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Flashcards in Collection and Physical Exam of Urine Deck (58):
1

What is first morning collection?

Collecting urine first thing in the morning: most concentrated, higher cellular elements and/or protein

2

What is fasting-second collection?

Urine voided after 8 hours of fasting.

3

What is postprandial-first collection?

Urine voided before a meal and specimen collected 2 hours after eating

4

What does a timed (aka 24 hr collection) collection measure? 5

creatinine
urine urea nitrogen
glucose
sodium
potassium

5

What is midstream clean catch? why preferred?

prefered type of urine collection for bacteria and sensitivity culture/testing. preferred bc there is a reduced incidence of cellular and microbial contamination

6

what happens when urine sits for a long time?

RBCs undergo lysis, urine becomes alkalinized with the preciptation of salts

7

What is the most common urine preservative chemical?

Boric acid

8

what is the preferred way of preserving urine?

regrigeration

9

how soon after collection must testing happen?

two hours

10

What are the 3 parts of a routine urinalysis?

physical exam
chemical exam
microscopic exam

11

What are the 3 aspects of the physical exam? A4SV

Appearance (color, clarity, foam, odor)
Specific gravity
volume

12

What is the pigment that makes urine yellow?

urochrome

13

What pigment may contribute pink/red coloration?

uroeythrin

14

3 pathogenic WHITE color variations. CLP

Chyle (milky body fluid of lymph, fats, FFA's)
Lipids
Pyuria (many WBC's)

15

2 non-pathogenic WHITE color variations

phosphates
vaganal creams

16

2 pathogenic YELLOW/ORANGE color variations. LC

liver dysfunction (++urobilin or bilirubin)
Chemotherapy drugs

17

2 pathogenic YELLOW/GREEN color variations. BB

biliverdin
bilirubin

18

5 non-pathogenic YELLOW/ORANGE color variations. CCFVM

carrots (beta carotene)
concentrated urine (dehydration)
Food color
vit. B or C
meds

19

1 non-pathogenic YELLOW/GREEN color variation

asparagus

20

4 pathogenic PINK/RED color variations RHMP

RBC's
Hemoglobin
Myoglobin
Porphyrin

21

3 non-pathogenic PINK/RED variations BFM

beets
food color
medications

22

1 pathogenic RED/PURPLE color variation. P

Porphyrin

23

5 pathogenic RED/BROWN/BLACK color variations BMMMH/A

bilirubin
methemoglobin
myoglobin
melanin
homogentisic acid/alkpton

24

4 non-pathogenic BROWN/BLACK color variations. IFAM

Iron compounds
Fava beans
Aloe
Meds

25

1 pathogenic BLUE color variation. P

Pseudomonas infection

26

4 non-pathogenic BLUE color variations. VTDM

Vit. B12
Thymole
Diuretic Therapy
Meds

27

What makes urine white and cloudy?

amorphous phosphates preciptates

28

what makes urine pink and cloudy

amorphous urate precipitate (uroerythrin)

29

What makes urine cloudy?

salts / crystals

30

what makes urine hazy?

mucus

31

what makes urine smoky?

RBC's

32

What makes urine turbid? LBPPE

leukocytes
bacteria
pus
proteins
epithelial cells

33

what makes urine milky? 2

fat or chyle

34

2 pathogenic CLEAR color variations. VdP

very dilute
polyuria (DM or DI)

35

non-pathogenic CLEAR color variation

over-hydrated

36

How would the urine appear if you observed these in it: "varying degrees of casts, cells, crystals/calculi, fat, microorganisms, fecal contaminatation"?
Pathogenic or not?

Hazy/cloudy/turbid
pathogenic

37

5 non-pathogenic substances that may create a hazy/cloud/turbid appearance. CCMRPF

creams/lotions
crystals
mucus
radiographic dyes
powders
fecal contamination

38

3 pathogenic causes of FOAMY urine

++protein (kidney disease)
UTI (pus)
Fistula from colon to bladder (fecal cont.)

39

3 non-pathogenic causes of FOAMY urine

Rapid urination
++concentration (dehydration)
toilet cleaner

40

cause of "sweet/fruity" odor

ketones (DM)

41

cause of "pungent" odor

bacteria (ammonia, eg UTI)

42

cause of "maple syrup" odor

amino acids (maple syrup urine disease)

43

cause of "musty/mousy" infant urine odor

phenylketonuria

44

cause of "rancid butter/fishy" odor

hypermethioninemia

45

cause of "stronger ammonia" odor

dehydration

46

4 aspects of urine concentration test. SRPO

specific gravity
refractive index
pKa
osmolarity

47

what is specific gravity of urine?

ratio of weight: vol. urine: vol. distilled water

48

What does specific gravity measure?

concentrating and diluting ability of the kidneys

49

What is one of the first functions to be lost in the case of kidney tubular damage?

urine concentration ability

50

What is normal specific gravity range?

1.003-1.035

51

What does the refractive index measure? How?

Specific gravity via the total number of solids (aka how dense) in the urine. By how much light refracts when moving through urine

52

what specifically do pKa strips measure?

Ionic concentration; specific gravity

53

what makes urine more acidic?

increase in specific gravity

54

what does urine osmolality measure?

total solute concentration

55

how are urine osmolality and specific gravity different?

Osmolality measures number of particles in the solution
pKa measures the number and weight of the solutes

56

what is osmolality a better indicator than pKa for?

determining the concentrating and diluting abilities of the kidney

57

Is osmolality usually measured in routine assessments?

no

58

what 3 conditions should osmolality be measured for?

uncontrolled DM
nephrotic syndrome
assessing hydration status