phys exam of urine

urochrome

-yellow pigmentation (color) of urine

-produced by endogenous metabolism

-inc at RT

hematuria

RBCs in urine

hemoglobinuria

no intact RBCs in urine

myoglobinuria

muscle breakdown substances in urine

colorless

urine color with recent fluid consumption

-random specimens

polyuria and DI

urine pale yellow

-inc 24-hr vol

-low SG

DM

urine pale yellow

-elevated SG

-pos glucose

dilute random

urine pale yellow

-recent fluid consumption

concentrated

urine dark yellow

-normal after exercise or in first morning specimen

dark yellow

color of urine from B complex vitamins

dehydration

urine dark yellow

-due to fever or burns

bilirubin

urine dark yellow

-yellow foam when shaken

-pos bilirubin

acriflavine

urine dark yellow

-neg bile test

-green fluorescence

A

A

Phenazopyridine (Pyridium)

urine orange-yellow

-drug for UTIs

phenindoine

urine orange-yellow

-anticoag

-orange in alkaline urine

-colorless in acidic urine

biliverdin

urine yellow-green

-bilirubin oxidation

-colored foam in acidic urine

-false-neg for bilirubin

pseudomonas infection

urine green

-pos urine culture

amitryptiline

urine blue-green

-antidepressant

A

A

A

a

A

A

methylene blue

urine blue-green

-fistulas

A

A

RBCs

urine pink

-cloudy

-pos for blood

-microscopically visible

Hgb

urine red

-clear urine

-pos for blood

-intravasc hemolysis

beets

urine red

-alkaline urine

-genetic

Rifampin

urine red

-tuberculosis med

red

urine color with menstrual contamination

-cloudy

-RBCs, mucus, clots

porphyrins

urine port wine colored

-neg for blood → additional testing

-AIP

methemoglobin

urine red-brown

-RBC oxidation

-acidic urine after sitting out

-pos for blood

red-brown

urine color with myoglobin

homogentisic acid

urine brown/black

-alkaline urine after sitting out

-alkaptonuria

-specific tests

malignant melanoma

urine brown/black

-darkens sitting out

-reacts with nitroprusside and ferric chloride

melanin (melanogen)

urine brown/black

-interference with copper reduction tests

phenol derivs

urine brown/black 

-colorless with ferric chloride

Argyrol

urine brown/black

-antiseptic

methyldopa, levodopa

urine brown/black

-antihypertensives

metronidazole (Flagyl)

urine brown/black

-darkens sitting out

-intestinal and vaginal infections

turbidity

clarity or transparency

-clear, hazy, cloudy, turbid, milky

-caused by WBCs, RBCs, epithelial cells, bact, amorphous crystals, mucus, lymph fluid, semen

uroerythrin

gives acid urine pink color and precip crystals in fridge

specific gravity

-density of solution compared to density of a similar vol of distilled water

-concentrating and reabs ability of kidneys

isosthenuric

SG=1.010

-CKD, acute kidney injury

-loss of ability to concentrate/dilute no matter the water intake

1.010

isosthenuric SG

1.035

maximum SG that kidney can concentrate to

hyposthenuric

SG <1.010

-no urine concentration

-DI

<1.010

hyposthenuric SG

hypersthenuric

SG >1.010

-very concentrated urine

-dehydration

>1.010

hypersthenuric SG

refractometer

uses refractive index - comparison of velocity of light in air with velocity of light in solution

-inc density, inc refractive index

urine dipstick

-measures change in pKa of polyelectrolyte in alkaline medium

-inc acidity, inc SG

pKa

value measured in urine dipstick

dec

SG is inc/dec with:

-large urine volume

-glomerulonephritis, pyelonephritis, etc renal anomalies (tubular damage)

-DI

inc

SG is inc/dec with:

-DM

-adrenal insufficiency

-hepatic disease

-CHF

-vom, sweating, fever, diarrhea

ammonia

odor of old samples assoc w UTI

sweet

urine odor assoc with MSUD or with ketones (diabetes)

musty

odor assoc with PKU and other liver diseases