38 Questions
What is the primary factor that affects the color of fresh urine?
Recent diet
What is the typical range of colors for fresh urine?
Light yellow to amber
What is the classification of urine based on its clarity?
Clear or turbid
What is the term for cloudiness caused by excessive cellular material or protein in the urine?
Turbidity
What is NOT a factor that affects the color of fresh urine?
Time of day
Which of the following odors is associated with high urea levels in the urine?
Ammoniac odor
What is the typical characteristic of fresh urine?
It varies in color and clarity
What is the normal range of urine pH?
4.5-8.0
What is the term for a urine volume of less than 500ml/24hr?
Oliguria
What is the normal range of specific gravity in urine?
1.002-1.035
What is the term for excess protein in the urine?
Proteinuria
At what blood glucose level will glucose appear in the urine?
180 mg/dl
What is the term for excess sugar in the urine, often associated with diabetes mellitus?
Glycosuria
What is the primary function of the kidneys in the process of urination?
To excrete waste products and excess fluids from the body
What is the term for the process of eliminating waste products from the body through the urine?
Urination
Which of the following is NOT a component of normal urine?
Microorganisms
What is the purpose of the urine dipstick chemical analysis?
To measure the pH and specific gravity of the urine
What is the term for the examination of urine under a microscope?
Microscopic examination
What is the term for the study of the structure and function of cells in the urine?
Urine cytology
Which of the following is a component of a routine urinalysis?
Urine biochemical tests
What is the term for the examination of urine for abnormal constituents?
Urine analysis
Which of the following is NOT a type of urine test?
Radiological examination
What is the purpose of a urine urinalysis?
To detect abnormal constituents in the urine
In which condition do ketones, such as acetone, typically appear in urine?
In diabetic ketoacidosis
What is the primary purpose of centrifuging the specimen in the microscopic examination?
To separate the components of the sample
What is the recommended volume of the specimen to be collected in the tube?
40ml
What is the primary function of the gloves in the microscopic examination?
To protect the sample from contamination
What is the duration of centrifugation recommended for the specimen?
5 minutes at low speed
What is the primary purpose of examining the urine sample under low power?
To identify most crystals, cast, and squamous cells
What is the normal range of RBCs in urine per high power field?
4 cells
What does the presence of 2 or more WBCs in high power field indicate?
Infection in the renal system
What is the characteristic of WBCs in urine?
They have a lobed nucleus and granular cytoplasm
What is the characteristic of epithelial cells in urine?
They have a round or oval nucleus
What type of cast is seen in healthy individuals?
Hyaline cast
What is the commonest organism seen in urine?
Bacteria
Which of the following crystals is always abnormal in urine?
Cysteine
What is an artifact that can be seen in urine samples?
Hair
What is the purpose of collecting the urine sample in a dry and clean container?
To prevent contamination of the sample
Study Notes
Urine Exam (GUE)
- Urine is a sterile, liquid by-product of the body, secreted by the kidneys and excreted through the urethra through a process called urination.
Properties of Normal Urine
- Normal urine is sterile and contains no microorganisms.
- Urine is a mixture of water, chemicals, proteins, and electrolytes such as sodium, potassium, urea, creatinine, etc.
- Urine pH ranges from 4.5 to 8.0 and generally reflects blood pH.
Urinalysis
- Urinalysis or general urine exam includes:
- MACROSCOPIC EXAM (visual observation of urine)
- Urine dipstick chemical analysis
- MICROSCOPIC EXAM (examination under a microscope)
MACROSCOPIC EXAM
- Examines urine color, transparency, odor, and volume.
- Normal urine color: pale yellow to amber.
- Transparency: classified as clear or turbid.
- Odor: aromatic (normal), ammoniac (high urea), or fruity (DM due to presence of ketones).
- Volume: normal (800-2000ml/24hr), oliguria (below 500ml/24hr), anuria (below 100ml/24hr), or increased (above 2000ml/24hr).
Urine Dipstick Chemical Analysis
- pH: ranges from 4.5 to 8.0.
- Specific gravity (sp gr): ranges from 1.002 to 1.035 and measures solute concentration.
- Protein: normal range (less than 150mg/24hr); proteinuria means excess protein in urine.
- Glucose: appears in urine when blood glucose is above 180 mg/dl; glycosuria means excess sugar in urine (diabetes mellitus).
- Ketones: like acetone, not found in normal urine, but appears in diabetic ketoacidosis or starvation.
MICROSCOPIC EXAM
- Examines urine under a microscope to identify:
- RBCs (red blood cells)
- WBCs (white blood cells)
- Epithelial cells
- Casts (solid, cylindrical structures formed by debris in kidney)
- Microorganisms (bacteria, yeast, etc.)
- Crystals (uric acid, calcium oxalate, etc.)
RBCs
- Hematuria: presence of abnormal number of RBCs in urine, seen in cases like trauma, stones, infection, or cancer.
- Normally, 4 RBCs are found in high power field (HPF).
WBCs
- Pyuria: presence of abnormal number of WBCs in urine, indicates infection in the renal system.
- High WBCs in urine sample: abnormal.
- WBCs have lobed nuclei and granular cytoplasm.
Epithelial Cells
- Larger than WBCs, contain round or oval nucleus.
- Found in small numbers in the sample.
- Increased in some medical diseases of the kidney, like nephrotic syndrome.
Casts
- Solid, cylindrical structures formed by debris in the kidney.
- Hyaline casts: seen in healthy individuals.
- RBCs casts, WBCs casts, and cellular casts can also be seen.
Microorganisms
- Bacteria are the most common organism seen and common contaminant.
- Fungus, like Trichomonas vaginalis, can also be seen.
Crystals
- Common crystals seen in healthy persons: uric acid, calcium oxalate, and ammonium magnesium phosphate.
- Certain crystals, like cysteine, tyrosine, and leucine, are always abnormal if detected in urine.
Artifacts in Urine Sample
- Hair, air bubbles, fat droplets, and cloth fibers can be present as artifacts in the urine sample.
Learn about the properties of normal urine, including its composition and pH levels. Understand the process of urinalysis and its significance in medical diagnosis.
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