs, Bacteria, Yeast, spermatozoa”
Laboratory correlations of soluble in ether
“Lipids, Lymphatic fluid, chyle”
Normal urine odor
“Aromatic, faintly, distinct, fragrant”
Acute tubular necrosis (acute renal failure) odor of urine
“Odorless”
Foul, ammoniacal, pungent odor is seen with
“UTI (Proteus vulgaris), old urine”
Fruity, sweet odor is seen with
“Ketones (Diabetes mellitus, starvation, vomiting)”
Odor of MSUD
“Caramelized sugar, curry, maple syrup”
Phenylketonuria odor
“Mousy, Musty, Barny”
Tyrosinemia odor
“Rancid butter”
Sweaty feet, acrid odor of urine
“Isovaleric acidemia, glutaric acidemia”
Menthol like odor of urine
“Phenol containing medication”
Specimen adulteration or container contamination odor
“Bleach”
Cabbage, hops odor
“Methionine malabsorption (Oasthouse disease)”
Sulfur, rotten egg odor
“Cystine disorder”
Rotting fish odor
“Trimethylaminuria”
Pungent, fetid odor
“Ingestion of onions, garlic, asparagus (methylcaptan), UTI (brunzel)”
Swimming pool odor
“Hawkinsuria (chlorine)”
Cat urine odor
“3-Hydroxy-3-methylglutaric aciduria”
Tomcat urine odor
Multiple carboxylase deficiency
