S1 [LEC]: URINALYSIS (Specimen collection + Physical examination) Flashcards
The beginning of laboratory medicine started with ___ wherein drawings of ___ and ___ where found
Analyzing urine
Cavemen
Egyptian hieroglyphics
In 5th century BC, ___ wrote a book on “uroscopy”
Hippocrates
In ___, color charts have been developed that described the significance of 20 different color of urine
1140 CE
In 1694, ___ discovered albuminuria by boiling urine
Frederick Dekkers
In 1925, ___ developed methods quantitating microscopic sediments
Thomas Addis
In 1827, ___ introduced the concept of urinalysis as part of a doctor’s routine patient examination
Richard Bright
Ultrafiltrate of the plasma
Urine
Urine is ___% water and ___% solute
95
5
The organic components of urine include:
Urea
Creatinine
Uric Acid
The inorganic compounds of urine include:
Chloride
Sodium
Potassium
Phosphate
Ammonium
Calcium
Normal daily urine output
1200 to 1500 mL
600 to 2000 mL
Decrease in urine output
Oliguria
Volume of urine output to be classified as oliguria in children
<0.5 mL/kg/hr
Cessation of urine flow
Anuria
Increase in the nocturnal excretion of urine
Nocturia
Increase in the daily urine volume
Polyuria
Volume of urine output to be classified as polyuria in children
> 2.5 to 3 mL/kg/day
In diabetes mellitus, the specific gravity of urine is ___
High
In diabetes insipidus, the specific gravity of urine is ___
Low
Give two conditions that cause polyuria
Diabetes mellitus
Diabetes insipidus
Recommended capacity of urinalysis collection container
50 mL
Volume of urine specimen needed for analysis
12 mL
Specimen should be delivered to the laboratory promptly and tested within ___
2 hours
Preservative for cherry red/ yellow preservative plus tube
Sodium propionate
Preservative for drug analysis
Sodium fluoride
In case of delay, specimens should be at ___ temperature or have an appropriate chemical preservative added
2-8C
Normal color of urine
Yellow
T/F: Any color of urine is accepted to be examined
True
Pigment of the urine:
Yellow
Urochrome
Pigment of the urine:
Pink
Uroerythrin
Pigment of the urine:
Orange-brown
Urobilin
Give the expected color of the urine:
Recent fluid consumption
Colorless or pale yellow
Give the expected color of the urine:
Commonly observed with random specimens
Colorless
Give the expected color of the urine:
Polyuria or diabetes insipidus
Pale yellow
Give the expected color of the urine:
Diabetes mellitus
Pale yellow
Give the expected color of the urine:
Diluted random specimen
Pale yellow
Give the expected color of the urine:
Increased 24-hour volume and low specific gravity
Pale yellow
Give the expected color of the urine:
Elevated specific gravity and positive glucose test result
Pale yellow
Give the expected color of the urine:
Concentrated specimen
Dark yellow
Give the expected color of the urine:
May be normal after strenous exercise or in first morning specimen
Dark yellow
Give the expected color of the urine:
B complex vitamins
Dark yellow
Give the expected color of the urine:
Dehydration
Dark yellow
Give the expected color of the urine:
Fever or burns
Dark yellow
Give the expected color of the urine:
Bilirubin
Dark yellow
Give the expected color of the urine:
Acriflavine
Dark yellow
Give the expected color of the urine:
Nitrofurantoin
Dark yellow
Give the expected color of the urine:
Antibiotic administered for UTI
Dark yellow
Give the expected color of the urine:
Phenazopyridine (pyridium)
Orange-yellow
Give the expected color of the urine:
Phenindione
Orange-yellow
Give the expected color of the urine:
Bilirubin oxidized to biliverdin
Yellow-green
Give the expected color of the urine:
Pseudomonas infection
Green
Give the expected color of the urine:
Amitriptyline
Blue-green
Give the expected color of the urine:
Methocarbamol (Robaxin)
Blue-green
Give the expected color of the urine:
Clorets
Blue-green
Give the expected color of the urine:
Indican
Blue-green
Give the expected color of the urine:
Methylene blue
Blue-green
Give the expected color of the urine:
Oxidized phenol
Blue-green
Give the expected color of the urine:
RBCs (hematuria)
Pink
Give the expected color of the urine:
Hemoglobin
Red
Give the expected color of the urine:
Myoglobin
Red
Give the expected color of the urine:
Beets
Red
Give the expected color of the urine:
Rifampin
Red
Give the expected color of the urine:
Menstrual contamination
Red
T/F: When there are hemoglobin and myoglobin in the blood, the urine is expected to be turbid or milky
False (clear)
Give the expected color of the urine:
Porphyrins
Port wine red
Give the expected color of the urine:
RBCs (or myoglobin) oxidized to methemoglobin
Red-brown
Give the expected color of the urine:
Homogentisic acid
Brown or black
Give the expected color of the urine:
Malignant melanoma
Black
Give the expected color of the urine:
Melanin
Black
Give the expected color of the urine:
Phenol derivatives
Black
Give the expected color of the urine:
Argyrol
Black
Give the expected color of the urine:
Methyldopa or Levodopa
Black
Give the expected color of the urine:
Metronidazole (flagyl)
Black
Also known as urine transparency
Clarity
Freshly voided normal urine is usually ___
Clear
If there are no squamous epithelial cells in a urine specimen, the sample is possibly ___
Adulterated
Translucent threadlike structures found in the urine
Mucus
Non-pathologic cause of urine turbidity that precipitates when refrigerated or when the patient is dehydrated
Amorphous phosphates
Carbonates
Urates
A fecal contamination in the urine requires ___
Repeat collection
Specific gravity of radiographic contrast media that causes non-pathologic turbidity in the urine sample
1.035 to 1.040
Direct methods for determining specific gravity
Urinometer
Harmonic Oscillation Densitometer
Indirect methods for determining specific gravity
Reagent strip
Refractometer
Specific gravity of urine classified as isosthenuric
1.010
Specific gravity of urine classified as hyposthenuric
<1.010
Specific gravity of urine classified as hypersthenuric
> 1.010
The Stamey-Mares Test for Prostatitis uses the ___-glass urine collection technique
Four
A pigment in the urine that is increased when the specimen stands at room temperature
Urochrome
Pigment in the urine that is the product of endogenous metabolism
Urochrome
Uroerythrin, a pink pigment in the urine, is enhanced with ___
Refrigeration
Refrigeration allows this specific pigment in the urine to attach to the sediments, giving it a certain color
Uroerythrin
Causes yellow foam when shaken, which could be mistaken for bilirubin
Phenazopyridine (Pyridium)
Bacterial species that cause purple urine color
Klebsiella spp.
Providencia spp.
Indican causes a blue-green urine, specific in babies with ___
Blue diaper syndrome
T/F: Pseudomonas infection causes an increased urinary indican
True
This specific urine color is indicative of glomerular bleeding if found in fresh urine
Brown
Nonpathologic causes of hazy but normal urine in females which increase during refrigeration
Squamous epithelial cells
Mucus
Formed when acidic urine is refrigerated
Amorphous urates
Formed when alkaline urine is refrigerated
Amorphous phosphates
Carbonates
T/F: Specific gravity is an absolute value
False (relative value)
A method of specific gravity determination that is less accurate and uses a weighted float attached to a scale
Urinometer
A method of specific gravity determination that uses the frequency of a sound wave entering a solution that changes in proportion to the density of the solution
Harmonic Oscillation Densitometer
A refractometer uses ___ to direct a specific wavelength of daylight to relate the specific gravity of the urine
Prism
This method of specific gravity determination compares the velocity of lightning the air with the velocity of light in a solution
Refractometer
Give the possible urine odor:
Normal
Aromatic
Give the possible urine odor:
Bacterial decomposition, urinary tract infection
Foul, ammonia-like
Give the possible urine odor:
Ketones caused by diabetes mellitus, starvation, vomiting
Fruity, sweet
Give the possible urine odor:
Phenylketonuria
Mousy
Give the possible urine odor:
Tyrosinemia
Rancid
Give the possible urine odor:
Isovaleric acidemia
Sweaty feet
Give the possible urine odor:
Methionine malabsorption
Cabbage
Give the possible urine odor:
Contamination
Bleach
Volume of urine output to be classified as oliguria in adult
<400 mL/day
Volume of urine output to be classified as polyuria in adult
> 2.5 L/day
A metabolic waste product produced in the liver from the breakdown of protein and amino acids
Urea
Accounts for nearly half of the total dissolved solids in urine
Urea
The major inorganic solid dissolved in urine
Chloride
Identify the component in normal urine:
Product of creatine metabolism by muscles
Creatinine
Identify the component in normal urine:
Product of nucleic acid breakdown in food and cells
Uric acid
Identify the component in normal urine:
Found in combination with sodium and many other inorganic substances
Chloride
Identify the component in normal urine:
Combined with chloride and other salts
Potassium
Identify the component in normal urine:
Regulates blood and tissue fluid acidity
Ammonia
Identify the component in normal urine:
Combines with chloride, sulfate, and phosphate
Calcium
Oliguria is seen when the body enters a state of ___
Dehydration
T/F: The kidneys excrete two to three times more urine during the day than during the night
True
When there is a cloudy urine with positive chemical test results for blood, the cause of pink red urine is ___
RBCs
When there is a clear urine with positive chemical test results for blood, the cause of pink red urine is ___
Hemoglobin
Myoglobin
When there is a cloudy specimen with RBCs, mucus, and clots, the pink red urine may be caused by ___
Menstrual contamination
One of the most common causes of abnormal urine color
Blood
If a patient has a clear and red urine, this may either be hemoglobinuria or myoglobinuria. How can we differentiate them?
Patient’s plasma (hemoglobin = red plasma, myoglobin = clear plasma)
A comparison of the velocity of the light in the air with the velocity of light in a solution
Refractive index
The corrected SG is done through adding/subtracting ___ for each gram of protein present
0.003
The corrected SG is done through adding/subtracting ___ for each gram of glucose present
0.004
