Physical Examination

Pale Yellow

Yellow

Dark yellow

Normal color of urine

colorless

color of urine- recent fluid intake, seen in random specimen

Diabetes Mellitus

diabetes in high specific gravity

Riboflavin (multivitamins)

cause of bright yellow urine

bilirubin

causes yellow foam when shaken

Carotene

may cause orange urie

Bilirubin

Warfarin/ Coumadin

Causes of amber/orange color of urine

protein

causes white foam when shaken

Phenindione

causes orange yellow, alkaline urine, colorless in acidic

Bilirubin oxidized to biliverdin

causes yellow-grenn in urine

Pseudomonas infection

Asparagus

causes green urine

• Amitriptyline

• Methocarbamol

• clorets

• indican

• methylene blue

• phenol

• propofol

• familial hypercalcemia

• indomerhacin

causes blue-green color of urine

Klebsiella and Providencia species

purple color in catheter bag - bacterial infection caused by ?

Familial hypercalcemia

inherited disorder also called “blue diaper syndrome”

urate crystals

Lesch-Nyhan Syndrome

“orange sand diaper" is cause by ___ and while it is classic early sign of ____

• RBCs

• Hemoglobin

• Myoglobin

• Beets

• Rifampin

• Menstrual contamination

causes of pink color in urine

intravascular hemolysis

Hemoglobin = clear urine, positive in chem test, red plasma = ___

Muscle damage

Pink color - Myoglobin =

Porphyrins / Porphyria

cause of Port-wine color of urine

rhabdomyolysis

Cola colored urine is associated with?

good light source

newspaper print bg

how to test urine clarity?

Nubecula

a faint, light cloud or haze that forms in a urine sample when it sits and cools due to rbc, wbc, epithelial cell and mucus

4.5-6.0

ph for acidid

6.5-8.5

pH alkaline

• Clear

• Hazy

• Cloud

• Turbid

• Milky

Urine clarity reporting:

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 precipitte or be clotted

• Mucus

• Amorphous phosphate carbonate

• Squamous epithelial cell

• Semen

• Radiographic contrast media

• Falcum powder

• Vaginal creams

Non-pathological causes of urine turbidity:

• Wbc

• Lymph fluid

• Abnormal crystals

• Bacteria

• Lipids

• Yeast

• Rbc

• Non-squamous epithelia cells

Pathological causes of turbidity

amorphous urates, radiographic contrast media

acidic urine

amorphous urates, cabonate

alkaline urine

amorphous urates, uric acid crsytals

solublw with heat

rbcs, amorphous urates, carbonates

okubke in dilute acetic acid

wbcs, bacteria, yeast, spermatozoa

insoluble in dilute acetic acid

lipids, lymphatic fluid chyle

soluble in ether

aromatic/ fragrant

normal odor

foul, ammonia-like, fetid

• bacterial decomposition

• UTI

• Old urine

ODOR

• ketones

• DM

• starvation

• vomiting

fruity / sweet odor

Maple Syrup

maple syrup urine disease, caramel sugar

phenylketonuria

mousy/barny or musty ODOR

tyrosinemia

cause of rancid odor

Isovaleric acidemia

sweaty feet odor

methionine malabsorption

cabbage hops odor

contamination

bleach odor

Acute tubular necrosis

odorless urine

trimetylaminuria

rotting fish odor

Asparagus garlic, onion, ingestion

UTI

pungent or distinctive odor

Hawkinsinuria

swimming pool odor

Cystinuria

sulfur odor/ Rotten egg

Phenol-containing medications

menthol-like odor

asparagus, garlic, and egg

Mercaptan odor

Specific Gravity

is defined as the density if a solution compared with the density of a similar volume of a distilled water at a similar temperature

1.002 - 1.035

SG of normal random urine

1.015 - 1.030

SG- Most of the random specimen falls between:

above 1.040

recently undergone an intravenous pyelogram

Abnormally high SG resul: —- and can be seen in patients who have ____

1.001-1.009

dilute urine; associated with increased water intake or water diuresis

1.010-1.025

indicates average solute and water intake and excretion

1.025-1.035

concentrated urine; associated with dehydration, fluid restriction, profuse sweating, osmotic diuresis

1.040

physiologically impossible; indicated presence of iatrogenic substance

Direct method

• hydrometer

• harmonic oscillation densitometry falling drop (HODFD)

Indirect methods

• Refractometer reagent strip

• refractometer

• refractive index

Methods for detection of urine specific gravity

refractometer

-determines the concentration of dissolved particles in a specimen by measuring refractive index

refractive index

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

Isosthenuria / Isosthenuric

1.010 SG indicates?

Water - 1.000

3% NaCl - 1.015 +- 0.001

4% NaCl - 1.022+- 0.001

9% Sucrose - 1.034+- 0.001

Calibrating fluid: