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Aubf Lec > PHYSICAL EXAMINATION OF URINE > Flashcards

PHYSICAL EXAMINATION OF URINE Flashcards

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1
Q

encompasses a systematic series of procedures such as physical, chemical, and microscopic examination of urine that are able to be correlated to each other in order to ensure reliable and coherent diagnosis of one’s illness.

A

Routine urinalysis

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2
Q

is a thorough investigation and documentation of urine’s physical characteristics. It is a crucial step in routine urinalysis procedure because it provides preliminary information about the patient’s health status and is used to confirm or to explain findings in the chemical and microscopic areas of urinalysis.

A

Physical examination of urine

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3
Q

The __________ of a certain person reflects his/her hydration status.

A

urine volume

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4
Q

There are several factors that affect urine volume. These factors include:

A

fluid intake
fluid loss from nonrenal sources
variations in ADH
necessity to excrete dissolved substance

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5
Q

VARIATION IN URINE VOLUME IN A DAY:
Oliguria in infants

A

<1ml/kg/hr
<0.5 ml/kg/hour

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6
Q

VARIATION IN URINE VOLUME IN A DAY:
Oliguria in adults

A

<400 ml/day

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7
Q

VARIATION IN URINE VOLUME IN A DAY:
Polyuria in children

A

2.5-3 ml/kg/day

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8
Q

VARIATION IN URINE VOLUME IN A DAY:
Polyuria in adults

A

2.5 L

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9
Q

This parameter in the physical examination of urine is not routinely reported, though it is necessary that distinct odor in urine samples received in the laboratory should be notified to attending physicians for the consideration of metabolic disorders or aminoaciduria.

A

Odor

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10
Q

VARIATIONS OF URINE ODOR
Cause: normal

A

Aromatic

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11
Q

VARIATIONS OF URINE ODOR
Cause: Bacterial decomposition, Urinary Tract Infection (UTI)

A

Foul
Ammonia-like

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12
Q

VARIATIONS OF URINE ODOR
Cause: Ketones (diabetes mellitus, starvation, vomiting)

A

Fruity
sweet

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13
Q

VARIATIONS OF URINE ODOR
Cause: maple syrup urine disease

A

Maple syrup

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14
Q

VARIATIONS OF URINE ODOR
Cause: phenylketonuria

A

Mousy

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15
Q

VARIATIONS OF URINE ODOR
Cause: tyrosinemia

A

Rancid

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16
Q

VARIATIONS OF URINE ODOR
Cause: isovaleric acidemia

A

Sweaty feet

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17
Q

VARIATIONS OF URINE ODOR
Cause: methionine malabsorption

A

Cabbage

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18
Q

VARIATIONS OF URINE ODOR
Cause: contamination

A

Bleach

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19
Q

one parameter used in urinalysis to predict urine concentration and probable dissolved substances present in it

A

Urine color

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20
Q

Urine color

Normal variations are caused by:

A

a. Normal metabolic functions
b. Physical activity
c. Ingested materials
d. Pathologic condition
e. Abnormal variations caused by bleeding
f. Liver disease
g. Infection

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21
Q

pigments that are present urine that gives its normal color.

A

Urochrome
Uroerythrin
Urobilin

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22
Q
  • gives the normal yellow coloration of urine.
  • It is normally excreted at a constant rate, though an increased production is expected in thyroid disorders and fasting states.
  • It also increases when the specimen sits at room temperature.
A

Urochrome

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23
Q

is a pigment that deposits amorphous crystals in urine upon refrigeration. It attaches itself on amorphous crystals’ surface creating a brick dust appearance especially on amorphous urates.

A

Uroerythrin

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24
Q

is a derivative of protoporphyrins that come from RBC catabolism. It provides orange-brown color in older urine specimens.

A

Urobilin

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25
an oxidation product of the normal urinary constituent urobilinogen.
Urobilin
26
LABORATORY CORRELATION OF URINE COLOR CAUSE: Recent fluid consumption CLINICAL/ LABORATORY CORRELATIONS: Commonly observed with random specimens
Colorless
27
LABORATORY CORRELATION OF URINE COLOR CAUSE: Polyuria or diabetes insipidus CLINICAL/ LABORATORY CORRELATIONS: Increased 24-hour volume and low specific gravity
Pale yellow
28
LABORATORY CORRELATION OF URINE COLOR CAUSE: D.mellitus CLINICAL/ LABORATORY CORRELATIONS: Elevated specific gravity and positive glucose test result
Pale yellow
29
LABORATORY CORRELATION OF URINE COLOR CAUSE: dilute random specimen CLINICAL/ LABORATORY CORRELATIONS: Recent fluid consumption
Pale yellow
30
LABORATORY CORRELATION OF URINE COLOR CAUSE: concentrated specimen CLINICAL/ LABORATORY CORRELATIONS: May be normal after strenuous exercise or in first morning specimen
Dark yellow
31
LABORATORY CORRELATION OF URINE COLOR CAUSE: B complex vitamins
Dark yellow
32
Causes colorless urine
Recent fluid consumption
33
Causes pale yellow urine
Polyuria or diabetes insipidus Diabetes mellitus Dilute random specimen
34
Causes dark yellow urine
Concentrated specimen B complex vitamins Dehydration Bilirubin Arcriflavine Nitrofurantoin
35
Causes orange-yellow urine
Phenazopyridine (Pyridium) Phenindione Sulfasalazine (Azulfidine)
36
Cause yellow-green urine
Bilirubin oxidized to biliverdin
37
Causes green urine
Pseudomonas infection Asparagus
38
Causes blue-green urine
Amitriptyline Methocarbamol (Robaxin) Clorets Indican Methylene blue Phenol Propofol Familial hypercalcemia Indomethacin (Indocin Tivorbex)
39
Causes pink red urine
RBCs Hemoglobin Myoglobin Beets Rifampin Menstrual contamination
40
Causes port wine urine
Porphyrins
41
Causes red-brown urine
RBCs oxidized to methemoglobin Myoglobin
42
Cause brown black urine
Homogentisic acid (alkaptonuria) Malignant melanoma Melanin or melanogen Argyrol (antiseptic) Methyldopa or levodopa Metronidazole (Flagyl) Chloroquine and primaquine Methocarbamol Fava beans, rhubarb, or aloe
43
It pertains to the clarity or turbidity of a urine specimen
Transparency
44
True or false: Normally, a urine has a clear transparency or clarity
True
45
True or false: Decrease in clarity or increase in turbidity is not always associated to a renal disease or metabolic pathologies
True
46
➔ View the urine against a white background using adequate room lighting ➔ View through a newspaper print
Urine Clarity Determination
47
URINE CLARITY PARAMETER No visible particulates, transparent
Clear
48
URINE CLARITY PARAMETER Few particulates, print easily seen through urine
Hazy
49
URINE CLARITY PARAMETER Many particulates, print blurred through urine
Cloudy
50
URINE CLARITY PARAMETER Print cannot be seen through urine
Turbid
51
URINE CLARITY PARAMETER May precipitate or be clotted
Milky
52
can result in urine that is hazy but normal.
Presence of : squamous epithelial cells and mucus, particularly spx from women
53
frequently develop a thick turbidity caused by precipitation of amorphous phosphates, carbonates, and urates.
Refrigerated specimens
54
Produce a white precipitate in urine with an alkaline pH
Amorphous phosphates and carbonates
55
produce a precipitate in acidic urine that resembles pink brick dust due to the presence of uroerythrin.
amorphous urates
56
A. Hazy female specimens with squamous epithelial cells and mucus B. Bacterial growth in unpreserved specimens C. Refrigerated specimens with precipitated amorphous phosphates and urates D. Contamination; fecal talc, semen, vaginal creams, IV contrast media
NON PATHOLOGIC TURBIDITY
57
A. Most common: RBCs, WBCs, bacteria B. Nonsquamous epithelial cells, yeast C. Abnormal crystals D. Lymph fluid E. Lipid
PATHOLOGIC TURBIDITY
58
is determined by the concentration of free H+ ion present in urine sample. As H+ ion increases, pH decreases making the urine acidic while as H+ ion decreases, pH increases bringing alkalinity to urine sample.
urine pH
59
The lung excretes ___________through respiration, while the kidney reclaims and generates bicarbonate and secretes ammonium ions.
carbon dioxide
60
is responsible for the bulk of the bicarbonate reabsorption/generation, while the distal tubule provides the remaining function.
proximal renal tubule
61
may be produced through ingestion of meat, fruits such as cranberries and various pharmacologic agents (ammonium chloride, methionine and methenamine mandelate).
Acidic urine
62
may be produced after the ingestion of fruits and vegetables (citrus fruits), following a meal ( the so-called alkaline tide), taking medications (Sodium bicarbonate, potassium citrate and acetazolamide).
alkaline urine
63
Normal urine pH in random sample
4.5 - 8.0
64
Normal urine pH in first morning urine sample
5.0 - 6.0
65
Normal urine pH in Nnormal protein diet sample
4.5 - 6.5
66
Normal urine pH in Unpreserved Urine
9.0
67
is useful in the evaluation of urine concentration. ● It can determine if the specimen is concentrated enough to provide reliable screening results.
Specific gravity
68
● It is known as the density of a solution compared with the density of an equal volume of distilled water at the same temperature. ● It is influenced by the number and size of particles present
Specific gravity
69
URINE SPECIFIC GRAVITY Hyposthenuric Isosthenuric Hypersthenuric Random specimen Normal Range
<1.010 1.010 >1.010 1.015-1.025 1.023
70
● It is a conventional means to measure urine’s specific gravity ● less accurate than the other methods, it is a simple method that can be done in basic laboratory.
Urinometer
71
The major limitation of using a urinometer to measure specific gravity is…
it requires a large volume of specimen
72
Determines the concentration of dissolved particles in a specimen by measuring refractive index.
Refractometer
73
a comparison of the velocity of light in the air with the velocity of light in a solution.
Refractive index
74
measures velocity of light in air versus velocity of light in a solution. The concentration of urine changes the velocity and angle at which the light passes through the solution.
Refractometer
75
The __________ in the refractometer determines the angle that light is passing through the urine and converts angle to calibrated viewing scale
prism
76
It is a way of determining the urine specific gravity through sound waves of specific frequency that is generated at one end of the tube and as the sound waves oscillate through urine, their frequency is altered by the density of the specimen
Harmonic Oscillation Densitometry
77
most convenient and most commonly used means of measuring specific gravity in many laboratories worldwide.
Reagent Strip
78
is based on the change in pKa (dissociation constant) of a polyelectrolyte in an alkaline medium
reagent strip reaction
79
True or false: The releasing of H ions is directly proportional to the number of ions in the solution. The more hydrogen ions released, the lower is the pH.
True
80
Macroscopic hematuria
Red turbid Red cloudy
81
Microscopic hematuria
Red color Clear urine
82
Blodhein’s test 3.2g Ammonium sulfate + urine = red precipitate 2.8g Ammonium sulfate + urine = clear
Hemoglobinuria
83
Blodhein’s test 3.2g Ammonium sulfate + urine = red color, no precipitate 2.8g Ammonium sulfate + urine = clear
Myoglobinuria
84
Urinometer: In every 3C increase in temp. add?
0.001 in SG
85
Urinometer In every 3C<20C, subtract?
0.001 SG
86
Refractometer Unless protein is present, subtract?
0.003
87
Refractometer Unless glucose is present, subtract?
0.004
88
Evident pigment when the urine is unpreserved
Urobilin
89
Most famous urine pigment
Urochrome
90
Normal color of urine
Pale yellow-datk yellow
91
Urine color of TB immunocompromised-HIV patient
Red
92
Presence of __________ causes the urine coffe-black appearance
Methemoglobin
93
Parameters that measures how concentrated the urine
Specific gravity Color Clarity
94
Most reliable parameter that measures the concentration of urine
Specific gravity
95
Which method of measuring SG is prone to interferences?
Urinometer
96
Advantage of using refractometer
Smaller volume of urine is used No temperature calibration
97
- metabolite will crystallize - indicating presence of UTI
Amphicilin & sulfonamide crystals
98
A contaminant from plastic containers
Talc
99
Presence of leucine tyrosine and bilirubin crystals are indication of what?
Liver damage

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