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Clinical Urine and Fluid Analysis Physical Examination of Urine

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1 Clinical Urine and Fluid Analysis Physical Examination of Urine

2 in physical examination of urine we'll deal with : -color -odor
-specific gravity

3 Figure. Urine specimens of varying color.
Physical Examination of Urine Color : Normal urine has a wide range of color, which is mainly determined by its concentration . color may vary from a pale yellow to a dark amber, There are, however, many factors and constituents that can alter the normal urine color. These include medications and diet as well as various chemical that can be present in disease. Figure. Urine specimens of varying color.

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6 Although not routinely reported, foam may be a significant
Physical Examination of Urine FOAM Although not routinely reported, foam may be a significant finding. A white stable foam that is formed upon agitating the specimen can be seen in urine containing a moderate or large amount of protein. Foam that is present in agitated urine specimens may appear yellow to yellow–green if sufficient amount of bilirubin is present. Other substances that alter urine color usually do not alter the color of foam that may be formed upon agitating the specimen. The observance of foam and its color should guide the technologist’s interpretation of chemical tests and selection of confirmatory procedures. Figure. Foam in urine

7 Normal urine is usually clear but it may become cloudy due
Physical Examination of Urine CLARITY Normal urine is usually clear but it may become cloudy due to the precipitation of amorphous phosphates in alkaline urine, or amorphous urates in an acid urine. Amorphous phosphates are a white precipitate which will dissolve when acid is added. Amorphous urates frequently have a pink color from urinary pigments, and they will dissolve if the specimen is heated. Urine can be cloudy from the presence of leukocytes or epithelial cells. The presence of these cells can be confirmed by microscopic examination of the sediment. Bacteria can also cause cloudiness, especially if the specimen has been

8 Physical Examination of Urine

9 Normal odor of urine is …..
Physical Examination of Urine ODOR Although not routinely reported urine odor may be a significant observation. Ketones smell sweet or fruity. A specimen contaminated with bacteria may have a pungent smell from the ammonia that is produced. The excretion of “sweaty feet” odor is found in isovaleric acidemia or in individuals who have excessive amounts of butyric or hexanoic Acid . Hypermethioninemia has been associated with a “rancid butter” or “fishy” odor. Prolonged presence of any strong unusual odor may be associated with inherited disorders. Normal odor of urine is …..

10 causes of changes Color Oxidation of substances
Physical Examination of Urine causes of changes Color Oxidation of substances Clarity Increased turbidity due to proliferation of bacteria or precipitation of chemical substances Odor Increasing strength due to proliferation of bacteria

11 Specific gravity and refractometer
Physical Examination of Urine Specific gravity and refractometer The specific gravity of urine is a messier of dissolved substances in a specimen .. Normal range is – 1.035 Specific gravity of urine can be tested by refractometry.

12 Physical Examination of Urine

13 Physical Examination of Urine
References : Graff’s Textbook of Routine Urinalysis and Body Fluids SECOND EDITION


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