UACHEATSHEET

PHYSICAL
Physicalexaminationofurineincludes:
Color
Clarity
Specificgravity
Volume
Odor
Resultsprovide:
Preliminaryinformation
Correlationwithotherchemicalandmicroscopicresults

1.Color
Paleyellow,yellow,darkyellow,amberNORMAL
Colorisincreasedinthyroiddisordersandfasting
Increaseswhenspecimensitsatroomtemperature
Providesestimateofbodyhydration
Commonabnormalcolors:
Darkyellow/amber/orange
Red/pink/brown
Brown/black
Blue/green

2.Clarity
Referstothetransparencyorturbidityofaspecimen
Normalreporting:
Clear,hazy,cloudy,turbid,milky
Clear:Novisibleparticulates,transparent
Hazy:Fewparticulates,printeasilyseenthroughurine
Cloudy:Manyparticulates,printblurredthroughurine
Turbid:Printcannotbeseenthroughurine
Milky:Mayprecipitateorbeclotted
Visualexamination
Gentlyswirlspecimeninaclearcontainerinfrontofagoodlightsource
Automatedturbidityreadingsareavailable
Freshcleancatchurineisnormallyclear


3.Specificgravity
Remembertocleanrefractometerwithanalcoholpreppadandcalibrate
withasingledropofwater.Thedropofwatermustreadat1.000
RR:1.0151.025

4.Volume
Thevolumeofthespecimenisfoundprintedontheconeshapedtubes.
Besuretostatethevolume

5.Odor
Freshurine:faintlyaromatic
Olderurine:ammonia
Metabolicdisorders:maplesyrupurinedisease,ketosis(fruity),infection
(ammonia/unpleasant)
Food:garlic,onions,asparagus(genetic:onlycertainpeoplecansmell
asparagusbutallproduceodor)
Odor

Cause
Aromatic
Normal
ABNORMAL:
Foul,ammonialike
Bacterialdecomposition,urinarytractinfection
Fruity,sweet

Ketones(diabetesmellitus,starvation,

vomiting)
Maplesyrup

Maplesyrupurinedisease
Mousy

Phenylketonuria
Rancid

Tyrosinemia
Sweatyfeet
Isovalericacidemia
Cabbage
Methioninemalabsorption
Bleach

Contamination

CHEMICAL
Reagentstripsareusedtoperformtheroutinechemicaltestsonurine
Stripsconsistofchemicalimpregnatedabsorbentpadsonaplasticstrip
Testperformedfor:pH,protein,glucose,ketones,blood,bilirubin,
urobilinogen,nitrite,leukocyteesterase,specificgravity(SG)

Reagentstriptechnique
Dipstripbrieflyintoawellmixedanduncentrifugedurinespecimenat
roomtemp
Removerexcessurinebytouchingtheedgeofthestriptothecontainer
asthestripisbeingwithdrawn
Blottheedgeofthestriponpapertowelsortheabsorbentpad
Waitthespecifiedamountoftimeforthereactiontooccur(pH
immediatelyLEat120seconds)
ReadstartingfromthebottomatGlucoseLE
Comparethecolorreactionofthestripspadstothemanufacturers
colorchartingoodlighting.

**IMPORTANT:IfaConfirmatoryTestisneededafteryouuse
thereagentstriptest,youmustCENTRIFUGETHE
PT/UNKNOWNURINESAMPLE!!Beforeyoubeginthe
ConfirmatoryTests,whichare:SSA,Clinitest,Acetestand
Ictotest.

NOTE:Timethecentrifugefor5minutes.
BALANCE:Ifotherstudentsarenotcentrifugingsamplesalongwithyou,useyour
POSITIVEandNEGATIVEcontroltobalanceoutthecentrifuge.

1.pH
RRofrandomsamplesis4.58.0
pHisanaidindeterminingtheexistenceofsystemicacidbasedisordersof
metabolicorrespiratoryorigin,andinthemanagementofurinary
conditionsthatrequireurinetobeaspecificpH.
***NopHof9=animproperlypreservedspecimen
pHcorrelateswithothertests:Nitrite,LE,andMicroscopic

2.Protein
RRforproteinis<10mg/dl
Proteinuriais>30mg/dl
Readingsarereportedaseithernegative,trace,1+,2+,3+and4+
Tracevaluesareconsideredtobe<30mcg/dl
Proteinuriaindicates:
Prerenal:muscleinjury
Renal:strenuousexercise,dehydration,hypertension
Postrenal:UTI,injury/trauma,menstrualcontamination,prostaticfluid,
spermatozoa,andvaginalsecretions
Proteincorrelateswith:Blood,Nitrite,LE,andMicroscopic

2A.SSAConfirmatoryTest(RUNALLCONTROLS)
Howtoperformthetest:
1. Obtainplasticcentrifugetubesw/lids
2. Checktheturbidityofthecentrifugedurinebeforestartingthetest
3. Add3mlofSSAreagentto3mlofcentrifugedurine
4. Invertandobserveforcloudiness
5. Gradethedegreeofturbidityandrecordresults

3.Glucose
TestsforDM
ReadingreportedintermsofNegative,Trace,1+,2+,3+and4+
CorrelateswithKetonesandProtein

3A.ClinitestConfirmatoryTest(RUNALLCONTROLS)
employstheBenedictstest
Howtoperformthetest:
1. Obtainatesttuberackandglasstesttubes
2. Add5dropsofurinetothetesttube
3. Add10dropsofdistilledwatertotheurineinthetesttube
4. Drop1Clinitesttabletintothetesttube
5. Observethereactionuntilcompletion(itstopsboiling)
6. Wait15secondsafterboilinghasstoppedandgentlyshakethetube
7. Comparethecolorofthemixturetothechartandrecordresults


4.Ketones
Ketonuriaisthecauseofdiabeticacidosis,insulindosagemonitoring,
starvation,strenuousexercise,andvomiting
Alsoindicatesadeficiencyininsulinregulation

4A.AcetestConfirmatoryTest(RUNALLCONTROLS)
Howtoperformthetest:
1. RemoveAcetesttabletfromthebottleandplaceonacleandrypieceofthe
absorbantpad
2. Placeonedropofurineontopofthetablet
3. Wait30seconds
4. Comparethetabletcolorwiththechart
5. ResultsarereportedasNegative,Trace,Small1+,Moderate2+,andLarge
3+
6. CorrelateswithGlucose

5.Bilirubin
Detectionofliverdisease(earlyindication)
Determinesclinicaljaundice
ReportedasNegative,Small1+,Moderate2+,andLarge3+

5A.IctotestConfirmatoryTest(RUNALLCONTROLS)
Howtoperformthetest:
1. Place10dropsofurineontoonesquareoftheabsorbenttestpad(itcomes
withthetabletsinthebox,ripoffacoupleofpiecesasneeded)
2. RemoveoneIctotesttabletandplaceitontheurinesoakedsquare
3. Usingapipette,place1dropofwateronthetabletandwait5seconds
4. Placeaseconddropofwaterontothetabletsothatthewaterrunsoffthe
tabletandontothemat***
5. Observethecolorofthemataroundthetabletattheendof1minute
6. Positivetest:BluePurple
Negativetest:Pink

MICROSCOPIC
Microscopicisperformedbasedonphysicalandchemicalresults
Color,clarity,blood,protein,nitrite,leukocyteesterase,andpossibly
glucose
Specialpopulations:pregnantwomen;pediatric,geriatric,diabetic,
immunocompromised,renalpatients
ExaminationofSediment
Minimum10lpfsand10hpfs
Lowpower:casts,generalcomposition
Scanedgesforcastswithglassslidemethod
Highpower:identification
Initialfocusing:lowpower,reducedlight
Focusonepithelialcell,notartifactsthatareinadifferentplane
Usefineadjustmentcontinuouslyforbestview
Watchoutforartifacts

Howtopreparetheslide:
1. Obtainslideandcoverslip
2. Usingonlythepatientssample,pouroffthesupernatantofthe
centrifugedurine(thetoppart)toanothercontainer
3. Savethesedimentpelletatthebottom
4. Inanothercentrifugetube,pipetteequalpartsofthesedimentpellet
andSedistainina1:1ratio(3dropssedimentand3dropsstain)and
mix
5. Addadropofthemixtureontoaslideandattachthecoverslip

6.Blood
Amountofbloodgreaterthan5cells/mlisclinicallysignificant
ReportedinChemicalas:Trace,Small1+,Moderate2+,andLarge3+
ReportedinMicroscopicas:Rare,few,moderate,many,orfullfield

7.Nitrite
ScreeningforUTI
Detectionofbacteria
ReportedinMicroscopicas:Rare,few,moderate,many,orfullfield
WBCsshouldaccompanybacteriainUTI***
Reportfew,moderate,manyperhpf

 Rodsandcoccimaybeseen;rodsmostcommon
Nitritehelpstoconfirmrods,notcocci***

8.LeukocyteEsterase
IndicatesUTI
DetectspresenceofesteraseingranulocyteWBCs
DetectsbacterialandnonbacterialUTI,inflammationofurinarytract,
screeningofurinaryculturespecimens
WBCsshouldaccompanybacteriainUTI***
Reportfew,moderate,manyperhpf