1. Physical Examination of Urine

2. Introduction Physical examination is 1st part of UA performed
Includes:
Observing urine color
( )
Measuring ( )

3. Physical Characteristics

4. Color Normal ranges from pale yellow to amber Variations caused by:
( )
Medications
Physical activity disease

5. Colors Caused by Food or Medications Colors Caused By Disease States
Red
Beets, rhubarb
Yellow-orange
Carrots, vitamins, some antibiotics
Green, blue-green
Amitriptyline
Brown-black
Methyldopa, metronidazole
Colors Caused By Disease States
Color
Cause
Red, Red-brown
RBC, Hgb, myoglobin
Wine red
Porphyrins
Brown-black
Melanin, homogentisic acid, Hgb
Dark yellow-brown or green-brown
Bilirubin, bile pigments

6. Yellow Urine ( ) produces the yellow-amber color
More concentrated- ( )
Dilute- ( )

7. Red Urine Abnormal color seen most frequently ( )- presence of blood
( )- presence of hemoglobin/myoglobin

8. Brown or Black urine
Hgb will become brown in acidic urine that has been standing
( )
Patients with advanced ( )

9. Yellow-Brown or Green-Brown
( )
Can form a yellow-green foam when shaken
Can be present in ( ) patients

10. Transparency ( ) Normal- clear immediately after voiding
Normal microscopic results
As it reaches room temp. or after refrigeration- turbid

11. Normal Urines Transparency Causes Abnormal Urines Transparency Causes
Hazy
Mucus (females), talcum powder, squamous epithelial cells
Cloudy
Calcium oxalate, uric acid crystals, amorphous phosphates, amorphous urates
Abnormal Urines
Transparency
Causes
Cloudy-red
RBCs
Turbid or Cloudy
WBCs, bacteria, yeasts, renal epithelial cells, lipids
Opalescent, milky
Fats, lipids

12. Odor Changes can be due to disease, diet, or presence of M.O.
Not usually report on UA form but alerts to abnormality
If unrefrigerated for hours- any bacteria present can break down urea to form
( )
Certain foods can produce abnormal odor- garlic and ( )

13. Odor Uncontrolled diabetes- fruity Phenylketonuria (PKU)- ( )
Presence of ketones
Phenylketonuria (PKU)- ( )
Maple syrup urine disease
Recently voided with foul odor- ( )

14. ( )
Ratio of the weight of the solution compared to weight of an equal volume of distilled H20 at same temp.
Normal urine
Most are ( )
( ) in the morning
Estimates concentrations of solutes
Urea, protein, sugars, phosphates
Used to assess ability of kidneys to reabsorb essential chemicals and water
( )- may have high specific gravity

15. Performing a Physical Exam of Urine

16. Specimen Preparation
Physical characteristics are best observed by examining immediately after voiding before it is refrigerated
Can be refrigerated at 4 °C up to ( )
Needs to reach room temp before UA performed

17. Procedure Mixed well by gentle ( ) Portion is poured into clear tube
Observed for color and transparency

18. Physical Characteristics of normal Urine
Transparency-clear
Color- pale yellow to amber
Specific gravity

19. Color and Transparency
Pale (straw), yellow, amber or other
Transparency- clear, hazy, cloudy, milky
Measurement of Specific Gravity
Urinometer, refractometer, reagent strip
Urinometer-requires ( )
Refractometer- a drop

20. Urinometer Method Poured into a special glass cylinder
A weighted float with a calibrated stem is placed in the urine with a slight spinning motion
Specific gravity is read at the urine’s meniscus
Urinometer will float high in concentrated sample
Sink lower in ( ) sample

21. ( )
Measure specific gravity optically by measuring the refractive index
Ratio of the speed of light in air to speed of light in a solution
Place a drop of urine on the glass plate and close it
The specific gravity is read directly from a scale that converts it