Unit A 18 Phys, Urinalysis

Microscopic

A complete urinalysis consist of three parts: 1) Macroscopic Observation (Visual/smell examination) for color, turbidity (clearness), and odor, 2) Chemical analysis and specific gravity, and 3) _________________________ examination or urine sediment.

Macroscopic

A complete urinalysis consist of three parts: 1) __________________________ Observation (Visual/smell examination) for color, turbidity (clearness), and odor, 2) Chemical analysis and specific gravity, and 3)Microscopic examination or urine sediment.

Chemical

A complete urinalysis consist of three parts: 1) Macroscopic Observation (Visual/smell examination) for color, turbidity (clearness), and odor, 2) __________________ analysis and specific gravity, and 3)Microscopic examination or urine sediment.

Urochrome

Normal, fresh urine is pale to dark yellow or amber in color and clear. The color is due to the pigment _________________________ (urobilin), a metabolic product of hemoglobin.

Bilirubin

Stercobilins and urobilins (urochorme) are derived from a breakdown product of blood known as _______________________

120

Red blood cells (RBCs) have an average life span of _______________days

Spleen

Macrophages in the liver, ______________________, and bone marrow brake down old worn out RBCs and damaged RBCs. Macrophages in other tissues can clear damaged blood cells such as in the case of a bruise.

Amino acids

Once a RBC is engulfed by a macrophage each component of the hemoglobin molecule has a different fate. The globin proteins are broken down to _________________________ and released into the bloodstream for use by other cells for protein synthesis or metabolized for energy.

Bone marrow

Once a RBC is engulfed by a macrophage each component of the hemoglobin molecule has a different fate. The heme group (porphyrin ring + iron) is stripped of its iron which can be transported back to the __________________ and reused in the production of more RBCs.

Porphyrin ring

The heme group of hemoglobin consists of iron and a __________________________

Biliverdin

Once a RBC is engulfed by a macrophage each component of the hemoglobin molecule has a different fate. The heme group's porphyrin ring is converted to ____________________

which has a green color. this is then converted to bilirubin, an orange-yellow pigment and released into the blood stream.

Bilirubin

Once a RBC is engulfed by a macrophage each component of the hemoglobin molecule has a different fate. The heme group's porphyrin ring is converted to biliverdin

which has a green color. This is then converted to _____________________, an orange-yellow pigment and released into the blood stream.

Albumin

Bilirubin is not water soluble so it is transported bound to _____________ which makes is more water soluble and is transported to the liver for excretion in bile.

Jaundice

If the bile ducts are blocked or the liver is damaged/diseased and cannot absorb or excrete bilirubin, then the levels can increase. Bilirubin then diffuses into peripheral tissue giving them a yellow color that is most apparent in the skin and sclera of the eyes resulting in _______________________

Sterocobiliins

In the large intestine, bacteria convert bilirubin (released in the bile) to related pigments called urobilinogens and stercobilinogens. On exposure to oxygen, some of the urobilinogens and stercobilinogens are converted to urobilins (urochrome) and ______________________ which give feces its brown color.

Urobillin

Some to the urobilinogen's in the bile are reabsorbed by the intestinal mucosa into the blood stream. Most of this is re-excreted by the liver back into the bile and some is filtered by the kidneys into the urine were it is converted to ______________________ (urochrome), which is the primary cause of urine's yellow color.

Myoglobin

A red or red-brown color is abnormal and cold be from a food dye, eating fresh beets, certain medications, or the presence of either hemoglobin or _________________________

Hemoglobin

A red or red-brown color is abnormal and cold be from a food dye, eating fresh beets, certain medications, or the presence of either ___________________ or myoglobin

Dilute

The intensity of the urine color generally indicates the concentration of the urine; pale or colorless urine indicates that it is ___________________ (dilute or concentrated)

Vitamin B

Dark yellow urine can be caused by conditions such as low fluid intake or dehydration. ________________________ supplements can also turn urine bright yellow.

Turbidity

Scientific term that is also called transparency, opacity or clarity. Determines the cloudiness of urine. It measures the degree to which a fluid loses its transparency due to the presence of suspended particulates. Bacteria, blood, sperm, crystals, or mucous can make urine appear cloudy.

Nutty

A normal odor for urine is a slightly "___________" (aromatic) smell. Some foods (such as asparagus), vitamins, and antibiotics (such as penicillin) can cause urine to develop an unusual odor

Amino acids

Urine that smells like maple syrup can indicate maple syrup urine disease, a rare genetic condition caused by the body's inability to break down certain branched-chain _____________________ (BCAAs) [Leucine, Isoleucine and Valine] in the body.

Leukocytes

A positive test for ________________________ (scientific term) in the urine would indicate some type of inflammation or infection of the urinary tract (kidneys, ureters, urinary bladder, and urethra).

Nitrites

A positive urine test for the chemical known as _________________________ would confirm the presence of bacteria along with a higher leukocyte count and indicate a urinary tract infection. Gram negative rods such as E. coli are more likely to give a positive test.

Leukocyte

A positive test urine test for nitrites would confirm the presence of bacteria along with a higher _____________________ count and indicate a urinary tract infection. Gram negative rods such as E. coli are more likely to give a positive test.

pH

A normal urine ____________ is somewhere between 4.5 to 8, although the number can vary greatly.

Acidic

In a diet high in protein the urine is tends to be more __________________________ (alkaline, neutral, acidic). while a diet high in vegetable material yields a urine that is more alkaline.

Alkaline

In a diet high in vegetable material the urine is tends to be more __________________________ (alkaline, neutral, acidic).

Alkaline

Prolonged vomiting, a kidney disease, and some urinary tract infections can cause urine pH to become more _____________________ (alkaline or acidic)

Acidic

Severe lung disease (emphysema), uncontrolled diabetes, aspirin overdose, prolonged diarrhea, starvation, drinking an excessive amount of alcohol, or drinking antifreeze (ethylene glycol) can cause urine to become more _____________________ (alkaline or acidic)

True

True or False: Proteins are not normally filtered by the nephron and do not appear in the urine. Although trace amounts may be found in the urine, A positive protein test may indicate a kidney infection, hematuria, or result from intense exercise. Albumin is the major protein detected

True

True or False: Normally the nephron can reabsorb all of the remaining blood glucose. A positive test may indicate extra sugar intake from your diet or possible diabetes mellitus. Large amounts of ketones may signal a dangerous condition known as diabetic ketoacidosis.

Glucosuria

Excess glucose in the urine is called __________________ and can also be called glycosuria.

Glycosuria

_____________________________ is a term that defines the presence of sugars in the urine, such as glucose, galactose, lactose, and fructose. Glucosuria is specific for the presence of glucose in the urine and is the most frequent type of this term.

Ketonuria

Scientific term for the excretion of abnormally large amounts of ketones in the urine.

Ketones

A positive chemical test of this substance might indicate a fasting condition or starvation or uncontrolled diabetes mellitus.

Acetoacetic acid

The principle ketones are acetone, beta hydroxybutyric acid, and ___________________

Acetone

The principle ketones are _________________, beta hydroxybutyric acid, and acetoacetic acid

Hemolysis

Bilirubin is a byproduct of hemoglobin catabolism which happens primarily in the liver, spleen, and bone marrow. Normally the liver can successfully process bilirubin and no detectable levels should appear in the urine. A positive test may indicate liver dysfunction, or ____________________________

Specific gravity

Scientific term for the measurement of the solute concentration of the urine. It is the measurement of the density of urine compared to pure (distilled) water.

Low

Abnomally _____________________ (low or high) specific gravity indicated dilute urine that may be caused by:

- Drinking excessive amounts of liquid, severe kidney disease, use of diruetics, and diabetes insipidus

High

Abnormally _____________________ (low or high) specific gravity indicated a very concentrated urine caused by

- Not drinking enough liquid, loss of too much liquid (excessive vomiting, sweating, or diarrhea), substances such as glucose or protein in the urine. Excess glucose can be caused by uncontrolled diabetes mellitus.

Low

A person with uncontrolled diabetes insipidus will have an abnormally _____________________ (low or high) specific gravity.

High

A person with uncontrolled diabetes mellitus would have an abnormally _____________________ (low or high) specific gravity.

Casts

Some types of kidney disease can cause plugs of material called _____________________, to form in the nephrons of the kidneys. These are cylindrical protein-based molds of the nephron tubule which can then get flushed out into the urine. They can be made of different types of material, such as red or white blood cells, waxy, or fatty substances, or protein. The type and make-up of these substances can provide clues about the type of kidney abnormalities that may be present.

Pyuria

What is the scientific term for presence of abnormal numbers of leukocytes in the urine?

Kidney stones

Healthy people often only have a few crystals in their urine. However, a large number of crystals, or the presence of certain types of crystals, may indicate _______________________ or a problem with how the body is metabolizing food.

Urinary tract infection

The presence of bacteria, yeast cells or parasites in urine can indicate a UTI which stands for _______________________________