Urinalysis

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What is the normal volume of urine excreted in a 24-hour period?

0.8 - 2.0 liters

Which has a greater specific gravity: 1 ml of urine or 1 ml of distilled water? Explain your answer.

1 ml of urine. Urine contains dissolved solutes, which are not found in distilled water and add to the density of the sample.

The specific gravity of urine ranges from what to what?

1.001 to 1.030

The pH of urine ranges from what to what?

4.5 to 8.0

The average pH value of urine is ________________.

6.0

What is the average pH of urine?

6.0 (slightly acidic)

Normally, blood sugar levels are maintained between ________ and ________ mg/100 ml of blood.

80 and 100

Water accounts for what percentage of urine volume?

95%

What is urochrome?

A pigment metabolite that arises from the body's destruction of hemoglobin and travels to the kidney as bilirubin or bile pigments.

When determining the presence of inorganic constituents such as sulfates, phosphates, and chlorides, you will be looking for the "formation of a precipitate." What is a precipitate?

A precipitate is an insoluble compound that is no longer in solution.

Albuminuria is generally indicative of what?

Abnormally increased permeability of the glomerular filtration membrane

Assuming normal conditions, would albumin be in greater or lesser concentration in the urine than in the glomerular filtrate, or absent from both?

Absent from both the urine and the glomerular filtrate

Assuming normal conditions, would nitrites be in greater or lesser concentration in the urine than in the glomerular filtrate, or absent from both?

Absent from both the urine and the glomerular filtrate

Assuming normal conditions, would pus (WBCs) be in greater or lesser concentration in the urine than in the glomerular filtrate, or absent from both?

Absent from both the urine and the glomerular filtrate

Assuming normal conditions, would red blood cells be in greater or lesser concentration in the urine than in the glomerular filtrate, or absent from both?

Absent from both the urine and the glomerular filtrate

Name three ketone bodies.

Acetoacetic acid, beta-hydroxybutyric acid, and acetone.

________________ is the single most abundant blood protein and is very important in maintaining the osmotic pressure of the blood.

Albumin

________________, like other blood proteins, is too large to pass through the glomerular filtration membrane and is normally not found in urine.

Albumin

________________ refers to the presence of albumin in urine.

Albuminuria

How does starvation influence urine pH?

Becomes acidic

How does a urinary tract infection influence urine pH?

Becomes alkaline

________________ is signaled by a yellow foam that forms when the urine sample is shaken.

Bilirubinuria

________________ refers to the presence of bilirubin (bile pigments) in urine.

Bilirubinuria

What other constituents of urine may be found in much smaller amounts?

Calcium, magnesium, and bicarbonate ions.

________________ are hardened cell fragments, usually cylindrical, which are formed in the distal convoluted tubules and collecting ducts and then flushed out of the urinary tract. They form when the filtrate flow rate is slow, the pH is low, or the salt concentration is high.

Casts

Ketonuria coupled with a finding of glycosuria is generally diagnostic for what condition?

Diabetes mellitus

Blood composition depends on what three major factors?

Diet, cellular metabolism, and urinary output

(T/F) Albuminuria is a normal finding.

False

(T/F) Glucose can usually be found in all normal urine.

False

(T/F) When testing the pH of the urine, you will use the same piece of wide-range pH paper for each test.

False

Explain why urinalysis is a routine part of any good physical examination.

Finding "abnormal" constituents in the urine may indicate pathology.

Assuming normal conditions, would amino acids be in greater or lesser concentration in the urine than in the glomerular filtrate, or absent from both?

Lesser concentration in the urine than in the glomerular filtrate

Assuming normal conditions, would glucose be in greater or lesser concentration in the urine than in the glomerular filtrate, or absent from both?

Lesser concentration in the urine than in the glomerular filtrate

Assuming normal conditions, would sodium ions be in greater or lesser concentration in the urine than in the glomerular filtrate, or absent from both?

Lesser concentration in the urine than in the glomerular filtrate

Assuming normal conditions, would water be in greater or lesser concentration in the urine than in the glomerular filtrate, or absent from both?

Lesser concentration in the urine than in the glomerular filtrate

What conditions produce urine with a high specific gravity?

Limited fluid intake, fever, or pyelonephritis (kidney inflammation)

Bilirubinuria is usually indicative of what pathological conditions?

Liver pathology such as hepatitis, cirrhosis, or bile duct blockage

________________ is the relative weight of a specific volume of liquid compared with an equal volume of distilled water.

Specific gravity

Why do urine specimens become alkaline and cloudy on standing at room temperature?

This is a result of bacterial metabolism of urinary components.

(T/F) All urine specimens become alkaline and cloudy on standing at room temperature.

True

(T/F) The greater the solute concentration in the urine, the deeper the color.

True

Pathological glycosuria occurs in conditions such as ________________.

Uncontrolled diabetes mellitus

Glucose and albumin are both normally absent in the urine, but the reason for their exclusion differs. Explain the reason for the absence of each.

Unless it is present in the blood in excessive levels, glucose is completely reabsorbed. Albumin is simply too large to pass through the filtration membrane.

Explain the difference between organized and unorganized sediments.

Unorganized sediments (such as certain salts and uric acid) crystallize or precipitate out of solution, whereas organized sediments contain cellular elements (epithelial cells, WBCs, RBCs, and casts).

What is the second largest component of urine?

Urea

List the normal solute constituents of urine, in order of decreasing concentration.

Urea, sodium ions, potassium ions, phosphate ions, sulfate ions, creatinine, and uric acid.

Name the three major nitrogenous wastes found in the urine.

Urea, uric acid, and creatinine

What conditions favor the formation of renal calculi?

Urinary retention, urinary tract infection, and alkaline urine

________________ is produced in the intestine from bilirubin and gives feces a brown color.

Urobilinogen

What substance is responsible for the normal yellow color of urine?

Urochrome

Name three constituents that might be present in urine if a urinary tract infection exists.

WBCs (pus), RBCs, and casts

What is the largest component of urine?

Water

What conditions produce urine with a low specific gravity?

When a person drinks excessive amounts of water, uses diuretics, or suffers from diabetes insipidus or chronic renal failure.

High protein foods and whole wheat products increase the acidity of urine and are therefore called ________________.

acid ash foods

High protein foods and whole wheat products increase the (acidity/alkalinity) of urine.

acidity

Pregnancy or excessive exertion may lead to the presence of what abnormal constituent(s)/condition(s) in urine?

albumin

Glomerulonephritis may be indicated by what abnormal constituent(s)/condition(s) present in urine?

albumin or casts

A bacterial infection of the urinary tract may cause the urine to become more (acidic/alkaline).

alkaline

A vegetarian diet increases the alkalinity of urine, thus these foods are called ________________.

alkaline ash foods

A vegetarian diet contains food that increase the (acidity/alkalinity) of urine.

alkalinity

Hepatitis may be indicated by what abnormal constituent(s)/condition(s) present in urine?

bilirubin

Liver cirrhosis may be indicated by what abnormal constituent(s)/condition(s) present in urine?

bilirubin

The appearance of bile pigments in the urine, a condition known as ________________, can be an indication of liver disease.

bilirubinuria

Kidney stones may be indicated by what abnormal constituent(s)/condition(s) present in urine?

blood cells

Cystitis may be indicated by what abnormal constituent(s)/condition(s) present in urine?

blood cells, ketone bodies, or pus

The presence of blood cells in urine may be indicative of what condition(s)/disease(s)?

cystitis or kidney stones

The presence of ketone bodies in urine may be indicative of what condition(s)/disease(s)?

cystitis, diabetes mellitus, or starvation

The presence of pus in urine may be indicative of what condition(s)/disease(s)?

cystitis, gonorrhea, or pyelonephritis

Urine with a low specific gravity may be indicative of what condition(s)/disease(s)?

diabetes insipidus

The presence of glucose in urine may be indicative of what condition(s)/disease(s)?

diabetes insipidus, diabetes mellitus, or eating a 5-lb box of sweets for lunch

Urine with a high specific gravity may be indicative of what condition(s)/disease(s)?

diabetes mellitus, gonorrhea, or pyelonephritis

The presence of casts in urine may be indicative of what condition(s)/disease(s)?

glomerulonephritis or pyelonephritis

The presence of albumin in urine may be indicative of what condition(s)/disease(s)?

glomerulonephritis, pregnancy, or exertion

Eating a 5-lb box of sweets for lunch may be indicated by what abnormal constituent(s)/condition(s) present in urine?

glucose

The presence of glucose in the urine is called ________________.

glycosuria

Hemolytic anemias may be indicated by what abnormal constituent(s)/condition(s) present in urine?

hemoglobin

The presence of hemoglobin in urine may be indicative of what condition(s)/disease(s)?

hemolytic anemias

The presence of bilirubin in urine may be indicative of what condition(s)/disease(s)?

hepatitis or cirrhosis of the liver

Gonorhhea may be indicated by what abnormal constituent(s)/condition(s) present in urine?

high specific gravity or pus

Pyelonephritis may be indicated by what abnormal constituent(s)/condition(s) present in urine?

high specific gravity, casts, or pus

Diabetes mellitus may be indicated by what abnormal constituent(s)/condition(s) present in urine?

high specific gravity, glucose, or ketone bodies

Starvation may lead to the presence of what abnormal constituent(s)/condition(s) in urine?

ketone bodies

Diabetes insipidus may be indicated by what abnormal constituent(s)/condition(s) present in urine?

low specific gravity or glucose

The presence of urinary ________________ is a valuable finding for early detection of bladder infections.

nitrites

Uric acid comes from the breakdown of ________________.

nucleic acids

Urea comes from the breakdown of ________________.

protein

Complete absence of ________________ in the urine may indicate renal disease or obstruction of bile flow in the liver.

urobilinogen

Increased levels of ________________ in the urine may indicates hepatitis A, cirrhosis, or biliary disease.

urobilinogen

Normal urine is usually pale yellow to amber in color, due to the presence of ________________.

urochrome

The normal yellow color of freshly voided urine is due to ________________.

urochrome

What causes the formation of kidney stones?

If urine becomes excessively concentrated, some of the substances normally held in solution begin to precipitate or crystallize, forming kidney stones.

________________ indicates inflammation of the urinary tract.

Pyuria

________________ is the presence of white blood cells or other pus constituents in the urine.

Pyuria

________________, the presence of white blood cells or pus in the urine, is consistent with inflammation of the urinary tract.

Pyuria

What is another name for kidney stones?

Renal calculi

________________ is a metabolite of creatine phosphate that is present in large amounts in skeletal muscle.

Creatinine

________________ indicates abnormally high blood sugar levels.

Glycosuria

Assuming normal conditions, would creatinine be in greater or lesser concentration in the urine than in the glomerular filtrate, or absent from both?