My notes comprehensively cover urine examination, detailing color variations, odor characteristics, transparency indicators such as turbidity causes (both pathologic and non-pathologic), and specific gravity implications, ensuring a thorough understanding for clinical assessment and diagnosis.
PHYSICAL EXAMINATION
COLOR
Normal Varies from almost colorless; straw or light yellow (low SG, increased volume) to dark yellow, yellow-orange, or amber
Pigments in Urine a. Urochrome – product of endogenous metabolism; increases in urine at room temperature
b. Uroerythrin – pink pigment seen in refrigerated urine due to precipitation of amorphous urates
c. Urobilin – oxidation product of urobilinogen; imparts an orange-brown color to urine
Variations a. Colorless / pale yellow – recent fluid consumption, polyuria DI, DM, alcohol consumption
b. Dark-yellow – concentrated specimen
c. Orange-red / reddish brown – urobilin
d. Amber / orange – bilirubin, acriflavine, phenazopyridine, nitrofurantoin, phenindione
e. Yellow-green / yellow-brown – bilirubin-biliverdin
f. Blue / green – pseudomonas infection, amitriptyline, methocarbamol, clorets, indican, methylene blue
g. Pink / red – intact RBCs, hemoglobin, myoglobin, porphyrins, beets, menstrual contamination
h. Brown / black – methemoglobin, homogentisic acid, melanin, phenol derivative, argyrols, methyldopa, levodopa, metronidazole
ODOR
Normal Faint aromatic, due to volatile acids; becomes ammoniacal as the specimen stands
Variations a. Ammoniacal (freshly voided) – UTI, (Proteous and other urease-producing bacteria)
b. Mousy – PKU
c. Rancid – Tyrosinuria
d. Sweaty feet – Isovaleric academia
e. Maple syrup / caramel-like – MSUD
f. Rotting fish – Trimethyl aminuria
g. Sulfur odor – cysteine disorders
h. Fecaloid – recto-vesicular fistula
i. Fruity / sweet – diabetes ketoacidosis (acetone or diacetic acid)
j. Cabbage / hops – methionine malabsorption
k. Mercaptan – ingestion of asparagus, garlic and eggs
l. Bleach - contamination
TRANSPARENCY
Normal Clear – no visible particulates, transparent
Variations a. Hazy – few particles, print easily seen through urine
b. Cloudy – many particulates, print blurred through urine
c. Turbid – print cannot be seen through urine
d. Milky – may precipitate or be clotted
NUBECULA
Faint, whitish cloud formed from mucus, cells, bacteria, and alkaline salts in old urine.
Non-pathologic causes of Turbidity Pathologic Causes of Turbidity
Epithelial Cells Red blood cells – 500/mm3
Normal crystal White blood cells- 200/mm3
Bacteria (old urine) Bacteria, yeasts
Semen, prostatic fluid Non-squamous epithelial cells
Fecal contamination Abnormal crystals, casts
Mucus Lymph fluid/chyle
Radiographic contrast media Lipids
h. Vaginal creams, talcum powder Fecal matter
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller MedTechNotesHub. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $5.99. You're not tied to anything after your purchase.