urinalisis.pptx
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This document provides information about urinalysis tests. It discusses the types of urine samples that can be collected, including early morning, random, 24-hour, and midstream samples. The document describes microscopic and chemical examinations of urine, including normal and abnormal colors, volumes, and presence of crystals, casts, glucose, bilirubin, ketones, specific gravity, blood, pH, and protein. Abnormal results can indicate conditions such as urinary tract infections, diabetes, liver and kidney diseases.
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Urine analysis
Urine analysis provides important information about kidney and overall health. A urine sample can be analyzed through macroscopic, chemical, and microscopic examination. The macroscopic exam evaluates attributes like color, clarity, and specific gravity. Chemical tests detect substances like proteins, glucose, ketones, and blood. Microscopic analysis identifies casts, crystals, epithelial cells, and other elements in urine sediment. Urine dipsticks provide a convenient, first-line screening for various analytes through color-changing indicators. Collectively, a urine analysis can detect disorders of the kidneys, urinary tract, and other body systems.
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Urinalysis.ppt
Urinalysis provides important information about overall health and diseases affecting the kidneys, urinary tract, and other body systems. It can detect disorders like diabetes, kidney disease, urinary tract infections, and drug abuse. Abnormalities in urine color, odor, volume, pH, specific gravity, protein, glucose, bilirubin, blood, and casts can indicate various underlying health issues. A urinalysis is a generally safe and noninvasive test that provides clinicians with valuable clues for diagnosis, monitoring disease progression, and screening for certain conditions.
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Urine Analysis and Urine Culture.pptx
WHAT IS URINE ANALYSIS?
Urine analysis, also called Urinalysis – one of the oldest laboratory procedures in the practice of medicine.
Also knows as Urine- R&M (routine & microscopy)
Is an array of tests performed on urine
WHY URINALYSIS?
General evaluation of health
Diagnosis of disease or disorders of the kidneys or urinary tract
Diagnosis of other systemic disease that affect kidney function
Monitoring of patients with diabetes
Screening for drug abuse (eg. Sulfonamide or aminoglycosides)
COLLECTION OF URINE SPECIMENS
Improper collection---- may invalidate the results
Containers for collection of urine should be wide mouthed, clean and dry.
Analyzed within 2 hours of collection else requires refrigeration.
URINE CULTURE
Culture within 1 hour after collection or stored in a refrigerator at 4oC for no more than 18 hours.
Culture is performed when Polynephritis or Cystitis is suspected.
UTI is most frequent caused by E.Coli.
Other common agents are Enterobacter, Proteus, and Enterococcus faecalis.
URINALYSIS; WHAT TO LOOK FOR?
• Urinalysis consists of the following measurements:
Macroscopic or physical examination
Chemical examination
Microscopic examination of the sediment
Urine culture
PHYSICAL EXAMINATION OF URINE
Examination of physical characteristics:
Volume
Color
Odor
pH
Specific gravity
The refractometer or a reagent strip is used to measure specific gravity
PHYSICAL EXAMINATION
Normal- 1-2.5 L/day
Oliguria- Urine Output < 400ml/day
Dehydration
Shock
Acute glomerulonephritis
Renal Failure
Polyuria- Urine Output > 2.5 L/day
Increased water ingestion
Diabetes mellitus and insipidus.
Anuria- Urine output < 100ml/day
Seen in renal shut down Volume
PHYSICAL EXAMINATION
Normal
pale yellow in color due to pigments urochrome (different colour pigments in urine), urobilin (When urobilinogen- degraded product of bilirubin, is exposed to air, it is oxidized to urobilin, giving urine its yellow color) and uroerythrin (red pigment in urine).
Cloudiness
may be caused by excessive cellular material or protein, crystallization or precipitation of non pathological salts upon standing at room temperature or in the refrigerator.
Color
Colour of urine depending upon it’s constituents.
PHYSICAL EXAMINATION
Abnormal Colors:
Colorless – diabetes, diuretics.
Deep Yellow – concentrated urine, excess bile pigments, jaundice Color
Blue-Green – Methylene Blue, Pseudomonas (Bactrium), Riboflavin (Vitamin B2, in FAD give Yellow Orange Color)
Pink-Orange-Red – Hemoglobin, Myoglobin, Phenolphthalein, Porphyrins, Rifampicin (antibiotic against TB give orange color to urine)
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Urine analysis is a common medical diagnostic tool that can evaluate general health, diagnose diseases of the kidneys and urinary tract, and monitor conditions like diabetes. A urine analysis involves macroscopic examination of properties like volume, color, odor, pH and specific gravity. Microscopic examination analyzes cellular elements and crystals in sediment. Chemical analysis tests for proteins, glucose, ketones, blood, and other substances. Abnormal results can indicate issues with the kidneys, urinary tract, liver or other organs. Precise diagnosis requires correlating clinical history with comprehensive urine analysis findings.
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Oliguria is a low urine output defined as less than 1 mL/kg/hr in infants, less than 0.5 mL/kg/hr in children, and less than 300 mL daily in adults. It indicates an underlying disorder and can lead to acute renal failure if left untreated. Anuria is even less urine output at less than 50 mL/day. Causes of oliguria and anuria include pre-renal (low blood volume), renal (kidney damage), and post-renal (urinary tract obstruction). Evaluation and management depends on determining the cause through history, physical exam, urinalysis, and blood tests to guide volume replacement or other interventions to prevent further kidney injury.
Urine analysis
1. Urinalysis provides important information for diagnosing and managing various renal and metabolic conditions. It involves examining the physical and chemical properties of a urine sample, as well as inspecting it microscopically.
2. The timing and method of urine collection depends on the tests being performed. A first morning midstream sample is preferred for routine analysis but random or postprandial samples are also used.
3. Normal urine has characteristics such as a yellow color, slight acidity, and absence of protein, glucose, and ketones. Abnormal findings provide clues to diseases like urinary tract infections or kidney disorders.
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2. It describes normal ranges and possible indications for abnormal findings for each component such as specific gravity being high in diabetes insipidus and low in renal failure.
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WHAT IS URINE ANALYSIS?
Urine analysis, also called Urinalysis – one of the oldest laboratory procedures in the practice of medicine.
Also knows as Urine- R&M (routine & microscopy)
Is an array of tests performed on urine
WHY URINALYSIS?
General evaluation of health
Diagnosis of disease or disorders of the kidneys or urinary tract
Diagnosis of other systemic disease that affect kidney function
Monitoring of patients with diabetes
Screening for drug abuse (eg. Sulfonamide or aminoglycosides)
COLLECTION OF URINE SPECIMENS
Improper collection---- may invalidate the results
Containers for collection of urine should be wide mouthed, clean and dry.
Analyzed within 2 hours of collection else requires refrigeration.
URINE CULTURE
Culture within 1 hour after collection or stored in a refrigerator at 4oC for no more than 18 hours.
Culture is performed when Polynephritis or Cystitis is suspected.
UTI is most frequent caused by E.Coli.
Other common agents are Enterobacter, Proteus, and Enterococcus faecalis.
URINALYSIS; WHAT TO LOOK FOR?
• Urinalysis consists of the following measurements:
Macroscopic or physical examination
Chemical examination
Microscopic examination of the sediment
Urine culture
PHYSICAL EXAMINATION OF URINE
Examination of physical characteristics:
Volume
Color
Odor
pH
Specific gravity
The refractometer or a reagent strip is used to measure specific gravity
PHYSICAL EXAMINATION
Normal- 1-2.5 L/day
Oliguria- Urine Output < 400ml/day
Dehydration
Shock
Acute glomerulonephritis
Renal Failure
Polyuria- Urine Output > 2.5 L/day
Increased water ingestion
Diabetes mellitus and insipidus.
Anuria- Urine output < 100ml/day
Seen in renal shut down Volume
PHYSICAL EXAMINATION
Normal
pale yellow in color due to pigments urochrome (different colour pigments in urine), urobilin (When urobilinogen- degraded product of bilirubin, is exposed to air, it is oxidized to urobilin, giving urine its yellow color) and uroerythrin (red pigment in urine).
Cloudiness
may be caused by excessive cellular material or protein, crystallization or precipitation of non pathological salts upon standing at room temperature or in the refrigerator.
Color
Colour of urine depending upon it’s constituents.
PHYSICAL EXAMINATION
Abnormal Colors:
Colorless – diabetes, diuretics.
Deep Yellow – concentrated urine, excess bile pigments, jaundice Color
Blue-Green – Methylene Blue, Pseudomonas (Bactrium), Riboflavin (Vitamin B2, in FAD give Yellow Orange Color)
Pink-Orange-Red – Hemoglobin, Myoglobin, Phenolphthalein, Porphyrins, Rifampicin (antibiotic against TB give orange color to urine)
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Urine analysis is a common medical diagnostic tool that can evaluate general health, diagnose diseases of the kidneys and urinary tract, and monitor conditions like diabetes. A urine analysis involves macroscopic examination of properties like volume, color, odor, pH and specific gravity. Microscopic examination analyzes cellular elements and crystals in sediment. Chemical analysis tests for proteins, glucose, ketones, blood, and other substances. Abnormal results can indicate issues with the kidneys, urinary tract, liver or other organs. Precise diagnosis requires correlating clinical history with comprehensive urine analysis findings.
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Oliguria is a low urine output defined as less than 1 mL/kg/hr in infants, less than 0.5 mL/kg/hr in children, and less than 300 mL daily in adults. It indicates an underlying disorder and can lead to acute renal failure if left untreated. Anuria is even less urine output at less than 50 mL/day. Causes of oliguria and anuria include pre-renal (low blood volume), renal (kidney damage), and post-renal (urinary tract obstruction). Evaluation and management depends on determining the cause through history, physical exam, urinalysis, and blood tests to guide volume replacement or other interventions to prevent further kidney injury.
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This document discusses polyuria, which is excessive urine output of greater than 3 liters per day in adults. Polyuria can be caused by physiological factors like excessive fluid intake or anxiety, or pathological factors like endocrine, renal, or psychiatric conditions. It may occur due to increased solute excretion (solute diuresis) or increased water excretion due to a defect in ADH production or renal responsiveness (water diuresis). Other conditions discussed include proteinuria, hematuria, and urinary retention. Causes, diagnostic testing, and treatment approaches are provided for each condition.
Hematuria
Hematuria can be caused by various upper and lower urinary tract diseases. Common causes of glomerular hematuria include IgA nephropathy, Alport syndrome, and thin basement membrane disease. Post-streptococcal glomerulonephritis is associated with a preceding streptococcal infection. Membranous nephropathy presents with nephrotic syndrome. Goodpasture disease involves anti-GBM antibodies attacking the lungs and kidneys. Diagnosis involves urinalysis, renal biopsy, and identifying underlying causes or associations. Treatment depends on the specific condition but may include antibiotics, steroids, immunosuppressants, blood pressure control, and addressing complications.
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2. It describes normal ranges and possible indications for abnormal findings for each component such as specific gravity being high in diabetes insipidus and low in renal failure.
3. It explains what certain findings may indicate such as bilirubin in urine signifying obstructive jaundice or urobilinogen signifying hepatocellular jaundice.
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Jaundice is caused by high levels of bilirubin in the blood which leads to yellowing of the skin and eyes. Bilirubin is produced from the breakdown of red blood cells and is processed by the liver. There are three main types of jaundice depending on where the bilirubin processing is disrupted: pre-hepatic (before the liver), hepatic (in the liver), and post-hepatic (after the liver). Jaundice is diagnosed based on symptoms of yellow skin and testing of liver function and bilirubin levels. Treatment depends on the underlying cause but may include medications, procedures to remove gallstones or tumors, or liver transplantation in severe cases.
evaluation of jaundice
This document discusses the evaluation of jaundice. It begins by classifying jaundice into pre-hepatic, hepatic, and post-hepatic types. Common and uncommon causes of jaundice are then outlined. Signs and symptoms of jaundice are described along with specific examination findings of the abdomen. Aims of investigations are stated as determining the site of biliary obstruction, assessing liver function impairment and its cause, and establishing potential for treatment. Ten specific investigations are then detailed including hematology, liver function tests, bilirubin, alkaline phosphatase, transaminases, urine analysis, serology, abdominal radiology, liver biopsy, and other tests such as ERCP.
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urinalisis.pptx
- 1. Urinalysis Urinalysis tests Introduction Urine is formed in the kidneys, is a product of ultra filtration of plasma by the renal glomeruli.
- 2. Urine sample Early morning sample-qualitative Random sample- routine 24hrs sample- quantitative Midstream sample-UTI Post prandial sample-D.M
- 3. Urine examination Macroscopic examination Chemical examination Microscopic examination
- 4. Color & appearance Normal= clear & pale yellow 1. Colourless- dilution, diabetes mellitus, diabetes insipidus, diuretics 2. Milky-purulent genitourinary tract infection 3. Orange-fever, excessive sweating 4. Red-haematuria 5. Brown/ black- melanin
- 5. Urinary volume Normal = 600-1550ml/day Polyuria- >2000ml Oliguria-<400ml Anuria-complete cessation of urine(<200ml) Nocturia-excretion of urine by a adult of >500ml with a specific gravity of <1.018 at night (characteristic of chronic glomerulonephritis)
- 6. Causes of polyuria Diabetes mellitus Diabetes insipidus Polycystic kidney Chronic renal failure Diuretics Intravenous saline/glucose
- 7. oliguria Dehydration-vomiting, diarrhoea, excessive sweating Renal ischemia Acute tubular necrosis Obstruction to the urinary tract Acute renal failure
- 8. Chemical tests- 1. Protein Causes of proteinuria Prerenal causes-Heavy exercise,Fever,hypertension, multiple myeloma, ecalmpsia Renal –acute & chronic glomerulonephritis,Renal tubular dysfunction,Polycystic kidney, nephrotic syndrome Post renal- acute & chronic cystitis, tuberculosis cystitis
- 9. 2. Bilirubin Test- fouchet’s test. Causes Liver diseases-injury,hepatitis Obstruction to biliary tract 3. Urobilinogen est- ehrlich test Causes-hemolytic anemia's Bile salts- Hay’s test Cause- obstruction to bile flow (obstructive jaundice)
- 10. 3. Urobilinogen Test- ehrlich test Causes-hemolytic anemia's Bile salts- Hay’s test Cause- obstruction to bile flow (obstructive jaundice)
- 11. 4. Blood RBCs-Causes of hematuria Pre renal- bleeding diathesis, hemoglobinopathies, malignant hypertension. Renal- trauma, acute & chronic glomerulonephritis, renal tumors Post renal – severe UTI, calculi, trauma, tumors of urinary tract
- 12. Crystals in urine Crystals in acidic urine Uric acid Calcium oxalate Cystine Leucine Crystals in alkaline urine Ammonium magnesium phosphates(triple phosphate crystals) Calcium carbonate
- 13. Different crystals (indicative of renal disfunction)
- 14. Types of casts Acellular casts Hyaline casts Granular casts Waxy casts Fatty casts Pigment casts Crystal casts Cellular casts Red cell casts White cell casts Epithelial cell cast
- 15. Fatty casts Formed by the breakdown of lipid-rich epithelial cells, these are hyaline casts with fat globule inclusions They can be present in various disorders, including nephrotic syndrome, diabetic or lupus nephropathy, Acute tubular necrosis
- 16. Red cell casts The presence of red blood cells within the cast is always pathologic, and is strongly indicative of glomerular damage. They are usually associated with nephritic syndromes.
- 17. White blood cell casts Indicative of inflammation or infection (especially when there is a pus), pyelonephritis acute allergic interstitial nephritis, nephrotic syndrome, or post-streptococcal acute glomerulonephritis
- 18. Negative Trace (100 mg/dL) + (250 mg/dL) ++ (500 mg/dL) +++ (1000 mg/dL) ++++ (2000+ mg/dL) The Urine Glucose Dipstick: Significance – Diabetes mellitus – Renal glycosuria Normal concentration: 15 mg/dl
- 19. Negative + (weak) ++ (moderate) +++ (strong) The Urine Bilirubin Dipstick: Bilirubin : is a break down of aged RBC or hemoglobin-result in yellowish color-it is excretd in urine and bile Significance -jaundice (direct bilirubin) Hepatitis, cirrhosis, other liver disorders Biliary obstruction
- 20. Negative Trace (5 mg/dL) + (15 mg/dL) ++ (40 mg/dL) +++ (80 mg/dL) ++++ (160+ mg/dL) The Urine Ketones Dipstick: Ketones: are produced by the liver as part of fatty acid metabolism/when lack of glucose occured Significance - Diabetic ketoacidosis - Prolonged fasting (starvation)
- 21. 1.000 1.005 1.010 1.015 1.020 1.025 1.030 It measures the concentration of all chemical particles of urine Normal-1.016-1.022 Significance - Diabetes insipidus (a disorder of the pituitary gland that causes the body to produce large amounts of urine). Urine Specific Gravity
- 22. Negative Moderate Trace + (weak) ++ (moderate) +++ (strong) The Urine Blood Dipstick: Significance - Hematuria Renal problem Glomerulonephritis Tumors
- 23. 5.0 6.0 6.5 7.0 7.5 8.0 8.5 The Urine pH Dipstick: Significance - Acidic (less than 4.5) - Alkaline (greater than 8.0): renal tubular acidosis (>5.5) • respiratory or metabolic acidosis/ketosis respiratory or metabolic alkalosis • renal tubular acidosis • renal calculi /renal stoneformation
- 24. Negative Trace + (30 mg/dL) ++ (100 mg/dL) +++ (300 mg/dL) ++++ (2000 mg/dL) The Urine Protein Dipstick: Significance - Proteinuria:- indicative of early kidney damage Tubular damage Glomerular damage