PHYSICAL EXAMINATION OF URINE (1).pdf

PHYSICAL EXAMINATION OF URINE 2. CLARITY 1. COLOR Refer to the transparency and turbidity of a Urochrome-...

PHYSICAL EXAMINATION OF URINE 2. CLARITY 1. COLOR Refer to the transparency and turbidity of a Urochrome- yellow color of urine name by urine specimen. Thudichum, in 1864 Clarity determined in the same manner that the ancient physicians used: by virtually - product of endogenous metabolism. examining the mixed specimen while Two additional pigments holding it in front of a light source. a. uroerythrin- attaches to the urates, URINE CLARITY producing a pink color to the sediments. b. urobilin- an oxidation product of urobilinogen, imparts an orange- brown color to urine that is not fresh. Color Cause Colorless Recent fluid consumption Pale yellow -Polyuria or diabetes insipidus -Diabetes mellitus URINE COLOR AND CLARITY PROCEDURE -Dilute random specimen 1. Evaluate an adequate volume of specimen Dark yellow -B complex vitamins 1. Use well-mixed specimen -Dehydration 2. View the urine through a clear container -Bilirubin 3. View the urine against a white background -Acriflavine -Nitrofurantoin using adequate room lighting 4. Maintain adequate room lighting Orange-yellow -Phenazopyridine 5. Evaluate a consistent volume of urine (Pyridium) Determine the urine color -Phenindione Describe the urine clarity -Sulfasalazine (Azulfidine) PATHOLOGICAL CAUSE OF URINE yellow-green Bilirubin oxidized to TURBIDITY biliverdin -RBCs -nonsquamous epithelial cell Green Pseudomonas infection -WBCs -abnormal crystals -bacteria -lymph fluid blue-green -Amitriptyline -Methocarbamol (Robaxin) -Yeast -lipids -Clorets -Trichomonas -Indican NONPATHOLOGIC CAUSE OF URINE -Methylene blue TURBIDITY -Phenol -Propofol - Squamous epithelial cells -Familial hypercalcemia - Mucus Indomethacin (Indocin, - Amorphous phosphates, carbonates, urates Tivorbex) - Semen, spermatozoa  - Fecal contamination Random specimen usually falls between - Radiographic contrast dye 1.015 and 1.030 - Talcum powder METHOD USED IN SPECIFIC GRAVITY - Vaginal cream MEASUREMENTS Laboratory Correlations in Urine Turbidity a. Refractometer measures urine concentration by determining refractive index. Acidic Urine Amorphous urates radiographic The refractive index compares light velocity contrast media in air with light velocity in solutions Alkaline Urine Amorphous phosphates, Corrections: carbonates Subtract 0.003 for each gram of protein and 0.004 for each gram of glucose present. Soluble With Amorphous urates, uric acid Note: temperature corrections are not necessary Heat crystals because the light beam passes through a temperature-compensating liquid prior to being Soluble in RBCs, amorphous phosphates, directed at the specific gravity scale. Temperature Dilute Acetic carbonates is compensated between 15°C and 38°C. Acid Calibration of Refractometer Insoluble in WBCs, bacteria, yeast, Distilled water(1.000) Dilute Acetic spermatozoa 5% NaCl (1.02210.0001) Acid 9% sucrose (1.034+0.001) Soluble in Lipids, Lymphatic fluid, Chlye Ether b. Osmolality: measures changes in colligative properties by particle number 3. SPECIFIC GRAVITY c. Reagent strip method: Measures pKa changes of polyelectrolyte by ions present not by presence of Define as the density of a solution high molecular weight substances (plasma compared with the density of a similar expanders, radiographic contrast media) volume of distilled water (SG. 1.000) at a similar temperature. 4.ODOR Urine specific gravity lower than 1.002 is Freshly voided urine has a faint aromatic probably not urine. odor. Isosthenuric specimen with 1.010 specific gravity COMMON CAUSES OF URINE ODORS Hyphosthenuric specimen below 1.010 specific gravity Hypersthenuric above 1.010 specific gravity