AP2 LAB Quiz Urinalysis

macroscopic observations

direct visual observation of color, turbidity, and odor

color of normal, fresh urine

pale to dark yellow or amber in color and clear

what makes pee yellow?

pigment urochrome (metabolic product of hemoglobin breakdown)

abnormal color

red or red-brown

what can cause abnormal color of urine?

food dye, drugs, presence of hemoglobin or myoglobin

intensity of the color generally indicates

concentration of urine

colorless urine may be caused by

long-term kidney disease or uncontrolled diabetes

color of concentrated urine

deep yellow urine (due to dehydration)

bright yellow urine can be caused by

vitamin b supplements

turbidity

refers to cloudiness of urine

normal turbidity of urine

clear to very slightly cloudy

what causes excess turbidity

presence of suspended particles (ex: bacteria, blood, sperm, crystals, mucus)

normal odor for urine

slightly “nutty”

diabetes/ starvation affect on smell of urine

sweet, fruity odor

maple syrup urine disease

body cannot breakdown leucine, isoleucine, and valine (branched amino acids) which causes the urine to smell like maple syrup

chemstix strips

strips composed of sections of paper with test reagents that react with urine components if present (10 panels)

10 panels chemstix test for

leukocytes, nitrite, urobilinogen, protein, pH, blood, specific gravity, ketone, bilirubin, and glucose

specific gravity

measures the number of substances dissolved in the urine which monitor the concentrating and diluting power of the kidney

the higher the specific gravity,

the more solid material is dissolved in the urine

pH

measure of how acidic or alkaline urine is (normal pH is 4.5-8.0)

what is the effect of high protein diet on urine?

more acidic

high pH of urine can be caused by

prolonged vomiting, kidney disease, UTIs, and asthma

low pH of urine may be a sign of

severe lung disease, uncontrolled diabetes, dehydration, starvation

proteinuria

presence of high levels of protein in urine which is a sign of kidney disorder but can also occur after strenuous exercise, fever, pregnancy

normal amount of protein in urine

contains little protein

glucose

type of sugar usually found in blood but very little to no found in urine

glycosuria

excess sugar in urine (diabetes melitus)

glucose can occur in the urine when

kidneys are damaged, adrenal gland problem, liver damage

ketone

byproducts or fat breakdown that is released into the urine

common ketones

aceotacetic acid, beta-hydroxybutyric acid, and acetone

ketones in urine can indicate

poorly controlled diabetes, low- carb diet, starvation, alcoholism, or poisoning from rubbing alcohol (intermittent fasting)

positive nitrite test

indicates bacteria may be present in significant numbers in the urine

blood test in urine

based on detection of molecules of heme (present in hemoglobin or myoglobin)

hematuria

blood in urine is detectable by chemstix and confirmed by viewing urine with microscope

bilirubinuria

results when conjugated bilirubin levels in blood are elevated due to hepatobillary disease (normal urine has none)

urobilinogen

produced from conjugated bilirubin by bacteria in the large intestine (normal= 0.2-1.0)

increased urobilinogen indicate

significant hemolysis of erythrocytes to the point that liver cannot process the bilirubin

leukocyte esterase

enzyme found in certain white blood cells that is detected by chemstix as a sign of inflammation (presence of whole of lysed WBC)