1. Urinalysis Gross examination

2. KEY TERMS CHAPTER 4 CLARITY HARMOBNIC OSCILLATION DENSITOMETRY
HYPERSTHENURIC
HYPOSTHENURIC
ISOSTHENURIC
REFRACTOMETRY
SPECIFIC GRAVITY
URINOMETRY

3. Physical Examination of Urine
Physical examination of urine includes determination of color, clarity, and specific gravity
Provides preliminary information
Measurement of SG aids in evaluation of renal tubular function
Confirms or can explain findings in chemical and microscopic evaluation

4. Color of Urine Urochrome is the primary pigment responsible for the normal color
Color of urine gives the estimate of concentration
Colorless
Recent fluid consumption
Pale yellow
Polyuria
Diabetes insipidus
Diabetes mellitus
Dark yellow
Concentrated
Amber/Orange
Bilirubin
Acriflavine
Pyridium
Nitrofurantion
Phenindione
Yellow-green/brown
Bilirubin oxidized to biliverdin

5. Dark Yellow/Amber/Orange
Foam
Yellow - bilirubin is responsible
White – protein is responsible
Red Color contribution
Amount of blood pH
Length of contact

6. Color of Urine Green/ Blue- Green Pink/Red (Fig 4.1)
Pseudomonas infection
Amitriptyline
Robaxin
Clorets
Indican
Methylene blue
Phenol
Pink/Red (Fig 4.1)
RBC’s
Hgb
Myoglobin
Porphyrins
Beets
Rifamin
Menses

7. Color of Urine Brown/Black RBC’s oxidized to methmoglobin
Homogentistic acid
Melanin
Phenol derivatives
Argyrol
Levodopa
Flagyl

8. Clarity (Table 4-2, p.36) Term that refers to transparency/turbity
Determined by visual inspection
Color and clarity determined at the same time
Terminology should be consistent within lab

9. Clarity (Table 4-2, p36) Normal Clear
Precipitation of amorphous phosphates and carbonates may cause white cloudiness

10. Nonpathologic Turbidity
Squamous epithelial cells
Mucus
Specimens allowed to stand or refrigerated
Semen
Fecal contamination
Radiographic contrast media
Talcum powder
Vaginal creams
Pedi-diaper creams

11. Pathologic Turbidity Rbcs' WBC's Bacteria Nonsquamous epithelial cells
Yeast
Abnormal crystals
Lymph fluid
Lipids

12. Laboratory Correlations with Turbidity
Table 4-5, p. 37
Example questions:
How would a specimen containing intact red blood cells differ from one that has hemoglobin?
Addition of dilute acetic acid to a cloudy urine specimen dissolves _______
Slight warming of turbid specimen may dissolve _________

13. Specific Gravity
Defined as the density of a solution compared to density of similar volume of distilled water at a similar temperature
Kidneys ability to selectively reabsorb essential chemicals and water from the glomerular filtrate is one of the most important body functions;
SG detects dehydration, abnormalities in ADH, influenced by urea molecules, sodium, chloride, glucose, dissolved solids, cells present

14. Specific Gravity Measure of the density of the dissolved chemicals
Influenced by number of particles and size
Larger particles contribute more

15. Urinometery
Consists of a weight float attached to a scale that has been calibrated in terms or urine specific gravity.
Weighted float displaces volume of liquid
Considered less accurate than other methods
Not recommended by NCCLS

16. Refractometery
Determines concentration of dissolved particles in specimen by measuring refractive index.
Refractive index is a comparison of the velocity of light in air with velocity of light in solution.
Concentration of dissolved particles present in a solution determines the velocity and angle at which light passes through a solution.

17. Refractometery
Concentration of specimen determines angle at which light beam enters prism. Specific gravity scale is calibrated in terms of angles at which light passes through specimen.
Small amount is needed and temperature corrections not necessary.

18. Specific Gravity Harmonic Oscillation Densitometry Reagent Strip
Based on the principle that frequency of a sound wave entering a solution will change in proportion to the density of solution
Reagent Strip
SG measured by chemical reaction producing a color reaction

19. Clinical Correlations
Isothenuric
SG of 1.010
Plasma filtrate entering glomerulus
Hyposthenuric
Below SG 1.010
Hypersthenuric
Above SG 1.010
Normal random specimens may range between to 1.035
Most random specimens range to 1.025

20. Odor Seldom has clinical significance Faint aromatic odor
Breakdown of urea responsible for ammonia odor
Unusual odors results of bacterial infections, diabetic ketones, serious metabolic disorders, certain food ingestion