Urinalysis and Urine Components

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Questions and Answers

Which of the following best describes the primary function of urinary secretion?

  • To synthesize alkaloids and uric acid.
  • To produce urobilin for pigmentation.
  • To eliminate final products of nitrogen metabolism and maintain hydroelectrolytic balance. (correct)
  • To regulate the production of creatinine.

A urine sample for routine urinalysis, aimed at detecting abnormalities and/or examining sediment, necessitates a complete 24-hour urine collection.

False (B)

What are the three main components of a comprehensive urinalysis?

Physical examination, biochemical examination, and urinary sediment examination

The normal pH range for urine in adults is between ______ and 6.5.

<p>5.0</p> Signup and view all the answers

Match each component of urine analysis with its purpose:

<p>Physical examination = Assessment of macroscopic characteristics (color, density, etc.) Biochemical examination = Detection of specific analytes (glucose, proteins, etc.) Urinary sediment examination = Microscopic analysis of cells, crystals, and pathogens Microbiological culture of urine = Identification of urinary tract infections</p> Signup and view all the answers

Crystal precipitation in urine can lead to which of the following conditions?

<p>Formation of urinary stones. (C)</p> Signup and view all the answers

Which of the following is NOT typically assessed during the physical examination of urine?

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

The concentration of analytes in urine can be accurately determined using only qualitative or semi-quantitative methods performed on a random urine sample.

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

Which of the following conditions is NOT typically associated with poliuria?

<p>Dehydration due to vomiting (C)</p> Signup and view all the answers

Anuria is defined as urine excretion greater than 500ml in 24 hours.

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

What is one reason urine may appear turbid upon initial production?

<p>presence of salts in suspension</p> Signup and view all the answers

The presence of ______ in urine might cause it to foam when agitated.

<p>proteins</p> Signup and view all the answers

Match the cause with the corresponding effect on urine production:

<p>Dehydration due to vomiting = Oliguria Terminal kidney insufficiency = Anuria Administering diuretic drugs = Poliuria Aldosterone deficit = Poliuria</p> Signup and view all the answers

A urine sample exhibits a reddish or pinkish sediment. Which type of precipitation is most likely causing this?

<p>Urates (uric acid) (A)</p> Signup and view all the answers

Adding acid to a urine sample will always dismiss all types of turbidity

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

Which condition is most likely to cause urine to have a high basis pH?

<p>Bacterial breakdown of urea (B)</p> Signup and view all the answers

Which urine color might indicate the presence of blood?

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

The standard color of urine is blue.

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

What condition is suggested by off-white urine?

<p>pyuria</p> Signup and view all the answers

A urine color of dark yellow-orange is often associated with few ______ or fever.

<p>liquids</p> Signup and view all the answers

Match the urine color with its possible association:

<p>Red = Hematuria Blue/Green = Medications Off White = Pyuria Dark Yellow/Orange = Low Liquid Intake</p> Signup and view all the answers

Golden or brown urine, that shows a dark yellow or brown foam when shaken, suggests the presence of what condition?

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

Standard urine is expected to have a strong, pungent odor.

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

What scent would most likely indicate the presence of acetone?

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

A urine sample with a fruity odor may indicate the presence of which substance, and what condition might this suggest?

<p>Acetone; ketosis or diabetes mellitus (A)</p> Signup and view all the answers

A urine sample left at room temperature for an extended period is likely to become more acidic due to the decomposition of urea into ammonia.

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

What condition is typically indicated by a urine density greater than 1.025?

<p>Dehydration or diabetes mellitus</p> Signup and view all the answers

A urine sample with a putrid odor may suggest the presence of an ______.

<p>Infection</p> Signup and view all the answers

Match the following pH indicator dyes with their corresponding color change:

<p>Bromothymol blue = Green to blue Methyl red = Yellow to red Phenolphthalein = Yellow-red</p> Signup and view all the answers

What does a low urine density (e.g., 1.010) typically indicate?

<p>Diuretic use or kidney issues affecting osmolarity (C)</p> Signup and view all the answers

How does the concentration of hydrogen ions relate to the pH value of a solution?

<p>pH decreases as hydrogen ion concentration increases. (B)</p> Signup and view all the answers

A pH value less than 7 indicates an alkaline solution.

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

What methods are used to measure urine density?

<p>Ureo densimeter and refractometers (D)</p> Signup and view all the answers

A urine density result of less than 6 should raise suspicion of diluted urine.

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

In reactive strips for urine analysis, the poli-electrolyte with an indicator at pH reacts based on the concentration of ______ in the urine.

<p>H+</p> Signup and view all the answers

Besides kidney issues, what other factor should be considered when a patient's urine analysis results are abnormal?

<p>Medications</p> Signup and view all the answers

What does omsolalidad relate to and what is measured in adults?

<p>Urine salinity, 50 to a big one (A)</p> Signup and view all the answers

Match the following urine tests/measurements with their primary indication or purpose:

<p>Urine Density = Indicates hydration status and kidney function Omsolalidad = Related to urine salinity levels Reactive Strips = Semi-quantitative analysis of various urine components</p> Signup and view all the answers

Which of the following best describes the primary function of pH measurement in the context of nephron activity?

<p>To assess the ability of nephrons to manage hydrogen levels resulting from metabolism (D)</p> Signup and view all the answers

What is the widespread method used for biochemical examination of urine in routine laboratories and emergency departments?

<p>Using reactive strips (A)</p> Signup and view all the answers

A urine pH of 9 is considered within the normal range.

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

Reactive strips offer high specificity in urine analysis.

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

Name three acids that nephrons can process, influencing urine pH.

<p>Lactic, pyruvic, and citric</p> Signup and view all the answers

Urine pH varies between 4 and 8, but the normal range is close to 5 and 6, indicating a slightly ______ condition.

<p>acidic</p> Signup and view all the answers

Match the following factors with their likely effect on urine pH:

<p>High-protein diet = Acidic urine Diabetes or acidosis = Acidic urine Certain drugs (e.g., chloride) = Acidic urine Diet high in bases = Basic urine</p> Signup and view all the answers

The determination of urinary pH uses three indicators that react with what?

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

What does acidic urine generally indicate?

<p>A diet high in proteins (A)</p> Signup and view all the answers

According to the content, serum tests are less effective than urine tests at indicating health.

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

Flashcards

Urine

Biological fluid from kidneys, excreted via the urinary tract. Contains urea, creatinine, salts, pigments, and other substances.

Normal daily urine volume in adults

700 to 1500 ml

Normal urine density

1.005 to 1.030

Normal urine pH

5.0 to 6.5

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Function of Urinary Secretion

Eliminates nitrogen waste and maintains electrolyte balance.

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Urine Analysis (Urinalysis)

Examination of urine for renal, metabolic, and urinary tract disorders.

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Physical Examination of Urine

Appearance, color, density, pH, osmolality, and diuresis.

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Biochemical Examination of Urine

Chemical tests for glucose, proteins, ketones, bilirubin, etc.

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Poliuria

Increased urine production, often due to fluid intake, diuretics, diabetes insipidus, or kidney issues.

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Oliguria

Urine excretion less than 500ml per 24 hours. Can be caused by dehydration, kidney issues, or urinary obstruction.

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Anuria

Practically absent urine production. Often linked to terminal kidney failure or complete urinary tract obstruction

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Urine Turbidity

Fresh urine is typically clear. Turbidity (cloudiness) indicates the presence of suspended particles.

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Salts in Urine

Suspended salts, like phosphates or carbonates, can cause urine to appear turbid.

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Reddish/Pink Urine Sediment

May indicate urate precipitation. It can be dissolved with heat.

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Piuria

Pus in the urine, indicating a possible infection.

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Urine Color Variations

Color can range from colorless (dilute) to dark (concentrated), reflecting hydration levels and potential issues like jaundice or bilirubin.

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Standard Urine Color

Normal urine color, due to urobilin.

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Dark Urine

Indicates low liquid intake or fluid retention.

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Dark Yellow/Orange Urine

May indicate few liquids or the presents of a fever.

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Off White Urine

May indicate pyuria (pus in urine) or coliforms.

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Red Urine

Indicates hematuria (blood in urine) or hemoglobinuria.

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Blue/Green Urine

May be caused by medications or asparagus ingestion.

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Black Urine

Can indicate beets or melanin.

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Normal Urine Scent

Normal urine has little to no smell. Altered smells can be a sign of illness

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Odorless Urine

Odorless urine.

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Ammoniacal Urine Odor

Urine odor resembling ammonia.

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Putrid Urine Odor

Foul-smelling urine, often indicates an infection.

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Fruity Urine Odor

Fruity-smelling urine, often indicates the presence of acetone, ketosis, or diabetes mellitus.

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High Urine Density

High urine density indicates dehydration.

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Low Urine Density

Low urine density indicates very dilute urine.

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Urinary Density

Urine density is measured using relative volumetric weight to assess nephron concentration.

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Factors Increasing Urine Density

Density increases with urea, creatinine, sodium, potassium, halides, glucose, and protein.

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Urine Density Measurement

Ureo-densimeter or refractometers are tools used to measure urine density.

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Osmolality

Urine osmolality measures the concentration of dissolved particles in urine. Serum osmolality measures the concentration of dissolved particles in serum.

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Normal Urine Osmolality (Adult)

Adult urine osmolality typically ranges from 50 to a higher value.

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Urine Osmolality and Kidney Health

Kidney issues can affect urine osmolality.

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Reactive Strips (Urinalysis)

Biochemical urine analysis often uses reactive strips for quick, semi-quantitative results.

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Reactive Strip Determinations

Reactive strips provide semi-quantitative results for up to eleven different urine determinations.

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Strip Sensitivity vs. Specificity

Reactive strips in urinalysis offer high diagnostic sensitivity but moderate specificity.

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Urine pH Significance

Urine pH indicates the balance of acids and bases, reflecting metabolic and respiratory functions, and the influence of substances like lactic, pyruvic, and citric acids.

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Importance of Correct Urine Testing

Urine tests are most accurate when performed correctly and promptly, yielding reliable results for analysis. Serum tests ensure accuracy.

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Factors Affecting Urine pH

Urine pH is affected by diet (e.g., proteins leading to acidity) and conditions like diabetes or acidosis, as well as certain drugs.

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Urinary pH Definition

Urinary pH is a measure of the acidity or basicity of urine throughout the day, reflecting the regulation of acids by the kidneys.

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Normal Urine pH Range

Normal urine pH typically ranges from 5 to 6, though it can vary between 4 and 8 depending on diet and other factors.

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Urine pH Test Principle

This test depends on 3 indicator.Methil what a bright with all cromo which reactions to with hydrosen , present that are what pee

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Acidic Urine Causes

Acidic urine (lower pH) can result from high-protein diets or conditions like diabetes and acidosis.

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Clinical Use of Urine pH

Urine pH measurement is used to assess the acid-base balance in the body. It can help diagnose conditions that cause an imbalance.

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Study Notes

Urine Analysis Introduction

  • Urine is a biological fluid produced in the kidneys and excreted via the ureters, bladder, and urethra.
  • Normal adult urine volume ranges from 700 to 1500 ml per 24 hours, with a density between 1.005 and 1.030, and a pH between 5.0 and 6.5.
  • Urine analysis (urianalysis) is an essential procedure to diagnose kidney, metabolic, and urinary tract disorders.
  • A urine analysis may include physical examination, biochemical analysis, and microscopic examination of the urinary sediment.

Physical Urine Examination

  • A physical examination of urine includes assessing its appearance (clarity), color, density, pH, osmolality, and diuresis over a 24-hour period.
  • Normal urine color is yellow-amber varying in intensity, due to urobilin.
  • Volume of urine excreted in 24 hours is called diuresis.
  • Normal urine volume varies on fluid intake, though the kidney maintains the body’s hydric balance.
  • Polyuria is the excretion of urine of superior volumes to average, with the volume surpassing 2,000 ml/24 h

Microscopic Urine Test

  • Recent urine is clear and transparent, cloudiness can be due to various reasons:
  • Suspended salts
  • White sediment indicates phosphates and carbonates
  • Red sediment indicates urates
  • Pus in the urine (Pyuria)
  • Turbidity doesn't dissipate following sedimentation, acidification, or heating due to pyuria, also, it occurs with basic pH from the breakdown of urea and generation of ammonia due to urease.

Urine Color Alterations

  • Incolor urine is caused by low concentration levels or dilution of urine
  • Yellow/greenish/brown/ dark orange urine, a sign of ictericia caused by bilirubin with a thick brownish foam.
  • Dark yellow or orange colored urine means concentrated urobilin for example, from fever
  • Red urine comes from hematies/hematuria with transparent hb, while myoglobin leads to a turbid hemoglobinuria
  • Blue/greenish colored urine occurs with use of certain medications or after asparagus ingestion.

Factors Affecting Urine Density

  • Normal urine density ranges between 1.003 and 1.030
  • If urine density is >1.025, it may represent dehydration, diabetes mellitus, cardiac insufficiency, or adrenal insufficiency.
  • If the value is <1.010, a patient may be going through diuretic use or renal disease

Factors Affecting Urine Odor

  • Normal fresh urine is odorless or has a slight ammoniacal smell.
  • Pútrido aroma: infection
  • Ammoniacal: infection after a long time being stored
  • Fruity: presence of acetone

Biochemical Urine Examination

  • Analyte presence can signify abnormal or altered physiological states.
  • Analytes include glucose, proteins, ketone bodies, bilirubin, hemoglobin, porphyrins, drugs, etc.
  • Urine is collected over a specific time frame to quantitatively analyze excreted substances.
  • Pre-analytical conditions, the analysis stages are important (collection, reception, transport, etc).

Microbiological Urine Culture

  • Purpose is to confirm a urinary infection, including agent quantification and antibiogram
  • Routinely uses a single urine sample
  • Quantitative tests, such as a 24-hour urine sample are needed when measuring substance concentration

Determining Urine pH

  • Determines body's acid-based condition.
  • Test relies on some indicators that alter shade with hydrogen ions.
  • Normal oscillating values: 4.6-8 with 5.5-6.5 normally but diet can affect it.
  • Higher level of protein in diet causes acid urine

Additional Important Info

  • Proteinuria: emission by the kidney of excessive protein.
  • Glycosuria: urine glucose, which can result from Cushing's syndrome.
  • Ketonuria: excretion elevated ketone quantities, associated with acidosis.
  • Hematuria: is when a urine sample tests positive for blood.
  • Bilirubinuria: presence of bilirubin.

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