Urinaslysis Chapter 5

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Physical Examination of Urine
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1

Urochrome

Lipid-soluble pigment in plasma excreted in urine at a constant rate. Gives urine its yellow color.

2

Urobilin

If specimen is exposed to light, urobilinogen will oxidize and turn orange-brown.

3

Uroerythrin

Pink pigment, most evident when it deposits on urate crystals, producing a precipitate often described as brick dust.

4

Bilirubin

By-product of hemoglobin catabolism and has characteristic yellow color. If significant, can give urine an amber color

5

Biliverdin

If specimen is improperly stored, bilirubin will oxidize and cause the urine to turn greenish color

6

Phenazopyridine

Used to treat UTI's gives urine a distinctive yellow-orange (orange soda pop) color. May interfere with the color interpretation on the chemical reagent strip

7

Foam

  • Not normally included on report
  • White indicates elevated Albumin
  • Yellow indicates elevated Bilirubin
8

Turbidity

  • Contamination from skin
  • bacteria growth
  • x-ray contrast media
  • Precipitation of dissolved solutes
  • RBCs, WBCs, epithelial cells
9

Amorphous Phosphates

Alkaline urine (produces a white or beige precipitate)

10

Amorphous Urates (and uric acid crystals)

Acidic urine (produces a pinkish precipitate "Brick dust")

11

Ammonia

Urine on standing becomes odorous due to bacterial conversion of urea

12

Ketones

Produce sweet or fruity smell

13

Urine Concentration

Normally 94% water and 6% solutes

14

Concentration

Quantity of solutes present in volume of urine excreted

Expressed as specific gravity or osmolality

15

Specific Gravity

Ratio of urine density to density of an equal volume of pure water under standard conditions. Affected by number of solute particles and molecular size

16

Reagent Strip Method

Indirect colorimetric estimation of urine density based on amount of ionic or charged solutes present. Nonionic solutes such as glucose, urea, protein, or radiographic media are not measured

17

Refractometry

Indirect method based on refractive index of light. Affected by wavelength of light used, Temperature, and concentration of solution.

18

Reagent strip principle

Impregnated with polyelectrolyte and pH indicator at an alkaline pH. Released protons change pH of test pad. resulting in a color change.

19

SG reads above 1.040

Suspect radiographic contrast media or another large molecular weight solute

20

Osmolality

Concentration of solution expressed in terms of osmoles of solute particles per kilogram of water

21

Normal urine osmolality

275 to 900 mOsm/kg

depends on diet, fluid intake, and physical activity

22

Normal serum osmolality

275 to 300 mOsm/kg

Remains relatively constant

23

Principle uses of osmolality

  • Concentrating ability of kidneys
  • Monitor renal disease
  • Fluid and electrolyte balance
  • Diagnose causes of polyuria
24

Normal urine volume

600 to 1800 mL/day

25

Isosthenuria

Inability of kidneys to change specific gravity of plasma ultrafiltrate (which is 1.010)

26

Polyuria

Excretion of greater than 3 L/day

27

Oliguria

Excretion of less than 400 mL/day

28

Anuria

Complete lack of urine excretion

29

SG range for urine

1.002 to 1.035

Density of urine / density of equal volume of pure water