KLUBSY: PHYSICAL EXAMINATION OF URINE Flashcards
(188 cards)
1
Q
The normal urine color includes ???
A
pale yellow > yellow > dark yellow
2
Q
The yellow color of urine is caused by the presene of what pigment?
A
Urochrome
3
Q
The actual amount of urochrome produced on the body is dependent on what?
A
dependent on the body’s metabolic state
4
Q
Increased urochrome production in what cases:
A
-thyroid conditions
-fasting
-urine stands at RT
*Increaed in OFT (old spx, fasting, thryoid conditions)
5
Q
What are the additional pigments present in urine in much smaller quantities?
A
- Uroerythrin
- Urobilin
6
Q
This is the pink pigment in the urine
A
Uroerythrin
7
Q
this pigment is the most evident in specimens that have been refrigerated, resulting in the precipitation of amorphous urates
A
Uroerythrin
8
Q
Uroerythrin is most evident in spx that have been refrigerated, resulting in the precipitation of what?
A
Amorphous urates
9
Q
This additional pigment is the orange brown color
A
Urobilin
10
Q
This is an oxidation product of the normal urinary constituent urobilinogen
A
Urobilin
11
Q
The concentration of a normal urine specimen can be ESTIMATED by what?
A
urine color
12
Q
How to check for urine color?
A
1- examine specimen under a good light source
2- read against a white background
13
Q
What drug causes an orange color if the urine alkaline and becomes colorless when acidified?
A
PHENINDIONE
14
Q
This is an anti-tuberculosis drug that causes a reddish or reddish -orange color in the urine?
A
Rifampin
15
Q
Medtech received a smoky urine. What must be done?
A
Accept and check for RBCs
16
Q
This drug is commonly administered for urinary tract infection and produces also a yellow foam when shaken
A
Phenazopyridine (Pyridium)
17
Q
Phenazopyridine produces what color when shaken
A
Yellow foam
18
Q
What color is urine in the presence of phenol when oxidized?
A
Green
19
Q
This is associated with bilirubin and phenzopyridine
A
yellow foam
20
Q
yellow foam is associated with what?
A
Bilirubin and phenazopyridine (pyridium)
21
Q
What characteristic of urine is expected when you ingest an anti-UTI drug?
A
Yellow foam or yellow orange, and Turbid or cloudy
22
Q
These interefere with copper reduction tests
A
phenol derivatives
23
Q
This is associated with alubiminuria/proteinuria
A
White foam
24
Q
White foam is associated with what
A
Albuminuria/Proteinuria
25
Riboflavin causes what color in the urine?
Bright yellow
26
Riboflavin is a.k.a
Vit b2
27
This causes a bright yellow color in urine
Riboflavin (multivitamins)
28
What characteristic of urine happens in the presence of hematuria (RBCs in urine)
Smoky urine
29
This is a general term that refers to the "transparency or turbidity" of a urine spx
Clarity
30
What is the purpose of mixing the spx in order to determine clarity?
to distribute the sediments
31
What container must we place the spx to see for the clarity?
clear container
32
this provides a key to the microscopic examination results, because the amount of turbidity should correspond with the amount of material observed under the microscope
The clarity of a specimen
33
T/F: Clear urine is not always normal
TRUE
34
This produces a faint cloud in urine after standing due to WBCs, epithelial cells and mucus
Nubecula
35
How to check for urine clarity?
- MIX specimen while holdng it in fron of a light source.
-View through a NEWSPAPER PRINT
36
What would be the result if the specimen if not mixed?
blood reagent strip becomes NEGATIVE
37
What parameter is affected if specimen is not mixed?
blood reagent strip (negative)
38
Determine the clarity: No visible particulates, transparent
clear
39
Determine the clarity: Few particulates, print easily seen through urine
Hazy
40
Determine the clarity: Many particulates, print blurred through urine
Cloudy
41
Determine the clarity: Print cannot be seen through urine
Turbid
42
Determine the clarity: May precipitate or be clotted
Milky
43
What is the description for a clear speciment?
No visible particulates, transparent
44
What is the description of a hazy specimen?
Few particulates, print really seen through urine
45
What is the description of a cloudy urine spx?
Many particulates, print blurred through urine
46
What is the description of a turid urine spx?
Print cannot be seen through urine
47
What is the descriptionn of a milky urine spx?
may precipitate or be clotted
48
What are the possible causes of a clear spx?
All solutes present are soluble (such as glucose and proteins)
49
What is the clarity when all solutes present are soluble?
Clear
50
What is the clarity when RBC and WBC are present?
Hazy
51
This is the urine clarity due to RBC and WBCs
Hazy
52
What is the clarity when there are crystals, microbes, fat (lipids, chyle), epithelial cells?
Cloudy
53
What is the clarity when there are mucus, mucin, pus, radiographic dye, semen, contaminants?
Turbid
54
What is the clarity when there are fats or lymph (lipiduria and chyluria)?
Milky
55
A milky urine spx is caused by?
fats or lymph
56
a turbid urine spx is caused by?
-mucus
-mucin
-pus
-radiographic dye
-semen
-contaminants
57
a cloudy urine spx is caused by what?
-crystals
-microbes
-fat (lipids, chyle)
- epithelial cells
58
What are the non-pathologic causes of urine turbidity?
-squamous epithelial cells
-mucus
-amorphous phosphates, carbonates, urates
-semen, spermatozoa
-fecal contamination
-radiographic contrast media
-talcum powder
-vaginal creams
59
What are pathologic causes of urine turbidity?
-RBCs
-WBCs
-Bacteria
-Yeast
-Non squamous epithelial cells
-Abnormal crystals
-Lymph fluid
-lipids
60
What are the lab correlation in urine turbidity that is soluble in dilute acetic acid?
-RBCs, amorphous phosphates, carbonates
*SRAP CARBO = Solube kapag Rbcs, Amorphous Phosphates, Carbonates
61
What are the lab correlation in urine turbidity that is insoluble in dilute acetic acid?
-WBCs, bacteria, yeast, spermatozoa
62
How to check for both clarity and color?
check urine with a white background with a good light source
63
how to check for the color of the urine spx?
color = good light source + white bg
64
How to check for the clarity of the urine spx?
Good light source + mixed urine spx
*hindi first choice ang "view sa newspaper print"
65
How to check for the color and clarity of a urine spx?
color and clarity = good light source + white bg
66
T/F: This is seldom of clinical significance and is not a part of the routine urinalysis
T
67
What is the normal urine odor?
Norma/Redolent/Fragrant/Odorous
68
Odor: Bacterial decomposition, UTI, old urine
Foul, ammonia-like, fetid, putrid
69
Odor: Ketones, DM, Starvation, vomiting, strenuous exercise, diarrhea
Fruity, sweet
70
Odor: Maple syrup urine disease, caramel sugar
Maple syrup
71
Odor: Phenylketonuria
Mousy odor, Barny or musty odor
72
Odor: Tyrosinemia
Rancid
73
Odor: Isovaleric academia
Sweaty feet
74
Odor: Methionine malabsorption
Cabbage, Hops
75
Odor: Contamination
bleach
76
Odor: Acute tubular necrosis
Odorless
77
Odor: Trimetylaminuria
Rotting fish
78
Odor: Asparagus, garlic, onion ingestion, UTI, bacteruria, increase urinary amines
Pungent or distinctive odor
79
What odor if wee homocystinuria?
Cabbage, hops
80
Odor: Hawkinsinuria
Swimming pool
81
Odor: Cystinuria
Sulfure or rotten egg
82
Odor: Phenol-containing medications
Menthol-like
83
Odor: Asparagus, garlic, and egg
Mercaptan odor
84
A purple staining may occur in catheter bags and is cused by an indicant in the urine or by a bacterial infection, frequently caused by what species of bacteria?
by Klebsiella or Providencia
85
This color of the urine is associated with rhabdomyolysis and in some patients taking L-dopa
cola-colored urine
86
a cola-colored urine is associated with what?
with rhabdomyolysis and in some patients taking L-dopa
87
What is formed if a normal urine specimen is shaken or agitated sufficiently?
a foam
88
What color of foam is formed due to bilirubin and phenazopyridine?
yellow foam
89
what color foam is formed due to protein mainly albumin?
white foam
90
a yellow foam is formed due to what?
due to bilirubin and phenazopyridine
91
A white foam is formed due to what?
due to protein mainly albumin
92
This is defined as the density of a solution compared with the density of a similar volume of distilled water at a smiliar temp
S.G
93
What is the S.G of distilled water?
1.000
94
S.G is influenced by what?
by the number of particles present and the size of the particles
95
What is the S.G of the plasma filtrate entering the glomerulus?
1.010
96
This is the term to describe urine with S.G 1.010
isosthenuric
97
the term to describe urine with S.G below 1.010
Hyposthenuric/Diluted urine
98
the term to describe urine with S.G above 1.010
Hypersthenuric/concentrated urine
99
What is the S.G of normal random urine?
1.002 - 1.035
100
Most of the random specimen falls between what S.G?
1.015 - 1.030
101
What is the S.G abnormally high S.G?
above 1.040
102
This S.G result is seen in patients who have recently undergone an intravenous pyelogram
above 1.040
103
S.G: Physlologically impossible-same as pure water; suspect adulteration of urine specimen
1.000
104
What is the indication/cause of an S.G of 1.000?
Physlologically impossible-same as pure water; suspect adulteration of urine specimen
105
S.G: Dilute urine
1.001-1.009
106
S.G: associated with increased water intake or water diuresis (e.g., diuretics, diabetis insipidus, inadequate secretion/action of ADH)
1.001-1.009
107
An S.G of 1.001 - 1.009 is indicative/caused by?
Dilute urine; assoclated with increased water intake or water diuresis (e.g., diuretics, Diabetes
insipidus, inadequate secretion/action of ADH)
108
S.G: Indicates average solute and water intake and excretion
1.010-1.035
109
An S.G of 1.010-1.025 is indicative/caused by?
Indicates average solute and water intake and excretion
110
S.G: Concentrated urine
1.025-1.035
111
S.G: associated with dehydration, fluid restriction, profuse sweating, osmotic diuresis
1.025-1.035
112
SG: associated with dehydration
1.025-1.035
113
SG: associated with fluid restriction
1.025-1.035
114
SG: associated with profuse sweating
1.025-1.035
115
SG: associated with osmotic diuresis
1.025-1.035
116
S.G: suspect adulteration of urine specimen
1.000
117
S.G: Physiologically impossible; indicates presence of iatrogenic substance (e.g., radiographic contrast
‘media, mannitol)
> 1.040
118
S.G: indicates presence of iatrogenic substance (e.g., radiographic contrast
‘media, mannitol)
>1.040
119
An S.G of 1.025 - 1.035 is indicative/caused by?
concentrated urine
120
An S.G of >1.040 is indicative/caused by?
indicates presence of iatrogenic substance (e.g., radiographic contrast
‘media, mannitol)
121
What are the methods for detection urine S.G?
-direct mtds
-indirect mtds
122
What are the direct mtds for detection of urine s.g?
-hydrometer
-harmonic oscillation densitometry
-falling drop
123
what are the indirect mtds for detection of urine s.g?
-refractometer
-reagent strip
124
What method of detection of urine s.g is this?
-Hydrometer
-harmonic oscillation densitometry
-falling drop
125
what methods of detection of urine s..g is this?
-refractometer
-reagent strip
126
A hydrometer is a.k.a?
Urinometer
127
This consists of a weighted float attach to a scale that has been calibrated in terms
of urine specific gravity
Urinometer
128
When using urinometer, an adequate amount of urine is poured into a proper-size
container and the urinometer is added with ....
with a spinning motion.
129
How to read a scale of a urinometer?
at the bottom of the urine meniscus
130
What is the MAJOR disadvantage of using a urinometer?
is that it requires a 10-15 mL specimen
131
This method of detection of urine s.g is less accurate than other methods and is not recommended by the CLSI
Urinometer
132
What is the calibrated temperature printed on the instrument?
about 20C
133
How to correct for the S.G in a urinometer?
1. Add 0.001 for every 3C ABOVE the calibration temp (20C)
2. Subtract 0.001 for every 3C BELOW the calibration temp
3. Subtract 0.004 for every 1 gram of glucose (4G)
4. Subtract 0.003 for every 1 gram of protein (proTHREEin)
134
What are the two calibrating fluids when using a urinometer?
-potassium sulfate
-Water
135
With potassium sulfate as a calibrating fluid, the S.G should be read at ???
1.015
136
With water as a calibrating fluid in a urinometer, the S.G should be read at ???
1.000
137
This calibrating fluid should be read at 1.015 when using a urinometer
potassium sulfate
138
With this calibrating fluid, the S.G should be reat at 1.000
water
139
A refractometer is a.k.a?
TS meter
140
It determines the concentration of dissolved particles in a specimen.
Refractometer
141
This method determines concentration of dissolved particles by measuring refractive index
Refractometer
*REFRACtive index = REFRACtometer
142
A refractometer determines what?
determines the concentration of dissolved particles in a spx
143
How does a refractometer determine the concentration of dissolved particles?
by measuring refractive index
144
This is a comparison of the velocity of light in air with the
wvelocity of light in a solution(urine).
Refractive index
145
Refractive index is a comparison between what?
velocity of light in air with the velocity of light in a solution (urine)
146
This provides the distinct advantage of determining specific gravity using a small volume of specimen (one or two drops)
Refractometer
147
T/F: Temperature corrections are necessary in the refractometry method
F.
NOT necessary
148
In a refractometer, the temperature is compensated between what???
between 15C and 38C
149
How to correct glucose in a refractometry?
subtract 0.004 for each gram
150
How to correct protein in refractometry?
subtract 0.003 for each gram
151
Calibration of a refractometer is performed using a what?
Using a calibration screw
152
What are the calibrating fluids using in refractometry?
- Water
- 3% NaCl
- 5% NaCl
- 9% Sucrose
153
In refractometry, the S.G of the calibrating fluid WATER should be read at ????
1.000
153
In refractometry, the S.G of this calibrating fluid should be read at 1.000?
Water
154
In refractometry, the S.G of calibrating fluid 3% NaCl should be read at ???
1.015 +/- 0.001
155
In refractometry, the s.g of the calibrating fluid 5% NaCl should be read at ????
1.022 +/- 0.001
156
In refractometry, the s.g of the calibrating fluid 9% sucrose should be read at ????
1.034 +/- 0.001
157
This method is based on the principle that the frequency of a sound wave entering a solution changes in proportion to the density of the solution
Harmonic oscillation densitometry
158
Swollen RBCs and glitter cells are due to?
HYPOsthenuria
*HYPO = HIPPO (swollen mataba)
159
Crenated RBCs are seen in ???
HYPERRRRRRRsthenuria
160
Harmonic oscillation densitometry is based on what principle?
based on the principle that the frequency of sound waves entering a solution changes in proportion to the density of the solution
161
S.G of triple distilled water
1.000
162
Where to read if the solution is colored?
BELOW the meniscus
163
What is used to calibrate the baseline of a urinometer?
WATER
164
The most commonly used method for detecting uring s.g?
Rgnt strip
165
This mtd to detect urine s.g is rarely used today despite its ability to accurately and precisely determine urine s.g
Harmonic Oscillation Densitometry
166
What is the s.g linearity in a harmonic oscillation densitometry
linearity up to 1.080
167
This method was initially used on a semiautomated urinalysis workstation known as the Yellow IRIS
Harmonic oscillation densitometry
168
HOD was initially used on a semiatuomated urinalysis workstation known as the ???
YELLOW IRIS
169
During a testing in HOD, a portion of the urine sample is held how?
in a U-shpaed glass tube that has an electromagnetic coil on one end and a motion detector on the other end
170
in HOD, this is applied to the coil generates a sound wave of fixed frequency
an electric current
171
in HOD, this is transmitted through the specimen and the frequency attenuation is measured
sonic oscillation
172
This is observed directly proportionate to the sample density, and a microprocessor converts the frequency to a corresponding specific gravity value
the frequency or the oscillating cycle period
173
In HOD, the frequency observed is directly proportionate to the what?
directly proportionate to the sample density
174
In HOD, converts the frequency to a corresponding specific gravity value
microprocessor
175
in HOD, a microprocessor converts the frequency to what?
to a corresponding specific gravity value
176
This is based on the change in the pKa of a polyelectrolyte in an alkaline medium
The rgnt strip reaction
177
The reagent strip reaction is based on what?
based on the change in the pKa (dissociation constant)
178
the reagent strip reaction is based on the change in the pKa of what?
change in the pKa of a polyelectrolyte in an akaline medium
179
T/F: Using a rgnt strip, S.G reading is NOT affected by radiographic contrast dye, protein, and glucose.
TRUE
180
In a rgnt strip, S.G reading is not affected by what?
not affected by radiographic contrast dye, protein, and glucose
181
In a rgnt strip, what is NOT affected by radiographic contrast dye, protein, and glucose
S.G reading
182
What factors must be corrected in a urinometer?
- correction for temp
- correction for glucose
- correction for protein
183
What factors must be corrected in a refractometer?
- correction for glucose
- correction for protein
184
what factors must be corrected in a rgnt strip?
- NO CORRECTIONS NEEDED
185
What is the formula for S.G dilution?
S.G x DILUTION = ACTUAL S.G
186
A specimen diluted 1:5 with a reading of 1.010 would have an actual S.G of:
1.015
*no need to include the WHOLE number (1) in multiplying
187
