Routine department repaired-
8 likes1,695 views
This document provides information about routine urinalysis, including normal ranges, potential causes of abnormal findings, types of urine samples, macroscopic and microscopic examination, and dipstick test results. It describes the appearance and potential causes of abnormal urine colors. It also lists normal ranges and clinical significance for various findings on dipstick testing for specific gravity, pH, protein, glucose, ketones, blood, leukocyte esterase, nitrite, bilirubin, and urobilinogen. Details are given about cellular and non-cellular components that may be seen microscopically in urine sediment and their clinical relevance.
Routine department repaired-
- 1. HUSSEIN REIAD ALMAYTAH & FATIMA ALMARAKSHI Routine department & body fluids ((report)) samples : urine , stool , Seminal fluid Other fluid like (Synovial fluid, CSF, peritoneal fluid, pleural fluid) instrument and equipment : light microscope , centrifuge , fume hood incubator , hemocytometer , slides and cover slide , conical tube micropipettes 20-200 µl ,dipstick ,wooden stick , disposable dropper . SECTION OF URINALYSIS : NOTE : NORMAL VALUE RANGES MAY VARY SLIGHTLY AMONG DIFFERENT LABORATORIES NORMAL URINE OUTPUT (MINIMUM):0.5-1 ML/KG/HR DAILY OLIGURIA LESS THAN 500ML/24 HOURS ANURIA LESS THAN 100ML/24 HOURS LOW URINE OUTPUT : POTENTIAL CAUSES PRERENAL -HEART FAILURE -SHOCK -VOLUME DEPLETION - RENAL ARTERY COMPROMISE RENAL -ACUTE TUBULAR NECROSIS -END-STAGE RENAL DISEASE -GLOMERULAR DISEASE POST-RENAL -NEUROGENIC BLADDER -OBSTRUCTION OF URETER, BLADDER NECK URINE SAMPLE TYPE : -RANDOM -FIRST MORNING -24HR COLLECTION -MIDSTREAM(CLEAN CATCH )
- 2. URINALYSIS, MACROSCOPIC APPEARANCE STRAW OR YELLOW COLORED CLEAR ABNORMAL URINE COLORS DARK YELLOW -CONCENTRATED URINE -DRUGS ; HEPARIN WARFARIN CHLORZOXAZONE DARK BROWN -BILE PIGMENT -HIGH BILIRUBIN CONCENTRATION -RHABDOMYLOSIS(MYOGLOBINURIA) -FAVA BEANS - SULFONAMIDES,QUININ,CASCARA DRUGS GREEN -HARTNUP DISEASE -INDICANURIA -PSEUDOMONAS INFECTION -ASPARAGUS -CLORETS ORANGE -HYPERCAROTENEMIA -DIABETES MELLITUS -HYPERLIPIDEMIA -HYPOTHYROIDISM -PROPHYRIA -BEETS -BLACKBERRIES RED -BLOOD -HEMOGLOBIN -MYOGLOBIN -PROPHYRINS -RHUBARB, BLACKBERRIES ,BEETS FOODS - TRAUMA -PRIMARY AND SECONDARY RENAL DISEASE -TB -SCHISTOSOMIASIS -PROSTATITIS -CYSTITIS -UTI -COAGULOPATHY
- 3. PINK OR PURPLE INFECTION -KLEBSIELLA PNEUMONIAE -P.AERUGINOSA -E.COLI -ENTEROCOCCUS SPP. BLACK -ALKAPTONURIA -MALIGNANT MELANOMA -METHEMOGLOBINURIA -ACUTE INTERMITTENT PORPHYRIA MILKY -PYURIA DIPSTICK CHART (CHEMICAL EXAMINATION )
- 4. TEST REMARKS SPECIFIC GRAVITY AN INDEX OF WEIGHT PER UNIT VOLUME REFLECT URINE CONC. NORMAL 1.001-1.035 INCREASE IN : -DEHYDRATION -GLYCOSURIA -PROTENURIA DECREASE IN : -COMPULSIVE WATER DRINKING -DIABETES INSIPIDUIS PH NORMAL URINE IS ACIDIC BUT IN RANGE 4.8-8.0 HIGH PH ( ALKALINE ) IN : - INFECTION WITH UREA-SPLITTING ORGANISMS EX.(PROTEUS) - SYSTEMATIC ALKALOSIS - RENAL TUBULAR ACIDOSIS LOW PH (ACID URINE) IN : METABOLIC ACIDOSIS PROTEIN GLOMERULAR DISEASE PRODUCES PROTEINURIA BY ALLOWING FILTRATION OF LARGER MOLECULES THAN NORMAL SLIGHTLY INCREASED PROTEIN IN : -PYELEONEPHRITIS -BENIGN ORTHOSTATIC PROTENURIA -IDIOPATHIC FOCAL GLOMERULONEPHRITIS MARKED PROTEINURIA IN : -DIABETES MELLITUS -SLE -RENAL VEIN THROMBOSIS -AMYLOIDOSIS DEGREE OF PROTEINURIA CAN BE QUANTIFIED BY A 24-HOUR URINE COLLECTION GLUCOSE GLUCOSE IS FILTERED IN THE GLOMERULUS THEN REABSORBED IN THE PROXIMAL TUBULE. IF SERUM GLUCOSE IS >180MG/DL THE FILTERED LOAD WILL EXCEED THE CAPACITY FOR TUBULAR REABSORPTION AND GLUCOSE
- 5. WILL APPEAR IN THE URINE GLUCOSURIA IN : - D.M - ACUTE TUBULAR DAMAGE - FANCONI SYNDROME KETONES KETONURIA INDICATES THAT CELLULAR METABOLISM IS DEPENDENT UPON FATTY ACIDS RATHER THAN GLUCOSE FOR ENERGY KETONURIA IN : -DIABETIC KETO-ACIDOSIS -FASTING/STARVATION -ALCOHOLIC KETOACIDOSIS BLOOD THE DIPSTICK TEST FOR HEME, WHICH IS FOUND IN BOTH HEMOGLOBULIN AND MYOGLOBIN. A DIPSTICK POSITIVE FOR BLOOD SHOULD BE FOLLOWED UP WITH A MICROSCOPIC ANALYSIS. HEMATURIA IN : -INFECTION/INFLAMMATION OF BLADDER OR PROSTATE -NEPHROLITHIASIS -MALIGNANCY ( BLADDER , RENAL ) LEUKOCYTE ESTERASE ( LE ) INDICATE THE PRESENCE OF LEUKOCYTE WHICH HAVE LIBERATED ESTERASE INFECTION OR INFLAMMATION WITHIN THE URINARY TRACT NITRITE INDICATE THE PRESENCE OF BACTERIA WHICH HAVE REDUCED NITRATE NITRITE BILIRUBIN BILIRUBINURIA IN : - HEPATIC DISEASE - OBSTRUCTIVE BILIARY DISEASE UROBILINOGEN NORMAL IN URINE <1MG/DL INCREASED IN : -HEMOLYTIC DISEASE -HEPATIC DISEASE BENCE-JONES PROTEIN NORMAL ( NOT FOUND) IF PRESENT INDICATE OF MULTIPLE MYELOMA
- 6. MICROSCOPIC EXAMINATION RED BLOOD CELLS LESS THAN 5/HPF IFMORE, SUGGESTS INFECTION OR INFLAMMATION OF BLADDER OR PROSTATE NEPHROLITHIASIS WHITE BLOOD CELLS LESS THAN 5HPF IF MORE, SUGGESTS INFECTION OR UTI *IN WOMEN THE UA MAY BE CONTAMINATED BY VAGINAL LEUKOCYTE RENAL CELLS NONE SEEN INCREASED NO. INDICATE NECROSIS OF THE TUBULES TRANSITIONAL CELLS NONE SEEN SPINDLE OVAL SHAPE ,INCREASE NO. INDICATE UTI SQUAMOUS CELLS RARE. USUALLY NO CLINICAL SIGNIFICANCE LARGE , FLAT SHAPE IN FEMALE SUGGEST CONTAMINATION.
- 7. BACTERIA RODS OR COCCI , MOTLE IN FRESH URINE .WITH WBC INDICATES UTI . YEAST OVAL ,SHOWING BUDDING DUE TO : UTI BY YEAST OR CONTAMINATION FROM VAGINAL SECRETION . HAYLINE CAST COLORLESS AND HOMOGENOUS RBC CAST ORANGE RED TO BROWN WBC CAST INDICATE INFLAMMATION WITH RBC CAST INDICATE GLOMERULONEPHRITIS
- 8. RENAL TUBULAR CAST LARGE SIZE , CELL ARRANGED IN PARALLEL ROWS GRANULAR CAST INCREASE IN URINE AFTER STRENUOUS EXERCISE WAXY CAST SMOOTH LOOKING WITH BLUNT END AND SERRATED MARGINS SHOW IN RENAL FAILURE CRYSTALS IN ACID URINE : URIC ACID ,CA++ OXALATE AMORPHOUS URATES IN ALKALINE URINE : TRIPLE PHOSPHATE CA++ PHOSPHATE AMMONIUM BIURATE
- 9. PARASITE - T .VAGINALIS -S. HAEMATOBIUM - E .VERMICULARIS PROCEDURE FOR EXAMINING THE URINARY SEDIMENT : - CENTRIFUGE 10ML OF URINE IN A CONICAL TUBE FOR 5 MIN - DECANT THE SUPERNATANT - PLACE THE FORMED ELEMENT ON A SLIDE UNDER A COVER SLIP TO BE EXAMINED WITH HPF