LAB: Physical Examination of Urine

This is a rough indicator of the degree of hydration and should correlate with the urine SG

Color

What is the normal color range for urine

Colorless to deep yellow

What is the abnormal range for color of urine

Red to red brown

What is the most common abnormal color of urine

Red to red brown

What are the three urine pigments

1. Urochrome

2. Uroerythrin

3. Urobilin

This is a pigment of urine where it is considered as themajor pigment and is responsible for the yellow color

Urochrome

This is apigment of urine where it may deposit amorphous urates and uric acid crystals

Uroerythrin

This is a urine pigment where it imparts an orange brown color of urine thatis not fresh

Urobilin

This is a normal urine color where it is because of recent fluid consumption

Colorless or straw

This is a normal urine color where it is comsidered as a dilute random specimen and can indicate polyuria by diabetes mellitus or diabetes insipidus

Pale yellow

This is a normal urine color where it is a concentrated specimen, usually after a strenuous exercise, or from a first morning urine specimen

Dark yellow

This is an abnormal urine color where it has the presence of bilirubin which is a yellow foam that appears when a specimen is shaken and this may contain hepatitis virus

Dark yellow/amber/orange

This is an abnormal urine color where there is biliverdin

Yellow green

This is a photo-oxidation of bilirubin

Biliverdin

This is an abnormal urine color where phenazopyridine/pyridium or azogantrisin is present and also produces a yellow foam

Yellow-orange

If the urine is fresh brown, this could be because of what

Glomerular bleeding

If the urine is red, brown, or pink, this may be caused by

Hemoglobin or myoglobin

The oxidation of hemoglobin to what causes the browning in urine

Methemoglobin

If the urine isport wine, burgundy red, purplish red, this may be because of the oxidation of what

Porphobilinogen

This color of urine can appear when there are

• Bacterial infections

• Intestinal tract infections

• Breath deodorizers

• Medication

Blue/Green

What are some example of medications that can cause blue or green urine

1. Methocarbamol or robaxin

2. Methylene blue

3. Amytriptyline or elavil

This color of urine can be found in catheter bags,means presencd of indican,bacterial infection of Klebsiella or Providencia spp.

Purple

Brown or black urine can be caused by

Methemoglobin and melanin

This is produced because of the oxidation of melanogen and is produced in excess when malignant melanoma is present

Melanin

This can cause brown or black urine as this is a metabolite of phenylalanine (alkaptonuria)

Homogentisic acid

(Blank) colors of urine can be caused by medications as well like levodopa, methyldopa, phenylderivatives, etc.

Brown or black

The drug levadopa causes what color in the urine

cola-colored

The drug Mepacrine (Atabrine) causes what effect in the color of the urine

Yellow

The drug methyldopa (aldomet) causes what effect in the color of the urine

Green-brown

The Metronidazole (Flagyl) causes what effect in the color of the urine

Darkening or reddish brown

The drug Phenazopyridine (pyridium) causes what effect in the color of the urine

Orange-red or has an acidic pH

The drug Rifampin causes what effect in the color of the urine

Bright orange-red

The drug Riboflavin causes what effect in the color of the urine

Bright yellow

This is a decrease in urine output when the body enters a state of dehydration

Oliguria

In oliguria, what is the common range of urine for infants

<1mL/kg/hr

In oliguria, what is the common range of urine for children

<0.5mL/kg/hr

In oliguria, what is the common range of urine for adults

<400mL/day

• Tthis is cessation of urine flow

• May result from any serious damage to the kidneys by a decrease in the flow of blood to the kidneys

Anuria

This is an increase in daily urine output

Polyuria

When an adult has polyuria,what is usually the amount of urine for adults

>2.5L/day

When an adult has polyuria,what is usually the amount of urine for children

2.5 to 3 mL/kg/day

This is often associated with diabetes mellitus and diabetes insipidus. This can be artifically induced by diuretics, caffine, alcohol which all supproess2the release of ADH

Polyuria

Increase urine output at night is

Nocturia

Diabetes insipidus or mellitus?

• Decreased SG

• Decreased production or functions of ADH

Diabetes insipidus

Diabetes insipidus or mellitus?

• Increase SG

• Decreased insulin

• Increase of glucose

Diabetes mellitus

• This describes the overall visual appearance of the urine specimen

• Refers to the transparency of the specimen

Clarity

• This is an expression in urine concentration in terms of densityb

• Measure of the density of dissolved chemicals in the specimen

Specific gravity

What is an example of direct method of measurement of SG

Urinometer

What are other names for urinometer

Hydrometer or harmonic oscilliation densitometry

What are examples or indirect methods to measure the urine

Refractometer and chemical reagent strip

• This method for measuring the SG is whereit is less accurate than the other methods currently available and is not recommended by the CLSI

• Requires a large volume about 10 to 15 mL

• Requires correction on temperaand solute

Urinometer

• This determines the concentration of dissolved particles in any specimen

• Measures the refractive index

• Only uses around 1 to 2 drops

• Correction only on solute concentration

Refractometer

This is a comparison of the velocity of lightin air with the velocity of light in a solution

Refractive index

This tool is based on the orincipke that the frequency of a sou d wave entering a solution changes in proposition to the density of the solution

Harmonic oscillation densitometry

This is due to organic or inorganic substances which are byproducts of metabolism

Odor

This odor is caused by bacterial decomposition or urinary tract infection

Foul or ammonia-like

This odor is caysed by ketones

Fruity, sweet, grape-like, corn-taco

This odor is caused by the maple syrup urine disease

Maple syrup or caramelized sugar

This odor is caused by phenylketonuria

Mousy

This odor of urine is caused by Tyrosinemia

Rancid

This odor of urine is caused by Isovaleric acidemia

Sweaty feet or trimethylamenuria

This odor of urine is caused by methionine malabsorption

Cabbage

This odor of urine is caused by contamination

Bleach

To get the exact volume of a urine specimen, we put it in a what

Cylinder

This can depend on the amount of solute present in the urine

Transparency/clarity

Most unnatural odors of urine are because of

Aminoaciduria

The number 1 cause of (blank) is uncontrolled BP because of Diabetes mellitus

CKD

For routine urine test, what is the needed volume

10 to 15 mL

Frog urine drug testing, what is the needed volume

30 to 45 mL

What clarity is this

• No visible particulates

• Transparent

• Visible print

• Readable print

Clear

What clarity is this

• Few particulates

• Visible print

• Readable print

Hazy

What clarity is this

• Many particulates

• Visible print

• Not readable

Cloudy

What clarity is this

• Not visible print

• Not readable

Turbid

What clarity is this

• Translucent

• Not readable

• Print cannot be seen

• Presence of fats

• Clotted urine

Cloudy

The urine's normal order is usually

Aromatic or fragrant

This odor is also known as swimming pool

Hawkinsinuria

Distilled water's SG is (blank), this never happens to urine

1.000

What is the lowest possible SG for urine

1.003

The the urinometry floats, does this have more solute or less?

more

The the urinometry sinks, does this have more solute or less?

Less

What is the calibrator for urinometry

Potassium permanganate (KMnO4)

When using KMnO4 to calibrate your urinometry, what SG should you see to know its calibrated

1.015

When using the urinometer, you zhould drop it in the graduated cylinder in a (blank) motion

Spinning

Tonread the urinometry, read the graduations at the (blank)

Lower meniscus

To correct the temperature in urinometer, in every 3 degrees C above 20 degrees C you should add (blank)

0.001

To correct the temperature in urinometer, in every 3 degrees C below 20 degrees C you should subtract (blank)

0.001

After correcting the temperature for urinometer, adjust the (blank and blank)

Glucose and protein

In adjusting the glucose, in every 1g/dL you should multiply it to

0.004

In adjusting protein, in every 1g/dL you should subtract what

0.003

When using a refractometer, put the urine drops on the (blank) and cover it with the (blank)

prism and daylight plate

In the refractometer, the blue light is the

Dark light

In the refrcatometer, the white light is the

Bright light

To read the refractometer, start at the

Bottom

To read the urinometer, start at the

Top

To read the refractometer, look at the bottom and see where the blue and white line (blank)

Intersects

The refractometer can only tell the SG at the maximum of

1.050

The reagent strip can only tell the SG at a maximum of

1.035

What is the most common dilution ratio of urine for SG

1 is to 4

To fix the dilution factor in refractometer, flip the (blank) and multiply the given SG to the numerator to get theactual reading

Ratio