Urine Physical Examination

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Questions and Answers

What is the characteristic of urine in cases of porphyria?

  • Red-brown color in acidic urine after standing (correct)
  • Red-brown color in alkaline urine after standing
  • Brown color in acidic urine after standing
  • Black color in acidic urine after standing

What is the characteristic of black urine in relation to nitroprusside and ferric chloride?

  • Reacts with both nitroprusside and ferric chloride (correct)
  • Does not react with either nitroprusside or ferric chloride
  • Reacts with ferric chloride but not nitroprusside
  • Reacts with nitroprusside but not ferric chloride

What is the term for urine with many particulates, where the print is blurred when seen through?

  • Hazy
  • Cloudy (correct)
  • Turbid
  • Clear

What is a non-pathologic cause of turbidity in urine?

<p>Squamous epithelial cells and mucus (A)</p> Signup and view all the answers

What is the term for urine that is transparent and has no visible particulates?

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

What is an antihypertensive associated with black urine?

<p>Not mentioned (B)</p> Signup and view all the answers

What is the primary pigment responsible for the yellow color of urine?

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

What is the significance of measuring specific gravity in the routine analysis of urine?

<p>To provide information about the kidney's ability to concentrate urine (D)</p> Signup and view all the answers

Which of the following methods is NOT used to determine specific gravity?

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

What is the possible cause of cloudy red urine?

<p>Hematuria or hemoglobinuria (D)</p> Signup and view all the answers

What is the primary measure of refractometry?

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

What is the advantage of measuring specific gravity using a reagent strip and osmolality?

<p>It is more convenient and provides a more accurate measurement (A)</p> Signup and view all the answers

What is the principle behind osmolality measurements?

<p>Changes in colligative properties by particle number (C)</p> Signup and view all the answers

What is the normal color of urine in a laboratory?

<p>Pale yellow, yellow, and dark yellow (B)</p> Signup and view all the answers

What is the advantage of using refractometry to measure specific gravity?

<p>It requires a small volume of specimen (1-2 drops) (D)</p> Signup and view all the answers

What is a common cause of a colorless urine specimen?

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

What is the term for a specific gravity of 1.010?

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

Which of the following can cause a dark yellow urine color?

<p>May be first morning specimen (D)</p> Signup and view all the answers

What is the principle behind reagent strip measurements?

<p>pKa changes of a polyelectrolyte by ions present (A)</p> Signup and view all the answers

What is affected by the type of particles present in a solution?

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

What is the cause of a yellow-green urine color?

<p>Colored foam in acidic urine and false-negative chemical test results for bilirubin (C)</p> Signup and view all the answers

Which of the following can cause a blue-green urine color?

<p>Antidepressant, Muscle relaxant, Bacterial infections, intestinal disorders (D)</p> Signup and view all the answers

What can be obtained by measuring osmolarity?

<p>A measure of renal concentrating ability (D)</p> Signup and view all the answers

What is the color change observed on a reagent strip as the specific gravity increases?

<p>From blue to green to yellow (B)</p> Signup and view all the answers

What is the cause of a pink urine color?

<p>Cloudy urine with positive chemical test results for blood (A)</p> Signup and view all the answers

What is the cause of a port wine-colored urine?

<p>Porphyrins excreted in the urine (B)</p> Signup and view all the answers

What is the effect of increased concentration of urine on pH?

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

What type of odor is characteristic of freshly voided urine?

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

Which of the following is a cause of foul, ammonia-like odor in urine?

<p>Bacterial decomposition, urinary tract infection (B)</p> Signup and view all the answers

What is the purpose of bromthymol blue on the reagent pad?

<p>To measure pH (A)</p> Signup and view all the answers

What is the characteristic of urine in cases of maple syrup urine disease?

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

What is the characteristic of urine in cases of isovaleric acidemia?

<p>Sweaty feet odor (A)</p> Signup and view all the answers

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Study Notes

Urine Color

  • The yellow color of urine is caused by the presence of urochrome, which increases in thyroid conditions, fasting states, and when left at room temperature.
  • Other pigments that can affect urine color include uroerythrin, urobilin, bilirubin, and biliverdin.
  • Abnormal urine colors and their possible causes:
    • Colorless: commonly observed with random specimens
    • Pale yellow: increased 24-hour volume, low specific gravity, or recent fluid consumption
    • Dark yellow: first morning specimen, fever, burns, or antibiotic administration
    • Orange-yellow: certain medications (e.g., Phenazopyridine)
    • Yellow-green: acidic urine with a positive chemical test result for bilirubin
    • Green: positive urine culture, RBCs visible microscopically, or intravascular hemolysis
    • Blue-green: certain medications, bacterial infections, or intestinal disorders
    • Pink: cloudy urine with a positive chemical test result for blood
    • Red: clear urine with a positive chemical test result for blood or intravascular hemolysis
    • Port wine: porphyrins excreted in the urine (porphyria)
    • Red-brown: acidic urine with a positive chemical test result for blood
    • Brown: alkaline urine with a positive chemical test result for blood
    • Black: urine darkens on standing and reacts with nitroprusside and ferric chloride

Urine Clarity

  • Cloudy urine: many particulates, print blurred through urine
  • Turbid urine: print cannot be seen through urine
  • Milky urine: may precipitate or be clotted
  • Non-pathologic turbidity: presence of squamous epithelial cells and mucus, semen, fecal contamination, radiographic contrast media, talcum powder, or vaginal creams
  • Pathologic turbidity: RBCs, WBCs, bacteria, or yeast

Specific Gravity

  • Measure of the density of dissolved chemicals in the specimen
  • Isosthenuric: specific gravity of 1.010
  • Hyposthenuric: specific gravity below 1.010
  • Hypersthenuric: specific gravity above 1.010
  • Methods of measuring specific gravity:
    • Refractometry: measures refractive index
    • Osmolality: measures changes in colligative properties by particle number
    • Reagent strip: based on pKa changes of a polyelectrolyte by ions present

Refractometry

  • Determines the concentration of dissolved particles in a specimen by measuring refractive index
  • Requires only a small volume of specimen (1-2 drops)
  • Measures the velocity of light in air and the velocity of light in a solution

Osmolality

  • Measures the number of solute particles per unit of solvent
  • Affected only by the number of particles present
  • Can be used to measure renal concentrating ability

Reagent Strip

  • Based on the change in pKa of a polyelectrolyte in an alkaline medium
  • Indicator bromthymol blue measures the pH
  • Increased concentration of urine = increased H+ ions released = decreased pH

Urine Odor

  • Normal urine: faint aromatic odor
  • Long-standing specimen: odor of ammonia becomes more prominent
  • Causes of abnormal urine odor:
    • Foul, ammonia-like: bacterial decomposition, urinary tract infection
    • Fruity, sweet: ketones (diabetes mellitus, starvation, vomiting)
    • Maple syrup: maple syrup urine disease
    • Mousy: phenylketonuria
    • Rancid: tyrosinemia
    • Sweaty feet: isovaleric acidemia
    • Cabbage: methionine malabsorption
    • Bleach: contamination

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