Cm6 ua intro

766 views

Published on

Published in: Technology, Business
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
766
On SlideShare
0
From Embeds
0
Number of Embeds
3
Actions
Shares
0
Downloads
25
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Cm6 ua intro

  1. 1. URINALYSIS: Introduction Crizelda D. Liwanag
  2. 2. History • Hieroglyphics • Uroscopy (Hippocrates) • Ant & taste testing (Sasruta) • Urine boiling (F. Dekkers)
  3. 3. History • Pisse prophets (charlatans) • Thomas Bryant • Microscope • Thomas Addis • Richard Bright • Modern urinalysis
  4. 4. Rationale of Urine testing • (Relatively) readily collected and easily available specimen • Contains information about the body’s major metabolic fxns • inexpensive
  5. 5. Rationale of Urine testing ? Disease conditions ? Hormonal activity ? Ruling out, ruling in, screening & prognosis
  6. 6. Urine Composition • How do the ff. affect composition: –Dietary intake –Physical activity –Body metabolism –Endocrine functions –Body position
  7. 7. Urine Composition • Substances readily reabsorbed –GANaCaKUP • Substances readily excreted –UCUA
  8. 8. Urine Composition • Organic – Urea – Creatinine – Uric acid – Urobilinogen • Other substances – Hormones – Vit & meds • Inorganic – Cl2, K, Na • Formed elements – Cells & casts – Crystals – Mucus – bacteria
  9. 9. Urine volume • Factors – Fluid intake – Non-renal fluid loss – ADH – Solute concentration • Definition & associated cond – Oliguria – Anuria – Nocturia – Polyuria – Pollakiuria – Incontinence – Residual urine
  10. 10. Specimen • What was used in the collection? – answered by COLLECTION TECH / MTD • When was the specimen collected? – answered by TYPE OF SPECIMEN • What are the criteria for acceptance & rejection of specimen for processing & analysis? • What is meant by QNS & COC? • Patient preparation?
  11. 11. Collection technique / method 1. Bottle method a. Routine void b. Midstream clean catch c. Drug testing 2. BD Vacutainer (gray, cherry red & yellow stopper) 3. Gauze method / pediatric bag 4. Catheterization 5. Suprapubic aspiration
  12. 12. Collection technique / method 1. Wash hands thoroughly. Do not open the sterile container until it is absolutely necessary. 2. Wash the vulva and surrounding area with soap and water. 3. Begin urinating into the toilet and stop after a few drops. 4. Position the container to catch the middle portion of the stream. Make sure that at least ¾ of the container has been filled up. 5. Urinate the remainder into the toilet. 6. Securely & immediately replace the cap without touching the inside rim of the container.
  13. 13. Collection technique / method
  14. 14. Types of Specimen 1. First morning specimen 2. Random 3. Fractional 4. Timed 1. Pre-determined length 2. Pre-determined time 1. Advantages 2. Disadvantages 3. Reminders / precautions 4.Uses 5. Subtypes
  15. 15. Specimen handling • Integrity • Preservation
  16. 16. Physical changes Color • Due to oxidation or reduction of substances Clarity • Falsely decreased • Due to bacterial proliferation, solute ppt’n Odor • Falsely increased • Due to bacterial proliferation
  17. 17. Chemical Changes pH • Falsely increased • Due to bacterial decomposition of urea to ammonia • Falsely decreased • Due to bacterial or yeast conversion of glucose to form acids
  18. 18. Chemical Changes glucose • Falsely decreased • Due to cellular or bacterial hydrolysis ketones • Falsely decreased • Due to bacterial metabolism of acetoacetate to acetone • volatilization of acetone
  19. 19. Chemical Changes bilirubin • Falsely decreased • Due to photo-oxidation to biliverdin and hydrolysis to free bilirubin urobilinogen • Falsely decreased • Due to oxidation to urobilin
  20. 20. Chemical Changes Nitrite • Falsely increased • Due to bacterial production following spx collection • Falsely decreased • Due to conversion to nitrogen
  21. 21. Microscopic Changes RBC, WBC, casts • Falsely decreased • Disintegration of cellular & formed elements, esp in dilute alkaline urine Bacteria • Falsely increased • Due to bacterial proliferation ff spx collection
  22. 22. Preservation WHY IS IT NECESSARY TO: • Maintain the pH? • Avoid bacterial contamination? • Avoid conversion of urea to ammonia? HOW DO YOU ACCOMPLISH THE AFOREMENTIONED STEPS?
  23. 23. Preservation A. Physical Methods PRINCIPLE ? A&D? 1. Refrigeration 2. Dry Ice B. Chemical Methods PRINCIPLE ? A&D? 1. Toluol 2. Thymol 3. Formalin 4. Chloroform 5. NaF
  24. 24. Preservation B. Chemical Methods 6. Benzoic acid 7. Phenol / tricresol 8. 6N Hcl 9. Boric Acid 10. H2SO4 11. Na carbonate 12. Acetic Acid 13. Saccomanno’s fixative

×