Abdullah khosa
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Abdullah khosa






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    Abdullah khosa Abdullah khosa Presentation Transcript

    • 11
    • CONTENTSCONTENTSIntroductionIntroductionTypes of SpecimenTypes of SpecimenSources of errorsSources of errorsTypes of AnalysisTypes of AnalysisMicroscopic ImagesMicroscopic Images 33
    • INTRODUCTIONINTRODUCTIONFirst laboratory test performedFirst laboratory test performedUsed for more than 6000 yearsUsed for more than 6000 yearsPowerful diagnostic toolPowerful diagnostic toolAn index to many normal and pathological mechanisms.An index to many normal and pathological mechanisms.By composition:By composition:95% waterRemaining 5% is composed of mainly ureaTrace amounts of vitamins, minerals,enzymes, hormones, proteins and antibodies 44
    • Types of SpecimenTypes of SpecimenFirst morningFirst morning ((most concentratedmost concentrated))Second voidedSecond voidedRandom specimenRandom specimen (( most convenientmost convenient))Post-prandial specimenPost-prandial specimen ( usually after 2 hour)( usually after 2 hour)24 hour urine24 hour urine55
    • SOURCES OF ERRORSOURCES OF ERROR Contamination with:Contamination with:Bacteria or chemicalsBacteria or chemicalsmenstrual bloodmenstrual bloodvaginal or urethral dischargevaginal or urethral discharge Inadequate mixing before examinationInadequate mixing before examination Wrong/inadequate preservativeWrong/inadequate preservative66
    • − MacroscopicMacroscopic− ChemicalChemical− MicroscopicMicroscopicTypes of AnalysisTypes of Analysis77
    • Macroscopic ExaminationMacroscopic ExaminationOdor:Odor:− Ammonia-like:Ammonia-like: (Urea-splitting bacteria)(Urea-splitting bacteria)− Offensive:Offensive: Old specimen, pus or inflammationOld specimen, pus or inflammation− Sweet:Sweet: GlucoseGlucose− Fruity:Fruity: KetonesKetonesColor:Color:− ColorlessColorless Diluted urineDiluted urine− Deep YellowDeep Yellow Concentrated UrineConcentrated Urine− Turbid cells or crystalsTurbid cells or crystals− Yellow-GreenYellow-Green Bilirubin / BiliverdinBilirubin / Biliverdin− RedRed Blood / HemoglobinBlood / Hemoglobin88
    • Chemical AnalysisChemical Analysis Urine DipstickUrine DipstickGlucoseBilirubinKetonesSpecific GravityBloodpHProteinUrobilinogenNitriteLeukocyte30 sec RR: Negative30 sec RR: Negative D. mellitus. Renal glycosuria.30 sec RR: Negative30 sec RR: Negative -increased bilirubin (correlate urobilinogen, S.bilirubin)40 sec RR: Negative40 sec RR: Negative Diabetic ketoacidosis Prolonged fasting2 min RR: 1.003-1.0352 min RR: 1.003-1.035 - Diabetes insipidus60 sec RR: Negative60 sec RR: Negative Hematuria - Hemoglobinuria2 min R.R.: 4.5-8.02 min R.R.: 4.5-8.0 <4.5): high-protein diet, >8.0): renal tubular acidosis60 sec RR: Negative60 sec RR: Negative - Proteinuria and the nephrotic syndrome.60 sec RR: 0.02-1.0 mg/dL60 sec RR: 0.02-1.0 mg/dL High: increased hepatic processing of bilirubin- Low: bile obstruction60 sec RR: Negative60 sec RR: NegativeGram negative bacteriuria2 min RR: Negative - Pyuria - Acute inflammation Renal calculus99SIGNIFICANCEPARAMETERSTIME OFREADING
    • Microscopic ExaminationMicroscopic ExaminationPer High Power Field (HPF) (400x)Per High Power Field (HPF) (400x)– > 3 erythrocytes> 3 erythrocytes– > 5 leukocytes> 5 leukocytes– > 2 renal tubular cells> 2 renal tubular cells– > 10 bacteria> 10 bacteriaPer Low Power Field (LPF) (200x)Per Low Power Field (LPF) (200x)– > 3 hyaline casts or > 1 granular cast> 3 hyaline casts or > 1 granular cast– > 10 squamous cells> 10 squamous cells– Any other cast (RBCs, WBCs)Any other cast (RBCs, WBCs)Presence of:Presence of:– Fungal hyphae or yeast, parasite,Fungal hyphae or yeast, parasite,– Pathological crystals (cystine, leucine, tyrosine)Pathological crystals (cystine, leucine, tyrosine)– Large number of uric acid or calcium oxalate crystalsLarge number of uric acid or calcium oxalate crystalsAbnormal FindingsAbnormal Findings1010
    • Microscopic ExaminationMicroscopic ExaminationRBCsRBCs1111
    • Microscopic ExaminationMicroscopic ExaminationWBCsWBCs1212
    • Microscopic ExaminationMicroscopic ExaminationTubular EpithelialTubular EpithelialCellsCells1313
    • Microscopic ExaminationMicroscopic ExaminationYeastsYeasts1414
    • Microscopic ExaminationMicroscopic ExaminationRBCs CastRBCs Cast1515
    • Microscopic ExaminationMicroscopic ExaminationWBCs CastWBCs Cast1616
    • Microscopic ExaminationMicroscopic ExaminationTubular Epith. CastTubular Epith. Cast1717
    • Microscopic ExaminationMicroscopic ExaminationGranular CastGranular Cast1818
    • Microscopic ExaminationMicroscopic ExaminationHyaline CastHyaline Cast1919
    • Microscopic ExaminationMicroscopic ExaminationWaxy CastWaxy Cast2020
    • Microscopic ExaminationMicroscopic ExaminationCalcium Oxalate CrystalsCalcium Oxalate Crystals2121
    • Microscopic ExaminationMicroscopic ExaminationCalcium Oxalate CrystalsCalcium Oxalate CrystalsDumbbellDumbbellShapeShape2222
    • Microscopic ExaminationMicroscopic ExaminationTriple Phosphate CrystalsTriple Phosphate Crystals2323
    • Microscopic ExaminationMicroscopic ExaminationUrate CrystalsUrate Crystals2424
    • Microscopic ExaminationMicroscopic ExaminationCholesterol CrystalsCholesterol Crystals2525
    • Microscopic ExaminationMicroscopic ExaminationLeucine CrystalsLeucine Crystals2626
    • Microscopic ExaminationMicroscopic ExaminationCystine CrystalsCystine Crystals2727
    • Thank youThank you2828