This document summarizes renal function tests and urine analysis. It describes the anatomy and function of the nephron, steps in urine formation, and normal ranges for physical and chemical urine tests including volume, color, odor, specific gravity, pH, creatinine, BUN, electrolytes, glucose, protein, and ketones. It discusses clinical implications of abnormal test values and interfering factors. Macroscopic urine examination for casts and cells is also covered, in addition to exogenous markers of glomerular filtration rate like inulin and iothalamate clearance tests.
Renal function test (RFT), also known as kidney function test is a group of tests used to assess the functions of kidney.
It is used screen for, detect, evaluate and monitor acute and chronic kidney diseases.
These are simple blood and urine tests that are used identify kidneys problems.
Tests of renal function have utility in-
Identifying the presence of renal disease
Monitoring the response of kidneys to treatment
Determining the progression of renal disease
RFT is ordered, if your doctor
thinks your kidneys may not be working properly which is known from signs and symptoms
and if you have other conditions that can harm the kidneys, such as diabetes or high blood pressure
Renal function tests are very useful for effective clinical evaluation of renal failure for effective management. So it is useful for medical and allied professional students and clinical practitioners.
Renal function test (RFT), also known as kidney function test is a group of tests used to assess the functions of kidney.
It is used screen for, detect, evaluate and monitor acute and chronic kidney diseases.
These are simple blood and urine tests that are used identify kidneys problems.
Tests of renal function have utility in-
Identifying the presence of renal disease
Monitoring the response of kidneys to treatment
Determining the progression of renal disease
RFT is ordered, if your doctor
thinks your kidneys may not be working properly which is known from signs and symptoms
and if you have other conditions that can harm the kidneys, such as diabetes or high blood pressure
Renal function tests are very useful for effective clinical evaluation of renal failure for effective management. So it is useful for medical and allied professional students and clinical practitioners.
Creatinine clearance may be used as indicator for GFR because:
Creatinine is endogenously produced.
Creatinine is released into body fluid at constant rate.
Its plasma level maintained within narrow limits.
Its plasma level not affected by dietary factors
A test in which blood or urine samples are checked for the amounts of certain substances released by the kidneys. A higher- or lower-than-normal amount of a substance can be a sign that the kidneys are not working the way they should. Also called kidney function test.
Proteinuria – early indicator of renal disease
Increases the risk of renal impairment, hypertension & cardiovascular disease.
Proteinuria of 1+ or more persisting on 2 subsequent dipstick tests at weekly intervals – requires further investigations.
Causes of transient proteinuria to be excluded
Creatinine clearance may be used as indicator for GFR because:
Creatinine is endogenously produced.
Creatinine is released into body fluid at constant rate.
Its plasma level maintained within narrow limits.
Its plasma level not affected by dietary factors
A test in which blood or urine samples are checked for the amounts of certain substances released by the kidneys. A higher- or lower-than-normal amount of a substance can be a sign that the kidneys are not working the way they should. Also called kidney function test.
Proteinuria – early indicator of renal disease
Increases the risk of renal impairment, hypertension & cardiovascular disease.
Proteinuria of 1+ or more persisting on 2 subsequent dipstick tests at weekly intervals – requires further investigations.
Causes of transient proteinuria to be excluded
this is a series of notes on clinical pathology, useful for undergraduate and post graduate pathology students. Notes have been prepared from standard textbooks and are in a format easy to reproduce in exams.
rft is described in detail . function of kidney, objectives of doing the test. the various test available for assessing the renal function with clinical interpretation is available.
INTRODUCTION
Cancer is a general term used to refer to a condition where the body’s cells begin to grow and reproduce in an uncontrollable way. Lung cancers are the fourth most common cancer reported in the Indian males.
DEFINITION
Lung carcinoma is a malignant lung tumor characterized by uncontrolled cell growth in tissues of the lung. If left untreated, this growth can spread beyond the lung by the process of metastasis into nearby tissue or other parts of the body.
CAUSES
The most common causes of fracture include,
I. Tobacco smoke
Tobacco use is responsible for more than one of every six deaths. The younger a person is when he or she starts smoking, the greater the risk of developing lung cancer.
II. Secondhand smoke
Passive smoking has been identified as a possible cause of lung cancer in nonsmokers. People who are involuntarily exposed to tobacco smoke in a closed environment (house, automobile, and building) have an increased risk of lung cancer when compared with unexposed nonsmokers.
III. Environmental and occupational exposure
Various carcinogens have been identified in the atmosphere, including motor vehicle emissions and pollutants fromrefineries and manufacturing plants. High levels of radon have been associated with the development of lung cancer, especially when combined with cigarette smoking. Chronic exposure to industrial carcinogens, such as arsenic, asbestos, mustard gas, chromates, coke oven fumes, nickel, oil, and radiation has been associated with the development of lung cancer.
IV. Genetics
Some familial predisposition to lung cancer seems apparent, because the incidence of lung cancer in close relatives of patients with lung cancer appears to be two to three times that in the general population regardless of smoking status.
TYPES OF LUNG CANCER:
1. Small cell lung carcinoma
• Accounts for 15%-25% of lung cancers
• It is most malignant form
• Tends to spread early via lymphatic and bloodstream
• Is frequently associated with endocrine disturbances
• Predominantly central and can cause bronchial obstruction and pneumonia.
2. Non-small cell lung carcinoma
Is further classified by cell type,
Adenocarcinoma
• Most common type
• Accounts for approximately 30%-40% of lung cancers
• More common in women
• Often gas no clinical manifestations until widespread metastasis is present
• Usually begins in mucous glandular tissue, is most commonly located in peripheral portions of lungs.
Squamous cell carcinoma
• Second most common type of lung cancer
• Accounts for 30%-35% of lung cancers
• Is more common in men
• Arises from the bronchial epithelium of the lungs or bronchus, slow-growing cancer that usually begins in the bronchial tubes.
Large cell carcinoma
• The least common form
• Accounts for 5%-15% of lung cancers
• Composed of large sized cells that are anaplastic and often arise in the bronchi, commonly causes cavitation
• Is highly metastatic via lymphatic and blood.
STAGING OF NON-SMALL CELL LUNG C
Obstructive jaundice (OJ) is a common problem in daily clinical practice. However, completely understanding the pathophysiological changes in OJ remains a challenge for planning current and future management. The effects of OJ are widespread, affecting the biliary tree, hepatic cells, liver function, and causing systemic complications. The lack of bile in the intestine, destruction of the intestinal mucosal barrier, and increased absorption of endotoxins can lead to endotoxemia, production of proinflammatory cytokines, and induce systemic inflammatory response syndrome, ultimately leading to multiple organ dysfunction syndrome. Proper management of OJ includes adequate water supply and electrolyte replacement, nutritional support, preventive antibiotics, pain relief, and itching relief. The surgical treatment of OJ depends on the cause, location, and severity of the obstruction. Biliary drainage, surgery, and endoscopic intervention are potential treatment options depending on the patient's condition. In addition to modern medical treatments, Traditional Chinese medicine may offer therapeutic benefits for OJ. A comprehensive search was conducted on PubMed for relevant articles published up to August 1970
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
5. RATE OF URINARY EXCRETION OF
ANY SOLUTE
= RATE OF GLOMERULAR FILTRATION
+ RATE OF SECRETION
- RATE OF REABSORPTION
6.
7. PHYSICAL TESTS
i. URINE VOLUME
Assessment of fluid balance and kidney
function.
Normal value;
adult : 800-2500 mL/day
children : 500-1400 mL/day
8. CLINICAL IMPLICATIONS
1. polyuria with elevated BUN and creatinine .
diabetic ketoacidosis
partial obstruction of urinary tract
tubular necrosis
2.polyuria with normal BUN and creatinine.
diabetes mellitus and diabetes
insipidus
tumours of brain and spinal cord
9. 3.oliguria
Renal causes
renal ischemia
renal disease due to toxic agents
Dehydration caused by prolonged
vomiting,diarrhoea,burns
Obstruction of some area of the urinary tract
Cardiac insufficiency
4.anuria
Complete urinary tract obstruction
Acute cortical necrosis
Glomerulonephritis
Acute tubular necrosis
11. 2.URINE COLOUR
Yellow colour due to urochrome.
Normal;
Pale yellow to amber
Straw colour- low SG
Amber colour-high SG
12. CLINICAL IMPLICATIONS
Almost colourless urine;
large fluid intake
chronic interstitial nephritis
untreated diabetes mellitus
diabetes insipidus
alcohol and caffeine ingestion
diuretic therapy
nervousness
Orange colour;
fever
carrots or vitamin A
phenazopyridine, nitrofurantoin
13. Green urine;
pseudomonal infection
chlorophyll
Red urine
RBCs
haemoglobin
myoglobin
porphyrins
Black urine
melanin
phenol poisoning
Smoky urine - RBCs
Milky urine - fat,cystinuria,WBCs
14. INTERFERING FACTORS
Colour darkens on standing
Drugs alter the colour
green - indomethacin
brown - chloroquine,furazolidone
pink to brown - laxatives
red-pink - daunorubicin
orange - rifampicin
blue urine - triamterene
black urine - chloroquine
metronidazole
15. 3.URINE ODOUR
Faint odour owing to the presence of
volatile oils.
normal; aromatic odour.
16. CLINICAL IMPLICATIONS
Diabetes mellitus patients urine have a
fruity odour.
UTIs result in foul-smelling urine .
Infants with a inherited disorder of amino
acid metabolism urine smells like burnt
sugar.
Cystinuria result in sulfurous odour.
17. 4.URINE SPECIFIC GRAVITY
(SG)
Measurement of the kidneys ability to
concentrate urine.
Compares the density of urine against
the density of distilled water.
Normal;
1.005-1.030
23. CHEMICAL EXAMINATION OF
URINE
ENDOGENOUS MARKERS
a) SERUM CREATININE (kreas)
breakdown product of muscle creatine phosphate.
excreted by glomerular filtration and tubular
secretion.
doubles with each 50% decrease in GFR.
if SCr is 1mg/dl, 100% renal function
2mg/dl, 50% renal function
24. Normal;
URINE CREATININE
men : 14-26mg/kg/24 hours
women: 11-20mg/kg/24 hours
SERUM CREATININE
men : 0.6-1.2 mg/dL
women : o.4-1.0 mg/dL
28. URINE CREATININE
INCREASED BY DECREASED BY
Ascorbic acid Anabolic steroids
Corticosteroids Captopril
Methotrexate Thiazides
Methyldopa Ketoprofen
Cefoxitin
29. CREATININE CLEARANCE
Rate at which creatinine is removed from
the blood.
Useful measure of
glomerular filtration rate
excreting capacity of the kidney.
31. SCHWARTZ FORMULA
crcl(ml/min) = k x ht in cm/scr(mg/dl)
k = 0.45 ,infants < 1 year of age
k = 0.55 ,children and adolescent
females.
k = 0.7, adolescent males.
33. CLINICAL IMPLICATIONS
INCREASED
State of high cardiac output
pregnancy
burns
carbon monoxide poisoning
DECREASED
Impaired kidney function
dehydration
hemorrhage
congestive heart failure
34. INTERFERING FACTORS
Exercise may increase creatinine
clearance and urine creatinine.
Pregnancy increases CrCl
Proteinuria and advanced renal failure
make CrCl an unreliable method for
determining GFR.
35. BLOOD UREA NITROGEN
End product of protein metabolism (liver)
It travels through the blood and is
excreted by the kidney.
BUN measures the amount of nitrogen in
the blood in the form of urea.
36. Normal value;
Adults : 6-20 mg/dl
Elderly patients : 8-23 mg/dl
Children : 5-18 mg/dl
AZOTEMIA; excessive retention of nitrogenous
waste products.
Renal azotemia ; renal disease (glomerulonephritis
and chronic pyelonephritis).
Prerenal azotemia; severe dehydration
hemorrhagic shock
excessive protein intake.
Postrenal azotemia; urethral stones
tumours
prostatic obstructions.
37. CLINICAL IMPLICATIONS
1.Increased BUN levels (azotemia)
a.impaired renal function
congestive heart failure
salt and water depletion
stress
acute MI
b. chronic renal diseases
c. Urinary tract obstruction
d. hemorrhage into GI tract.
e. diabetes mellitus
2. Decreased BUN levels
a. liver failure
b. acromegaly
c. malnutrition
39. ACE inhibitors
Indomethacin
Penicillin
Thiazides
Rifampin
Spironolactone
Timolol
Cefotaxime
Phenothiazines
Chloramphenicol
Levodopa
Amikacin
• BUN increased by BUN decreased by
40. GLOMERULAR FILTRATION RATE
GFR is the volume of water filtered or
cleared out of the plasma per minute.
GFR is approximated by measuring
the urinary excretion rate of a marker
substance.
Example for marker inulin.
42. URINE PROTEINS
Increased amounts of protein is an
important indicator of renal diseases.
Normal value;
Adult male:10-140 mg/dl
Female:30-100 mg/dl
55. URINE CHLORIDE
Diagnose dehydration or as a guide in
adjusting fluid and electrolyte balance.
Also useful in monitoring the effects of
reduced salt diets( CVD,HTN)
Normal value;
adult: 140-250 mEq/24 hours
child : 64-176 mEq/24 hours
57. URINE CHLORIDE
Ammonium chloride
administration
Excessive infusion of
normal saline
Ingestion of sulfides,
cyanides, halogens,
bromides and sulfhydril
compounds.
Carbenicillin therapy
Reduced dietary
intake of chloride
Ingestion of large
amounts of licorice
Alkali ingestion
Dehydration
INCREASED
CHLORIDE
DECREASED
CHLORIDE
58. URINE KETONES
From fatty acid and fat.
Consists mainly of three substances
: acetone,
β-hydroxybutyric acid
acetoacetic acid.
normal value;
urine: negative (<0.3 mg/dl)
59. CLINICAL IMPLICATIONS
Hyperthyroidism
Fever
Pregnancy or
lactation
Diabetes mellitus
Starvation
Anorexia
INCREASED
METABOLIC STATES
DECREASED
METABOLIC STATES
60. KETONES IN URINE
Amino salicylic acid
Cefixime
Valproic acid
Dimercaprol
Captopril
Aspirin
Phenazopyridine
INCREASED BY DECREASED BY
61. MACROSCOPIC EXAMINATION
of centrifuged urine.
1) Hematuria
it indicates trauma, tumour, systemic
bleeding.
2) casts
Casts are cylindrical elements with
parallel sides
67. EXOGENOUS MARKERS
INULIN CLEARANCE
normal value;
men : 127ml/min/m²
women: 118ml/min/m²
Fructose polysaccharide.
Patient receives inulin to achieve a steady
blood concentration.
The quantity in plasma and the amount
excreted in urine is measured.
68. IOTHALAMATE
Normal value;
men : 127 ml/min/m²
women: 118 ml/min/m²
Injection of the radioactive exogenous
marker .
These are not widely used.
69. REFERENCES
A manual of laboratory and diagnostic
tests; by Frances Fischbach, Marshall
B.Dunning, Edition 8.
Textbook of therapeutics; Drug and
disease management by
Eric.T.Herfindal,sixth edition.
Comprehensive pharmacy review by
Leon shargel,fourth edition.
Basic skills in interpreting laboratory
data by Mary Lee,fourth edition.
Principles of anaatomy and physiology
by Tortora, tenth edition.