Urine (Viva)

Q.1 What is the pH of normal urine?


Q.2 Why does the pH of the urine increases (i.e. becomes alkaline) on standing?

Due to the bacterial conversion of urea to ammonia, which raises the pH of the urine.

Q.3 What is the normal output of urine per day?

1200-1500 ml.

Q.4 What are the conditions in which urine volume is increased?

  • Physiological conditions:
    1. Excessive intake of water.
    2. Excitement.
    3. Cold climate
    4. High protein diet.

  • Pathological conditions:
    1. Diabetes mellitus.
    2. Diabetes insipidus.
    3. In certain types of kidney disease.

Q.5 What are the conditions in which urine volume is decreased?

  • Physiological conditions:
    i. In summer or hot weather due to increase loss of water by perspiration.

  • Pathological conditions:
    i. Acute nephritis.
    ii. Fever.
    iii. Diseases of heart and lung.
    iv. Diarrhea and vomiting.

Q.6 What is the specific gravity of normal urine?


Q.7 What does the specific gravity of urine indicates?

  1. Concentrating power of kidney.
  2. State of hydration of body.
  3. Presence of solutes in the urine.
  4. Effect of ADH.

Q.8 What are the normal constituents of Urine?

Organic constituents Inorganic constituents 
Urea Chloride as NaCl
Uric acid Sodium
Creatinine  Potassium
Hippuric acid Calcium
Amino acid Phosphorus as phosphates
Nitrogen Sulfur as Sulphates

Q.9 Give the amount of various normal constituents of urine.

Urea 20-30 gm
Uric acid 0.7 gm
Amino acids 0.5-1 gm
Ammonia 0.7 gm
Creatinine 1.4 gm
Ascorbic acid 15-20 mg
Chloride (as NaCl) 10-15 gm
Inorganic sulphate (as sulphur) 60-120 mg
Neutral sulphate (as sulphur) 80-160 mg
Sodium 3-5 gm
Calcium 0.1-0.3 gm
Phosphates (as inorganic phosphorous) 1.0-1.5 gm

Q.10 How will you calculate the total solids excreted in the urine?

 The total solids excreted in the urine in gm/ liter can be calculated by Long’s coefficient (2.66). The figures of second and third decimal places of specific gravity of urine are multiplied with 2.66.

Q.11 What are the abnormal constituents of urine?

  1. Reducing sugars.
  2. Proteins (mainly albumin).
  3. Ketone bodies.
  4. Blood
  5. Bile pigments (mainly bilirubin).

Q.12 What are the conditions in which abnormal constituents appear in urine?

  1. Glucose—diabetes mellitus and renal glycosuria.
  2. Proteins—Nephrotic syndrome.
  3. Ketone bodies—Starvation and severe diabetes mellitus.
  4. Blood—Hematuria.
  5. Bilirubin—Obstructive jaundice
  6. Urobilinogen—Hemolytic jaundice.

Q.13 What is the hormone which regulates chloride excretion?


Q.14 What is Addison’s disease?

Chronic disease of the adrenal cortex gives rise to Addison’s disease.

Q.15 Which hormone is associated with Addison’s disease?


Q.16 Why it is called aldosterone?

 Aldosterone contains an aldehyde group at position C18.

Q.17 What is the normal urinary excretion of chloride?

10-15 gm of chloride as sodium chloride.

Q.18 What are the conditions in which urinary excretion of chloride is increased?

Urinary chloride is increased in:

  1. High intake of chloride.
  2. Upon resolution of exudate.
  3. Addison’s disease.

Q.19 What are the conditions in which urinary excretion of chloride is decreased?

  1. Low salt intake.
  2. Diarrhea, vomiting.
  3. Diabetes insipidus.
  4. Chronic nephritis.
  5. Cushing syndrome.

Q.20 How urine is formed?

 Urine is formed by the following four processes.

  1. Filteration of blood plasma by the glomeruli.
  2. Selective reabsorption by the tubules of materials.
  3. Secretion by tubules of certain substances.
  4. Exchange of H+ ions and production of NH3.

Q.21 Name the hormones involved in urine formation.

  1. Aldosterone.
  2. Antidiuretic hormone (ADH).

 Q.22 What is the end-product of protein metabolism?


Q.23 What is the end product of purine metabolism?

Uric acid

Q.24 What is the daily excretion of urea?

25-30 gm

Q.25 What is the level of creatinine in blood?

1-2 mg%

Q.26 What is the method by which creatinine is estimated?

Jaffe’s method

Q.27 What is the creatinine coefficient?

 Creatinine coefficient is defined as the number of milligrams of creatinine plus creatinine nitrogen excreted per kilogram of body weight daily.

Q.28 Where it is present?

Creatinine is present in muscle, brain, blood, etc.

Q.29 In which form it is present?

Creatinine is present in free as well as in phosphorylated form.

Q.30 What are the precursors of creatine?

Glycine, arginine, methionine.

Q.31 What is the normal excretion of creatinine?

 0.4-1.8 g/day

Q.32 What are the conditions in which creatinine excretion is decreased?

  1. Starvation.
  2. Later stages of muscular dystrophy.
  3. Muscular weakness.

Q.33 What are the conditions in which creatinine excretion is increased?

  1. Early stages of muscular dystrophy when muscle destruction is occurring rapidly.
  2. In any wasting disease involving increased tissue catabolism.
  3. Hyperthyroidism.

Q.34 What tests will you do to assess the function of the kidney?

Urine analysis is the biggest kidney function test. Other kidney function tests are

  1. Urea clearance test.
  2. Insulin clearance test.
  3. Creatinine clearance test.

Q.35 What is urea clearance?

Urea clearance is defined as the number of ml of blood that contain urea when excreted by kidneys in a minute.

Urea Clearance = (mg of urea excreted per minute/mg urea per ml. of blood)

Q.36 What is maximum urea clearance?

If the rate of excretion of urine is 2 ml or more per minute.

Then maximum urea clearance is defined as: 
=(Observed urea clearance/Average normal maximum urea clearance) × 100

Q.37 What is standard urea clearance?

If the rate of excretion of urea is less than 2 ml.

Standard urea clearance is defined as:
= (Observed urea clearance/Average normal standard urea clearance×V) × 100

Q.38 What is maple syrup urine disease (MSUD)?

It is an extremely rare inherited disease characterized by sweat odor of the urine and sweat.

Q.39 What is urine incontinence?

It is an inability to control the passage of urine. This can range from an occasional leakage of urine to a complete inability to hold any time.

Q.40 What are the types of urinary incontinence?

Two main types of urinary incontinence are:

1. Stress incontinence—occurs while coughing, sneezing, laughing, or while exercise.

2. Urge continence—Involves a strong sudden need to urinate followed by instant bladder contraction and involuntary loss of urine.

Q.41 What is UTI (Urinary tract infection)?

An Infection that can happen anywhere along the urinary tract, i.e. the kidney, the ureters, the bladder.

Q.42 What are the risk factors of increased chances of getting UTI?

  1. Pregnancy and menopause
  2. Kidney stones
  3. Sexual intercourse, especially with multiple partners
  4. Prostate inflammation
  5. Decreased drinking fluids
  6. Bowel incontinence
  7. Catheterization.

Q.43 What are the symptoms of UTI?

  1. Pressure in lower pelvis
  2. Pain or burning with urination
  3. Frequent or urgent need to urinate
  4. Cloudy urine
  5. Foul or strong urine odor

Q.44 What is discoloration of urine?

Urine of an abnormal color appears different from the usual straw-yellow color

Q.45 Characteristic color of urine indicating the disease?

Cloudy—Urinary tract infection.
Dark brown or clear urine—acute viral hepatitis or cirrhosis.
Pink, red or smoky brown color urine— kidney cancer, bladder stones, Wilms’ tumor, hemolytic anemia, trauma to kidney.
Dark yellow or orange urine—laxative or B complex vitamins.
Green or blue urine—artificial color in food or drug. Drugs like amitriptyline, indomethacin.