Chapter 2: Physical & Chemical Examination Of Urine Flashcards
(118 cards)
1
Q
Normal urine daily output
A
600 - 2000 mL
2
Q
Average urine output
A
1200 - 1500 mL
3
Q
Refers to a decrease in urine output (<400 mL/day)
A
Oliguria
4
Q
Cessation of urine flow
A
Anuria
5
Q
Increase in daily urine output (>2.5 L/day)
A
Polyuria
6
Q
Increase in nocturnal excretion of urine
A
Nocturia
7
Q
Polyuria + Low SG (Problem with ADH)
A
Diabetes Insipidus
8
Q
Urine pigments
A
Urochrome, Uroerythrin, Urobilin
9
Q
How to examine urine color
A
Examine the specimen under a good light source, looking down through the container against a white background
10
Q
A pink pigment most evident in refrigerated specimens as a result of amorphous urates precipitation
A
Uroerythrin
11
Q
Oxidation product of urobilinogen and imparts an orange-brown color to urine that is not fresh
A
Urobilin
12
Q
Main urine pigment in that causes yellow color
A
Urochrome
13
Q
This substance produces stable yellow foam when specimen is shaken
A
Bilirubin
14
Q
This is an oxidation product of bilirubin
A
Biliverdin
15
Q
This also causes yellow foam when shaken but only briefly
A
Phenazopyridine (Pyridium) aka azo-gantrisin compounds
16
Q
Nitrofurantoin causes urine to produce a color
A
Dark yellow/Amber/Orange
17
Q
This causes red & cloudy urine
A
Red blood cells
18
Q
Associated with red & clear urine
A
Hemoglobin & myoglobin
19
Q
Causes a port-wine color from the oxidation of porphobilinogen
A
Porphyrins
20
Q
Red plasma + red & clear urine
A
Hemoglobin
21
Q
Normal color plasma + red & clear urine
A
Myoglobin
22
Q
Rifampin causes what color of urine?
A
Rifampin
23
Q
Phenolphthalein, Phenindione, Phenothiazines causes what color of urine?
A
Red
24
Q
This is a metabolite of phenylalanine that causes brown/black urine
A
Homogentisic Acid
25
An oxidation product of the colorless pigment Melanogen that causes brown/black urine
Melanin
26
This medication causes brown/black urine
Metronidazole
27
A substance used for gastric fluid analysis (tubeless method) causes what color of urine?
Blue (Azure A is the substance)
28
Phenol derivatives cause urine to appear
Black
29
Phenol in the urine makes urine appear
Blue
30
How to examine urine clarity?
Visually examine the specimen in a clear container while holding it in front of a light source
31
No visible particulates seen in urine, transparent
Urine is clear
32
Few particulates is seen, print easily seen through urine
Urine is Hazy
33
Many particulates in the urine, print is blurred through urine
Urine is cloudy
34
Print cannot be seen through the urine
Urine is turbid
35
Presence of precipitate or clotted urine
Milky
36
No (or rare) visible particles; transparent
Clear
37
Visible particles present; newsprint can be read when viewed through urine tube
Hazy/ Slightly cloudy
38
Significant particulate matter; newsprint is blurred or difficult to read when viewed through the urine tube
Cloudy
39
Newsprint cannot be seen when viewed through urine tube
Turbid
40
What causes uniform turbidity in the urine that cannot be cleared by filtration
Bacter
41
Nonsquamous epithelial cells is a cause for (pathologic/non pathologic turbidity)
Pathologic cause of turbidity
42
Used to measure the concentrating and diluting ability of the kidney in its effort to maintain homeostasis
Specific Gravity
43
Density of solution compared with density of similar volume of water at a similar temp
Specific gravity
44
First function to diminish in renal disease
Tubular reabsorption
45
Normal SG in random urine
1.002 - 1.035
46
Normal SG for 24 hr urine
1.015 - 1.025
47
SG of >1.035 may mean
Px body has taken in Radiographic contrast media
48
Urine with fixed specific gravity of 1.010
ISOSTHENURIA
49
Isosthenuria is seen in
End-stage renal disease
50
Refers to the comparison of the velocity of light in air with the velocity of light in a solution
Refractive index
51
Indirect methods on measuring SG
Refractometer (Total Solids Measure), Reagent strip
52
Calibration using distilled water in refractometer
1.000
53
Calibration using 3% & 5% NaCl in refractometer
3% NaCl: 1.015
5% NaCl: 1.022 +- 0.001
54
Calibration using 9% sucrose in refractometer
1.034 +- 0.001
55
This method in SG determination of urine needs temperature correction
Urinometer
(Cold subtract 0.001)
(Warm add 0.001)
* for every 3 deg c away from 20 deg c
56
Correction needed for glucose and protein in SG determination in urine
SUBTRACT:
0.004 for GLUCOSE
0.003 for PROTEIN
57
Freshly voided urine has what kind of odor?
FAINTLY AROMATIC
58
What is the significance of LACK of ODOR in urine
Acute Renal Failure w/ Acute Tubular Necrosis
59
Foul, ammonia like odor in the urine suggests
Bacterial decomp. suggestive of UTI
60
Fruity, sweet odor in the urine
Ketones (DM, starvation and vomiting)
61
Mousy odor of urine
Phenylketonuria
62
Rancid odor of urine
Tyrosinemia
63
Sweaty feet odor in urine
Isovaleric acidemia & glutaric acidemia
64
Methionine malabsorption produces what odor of urine?
Cabbage, Hops
65
Rotting fish odor of urine
Trimethylaminuria
66
Unusual or pungent smell of urine may indicate?
Ingestion of onions, garlic, and asparagus
67
Fill out the following NORMAL Values of Physical Examination of Urine
VOLUME:
COLOR:
TRANSPARENCY:
SPECIFIC GRAVITY:
ODOR:
VOLUME: 600 - 2000 mL/day
COLOR: Yellow to amber
TRANSPARENCY: Clear
SPECIFIC GRAVITY: 1.001 - 1.035
ODOR: Faintly aromatic
68
Normal urine pH of a randomly collected specimen
4.5 - 8.0
69
This parameter is determined by the concentration of free Hydrogen ions
pH
70
pH of first morning urine sample
5.0 - 6.0
71
Normal urine pH with normal protein diet
4.5 - 6.5
72
Vomiting leads to alkaline or acidic urine
Alkaline
73
Renal tubular acidosis leads to alkaline or acidic urine
Alkaline urine
74
This is parameter is most indicative of renal disease
Protein
75
Major serum protein found in the urine
Albumin
76
This is a mucoprotein produced by the renal tubules and forms matrix of all types of casts
Tamm-Horsfall protein (Uromucoid/Uromodulin)
77
Normal urine protein value (Quantitative)
<10 mg/dL or 100 mg/24 hrs
78
Protein reaching >30mg/dL (300 mg/L)
Clinical Proteinuria
79
This are abnormally produced proteins in multiple myeloma and macroglobulinemia
Immunoglobulin paraprotein
80
Abnormal protein found in multiple myeloma
Bence-Jones protein
81
Significant clinical finding in preeclampsia
Proteinuria
82
Glomerulonephritis significant clinical finding
Presence of dysmorphic rbc
83
Microalbuminuria in diabetic patients is suggestive of
Diabetic nephropathy
84
Microalbuminuria is significant when it drops to ___________ when using quantitative procedures for albumin using a 24 hr urine specimen
30-300 mg/24 hrs
85
Albumin excretion rate of _________ is indicative of microalbuminuria
20-200 ug/min
86
Normal urine glucose level
15 mg/dL
87
Normal urine glucose in fasting state
2 - 20mg/dL per 100 mL of urine
88
Positive reaction for clinitest
Blue to orange/red positive reaction
89
To prevent pass through phenomenon in clinitest
Change urine volume from 5 drops to 2 drops
90
Acetest cannot detect what kind of ketone bodies
B-Hydroxybutyric acid
91
Positive result for acetest
Purple
92
Parasite than cause hematuria
Schistosoma haematobium
93
Cholesterol-lowering statin medication lead to
Myoglobinuria
94
Test used to differentiates hemoglobin or myoglobin in urine
BLONDHEIM’S test
95
Positive result for ICTOTEST
Blue to purple color
96
Urobilinogen excretion peaks
Between 2-4 pm (Need early afternoon specimen)
97
1mg/dL is equals to ______ ehrlich urine
1 ehrlich unit
98
Positive result for Ehrlich’s test for urobilinogen
Cherry red color
99
This is a rapid screening test for urine porphobilinogen
Hoesch Test (Inverse Ehrlich)
100
Reagent for Ehrlich test
P-dimethylaminobenzaldehyde (PDAB) & Sodium acetate (enhance color reaction)
101
Reagent for Hoesch test
Hoesch reagent (Ehrlich reagent dissolved in 6M HCl)
102
This test distinguish the presence of urobilinogen and porphobilinogen in the urine
Schwartz-watson differentiation test
103
What is the 11th parameter in the reagent strip
Ascorbic acid/Vitamin C
104
Fill in the following normal values for the ff. Parameters
pH:
Protein:
Glucose:
Ketones:
Blood:
Bilirubin:
Urobiliogen:
Nitrite:
Leukocyte Esterase:
Protein: 4.5 - 8.0
Glucose: <10 mg/dL
Ketones: Neg
Blood: Neg
Bilirubin:Neg
Urobiliogen: <1 mg/dL
Nitrite: Neg
Leukocyte Esterase: Neg
105
How to store reagent strip
Store below 30 deg c; do not freeze
106
This is an green dye that stains nuclear membranes, mitochondria and negatively charged cell membranes
Carbocyanine
107
This is an orange dye that stains DNA used in automated urine analyzer
Phenathridine
108
This parameter in urine dip-stick is affected by run over
pH
109
Principle of glucose reagent strip test
Double sequential enzyme reaction
110
Principle of Ketone in reagent strip test
Sodium Nitroprusside
111
Principle of pH in reagent strip
Double indicator system
112
Principle of specific gravity in reagent strip test
pKa change of poly-electrolyte
113
Principle of protein in reagent strip test
Protein error of indicator
114
Principle of blood in reagent strip test
Pseudoperoxidase activity of Hgb
115
Principle of bilirubin in reagent strip
Diazo reaction
116
Principle of Urobilinogen in reagent strip
Ehrlich’s reaction
117
Principle of Nitrite in reagent strip
Greiss reaction
118
Principle of Leukocyte Esterase
Leukocyte Esterase
