URINALYSIS A. Physical Examination

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UrinalysisDr. A. Basu MD

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TopicDefinition and normal urine Indication Collection Examination Physical Chemical Microscopical

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Urinalysis : DefinitionQualitative and semi quantitative evaluation of renal products.

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Normal Urine = At a glance a. Physical - color - normally pale yellow transparency - clear specific gravity - 1.020 - 1.030 b. Chemical - pH acid in carnivores alkaline in herbivores protein - normally 0 mg/dl glucose - normally none blood - normally none c. Sediment - urine solids stained after centrifugation( no finding, except scanty epithelial cell)

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Indication Glomerulonephritis Diabetes mellitus Urinary tract infection Tumors

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Collection Random collection: Early morning: chemical are present in higher concentration 24 hours urine collection Nephrotic syndrome Suprapubic Trans- abdominal needle aspiration of the bladder (purest sample)

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Urine preservativesBoric acid HCl Sulfuric acid

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Collection Maintain patient privacy Do not clean the area with antiseptic Collect mid stream urine

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When you should examineImmediate Or, within One hour after collection of urine.

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The interval of time which elapses from collection to examination in the laboratory is important. Changes which occur with time after collection include: loss of ketone bodies, loss of bilirubin, overgrowth of contaminating microorganisms.

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URINALYSIS Three phasesA. Physical Examination B. Chemical Examination C. Microscopical Examination

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URINALYSIS A. Physical Examination 1.Volume 2. Color Odor 3.Appearance(e.g. transparent or Turbidity present) 4.pH 5. Specific Gravity

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ColourRed: Hematuria, hemoglobinuria, certain drugs, myoglobinuria . White: chyluria Red colour on standing : Porphyria urine darkens on standing - Alkaptonuria

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Odor Normal: ammonia In infection: fishy smell If Ketone is high: sweet smell.

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AppearanceNormal: transparent Turbid: High WBC High epithelial cells.

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phThe glomerular filtrate of blood plasma is usually acidified by renal tubules and collecting ducts and from a pH of 7.4 to about 6 in the final urine.

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Specific Gravity Low (1.007 to 1.010) : End stage kidney disease. High (1.035) : SIADH, contamination , presence of glucose.

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Chemical testProtein Sugar (Glucose) Ketone Blood Nitrite Leukocyte Esterase

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Protenuria More than 150 mg/day is defined as proteinuria

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Ketone Diabetic ketosis or Some other form of calorie deprivation (starvation).

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Nitrite Positive nitrite test ; Bacteria may be present

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Leukocyte EsterasePositive: WBC are present

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URINE DIPSTICK CHEMICAL ANALYSIS A dipstick is a paper strip with patches impregnated with chemicals that undergo a color change when certain constituents of the urine are present or in a certain concentration. The strip is dipped into the urine sample, and after the appropriate number of seconds, the color change is compared to a standard chart to determine the findings

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A sample Strip For Chemical Analysis Of UrineLeucocyte esteraseNitritepHProteinBloodSpecific GravityKetoneGlucoseBilirubinColors' are before examination In protenuria 4+

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Interpretation of the result

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Microscopical examinationRBC WBC Yeast Casts Crystals

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Last Updated: 8th March 2018

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