Routine Urinalysis Overview
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Questions and Answers

What effect does low fluid intake have on urine color and specific gravity?

  • Pale yellow urine and decreased specific gravity
  • Lighter urine color and lower specific gravity
  • Colorless urine and stable specific gravity
  • Darker urine color and higher specific gravity (correct)

Which of the following is considered a normal urine color?

  • Deep brown
  • Bright red
  • Colorless/straw (correct)
  • Dark yellow

What pigment is associated with alkaptonuria, affecting urine color?

  • Bilirubin
  • Urobilin
  • Melanin (correct)
  • Hemoglobin

What is a common cause of red/red-brown urine?

<p>Diabetes mellitus (C)</p> Signup and view all the answers

Which condition is linked to the deficiency of antidiuretic hormone?

<p>Diabetes insipidus (D)</p> Signup and view all the answers

How should urine specimens be evaluated for accurate color assessment?

<p>View through a clear glass container (C)</p> Signup and view all the answers

Which of the following urine characteristics is correlated with high fluid intake?

<p>Lower specific gravity (D)</p> Signup and view all the answers

What condition might result in polyuria and pale yellow urine?

<p>Diabetes mellitus (D)</p> Signup and view all the answers

What is the corrected specific gravity reading after adjusting for protein, glucose, and temperature?

<p>1.025 (C)</p> Signup and view all the answers

What type of crystals are soluble in heat?

<p>Uric acid crystals (C)</p> Signup and view all the answers

What does a refractometer measure?

<p>Concentration of solute in urine (B)</p> Signup and view all the answers

Which of the following substances is insoluble in dilute acetic acid?

<p>WBCs (B)</p> Signup and view all the answers

Which method is an indirect way to measure specific gravity?

<p>Refractometer (A)</p> Signup and view all the answers

What adjustment is necessary when measuring specific gravity?

<p>Solute correction (C)</p> Signup and view all the answers

At which temperature range is specific gravity measurements considered standard without corrections?

<p>15°C and 38°C (D)</p> Signup and view all the answers

Which types of substances are soluble in ether?

<p>Lipids and chyle (C)</p> Signup and view all the answers

What does dark yellow urine typically indicate?

<p>Severe dehydration (A)</p> Signup and view all the answers

What is urochrome a product of?

<p>Endogenous metabolism (C)</p> Signup and view all the answers

Which condition may lead to inadequate excretion of urochrome?

<p>Chronic kidney disease (C)</p> Signup and view all the answers

An orange or amber colored urine indicates what level of hydration?

<p>Moderate to severe dehydration (D)</p> Signup and view all the answers

What pigment shows deposition in urine due to liver issues?

<p>Bilirubin (A)</p> Signup and view all the answers

What is a common cause of red or pink urine?

<p>Presence of intact RBCs (A)</p> Signup and view all the answers

What color change in urine is associated with the consumption of phenazopyridine?

<p>Yellow (A)</p> Signup and view all the answers

Which urine color may indicate the presence of indole due to bacterial infection?

<p>Purple (A)</p> Signup and view all the answers

What does the presence of methemoglobin in urine indicate?

<p>Acidic urine (D)</p> Signup and view all the answers

What might cause urine to have a tea-colored appearance?

<p>Severe dehydration (C)</p> Signup and view all the answers

What abnormal urine color may be caused by medications like levodopa?

<p>Brown/Black (C)</p> Signup and view all the answers

What does a clear yellow urine suggest?

<p>Good hydration (B)</p> Signup and view all the answers

What happens to bilirubin upon standing or improper storage of urine?

<p>It gets oxidized to biliverdin (D)</p> Signup and view all the answers

How does dehydration affect urochrome concentration?

<p>Increases urochrome concentration (B)</p> Signup and view all the answers

What is the cause of cola-colored urine?

<p>Levodopa (A)</p> Signup and view all the answers

Which medication is associated with causing orange-red urine?

<p>Rifampin (B)</p> Signup and view all the answers

Which condition is characterized by decreased urine output?

<p>Oliguria (B)</p> Signup and view all the answers

What is a non-pathologic cause of urine turbidity?

<p>Mucus (B)</p> Signup and view all the answers

What pigment is produced in urine due to a Pseudomonas species infection?

<p>Pyoveridin (D)</p> Signup and view all the answers

Which factor does NOT influence urine volume?

<p>Presence of glucose (A)</p> Signup and view all the answers

In alkaline urine, what is a potential non-pathogenic cause for reddish-brown color?

<p>Dietary beets (B)</p> Signup and view all the answers

What could cause blue urine?

<p>Excessive mouthwash use (D)</p> Signup and view all the answers

How is urine turbidity analyzed traditionally?

<p>Using large volume sample analysis (A)</p> Signup and view all the answers

What is the normal daily urine output range for an adult?

<p>600 to 2000 mL (D)</p> Signup and view all the answers

Which statement about methylene blue is correct?

<p>It produces a bluish color in urine. (B)</p> Signup and view all the answers

Which of the following can artificially induce oliguria?

<p>Caffeine use (B)</p> Signup and view all the answers

What is the renal threshold for glucose?

<p>160 to 180 mg/dL (A)</p> Signup and view all the answers

What is the average specific gravity range for urine?

<p>1.015 to 1.030 (B)</p> Signup and view all the answers

Which method is considered less accurate for measuring urine specific gravity?

<p>Urinometry (D)</p> Signup and view all the answers

Which colligative property of water is lowered by 1 mole of solute?

<p>Freezing Point (D)</p> Signup and view all the answers

What causes the characteristic aromatic odor in normal urine?

<p>Urea (A)</p> Signup and view all the answers

Which urine odor is associated with diabetes mellitus?

<p>Fruity, sweet (B)</p> Signup and view all the answers

What is the main principle behind Harmonic Oscillation Densitometry?

<p>Frequency of sound wave changes (C)</p> Signup and view all the answers

What is the specific gravity of distilled water?

<p>1.000 (C)</p> Signup and view all the answers

Which urinalysis system can utilize a slideless microscope?

<p>Yellow iris system (D)</p> Signup and view all the answers

What change is observed in osmotic pressure with 1 mole of solute?

<p>Increased by 1.7 x 10^9 mm/Hg (B)</p> Signup and view all the answers

What is a common cause of a foul, ammonia-like odor in urine?

<p>Dehydration (D)</p> Signup and view all the answers

What specific gravity represents a 5% w/v NaCl solution?

<p>1.022 (B)</p> Signup and view all the answers

What is the effect of 1 mole of solute on vapor pressure at 25°C?

<p>Decreased by 0.3 mm/Hg (C)</p> Signup and view all the answers

Which condition can give a maple syrup odor to urine?

<p>Maple syrup urine disease (A)</p> Signup and view all the answers

Flashcards

Specific Gravity (SG)

A measurement of the concentration of dissolved particles in a urine sample, reflecting the density of the solution.

Direct Methods for SG Measurement

A technique used to directly measure the density of urine using a device that floats in the liquid.

Indirect Methods for SG Measurement

Techniques that indirectly measure SG based on the interaction of light with the urine.

Refractometer

A device that determines SG by measuring the refractive index of urine, a comparison of light speed through air and urine.

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Solutes Affecting SG

Substances in urine that can influence SG and need to be adjusted for.

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Solute Correction

The process of adjusting SG measurements to account for specific solutes influencing the reading.

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High Specific Gravity

A condition in urine where the dissolved substances have a higher concentration than normal.

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Low Specific Gravity

A condition where the dissolved substances in urine have a lower concentration than normal.

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Urine Color as Hydration Indicator

The physical appearance of urine can offer clues about hydration levels.

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Urine Specific Gravity

The concentration of solutes in urine, influencing its density.

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Factors Affecting Urine Color

The presence of substances that change urine color.

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Alkaptonuria

A condition where urine turns dark due to a buildup of a specific pigment.

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Polyuria

A condition where a significant amount of urine is produced, often with a pale yellow color.

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Diabetes Insipidus

A condition marked by excessive thirst and frequent urination, caused by a lack of antidiuretic hormone.

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Diabetes Mellitus

A condition characterized by increased blood sugar levels and excessive urination, resulting in a pale yellow urine.

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Urine Sediment Examination

The process of examining urine components under a microscope for abnormalities.

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Reddish-brown urine

A reddish-brown color in urine can be caused by the oxidation of hemoglobin to methemoglobin, which occurs during urine collection or storage.

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Green-brown urine

A green-brown color in urine can be caused by drugs like methyldopa (Aldomet) and metronidazole (Flagyl).

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Orange-red urine

A bright orange-red color in urine can be caused by drugs like Rifampin.

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Bright yellow urine

A bright yellow color in urine can be caused by Riboflavin.

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Blue urine

A blue color in urine can be caused by drugs like methocarbamol (Robaxin), methylene blue, and amitriptyline (Elavil).

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Normal urine volume

A common range of urine volume in adults is between 600 mL and 2000 mL per 24 hours.

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Factors affecting urine volume

Factors like fluid intake, body hydration, and excretion of antidiuretic hormone can influence urine volume.

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Urine turbidity

Urine with a cloudy appearance can be categorized into pathologic and non-pathologic causes.

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Non-pathologic urine turbidity

Non-pathologic causes of urine turbidity can include squamous epithelial cells, mucus, amorphous phosphates, carbonates, urates, semen, spermatozoa, fecal contamination, radiographic contrast media, talcum powder, vaginal creams, and lipids.

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Pathologic urine turbidity

Pathologic causes of urine turbidity can include red blood cells, white blood cells, bacteria, yeast, nonsquamous epithelial cells, abnormal crystals, and lymph fluid.

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Specific gravity of urine

The specific gravity of urine is a measure of its density, which is influenced by the concentration of dissolved solutes.

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Specific gravity of urine affected by solutes

The specific gravity of urine can be affected by various factors, including the presence of glucose, protein, and other solutes.

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Correcting specific gravity

A specific gravity reading of 1.030 with 1 g/dL protein and 1 g/dL glucose requires correction due to the presence of these solutes.

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Temperature correction for specific gravity

Specific gravity measurements require temperature correction to ensure accuracy, as temperature affects density.

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What is Urochrome?

A major pigment responsible for urine color. Produced constantly by the body and increases with increased metabolism.

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What is Uroerythrin?

A pink pigment found in urine that may deposit with urates and uric acid crystals.

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What is Urobilin?

An orange-brown pigment that can impart a color to urine that's not fresh. It's the oxidized form of urobilinogen.

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What is Biliverdin?

A pigment that produces a green-yellow color in urine. It's formed due to the photo-oxidation of bilirubin.

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What is Indican?

A pigment that produces a purple color in urine. It's found in indican and associated with purple bag syndrome.

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What is Methemoglobin?

A pigment that produces a brown/black color in urine. It's the oxidized form of hemoglobin found in acidic urine.

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What is Melanin?

A pigment responsible for brown/black urine color. It's a product of melanogen oxidation.

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What is Homogentisic acid?

A pigment that gives urine a brown/black color. It's a metabolite of phenylalanine and is associated with alkaptonuria.

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What is Indicanuria?

The presence of abnormally high levels of indican in urine. It can be caused by bacterial infections like Klebsiella and Providencia.

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What is Purple Bag Syndrome?

A condition characterized by a purple discoloration of urine due to the presence of indican. It can occur in infants.

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What is Blue Diaper Syndrome?

A condition in infants where urine contains indican and appears blue. It's caused by indicanuria.

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What is Yellow Skin Pigmentation?

A yellowish pigmentation of skin due to the accumulation of urochrome in subcutaneous fats. It can occur in patients with kidney disease, failure, or CKD.

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What is Phenazopyridine?

A UTI treatment medication that can cause a yellow foam to appear when urine is shaken.

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What are Renal disease, failure, or CKD?

A condition where the body is unable to filter out waste properly, leading to dark yellow or amber urine due to the presence of urochrome.

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What is Liver Problem?

A condition where a patient's body produces excessive amounts of urobilinogen, which is then oxidized into urobilin. This can lead to dark yellow/amber/orange urine.

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Urine Specific Gravity (SG)

A measure of the concentration of dissolved particles in a urine sample. It reflects the density of the solution, indicating how much water is being retained by the body.

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Urinometry

A method for determining the density of urine using a calibrated glass tube that floats in the liquid. It's less accurate than other methods.

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Harmonic Oscillation Densitometry

A method for measuring specific gravity that utilizes the change in the frequency of a sound wave as it passes through the urine solution. More accurate and precise than other methods.

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Urine Color and Hydration

The appearance of urine can be a visual indicator of hydration levels. Darker urine usually means dehydration, while pale yellow suggests adequate hydration.

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Urine Odor and Medical Conditions

The odor of urine can provide clues about underlying medical conditions. Normal urine has a faint, aromatic odor due to urea. Other odors may indicate the presence of ketones, bacteria, or inherited metabolic disorders causing unusual substances in the urine.

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Ketonuria

A condition characterized by an excess of ketones (products of fat breakdown) in the urine. This can result from diabetes mellitus, starvation, or excessive vomiting. The urine may have a fruity or sweet smell.

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Phenylketonuria (PKU)

A rare genetic disorder characterized by an inability to properly process phenylalanine, a type of amino acid. Urine may smell like mousy.

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Glucosuria

A condition involving an excess of sugar (glucose) in the urine, often associated with diabetes mellitus. Urine may have a sweet, fruity, or caramelized sugar-like odor. The urine may also be more watery than usual.

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Study Notes

Routine Urinalysis

  • Urinalysis involves evaluating specimens for hydration levels, identifying abnormal pigments, and assessing potential medical conditions.
  • Urine color is a rough indicator of hydration, with darker colors suggesting lower fluid intake and higher solute concentration.
  • Normal urine color ranges from colorless to deep yellow, while abnormal colors include red or red-brown, which are often associated with issues like dehydration or kidney problems.
  • Recommendations for evaluating urine involve using clear containers, examining against a white background, and evaluating a consistent specimen volume under adequate lighting.
  • Urine pigments, such as urochrome, are products of metabolic processes and contribute to the color.
  • Increased metabolism can lead to darker urine, while hydration levels directly influence the color.

Factors Affecting Urine Color

  • Factors impacting urine color include the concentration of substances, pH levels, and the structural form of substances.
  • The alkaline environment can affect pigments, making them appear darker (e.g. alkaptonuria).
  • Various substances and conditions can affect the color (e.g., diabetes mellitus, diabetes insipidus).

Urine Pigments

  • Urochrome is the major pigment responsible for yellow coloration produced by endogenous metabolism.
  • Increased metabolic activity can lead to higher levels of urochrome and darker urine.
  • Urochrome is normally present in the body and excreted in the urine, but its excretion may be affected by kidney function.
  • Abnormal urine pigments can be indicative of disease or medical conditions, such as bilirubin or porphyrins.

Abnormal Urine Colors

  • Dark yellow/amber/orange urine may indicate the presence of abnormal pigments like bilirubin.
  • Pink pigments are also possible, sometimes associated with crystals from excessive uroerythrin.
  • Other abnormal colors (port wine, reddish-brown, or brown), may point to various conditions, like blood or particular substances that have undergone oxidation processes.
  • Urine with an abnormal color or other unusual characteristics warrants further medical evaluation and investigation.

Urine Volume (Micturition)

  • Normal urine volume ranges from 600ml to 2000ml in 24 hours.
  • Sufficient water intake is essential because hydration levels significantly impact urine volume.
  • Factors that affect urine volume include fluid intake, fluid loss from non-renal sources (diarrhea, vomiting), antidiuretic hormone (ADH) excretion, and the excretion of dissolved solids.
  • Conditions like diabetes mellitus, diabetes insipidus, and renal diseases can lead to variations in urine volume.

Urine Odor

  • Urine odor can be a diagnostic tool, providing clues about underlying conditions.
  • Normal urine generally has a mild aromatic scent, stemming from metabolic byproducts.
  • Foul or unusual odors could signal issues such as infections (bacteria), diseases (diabetes), or ingested substances (medications, food).
  • Unusual odors, like rotten fish or maple syrup, suggest particular metabolic conditions.

Urine Turbidity

  • Turbidity, or cloudiness, in urine generally reflects suspended particles.
  • Factors like bacteria, WBCs, mucous, or other substances can cause cloudiness.
  • Presence of substantial/unusual particulate matter in urine suggests further assessment.

Specific Gravity

  • Specific gravity (SG) is a measure of urine concentration and can indicate hydration status or kidney function.
  • SG values are typically measured using a refractometer or urinometer; 1.003-1.035 is the typical range for specific gravity, with 1.015-1.030 being a common average.
  • SG values are influenced by factors like fluid intake and renal concentration ability. Abnormal values may indicate various medical conditions that should be investigated.

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Description

This quiz explores the routine analysis of urine, focusing on hydration levels and the evaluation of abnormal pigments. Understand the significance of urine color, factors influencing it, and proper evaluation techniques. Perfect for students learning medical diagnostics or health science.

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