PHYSICAL EXAMINATION OF URINE

600-2000 ml

Normal range of urine volume (24 hours)

1200-1500 ml

Average range of urine volume

<400 ml

Night urine output of urine volume

2-3 : 1

Night:day ratio of urine volume

50 ml

Container capacity of urine volume

10-15 ml

Required for routine of urine volume

12 ml

Urine analysis average of urine volume

>2000mL/24 hrs

Polyuria in adults (Henry)

2.5 L/day

Polyuria in adults (strasinger)

2.5-3.0 mL/kg/day

Polyuria in children

Increased fluid intake

Diuretics

Nervousness

DM

DI

Causes of polyuria

Increased SG

Specific gravity of DM

Decreased SG

Specific gravity of DI

Polyuria

Increased urine volume

Oliguria

Decreased urine volume

<500 mL/24 hrs)

Oliguria in adults (henry)

<400 mL/day

Oliguria in adults (strasinger)

<0.5 mL/kg/hr

Oliguria in children

Dehydration

Renal diseases

Renal calculi/tumor

Cause of oliguria

Anuria

Complete cessation of urine flow

<100 mL/24 hrs

Anuria (graff)

Complete obstruction

Toxic agents

Causes of anuria

Nocturia

Excretion of more than 500 mL of urine at night

Pregnancy

Cause of nocturia

<1.018

SG of nocturia

Urine color

Rough indicator of the degree of hydration;

Should collerate with urine SG;

Colorless to deep yellow

Normal urine color

Red/red brown

Abnormal urine color

Urochrome

Major pigment;

Production is directly proportional to metabolic rate

Urochrome

Pigment that turns urine yellow

Thyrotoxicosis

Fever

Starvation

Urochrome is increased in what?

Uroerythrin

Pigment that gives urine pink

Uroerythrin

May deposit in amorphous urates and uric acid crystals

Urobilin

Pigment that gives urine dark yellow/orange

Urobilin

Imparts an orange-brown color to a urine that is not fresh

Colorless

Recent fluid consumption

Pale yellow

Polyuria, dilute random specimen

Dark yellow

Concentrated spx;

Strenous excercise;

First morning specimen;

Carotene

Amber

Dehydration;

Fever;

Burns

Orange

Bilirubin

Yellow green, yellow brown

Bilirubin oxidized to biliverdin

Green

Pseudomonas infection

Blue-green

Indican;

Phenol

Methylene blue

Pink, red

Hematuria;

Intravascular hemolysis;

Myoglobin

Beets

Menstrual contamination

Rifampin

Burgundy/purplish red

Portwine

Porphyrins

Brown

Black

Methemoglobin

Homogentisic acid

Alkaptonuria

Melanin (most common)

Cola-colored

Levodopa

Yellow

Mepacrine

Green-brown

Methyldopa

Darkening, reddish brown

Metronidazole

Orange red, acid pH

Phenazopyridine

Rifampin

Bright orange-red

Clear

No visible particulates, transparent

Hazy

Few particulates;

Print easily seen through urine

Cloudy

Many particulates;

Print blurred through urine

Turbid

Print cannot be seen through urine

Milky

May precipitate or be clotted

RBCs, WBCs (UTI)

Bacteria

Yeast

Nonsquamous epithelial cells

Lymph fluid

Patholgic causes of urine turbidity

Acidic urine

Amorphous urates, radiographic contrast media

Alkaline urine

Amorphous phosphates;

Carbonates

Soluble with heat

Amorphous urates;

Uric acid crystals

Soluble in dilute acetic acid

RBCs;

Amorphous phosphates;

Carbonates

Insoluble in dilute acetic acid

WBCs,

Bacteria,

Yeast

Spermatozoa

Soluble in ether

Lipids, lymphatic fluid, chyle

Aromatic

Normal odor

Odorless

Acute tubular necrosis

Foul, ammoniacal

UTI

Fruity, sweet

Ketones

Caramelized sugar, maple sugar

MSUD

Mousy, musty

Phenylketonuria

Rancid butter

Tyrosinemia

Sweaty feet

Isovaleric academia

Cabbage

Oasthouse syndrome

Bleach

Contamination

Sulfur

Cystine disorder

Rotting fish

Trimethylaminuria

Pungent

Ingestion of onions, garlic, asparagus

Swimming pool

Hawkinsinuria