Normally, urine is some shade of yellow with acid urine usually a darker colour than alkaline urine. Pathologically, it may be any colour.

  • Drugs: Cimetidine, Promethazine, Amitriptyline, Flutamide, Indomethacin, Methocarbamol, Methylene blue, Mitoxantrone, Propofol, Phenylbutazone, Triamterene
  • Condition: Hartnup Disease, Indicanemia, Indicanuria
  • Infection: Pseudomonas Infection
  • Dyes: Carbolic Acid, Flavine derivatives, Indigo Blue, Methylene Blue, Resorcinol
  • Other: Clorets, Listerine, Magnesium Salicylate, Asparagus
  • Case: Verdant waste
  • Case: How Green is my urine
  • Drugs: Idarubicin, Ferrioxamine, Oxamniquine, Phenazopyridine, Rifampicin, Sulfasalazine, Warfarin
  • Food/supplements: Carotenes, B-complex vitamins, Senna, Rhubarb, Beets and blackberries
  • Condition (hypercarotenemia): Diabetes mellitus, hyperlipidemia, hypothyroidism, porphyria
  • Case: Where are the lemons?
  • Stones: (calculi in the renal pelvis, ureter or bladder)
  • Malignancy: TCC, RCC, Wilms
  • Trauma: Blunt or penetrating trauma to the abdomen or pelvis; a catheter will commonly cause haematuria. BPH is a common cause of intermittent gross haematuria
  • Renal: Primary renal disease (e.g. glomerulonephritis; including IgA-related, membranous, mesangiocapillary, focal and minimal change). Renal disease associated with / due to / secondary to systemic vasculitis (e.g. SLE, polyarteritis nodosa), Papillary necrosis secondary to analgesic nephropathy or diabetic nephrosclerosis. Hereditary (e.g. Alport’s syndrome).
  • Infection: Pyelonephritis, UTI, pyonephrosis, cystitis, prostatitis, TB, schistosomiasis
  • Coagulopathy: Anticoagulation, Inherited defect (e.g. haemophilia, Von Willebrand’s), Acquired defect (e.g. DIC, thrombocytopenia).
  • Drugs: Levadopa, nitrofurantoin, metronidazole
  • Condition: Rhabdomyolosis (myoglobinuria), bile pigment
  • Other: Fava beans
  • Case: Mahogany Myoglobinuria
Cherry red / Raspberry
  • Drug: Hydroxocobalamin, Sodium nitroprusside; amino-salicyclic acid derivatives – mesalazine/paraaminosalycylic acid/sulfasalazine; doxorubicin, ibuprofen, phenothiazines, phenolphthalein, propofol, rifampicin/rifampin
  • Diet: Beeturia, rhubarb, blackberries, food dyes
  • Condition: Cyanide toxicity; porphyria, urate crystals
  • Case: Raspberry urine?
  • Infection: Bacteria such as Providencia stuartii, Klebsiella pneumoniae, P. aeruginosa, Escherichia coli, and enterococcus species.
  • Condition: Hartnup Disease, Indicanemia, Indicanuria
  • Case: Tyrian Rage

  • Drugs: Stimulant laxatives (e.g. cascara, senna)
  • Condition: Alkaptonuria, methemoglobinuria
  • Other: Melanin
  • Case: Brown/Black urine

CCC Differential Diagnosis Series


Anosmia, Ataxia, Blepharospasm, Bulbar and Pseudobulbar palsy, Central Pontine Myelinosis, Cerebellar Disease, Chorea, Cranial nerve lesions, Dementia, Dystonia, Exophthalmos, Eye trauma, Facial twitches, Fixed dilated pupil, Horner syndrome, Loss of vision, Meningism, Movement disorders, Optic disc abnormality, Parkinsonism, Peripheral neuropathy, Radiculopathy, Red eye, Retinal Haemorrhage, Seizures, Sudden severe headache, Tremor, Tunnel vision


Bronchial breath sounds, Bronchiectasis, High airway pressures, Massive haemoptysis, Sore throat, Tracheal displacement


Atrial Fibrillation, Bradycardia, Cardiac Failure, Chest Pain, Murmurs, Post-resuscitation syndrome, Pulseless Electrical Activity (PEA), Pulsus Paradoxus, Shock, Supraventricular tachycardia (SVT), Tachycardia, VT and VF, SVC Obstruction


Abdominal distension, Abdominal mass, Abdominal pain, Asterixis, Dysphagia, Hepatomegaly, Hepatosplenomegaly, Large bowel obstruction, Liver palpation abnormalities, Lower GI haemorrhage, Malabsorption, Medical causes of abdominal pain, Rectal mass, Small bowel obstruction, Upper GI Haemorrhage


Genital ulcers, Groin lump, Scrotal mass, Urine colour, Urine Odour, Urine transparency


Arthritis, Shoulder pain, Wasting of the small muscles of the hand


Palmar erythema, Serious skin signs in sick patients, Thickened Tethered Skin, Leg ulcers, Skin Tumour, Acanthosis Nigricans


Diabetes Insipidus, Diffuse Goitre, Gynaecomastia, Hirsutism, Hypoglycaemia, SIADH, Weight Loss




Floppy infant 


Anaphylaxis, Autoimmune associated diseases, Clubbing, Parotid Swelling, Splinter haemorrhages, Toxic agents and abnormal vitals, Toxicological causes of cardiac arrest


CHEST: Atelectasis, Hilar adenopathy, Hilar enlargement on CXR, Honeycomb lung, Increased interstitial markings, Mediastinal widening on mobile CXR, Pulmonary fibrosis, Pseudoinfiltrates on CXR, Pulmonary opacities on CXR,
Gas on abdominal X-ray, Kidney mass,
Intracranial calcification, Intracranial structures with contrastVentriculomegaly,
OTHER: Pseudofracture on X-Ray


LOW: Anaemia, Hypocalcaemia, hypochloraemia, Hypomagnesaemia

HIGH: Bilirubin and Jaundice, HyperammonaemiaHypercalcaemia, Hyperchloraemia, Hyperkalaemia, Hypermagnesaemia

ACID BASE: Acid base disorders, Resp. acidosis, Resp. alkalosis,

Creatinine, CRP, Dipstick Urinalysis, Laboratory Urinalysis, Liver function tests (LFTs), Pleural fluid analysis, Urea, Urea Creatinine Ratio, Uric acid, Urinalysis, Urine Electrolytes


CCC 700 6

Critical Care


BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

Physician in training. German translator and lover of medical history.

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