URINE ANALYSIS
Urine dipstick• Screening for disease• Fresh urine is collected into clean dry  container• Reagent strip immersed in the u...
• Three urine samples are shown. The one at the left shows a  red, cloudy appearance. The one in the center is red but cle...
Parameters in urine dipstick test•   Glucose•   Bilirubin•   Urobilinogen•   Ketones•   Specific gravity•   pH•   Protein•...
Physical examination of urine• Volume  a) physiological factor  -increase intake of water  -temperature  -physical activit...
• Colour   - normal : pale yellowish- urochrom pigment   - abnormal : due to food intake and drugsRed                     ...
• Odour normal: aromatic odour- Food and drugs causes characteristic odour  e.g: methyl salicylic, asparagus- Ketosis : fr...
• Appearance/ transparencyNormal:-Slight turbidity: mucus (in women), squamous                    epithelial cell-Turbidit...
Normal urine composition•   Urea-   End product of protein metabolism-   50% from urine composition-   25-30 g/24hr•   Uri...
• Creatine- Can be found in muscle tissues in form of  phosphocreatin• Sulphur- Protein intake• Indican- Triptophan katabo...
•   Chloride-   Second largest composition found in urine-   Excreted in form of NaCl : 10-15g/24hr urine•   Phosphate-   ...
Pathological urine composition•   Glucose•   Protein•   Ketones•   Pus cells•   Red blood cells•   Lipid•   Amino acid•   ...
Microscopic sediment of urine• Cells -rbc, wbc, squamous epithelial cells, urethral epithelial cells• Casts- Represent a c...
Cyrstals•   Uric asid•   Amorphous urates•   Amourphous phosphate•   Calcium oxalate•   Triple phosphate•   Calcium carbon...
• Red blood cells in urine appear as refractile disks.  With hypertonicity of the urine, the RBCs begin to  have a crenate...
• These white blood cells in urine have lobed nuclei  and refractile cytoplasmic granules.
• Large polygonal squamous epithelial cells with small  nuclei are seen here.
• Oval fat bodies consist of degenerated tubular cells  containing abundant lipid, which appears refractile.
broad (Figure 3).Urinary casts. (A) Hyaline cast (200 X); (B) erythrocyte cast (100 X); (C)leukocyte cast (100 X); (D) gra...
Urinary crystals. (A) Calcium oxalate crystals (arrows; 100 X); (B) uric acidcrystals (100 X); (C) triple phosphate crysta...
Type of Urine Sample & CollectionSample            Sampling                PurposeMorning sample    First urine in the    ...
Urine analysis
Urine analysis
Urine analysis
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Urine analysis

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Urine analysis

  1. 1. URINE ANALYSIS
  2. 2. Urine dipstick• Screening for disease• Fresh urine is collected into clean dry container• Reagent strip immersed in the urine specimen, ensure all the reagent blocks are covered.• Errors in results
  3. 3. • Three urine samples are shown. The one at the left shows a red, cloudy appearance. The one in the center is red but clear. The one on the right is yellow, but cloudy.
  4. 4. Parameters in urine dipstick test• Glucose• Bilirubin• Urobilinogen• Ketones• Specific gravity• pH• Protein• Blood• Nitrite• Leucocytes
  5. 5. Physical examination of urine• Volume a) physiological factor -increase intake of water -temperature -physical activity-others due to diuretic drugs, coffee and alcohol-normal adult urine volume : 600-1200ml/hour-difference in urine volume due to: polyuria, oliguria, anuria and nocturia
  6. 6. • Colour - normal : pale yellowish- urochrom pigment - abnormal : due to food intake and drugsRed : beets, rhubarb (alkaline urine)Orange-yellowish : carrot, antibioticGreen, blue-green : drugs eg: amitryplineDark brown : drugs eg: methyldopa, metronidazole- abnormal : due to pathologicalRed/maroon : rbc, hemoglobin, myoglobin‘wine-red’ : porphyrinDark brown : melanin, homogentisic acidYellowish-brown orgreenish-brown : bilirubin, bile pigment
  7. 7. • Odour normal: aromatic odour- Food and drugs causes characteristic odour e.g: methyl salicylic, asparagus- Ketosis : fruity/sweet- Congenital metabolism disorder : e.g: phenylketonuria ‘mousy’
  8. 8. • Appearance/ transparencyNormal:-Slight turbidity: mucus (in women), squamous epithelial cell-Turbidity: calcium oxalate, uric acid, amorphous phosphate, amorphous uratesAbnormal:-turbid-red : rbc-turbid : bacterial or yeast infection -milky: lipid
  9. 9. Normal urine composition• Urea- End product of protein metabolism- 50% from urine composition- 25-30 g/24hr• Uric acid- End product of purine metabolism- 0.5-1 g/24hr• Creatinine- Skeletal muscle tissue
  10. 10. • Creatine- Can be found in muscle tissues in form of phosphocreatin• Sulphur- Protein intake• Indican- Triptophan katabolism in intestine• Ammonia- Final product of protein metabolism
  11. 11. • Chloride- Second largest composition found in urine- Excreted in form of NaCl : 10-15g/24hr urine• Phosphate- Protein intake- 1.1g/24hr urine
  12. 12. Pathological urine composition• Glucose• Protein• Ketones• Pus cells• Red blood cells• Lipid• Amino acid• Bile pigment• Calculi
  13. 13. Microscopic sediment of urine• Cells -rbc, wbc, squamous epithelial cells, urethral epithelial cells• Casts- Represent a collection of protein and cellular debris in a kidney tubule- Eg: hyaline : occasionally found in normal urine but their number is increased in renal diseases.- Cellular cast: one or more type of cells are trapped during their formation. Eg; pus cell casts, red cell casts, epithelial casts, and mixed cellular casts.- Granular casts : fine granules appear in glomerular and tubular renal disease.
  14. 14. Cyrstals• Uric asid• Amorphous urates• Amourphous phosphate• Calcium oxalate• Triple phosphate• Calcium carbonate• Tyrosine• Leucine• Cystine• Cholesterol
  15. 15. • Red blood cells in urine appear as refractile disks. With hypertonicity of the urine, the RBCs begin to have a crenated appearance
  16. 16. • These white blood cells in urine have lobed nuclei and refractile cytoplasmic granules.
  17. 17. • Large polygonal squamous epithelial cells with small nuclei are seen here.
  18. 18. • Oval fat bodies consist of degenerated tubular cells containing abundant lipid, which appears refractile.
  19. 19. broad (Figure 3).Urinary casts. (A) Hyaline cast (200 X); (B) erythrocyte cast (100 X); (C)leukocyte cast (100 X); (D) granular cast (100 X).
  20. 20. Urinary crystals. (A) Calcium oxalate crystals (arrows; 100 X); (B) uric acidcrystals (100 X); (C) triple phosphate crystals with amorphous phosphates(400 X); (D) cystine crystals (100 X).
  21. 21. Type of Urine Sample & CollectionSample Sampling PurposeMorning sample First urine in the Pregnancy test, morning microscopic testRandom sample No specific time Routine screening, chemical & FEMEPostprandial 2 hours after meal Determine glucose in diabetic monitoringMidstream/clean Discard first few ml, Culturematch collect the rest2 hours Within 2 hours period Determine urobilinogen24 hours Within 24 hours period Determine renal function

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