Term
| What does physical exam of urine include? (3) |
|
Definition
color
clarity
specific gravity (SG) |
|
|
Term
| What do results of physical exam of urine provide? |
|
Definition
preliminary info
correlation w/other chemical & microscopic results |
|
|
Term
| Color ranges from _ to _. |
|
Definition
|
|
Term
| normal color variations are caused by what? (3) |
|
Definition
physical activity
ingested material
metabolic functions |
|
|
Term
| abnormal color variations are caused by what (3) |
|
Definition
bleeding (UTI upper/lower, trauma)
liver disease (affecting filtration, bilurubin)
infection (bacteria, white cells) |
|
|
Term
| normal urine - common color terminology (4) |
|
Definition
pale yellow
yellow
dark yellow
amber
(consistent within institution) |
|
|
Term
| What is the pigment causing yellow color? |
|
Definition
|
|
Term
| Urochrome is normally excreted at a _ rate. |
|
Definition
|
|
Term
| When is urochrome increased? (3) |
|
Definition
thyroid disorders
fasting
when specimen sits @ room temp |
|
|
Term
| What provides estimate of body hydration? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What is the pink pigment? |
|
Definition
|
|
Term
| What does uroerythrin attach to? |
|
Definition
| amorphous urates (turbid crystals) formed in refrigerated specimens |
|
|
Term
| Urobilin is _ of normal constituent, _. |
|
Definition
| oxidation of normal constituent, urobilinogen |
|
|
Term
| What is orange-brown in older specimens? |
|
Definition
|
|
Term
| common abnormal urine colors (often reason pt comes to MD) |
|
Definition
dark yellow/amber/orange
red/pink/brown
brown/black
blue/green |
|
|
Term
Dark yellow & amber:
normal = ?
abnormal = ? |
|
Definition
normal = concentrated urine
abnormal = bilirubin |
|
|
Term
| bilirubin indicates what? |
|
Definition
| possible hepatitis virus present - take standard precautions |
|
|
Term
|
Definition
|
|
Term
| Bilirubin produces _ foam when shaken. |
|
Definition
|
|
Term
| Normal urine produces _ amount of _ foam caused by _. |
|
Definition
|
|
Term
| What produces yellow-orange urine? |
|
Definition
photo-oxidation of large amounts of urobilinogen
note: no yellow foam when shaken |
|
|
Term
| What produces yellow-green urine? |
|
Definition
| photo-oxidation of bilirubin to biliverdin |
|
|
Term
| What produces thick orange pigment and yellow foam (but not bilirubin)? |
|
Definition
phenzopyridine (pyridium) or azo-gantrisin for UTI
[thick pigmt obscures natural color, interferes w/reagent strips] |
|
|
Term
| What is a common cause of red urine? range? |
|
Definition
|
|
Term
| What is pink indicative of? |
|
Definition
|
|
Term
| What is brown indicative of? |
|
Definition
| oxidation of hemoglobin to methemoglobin |
|
|
Term
| What is methemoglobin from? |
|
Definition
| RBCs remaining in acid urine |
|
|
Term
| What can fresh brown specimen indicate? |
|
Definition
|
|
Term
| What is in cloudy red urine? |
|
Definition
|
|
Term
| What causes clear red urine? |
|
Definition
|
|
Term
| Where can hemoglobin come from? |
|
Definition
in vivo (body) lysis of RBCs - pt's plasma'll be red, too
consider in vitro lysis/specimen handling |
|
|
Term
|
Definition
| breakdown of skeletal muscle |
|
|
Term
| color of fresh urine with myoglobin |
|
Definition
|
|
Term
| myoglobin (possible electrical shock) - pt's plasma color |
|
Definition
|
|
Term
| How does myoglobin react to dipstick? |
|
Definition
|
|
Term
| What is the cause of port wine-colored urine? |
|
Definition
| oxidation of porphobilinogen to porphyrias |
|
|
Term
| What are possible causes of nonpathogenic red urine? (3) |
|
Definition
menstrual contamination
medications (rifampin, pheno- cmpds)
pigmented foods:
fresh beets in alkaline urine (genetically susceptible)
black raspberries in acidic urine |
|
|
Term
| When do you need additional testing for brown/black specimens? (2) |
|
Definition
turn black after standing at room temp
test negative for blood |
|
|
Term
| brown/black urine b/c of what? (3) |
|
Definition
melanin
homogentisic acid
medications |
|
|
Term
| brown/black urine - melanin - how? (2) |
|
Definition
excess in malignant melanoma
oxidation of melanogen to melanin |
|
|
Term
| brown/black urine - homogentisic acid - how? (2) |
|
Definition
black color in alkaline urine
alkaptonuria |
|
|
Term
| brown/black urine - what meds? (3) |
|
Definition
levodopa (Parkinson's)
phenol derivatives
flagyl (trichinalis vaginalis, other vaginal infection) |
|
|
Term
| Cause of blue/green urine? |
|
Definition
| urinary & intestinal bacterial infections = pathogenic causes |
|
|
Term
| urinary cause of blue/green urine |
|
Definition
|
|
Term
| intestinal cause of blue/green urine |
|
Definition
| infection causing increased urinary indican oxidizing to indigo blue |
|
|
Term
|
Definition
| catheter bags - Klebsiella, Providencia, & indican |
|
|
Term
| What medications cause green? |
|
Definition
IV phenol meds
clorets (green) meds: Robaxin, methylene blue, Elavil |
|
|
Term
| color & clarity procedure (6) |
|
Definition
well-mixed specimen
clear container to view
against white background
adequate room lighting
evaluate consistent specimen vol
get color + clarity |
|
|
Term
| What does clarity refer to? |
|
Definition
| transparency/turbidity of specimen |
|
|
Term
| normal reporting of urine clarity uses what 5 terms? |
|
Definition
| clear, hazy, cloudy, turbid, milky |
|
|
Term
| how to visually examine clarity |
|
Definition
gently swirl specimen in clear container in front of good light source
[automated turbidity readings = available] |
|
|
Term
| What clarity does a fresh clean-catch urine normally have? |
|
Definition
|
|
Term
| clarity: clear - definition |
|
Definition
| no visible particulates, transparent |
|
|
Term
| clarity: hazy - definition |
|
Definition
few particulates
print easily seen through urine |
|
|
Term
| clarity: cloudy - definition |
|
Definition
| many particulates, print blurred through urine |
|
|
Term
| clarity: turbid - definition |
|
Definition
| print can't be seen through urine |
|
|
Term
| clarity: milky - definition |
|
Definition
| may precipitate/be clotted |
|
|
Term
| nonpathogenic turbidity in female specimens |
|
Definition
| hazy due to squamous epithelial cells & mucus |
|
|
Term
| nonpathogenic turbidity in bacterial growth b/c of what? |
|
Definition
|
|
Term
| nonpathogenic turbidity in refrigerated specimens |
|
Definition
precipitated amorphous phosphates (white)
urates (pink) |
|
|
Term
| contamination that can cause nonpathogenic turbidity |
|
Definition
| fecal, talc, semen, creams, IV contrast media |
|
|
Term
| most common pathologic turbidity (3) |
|
Definition
|
|
Term
| other pathologic turbidity causes (5) |
|
Definition
| nonsquamous epithelial cells, yeast, abnormal crystals, lymph fluid, lipids |
|
|
Term
| Extent of turbidity corresponds to what? |
|
Definition
| amount of material observed in microscopic exam |
|
|
Term
| What is one of the criteria considered in determining the necessity of performing a microscopic exam? |
|
Definition
|
|
Term
| What roughly screens renal concentrating ability of kidneys? |
|
Definition
|
|
Term
| What determines if specimen is concentrated enough to provide reliable screening results? |
|
Definition
|
|
Term
| specific gravity definition |
|
Definition
| density of soln compared w/density of equal vol of DI water @ same temp |
|
|
Term
| direct methods of measuring SG (2) |
|
Definition
urinometer
harmonic oscillation densitometry (HOD) |
|
|
Term
| indirect methods of measuring SG (2) |
|
Definition
refractometer
chemical reagent strip |
|
|
Term
| To use urinometer, weight of float in water = ? |
|
Definition
|
|
Term
| urinometer - Density of urine _ float to _ level relative to density of urine. |
|
Definition
|
|
Term
| What is the least accurate method of obtaining SG of available methods? |
|
Definition
|
|
Term
| urinometer corrections - temperature |
|
Definition
| subtract 0.001 for every 3 degrees urine is below calibration temp |
|
|
Term
| urinometer corrections - protein |
|
Definition
| add 0.003 for every g of protein in specimen |
|
|
Term
| urinometer corrections - glucose |
|
Definition
| add 0.004 for every g glucose present in specimen |
|
|
Term
| urinometer corrections for _-density substances |
|
Definition
|
|
Term
| Refractometer measures velocity of light in _ versus velocity of light in _. |
|
Definition
|
|
Term
| refractometer: _ changes velocity & angle at which light passes through soln. |
|
Definition
|
|
Term
| _ in refractometer determines angle light passes through urine & converts angle to calibrated viewing scale. |
|
Definition
|
|
Term
| What are advantages of using a refractometer? (4) |
|
Definition
no need to correct for temp
light passes through temperature-compensating liquid
small specimen size (1-2 drops)
less affected by particle size |
|
|
Term
| methodology of refractometer (4) after calibration |
|
Definition
drop of urine placed on prism (center)
focus on light source
read scale
wipe off prism b/w specimens |
|
|
Term
| calibration of refractometer (3) |
|
Definition
adjust set screw - 1.000 for DI water
5% NaCl 1.022 +/- 0.001
9% sucrose 1.034 +/- 0.001 |
|
|
Term
| SG 1.010 (of plasma ultrafiltrate) |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| SG: normal random specimens range |
|
Definition
1.003-1.035
most common: 1.015-1.025
[below 1.003 may not be urine - need further testing for low readings] |
|
|
Term
|
Definition
|
|
Term
| reasons for abnormally high SG (2-3) |
|
Definition
radiographic contrast media (VP)
Dextran, other IV plasma expanders (keeps from shock- opens vessels, for burn pt, dehydrated, lost blood)
check pt's clinical course |
|
|
Term
| Are reagent strip readings and osmometry affected by high MW substances? |
|
Definition
|
|
Term
| If 1:2 dilution w/reading of 1.030, SG is what? |
|
Definition
|
|
Term
| What characteristic is not routinely reported? |
|
Definition
|
|
Term
| What is the odor of fresh urine? |
|
Definition
|
|
Term
| What is the odor of older urine? |
|
Definition
|
|
Term
| What metabolic disorders can cause change in urine odor? (3) |
|
Definition
maple syrup urine disease (genetic)
ketosis (fruity)
infection (ammonia/unpleasant) |
|
|
Term
| Foods causing urine odor (3) |
|
Definition
garlic
onions
asparagus - genetic ability to smell, but all produce odor |
|
|
Term
| What is the cause of aromatic odor? |
|
Definition
|
|
Term
| What is the cause of foul, ammonia-like odor? (2) |
|
Definition
|
|
Term
| What is the cause of fruity, sweet odor? |
|
Definition
| ketones (diabetes mellitus, starvation, vomiting) |
|
|
Term
| What is the cause of maple syrup odor? |
|
Definition
| maple syrup urine disease |
|
|
Term
| What is the cause of mousy odor? |
|
Definition
|
|
Term
| What is the cause of rancid odor? |
|
Definition
|
|
Term
| What is the cause of sweaty feet odor? |
|
Definition
|
|
Term
| What is the cause of cabbage odor? |
|
Definition
|
|
Term
| What is the cause of bleach odor? |
|
Definition
|
|
