Exercise 44 Urinalysis

Characteristics of the urine Color Pale yellow to amber Urochrome pigment from the destruction of hemoglobin Transparency Clear Normal change in the color Foods, medications, etc

Characteristics of the urine Odor Subtle fresh urine – characteristic Ammonia-like in standing urine

Characteristics of the urine pH 4.5-8.0 Acid ash foods Proteins, whole wheat Alkaline ash foods Vegetables Bacterial infections Increases the alkalinity of the urine

Characteristics of the urine Specific gravity It is the relative weight of a specific volume of liquid compared with an equal volume of distilled water Urine:1.001-1.030 <1.001=highly diluted urine >1.03=highly concentrated urine

Characteristics of the urine Diluted urine Diuretics Diabetes insipidus Excessive water drinking Concentrated urine Pyelonephritis Limited fluid intake Dehydration

Characteristics of the urine Renal calculi Caused by the precipitation and crystallization of the solutes of the urine

Characteristics of the urine Normal constituents Water Sodium, potassium Phosphates and sulfates Nitrogen wastes: creatinine, urea, uric acid Calcium, Urobilinogen,etc

Abnormal urinary constituents Glucose Glycosuria Diabetes mellitus Albumin “Physiological” albuminuria Pregnancy Excessive exercise

Abnormal urinary constituents Pathological albuminuria Hypertension Kidney trauma Ingestion of heavy metals Glomerulonephritis, etc

Abnormal urinary constituents Ketone bodies - Traces are normal Acetone Beta-hydroxybutyric acid Acetoacetic acid Ketonuria Excessive fat metabolism, diabetes mellitus, starvation, low carbohydrate diets, It causes acidosis

Abnormal urinary constituents Red blood cells Hematuria Calculi, urinary infections, trauma False hematuria menstruation

Abnormal urinary constituents Hemoglobin Hemoglobinuria Hemolytic anemia Blood transfusion reactions Burns Renal diseases

Abnormal urinary constituents Nitrites May indicated bacterial infection mainly gram-negatives rods Bile pigments Bilirubinuria Hepatitis, cirrhosis, bile duct blockage

Abnormal urinary constituents Urobilinogen is abnormal if: Complete absence Renal disease Obstruction of bile flow in the liver Increased levels Hepatitis A Cirrhosis, etc

Abnormal urinary constituents White blood cells Pyuria Urinary infection Casts Are hardened cell fragments Pathologic

Abnormal urinary constituents Hyaline casts Formed by the denaturation of mucoproteins secreted by the tubules Slow filtrate rate Low urine pH High urine salt content

Abnormal urinary constituents RBC casts Glomerulonephrites WBC casts Pyelonephrites Waxy casts Degeneration of the renal tubule cells End stage of renal disease