Physical Examination of Urine Flashcards
(217 cards)
1
Q
The ____ gives you an idea what are the results that you can obtain from the chemical and microscopic examination of urine.
A
Physical Examination
2
Q
The ____ is a rough indicator of the degree of hydration.
A
Urine color
3
Q
The urine color is a rough indicator of the ____.
A
degree of hydration
4
Q
The ____ should correlate with the urine specific gravity.
A
Urine color
5
Q
The urine color should correlate with the ____.
A
urine specific gravity
6
Q
Low fluid intake = ____ = ____ = ____.
A
- darker urine color
- higher amount of solute
- increased specific gravity
7
Q
High fluid intake = ____ = ____ = ____.
A
- lighter urine color
- lower amount of solute
- decreased specific gravity
8
Q
The yellow color of urine is caused by the presence of ____.
A
Urochrome
9
Q
Urochrome is a product of ____.
A
endogenous metabolism
10
Q
____ is a product of endogeneous metabolism.
A
Urochrome
11
Q
____ is produced by the body at a constant rate under normal conditions.
A
Urochrome
12
Q
The urochrome produced is dependent on the ____.
A
body’s metabolism
13
Q
TRUE OR FALSE.
Urochrome is decreased when left at room temperature.
A
False
Answer: Increased
14
Q
Because urochrome is excreted at a constant rate, a dilute urine will be ____.
A
pale yellow
15
Q
Because urochrome is excreted at a constant rate, a concentrated urine will be ____.
A
dark yellow
16
Q
____ is a water-soluble pigment.
A
Urochrome
17
Q
TRUE OR FALSE.
Urochrome is water-insoluble
A
False
Answer: Water-soluble
18
Q
The rate of production of urochrome depends on the ____.
A
metabolism
19
Q
The higher the metabolism, the production of urochrome is ____.
A
increased
20
Q
Is urochrome normally present in the body?
A
Yes, it is excreted in urine.
21
Q
Why is urochrome water-soluble?
A
Because the urine is made up of water
22
Q
Examples of instances when metabolism is increased, which will result in increased urochrome
A
- Hyperthyroidism
- Fever
- Starvation
23
Q
Why are patients with renal disease, failure, or CKD have a yellowish-skin?
A
Since the filtering capacity of their kidneys is damaged, the urochrome is deposited under the subcutaneous fats which causes the pigmentation.
24
Q
____ is most evident in specimens that have been refrigerated.
A
Uroerythrin
25
Uroerythrin is most commonly seen in specimens that have been ____.
refrigerated
26
____ deposit in amorphous urates and uric acid crystals.
Uroerythrin
27
____ gives a pink pigment to the sediments.
Uroerythrin
28
What pigment does uroerythrin produce?
Pink
| Also gives **reddish or brick-red** crystals
29
How does uroerythrin give the pink color to the sediment?
By attaching to urates
30
____ forms reddish or brick-red crystals.
Uroerythrin
31
Uroerythrin produces ____ crystals.
reddish or brick-red
32
____ imparts an orange-brown color of urine that is not fresh.
Urobilin
33
What pigment does urobilin produce?
Orange-brown
34
____ is the oxidized form of urobilinogen.
Urobilin
35
____ gives color in feces as *stercobilin*.
Urobilin
36
Is urobilin a normal constituent of urine?
No
37
Factors affecting urine color
* Amount of substance
* Urine pH
* Structural form
38
Urine Pigments
* Urochrome
* Uroerythrin
* Urobilin
39
Normal Urine Color
* Colorless/Straw
* Pale Yellow
* Dark Yellow
40
# **Determine the color of Urine**
Recent fluid consumption
Colorless or Straw
41
# **Determine the color of Urine**
Lead poisoning
Colorless or Straw
42
# **TRUE OR FALSE.**
A colorless first morning urine specimen is normal.
False
| **Reason:** Not normal as it should be concentrated; kidney failure.
43
Pathological instances when urine is colorless
* Kidney failure (first morning urine specimen is colorless)
* Lead poisoning
44
# **Determine the color of Urine**
Diluted random specimen
Pale yellow
45
# **Determine the color of Urine**
Polyuria
Pale yellow
46
# **Determine the color of Urine**
Diabetes mellitus
Pale yellow
47
# **Determine the color of Urine**
Diabetes insipidus
Pale-yellow to Colorless/Straw
48
In ____, glucose and water excretion is increased.
Diabetes mellitus
49
How will you describe the specific gravity of a patient with Diabetes Mellitus?
Increased
50
Why is the specific gravity of patients with Diabetes Mellitus increased?
Due to the excretion of glucose
51
In ____, there is a deficiency in ADH, but increased water excretion.
Diabetes insipidus
52
How will you describe the specific gravity of a patient with Diabetes Insipidus?
Decreased
53
How is diabetes mellitus similar to diabetes insipidus?
Both have increased water excretion
54
How is diabetes mellitus different than diabetes insipidus?
* **DM:** ↑ Glucose = ↑ SG
* **DI:** ↓ ADH = ↓ SG
55
# **Determine the color of Urine**
Concentrated specimen
Dark yellow
56
# **Determine the color of Urine**
Increased urochrome
Dark yellow
57
# **Determine the color of Urine**
Dehydration
Dark yellow
58
# **Determine the color of Urine**
Strenuous exercise
Dark yellow
59
# **Determine the color of Urine**
First morning urine specimen
Dark yellow
60
# **Determine the color of Urine**
Complex B vitamins
Dark yellow
61
# **Determine the color of Urine**
Bilirubin
Dark yellow
62
# **Determine the color of Urine**
Acriflavine
Dark yellow
63
# **Determine the color of Urine**
Nitrofurantoin
Dark yellow
64
# **Determine the color of Urine**
Good hydration, overhydration, or mild hydration
Clear
65
# **Determine the color of Urine**
Good hydration of mild hydration
Pale yellow
66
# **Determine the color of Urine**
Mild or moderate dehydration; taking vitamin supplements
Bright yellow
67
# **Determine the color of Urine**
Moderate or severe dehydration
Orange, Amber
68
# **Determine the color of Urine**
Severe dehydration or burned patients
Tea-colored
69
# **Determine the color of Urine**
Presence of abnormal pigment bilirubin
Dark yellow/Amber/Orange
70
____ produces a yellow foam when the specimen is shaken.
Bilirubin
71
Bilirubin produces a ____ when the specimen is shaken.
yellow foam
72
The yellow foam produced by bilirubin may contain ____.
hepatitis virus
73
____ also causes yellow foam.
Phenazopyridine (Pyridium)
74
Bilirubin increases when there is a ____.
liver problem
75
____ increases when there is a liver problem.
Bilirubin
76
↑ Bilirubin = ____ color.
orange
77
Normal color of foam in urine
White
78
A large amount of white foam in the urine indicates an ____.
increased concentration of protein
79
# **Determine the color of Urine**
Photo-oxidation of large amount of excreted urobilinogen to urobilin
Yellow-orange
80
# **TRUE OR FALSE.**
A yellow foam appears when photo-oxidation of large amounts of excreted urobilinogen to urobilin occurs.
False
81
# **Determine the color of Urine**
Phenazopyridine
Orange-yellow
82
# **Determine the color of Urine**
Phenindione
Orange-yellow
83
# **Determine the color of Urine**
Sulfasalazine (Azulfidine)
Orange-yellow
84
# **Determine the color of Urine**
Photo-oxidation of bilirubin
Yellow-green
85
The ____ is one of the most common causes of abnormal urine color.
presence of blood
86
____ is the most commonly encountered abnormal urine color.
Red
87
When is the red pigment pathological in urine?
If there is glomerular bleeding
88
# **Determine the color of Urine**
Intact RBC
Cloudy red or pink
89
# **Determine the color of Urine**
Hemolyzed RBCs
Clear red
90
Besides RBCs, ____ also produce a red urine.
Hemoglobin and Myoglobin
91
How can we differentiate hemoglobin from myoglobin?
Through Plasma Examination Test
**Hemoglobin:** Red
**Myoglobin:** Yellow
92
Color of hemoglobin in Plasma Examination Test
Red
93
Color of myoglobin in Plasma Examination Test
Yellow
94
# **Hemoglobin or Myoglobin?**
Stays in the blood
Hemoglobin
95
# **Hemoglobin or Myoglobin?**
Immediately filtered
Myoglobin
96
# **Determine the color of Urine**
Oxidation of phorphobilinogen (Porphyrins)
Port wine or Burgundy red
97
____ occurs when there is a problem in globin.
Thalassemia
98
A ____ causes Thalassemia.
problem in globin
99
____ lack the enzyme necessary to convert the pre-cursor substance to become heme.
Porphyria
100
____ is a familial disease.
Porphyria
101
# **Porphyria**
If there is no enzyme, ____.
no heme = ↑ pre-cursor susbtance
102
# **Determine the color of Urine**
Beets
Pink or Red
103
# **Determine the color of Urine**
Rifampin, phenolphthalein, pheninedione, and phenothiazines
Pink or Red
104
# **Determine the color of Urine**
Ingestion of blackberries
Red
105
# **Determine the color of Urine**
Oxidation of hemoglobin to methemoglobin
Red-brown
106
____ is a pre-cursor of heme.
Porphobilinogen
107
If you will check for hematuria, and the urine specimen submitted is contaminated with menstrual blood, should you accept or reject it?
Reject
108
# **Determine the color of Urine**
*Pseudomonas* infection
Green
109
# **Determine the color of Urine**
Asparagus
Green
110
# **Determine the color of Urine**
Amitriptyline
Blue-green
111
# **Determine the color of Urine**
Methocarbamol (Robaxin)
Blue-green
112
# **Determine the color of Urine**
Breath deodorizers such as clorets
Blue-green
113
# **Determine the color of Urine**
Indican
Blue-green
114
Indican came from ____.
indole
115
Indole is converted by bacteria to become ____.
Indican
116
____ is responsible for giving an indigo-blue color.
Indican
117
↑ organisms = ____ indole.
↑
118
# **Determine the color of Urine**
Methylene blue
Blue-green
119
# **Determine the color of Urine**
Phenol
Blue-green
120
# **Determine the color of Urine**
Propofol
Blue-green
121
# **Determine the color of Urine**
Familial hypercalcemia
Blue-green
122
# **Determine the color of Urine**
Indomethacin (indocin, tivorbex)
Blue-green
123
# **Determine the color of Urine**
Observed among catheterized patients
Purple
124
Purple bag syndrome is associated with patients with ____.
catheter bags
125
Aside from blue-green color of urine, indican/indole also gives a ____ pigment.
Purple
126
# **Determine the color of Urine**
Bacterial infection caused by *Klebsiella* or *Providencia* species
Purple
127
____ is an oxidation product of melanogen.
Melanin
128
____ is a colorless substance that precedes melanin.
Melanogen
129
____ is produced in excess when a malignant melanoma is present.
Melanogen
130
# **Determine the color of Urine**
Homogentisic acid
Black
131
____ imparts a black color to alkaline urine from patients with alkaptonuria.
Homogentisic acid
132
In patients with skin cancer, ____ proliferate.
melanocytes
133
____ is a substance of the phenyl-alanine-tyrosine pathway of amino acid.
Homogentisic acid
134
# **Determine the color of Urine**
Malignant melanoma
Black/Brown
135
# **Determine the color of Urine**
Melanin
Brown
136
# **Determine the color of Urine**
Phenol derivatives
Brown/Black
137
# **Determine the color of Urine**
Argyrol
Brown/Black
138
# **Determine the color of Urine**
Methyldopa or levodopa
Brown/Black
| **Levodopa:** cola-colored
139
# **Determine the color of Urine**
Metronidazole
Brown/Black
140
# **Determine the color of Urine**
Chloroquine and primaquine
Brown/Black
141
# **Determine the color of Urine**
Methocarbamol
Brown/Black
142
# **Determine the color of Urine**
Fava beans, rhubarb, or aloe
Brown/Black
143
# **Urine color changes with commonly used drugs**
Levodopa
* Cola-colored
* Due to myoglobin
144
# **Urine color changes with commonly used drugs**
Mepacrine (Atabrine)
Yellow
145
# **Urine color changes with commonly used drugs**
Methyldopa (Aldomet)
Green-brown
146
# **Urine color changes with commonly used drugs**
Metronidazole (Flagyl)
* Darkening
* Reddish-brown
147
# **Urine color changes with commonly used drugs**
Phenazopyridine (Pyridium)
* Orange-red
* Acidic pH
148
# **Urine color changes with commonly used drugs**
Rifampin
Bright red
149
# **Urine color changes with commonly used drugs**
Riboflavin
Bright yellow
150
Normal range of urine volume
600 mL - 2000 mL
151
Average range of urine volume
1200 mL - 1500 mL
152
Night:Day Ratio
1:2 or 1:3
153
Factors that influence urine volume
* Fluid intake
* Fluid loss from non-renal sources *(sweating, vomitting, diarrhea)*
154
____ is the decrease in urine output.
Oliguria
155
Oliguria amount
<400 mL/day
156
Causes of Oliguria
* Nephrotic syndrome
* Edema
* Dehydration
157
In order for us to maintain the filtration of blood within the glomerulus, we need ____.
constant pressure
158
↓ glomerular pressure = ____ = ____.
↓ filtration = ↓ UV
159
Nephrotic syndrome can lead to ____.
albuminuria
160
____ is a disease caused by the disruption of the shield of negativity.
Nephrotic syndrome
161
Edema occurs due to the ____.
accumulation of fluid in the interstitial tissues as a result of no pressure
162
____ is the cessation of urine flow.
Anuria
163
Anuria amount
<100 mL/day
| According to Graff's textbook
164
Causes of Anuria
Urinary tract obstruction (tumor, kidney stones, etc.)
165
Kidney stones are usually formed in the ____.
renal pelvis or urinary bladder
166
Composition of Kidney Stones
* Uric acid
* Cysteine
* Calcium oxalate
167
____ is the most common, and hardest kidney stone.
Calcium oxalate
168
____ is an increase in daily urine volume.
Polyuria
169
Amount of polyuria
* **Henry's**: 2000 mL/24 hours
* **Strasinger:** 2.5 L/day
170
Polyuria is artificially induced by ____.
Diuretics, caffeine, or alcohol
171
Diuretics, caffeine, and alcohol all suppress the secretion of ____.
ADH
172
Other causes of Polyuria
* Diabetes mellitus
* Diabetes insipidus
173
____ is the increased noctural excretion of urine.
Nocturia
174
Amount of nocturia
>500 mL/night
175
Causes of Nocturia
* Pregnancy
* Chronic progressive kidney failure
176
The ____ describes the overall visual apperance of a urine specimen.
Urine clarity
177
In ____, we will check the presence of particulates.
Urine clarity
178
↑ turbid = ____ SG.
↑
179
# **Urine Clarity**
No visible particles, transparent
Clear
180
# **Urine Clarity**
Few particulates, print easily seen through urine
Hazy
181
# **Urine Clarity**
Many particulates, print blurred through urine
Cloudy
182
# **Urine Clarity**
Print cannot be seen through urine
Turbid
183
# **Urine Clarity**
May precipitate or be clotted
Milky
184
Non-pathological causes of Turbidity
* Squamous epithelial cells
* Mucus
* Amorphous phosphates, carbonates, urates
* Semen, spermatozoa
* Fecal contamination
* Radiographic contrast media
* Talcum powder
* Vaginal creams
185
The presence of squamous cells with bacteria can indicate that the patient has ____.
UTI
186
# **TRUE OR FALSE.**
Turbid urine is normal in females before and after menstruation.
True
187
The presence of squamous cells and bacilli (*G. vaginalis*) can indicate that the patient has ____.
Bacterial vaginosis
188
# **Determine if pathologic or non-pathologic cause of turbidity**
Squamous epithelial cells
Non-pathologic
189
# **Determine if pathologic or non-pathologic cause of turbidity**
Mucus
Non-pathologic
190
# **Determine if pathologic or non-pathologic cause of turbidity**
Amorphous phosphates, urates, and carbonates
Non-pathologic
191
# **Determine if pathologic or non-pathologic cause of turbidity**
Semen, spermatozoa
Non-pathologic
192
# **Determine if pathologic or non-pathologic cause of turbidity**
Fecal contamination
Non-pathologic
193
# **Determine if pathologic or non-pathologic cause of turbidity**
Radiographic contrast media
Non-pathologic
194
# **Determine if pathologic or non-pathologic cause of turbidity**
Talcum powder
Non-pathologic
195
# **Determine if pathologic or non-pathologic cause of turbidity**
Vaginal creams
Non-pathologic
196
Pathological causes of Turbidity
* RBCs
* WBCs
* Bacteria
* Yeast
* Non-squamous epithelial cells
* Abnormal crystals
* Lymph fluid
* Lipids
197
# **Determine if pathologic or non-pathologic cause of turbidity**
RBCs
Pathologic
198
# **Determine if pathologic or non-pathologic cause of turbidity**
WBCs
Pathologic
199
# **Determine if pathologic or non-pathologic cause of turbidity**
Bacteria
Pathologic
200
# **Determine if pathologic or non-pathologic cause of turbidity**
Yeast
Pathologic
201
# **Determine if pathologic or non-pathologic cause of turbidity**
Non-squamous epithelial cells
Pathologic
202
# **Determine if pathologic or non-pathologic cause of turbidity**
Abnormal crystals
Pathologic
203
# **Determine if pathologic or non-pathologic cause of turbidity**
Lymph fluid
Pathologic
204
# **Determine if pathologic or non-pathologic cause of turbidity**
Lipids
Pathologic
205
RBCs are soluble in ____ acetic acid.
2%
206
Lipids are soluble in ____.
ether
207
RBCs are soluble in ____.
Dilute acetic acid
208
The ____ is an expression of urine concentration in terms of density.
Specific gravity
209
Specific gravity is correlated with ____.
Clarity and Color
210
The specific gravity of the plasma filtrate entering the glomerulus is ____.
1.010
211
The term ____ is used to describe urine with a specific gravity of 1.010.
Isosthenuric
212
The term ____ is used to describe urine with a specific gravity below 1.010.
Hypostenuric
213
The term ____ is used to describe urine with a specific gravity above 1.010.
Hyperstenuric
214
Specific gravity of Urine
1.003 - 1.035
215
Average specific gravity of Urine
1.015 - 1.030
216
↑ solute = ____ BP.
↑ BP
217
↑ solute = ____ FP.
↓FP
