Principles of Urinalysis

Question 1

Describe the colour of urine

Answer 1

Ranges from pale straw to amber colour depending on concentration

Question 2

What determines urine colour?

Answer 2

urochrome - a by-product of haemoglobin breakdown and concentration/hydration

Question 3

What is the normal clarity of urine?

Answer 3

Usually transparent

Question 4

How would you describe the smell of fresh urine?

Answer 4

Ideally should not be offensive

Question 5

What is the normal pH of urine?

Answer 5

Ranges from 4.5 - 8

acidic around pH 6

Question 6

What is the specific gravity of urine?

Answer 6

1.002 - 1.035

Question 7

What does a higher gravity of urine indicate?

Answer 7

1.035 is more concentrated as occurs in dehydration

Question 8

What does a lower gravity of urine indicate?

Answer 8

A lower reading (1.002) indicates more dilute urine e.g. due to higher fluid intake

Question 9

What percentage does water constitute to urine?

Answer 9

96%

Question 10

What dissolved substances are in urine?

Answer 10

• urea and other substances
• uric acid
• creatinine
• ammonia

Question 11

Give examples of ‘urea and other substances’ found in urine?

Answer 11

uric acid, sodium, potassium, creatinine, sulphates, oxalates, chlorides

Question 12

What is uric acid found in urine?

Answer 12

breakdown of nucleic acid urea - product of protein breakdown in liver

Question 13

What is creatinine found in urine?

Answer 13

results from metabolism in muscles

Question 14

What is ammonia found in urine?

Answer 14

by-product of amino acid breakdown

Question 15

When would urinalysis be carried out during pregnancy?

Answer 15

• antenatal booking & appointments
• monitor during labour
• admission to hospital
• specific medical disorder apparent
• clinical symptoms e.g. dysuria
• altered micturition

Question 16

What effects the colour of urine?

Answer 16

• hydration
• haematuria (blood in urine)
• diet (red foods - beetroot)
• medications

Question 17

What is the significance of cloudy urine?

Answer 17

• Cloudy if left to stand for several minutes due to precipitation of solutes.
• Proteinuria
• Bacteriuria

Question 18

What can affect the odour of urine?

Answer 18

• high concentration
• stagnant urine has an ammonia smell
• ketones = sweet odour
• infection = fishy, offensive odour
• foods - fish, curry etc

Question 19

What can cause protein to be present in the urine?

Answer 19

contamination, infection or underlying disease

Question 20

Why might blood be present in the urine?

Answer 20

infection, trauma, disease or vaginal contamination

Question 21

Why might glucose be present in the urine?

Answer 21

• glycosuria can be result of glucose threshold being lowered during pregnancy
• diabetes

Question 22

What are ketones? Why might ketones be present in the urine?

Answer 22

• Product of fat metabolism

- Due to fasting, vomiting, diabetes, in labour if energy stores reduced

Question 23

Why might nitrites be present in the urine?

Answer 23

Nitrates from diet are converted to nitrites in the presence of bacteria therefore if in urine indicative of urinary tract infection

Question 24

What does high levels of urobilinogen mean in the urine?

Answer 24

May indicate liver abnormalities or excessive destruction of red blood cells as in haemolytic anaemia

Question 25

Why might leucocytes (white blood cells) be present in urine?

Answer 25

Inflammation or infection along urinary tract often in the bladder or kidney