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UA > Collection and Physical Exam of Urine > Flashcards

Collection and Physical Exam of Urine Flashcards

1
Q

What is first morning collection?

A

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

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2
Q

What is fasting-second collection?

A

Urine voided after 8 hours of fasting.

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3
Q

What is postprandial-first collection?

A

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

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4
Q

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

A 
creatinine
urine urea nitrogen
glucose
sodium
potassium
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5
Q

What is midstream clean catch? why preferred?

A

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

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6
Q

what happens when urine sits for a long time?

A

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

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7
Q

What is the most common urine preservative chemical?

A

Boric acid

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8
Q

what is the preferred way of preserving urine?

A

regrigeration

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9
Q

how soon after collection must testing happen?

A

two hours

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10
Q

What are the 3 parts of a routine urinalysis?

A

physical exam
chemical exam
microscopic exam

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11
Q

What are the 3 aspects of the physical exam? A4SV

A

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

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12
Q

What is the pigment that makes urine yellow?

A

urochrome

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13
Q

What pigment may contribute pink/red coloration?

A

uroeythrin

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14
Q

3 pathogenic WHITE color variations. CLP

A

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

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15
Q

2 non-pathogenic WHITE color variations

A

phosphates

vaganal creams

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16
Q

2 pathogenic YELLOW/ORANGE color variations. LC

A 
liver dysfunction (++urobilin or bilirubin)
Chemotherapy drugs
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17
Q

2 pathogenic YELLOW/GREEN color variations. BB

A

biliverdin

bilirubin

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18
Q

5 non-pathogenic YELLOW/ORANGE color variations. CCFVM

A 
carrots (beta carotene)
concentrated urine (dehydration)
Food color
vit. B or C
meds
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19
Q

1 non-pathogenic YELLOW/GREEN color variation

A

asparagus

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20
Q

4 pathogenic PINK/RED color variations RHMP

A

RBC’s
Hemoglobin
Myoglobin
Porphyrin

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21
Q

3 non-pathogenic PINK/RED variations BFM

A

beets
food color
medications

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22
Q

1 pathogenic RED/PURPLE color variation. P

A

Porphyrin

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23
Q

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

A 
bilirubin
methemoglobin
myoglobin
melanin
homogentisic acid/alkpton
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24
Q

4 non-pathogenic BROWN/BLACK color variations. IFAM

A

Iron compounds
Fava beans
Aloe
Meds

25
Q

1 pathogenic BLUE color variation. P

A

Pseudomonas infection

26
Q

4 non-pathogenic BLUE color variations. VTDM

A

Vit. B12
Thymole
Diuretic Therapy
Meds

27
Q

What makes urine white and cloudy?

A

amorphous phosphates preciptates

28
Q

what makes urine pink and cloudy

A

amorphous urate precipitate (uroerythrin)

29
Q

What makes urine cloudy?

A

salts / crystals

30
Q

what makes urine hazy?

A

mucus

31
Q

what makes urine smoky?

A

RBC’s

32
Q

What makes urine turbid? LBPPE

A 
leukocytes
bacteria
pus
proteins
epithelial cells
33
Q

what makes urine milky? 2

A

fat or chyle

34
Q

2 pathogenic CLEAR color variations. VdP

A

very dilute

polyuria (DM or DI)

35
Q

non-pathogenic CLEAR color variation

A

over-hydrated

36
Q

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?

A

Hazy/cloudy/turbid

pathogenic

37
Q

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

A 
creams/lotions
crystals
mucus
radiographic dyes
powders
fecal contamination
38
Q

3 pathogenic causes of FOAMY urine

A

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

39
Q

3 non-pathogenic causes of FOAMY urine

A

Rapid urination
++concentration (dehydration)
toilet cleaner

40
Q

cause of “sweet/fruity” odor

A

ketones (DM)

41
Q

cause of “pungent” odor

A

bacteria (ammonia, eg UTI)

42
Q

cause of “maple syrup” odor

A

amino acids (maple syrup urine disease)

43
Q

cause of “musty/mousy” infant urine odor

A

phenylketonuria

44
Q

cause of “rancid butter/fishy” odor

A

hypermethioninemia

45
Q

cause of “stronger ammonia” odor

A

dehydration

46
Q

4 aspects of urine concentration test. SRPO

A

specific gravity
refractive index
pKa
osmolarity

47
Q

what is specific gravity of urine?

A

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

48
Q

What does specific gravity measure?

A

concentrating and diluting ability of the kidneys

49
Q

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

A

urine concentration ability

50
Q

What is normal specific gravity range?

A

1.003-1.035

51
Q

What does the refractive index measure? How?

A

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

52
Q

what specifically do pKa strips measure?

A

Ionic concentration; specific gravity

53
Q

what makes urine more acidic?

A

increase in specific gravity

54
Q

what does urine osmolality measure?

A

total solute concentration

55
Q

how are urine osmolality and specific gravity different?

A

Osmolality measures number of particles in the solution

pKa measures the number and weight of the solutes

56
Q

what is osmolality a better indicator than pKa for?

A

determining the concentrating and diluting abilities of the kidney

57
Q

Is osmolality usually measured in routine assessments?

A

no

58
Q

what 3 conditions should osmolality be measured for?

A

uncontrolled DM
nephrotic syndrome
assessing hydration status

UA (4 decks)

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