Urinalysis Overview and Composition
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Questions and Answers

What is a primary benefit of using Thymol in urine preservation?

  • It increases the pH of the sample.
  • It reduces the volume of the sample.
  • It inhibits bacteria and fungi. (correct)
  • It enhances the color of the urine.

Which of the following is NOT a physical examination characteristic of urine?

  • Volume
  • Clarity
  • Presence of glucose (correct)
  • Color

What could cause urine to appear brown in color?

  • Increased protein intake
  • High bilirubin levels
  • Severe dehydration (correct)
  • Excessive hydration

What does a pale yellow to an amber color in fresh urine primarily indicate?

<p>Normal hydration status (A)</p> Signup and view all the answers

Which condition could lead to the appearance of red urine?

<p>Presence of beets in the diet (A)</p> Signup and view all the answers

What medication is known to potentially cause orange-colored urine?

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

What is one potential cause of urinary incontinence?

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

Which biochemical test is NOT typically performed during urinalysis?

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

What is a potential cause of blue-green urine?

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

Which condition is characterized by high levels of pus or white blood cells in the urine?

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

What does the presence of milky or cloudy urine most likely indicate?

<p>Urinary tract infections (B)</p> Signup and view all the answers

Which of the following conditions can lead to polyuria?

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

What urinary volume is considered abnormal in oliguria?

<p>Less than 400 ml/24 hours (C)</p> Signup and view all the answers

Which treatment or procedure could possibly cause blue urine?

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

Which factor is NOT typically associated with variations in urine volume?

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

Which of the following conditions is LEAST likely to cause white (milky) urine?

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

What component is NOT typically found in normal urine?

<p>Bacteria such as E. coli (A)</p> Signup and view all the answers

Which method is preferred for routine urinalysis?

<p>First Morning, Midstream collection (B)</p> Signup and view all the answers

What effect does room temperature have on urine if it remains unprocessed for more than 2 hours?

<p>Formation of crystals (C)</p> Signup and view all the answers

What is a primary indication for performing a urinalysis?

<p>Detection of urinary tract infection (B)</p> Signup and view all the answers

Which urine preservation method is recommended for up to 8 hours?

<p>Refrigeration at 4-6°C (C)</p> Signup and view all the answers

What can occur due to bacterial proliferation in unprocessed urine?

<p>Oxidation of bilirubin (B)</p> Signup and view all the answers

Which chemical preservative is used specifically to preserve adrenal hormones in a 24-hour urine sample?

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

What happens to glucose levels in urine if it remains unprocessed for more than 2 hours?

<p>Decrease due to glycolysis (B)</p> Signup and view all the answers

Flashcards

What is urinalysis?

Urine analysis is a laboratory test that examines the physical, chemical, and microscopic properties of a urine sample.

What are the components of normal urine?

Cells, crystals, casts, debris, and microorganisms.

Why is first morning urine preferred for urinalysis?

First morning urine is preferred for routine urinalysis because it's more concentrated and contains higher levels of analytes.

What is a clean-catch urine sample?

A clean-catch urine sample is collected after cleansing the genital area to reduce contamination from bacteria.

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What happens to urine left at room temperature?

Urine left at room temperature for more than 2 hours can experience changes in pH, crystal formation, ketone loss, glucose decrease, bilirubin oxidation, urobilinogen oxidation, bacterial proliferation, and cellular disintegration.

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How can urine be preserved?

Refrigeration is the best method for preserving urine samples. It can be used up to 8 hours.

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Which preservative is used for adrenaline, noradrenaline, and steroids?

Hydrochloric acid is used for the preservation of a 24-hour urine sample for adrenaline, noradrenaline, and steroids.

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What does toluene do in urine preservation?

Toluene prevents bacterial growth and air contamination. It forms a thin layer on top of the urine sample.

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Urochrome

A pigment that gives urine its pale yellow to amber color.

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Urinary Incontinence

A condition characterized by involuntary leakage of urine.

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Amber Urine

An abnormal urine color that can indicate dehydration or liver issues.

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Orange Urine

An abnormal urine color that can be caused by dehydration, liver or bile duct issues.

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Brown Urine

An abnormal urine color that can indicate liver issues, severe dehydration, or blood in the urine.

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Red Urine (Hematuria)

An abnormal urine color that usually indicates the presence of blood in the urine.

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Boric Acid

A general preservative used for urine samples.

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Formalin

A chemical used to preserve the formed elements in urine samples.

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What causes blue or green urine?

Urine which is blue or green in colour is rare and usually caused by medications or dyes.

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What condition can cause green urine?

A bacterial infection called Pseudomonas can cause urine to appear green.

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What can cause milky or cloudy urine?

Milky or cloudy urine can indicate dehydration, diabetes, chyluria, pyuria, sexually transmitted infections (STIs), vaginitis, prostatitis, kidney stones, preeclampsia, or chronic kidney disease.

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What is chyluria?

A condition where lymphatic fluid is excreted into the urine, causing it to become milky white. Often triggered by parasitic infections.

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What is pyuria?

A condition where there are high levels of white blood cells or pus in the urine.

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What is the normal urine output per day?

Average adult urine output in 24 hours is 600-2000mls.

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What is polyuria?

Urine volume excreted is >2000ml/24 hours – excess urine output. Possible conditions include diabetes mellitus, diabetes insipidus, chronic renal failure, and diuretic therapy.

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What is oliguria?

Urine volume excreted is <400ml/24 hours – too little urine output. Possible conditions include dehydration, acute kidney injury, urinary tract obstruction, heart failure, and shock.

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Study Notes

Urinalysis Overview

  • Urinalysis is a procedure for examining urine to diagnose or monitor medical conditions.

Normal Urine Composition

  • Cells: Red blood cells (RBCs), white blood cells (WBCs), epithelial cells, renal cells
  • Crystals: Uric acid, bilirubin, calcium oxalate
  • Casts: Granular, cellular, hyaline
  • Debris: Hair, crystals from powders
  • Microorganisms: Bacteria, Trichomonas vaginalis

Indications for Urinalysis

  • Suspected renal diseases (e.g., glomerulonephritis, nephrotic syndrome, pyelonephritis, renal failure)
  • Detection of urinary tract infections (UTIs)
  • Detection and management of metabolic disorders (e.g., diabetes mellitus)
  • Differential diagnosis of jaundice
  • Detection and management of plasma cell dyscrasias
  • Diagnosis of pregnancy

Urine Collection Methods

  • First morning urine (midstream): Preferred for routine urinalysis
  • Random urine (midstream): Routine urinalysis
  • First morning urine (midstream); clean catch: Bacteriological examination
  • Post-prandial: Estimation of glucose, urobilinogen
  • 24-hour urine: Quantitative estimation of proteins or hormones
  • Catheterized: Bacteriological examination in infants, bedridden patients, and urinary tract obstructions

Effects of Room Temperature on Urine

  • Increased pH: Due to ammonia production from urea by urease-producing bacteria

  • Crystal formation: Precipitation of phosphates and calcium (turbidity)

  • Ketone loss: Ketones are volatile

  • Decreased glucose: Glucose is used by cells and bacteria

  • Bilirubin oxidation: False negative test for bilirubin

  • Urobilinogen oxidation: False negative test for urobilinogen

  • Cellular disintegration: Especially in alkaline and hypotonic urine

  • Bacterial proliferation

Urine Sample Preservation

  • Refrigeration (4-6°C): Best method for up to 8 hours
  • Hydrochloric acid: Preservation for 24-hour urine samples (adrenaline, noradrenaline, steroids)
  • Toluene: Physical barrier for bacteria and air; used for measuring biochemicals
  • Boric acid: General preservative
  • Thymol: Inhibits bacteria and fungi
  • Formalin: Excellent for preserving formed elements

Performing Urinalysis

  • Physical examination: Color, clarity, volume
  • Biochemical testing: Leukocytes, nitrite, ketone, pH, specific gravity, blood, urobilinogen, protein, glucose, bilirubin
  • Microscopy

Physical Examination - Color

  • Pale yellow/straw color: Healthy

  • Dark yellow/amber: Dehydration

  • Orange: Dehydration, liver issues, certain foods/medications

  • Brown: Liver issues, dehydration, blood, porphyria, certain conditions, infections

  • Red: Blood in urine, certain foods/medications, certain medical conditions

  • Blue/green: Unusual; rare conditions or medications

  • White/milky: Dehydration, diabetes, chyluria, infections, or other conditions.

  • Urine volume: Average output in 24 hours 600-2000 ml; can vary based on intake, climate, diet

  • Abnormal urine volume (Polyuria, Oliguria, Anuria): Conditions that can cause these include diabetes, congestive heart failure, acute glomerulonephritis, or other conditions.

  • Clarity: Clear, slightly cloudy, cloudy, turbid

  • Odor: Aromatic (freshly voided), ammonia (standing urine), fruity, fishy, foul, or other odors based on specific medical conditions

Urine Sample Preparation - Mixing of Sample

  • Mix urine thoroughly using a figure 8 pattern for even distribution of components and sediments (bacteria, crystals, casts, parasites, epithelial cells, white blood cells, fungi) before analysis.

Urine Biochemical Testing

  • Reagent strips: Used for quick detection of various substances in the urine
  • Detailed tables for specific biochemical tests, including normal ranges and clinical significance, are needed.

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Description

This quiz covers the essential aspects of urinalysis, including normal urine composition and indications for performing the test. It highlights various components found in urine, collection methods, and the significance of urinalysis in diagnosing medical conditions. Test your knowledge on how urinalysis aids in the detection of diseases such as UTIs and diabetes.

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