Urine Analysis PDF

Republic of Iraq Ministry of Higher Education and Scientific Research AL-Safwa University College Department of Pharmacy Urine Analysis 3RD CLASS 2 ND COURSE LEC.1,2...

Republic of Iraq Ministry of Higher Education and Scientific Research AL-Safwa University College Department of Pharmacy Urine Analysis 3RD CLASS 2 ND COURSE LEC.1,2 BY M S C. M O H A M M E D M A J ID ALREKAB I  Urine analysis or Urinalysis A urinalysis is a group of chemical and microscopic tests. They detect the by products of normal and abnormal metabolism, cells, cellular fragments, and bacteria in urine. Urine is the yield filtrate of the urinary system. The physical , chemical, microscopically , microbiological as well as immunological constituents reflects the state of normality or abnormality of the urinary system. According to the medical demands , urinalysis is classified into two groups of tests:  Routine urinalysis which is including: General Urine Examination (GUE). a. Examination of the physical appearance of urine. b. Examination of the chemical composition of urine. c. Examination of the microscopic components of urine.  Specific urinalysis including : a. Urine culture. b. Microbial sensitivity test. c. Immunological tests. Urine analysis or Urinalysis GUE  A. Physical Appearance of Urine Normal urine is pale yellow to amber with no turbidity (clear to slightly hazy) with ph 4.5- 8.0. This picture is changed in many abnormalities as follow :  A. Physical Appearance of Urine PH : ph of urine is not very helpful in deciding the urine abnormality. Kidney play an important role in the maintaining acid-base balance , so urine PH is affective by the acidosis or alkalosis of the blood. NOTES: ↑ protein food → Acidic urine. ↑ vegetable - ↓ COH - ↑ citrus fruits → Alkaline urine.  A. Physical Appearance of Urine Specific gravity : Normal urine is ranging between (1.010- 1.025). SG is a measure of the concentration of dissolved solutes (substance in a solution) and it reflect the ability of the kidney to concentrate the urine. it can be measured by refractometry or by chemical analysis. ↑ SG → ↑ Urine con. (1.035) → 1. Diabetes mellitus 2. Large amount of medication 3. Radiologic studies 4. Oligo urea ↓ SG → ↓ Urine con. (1.003) → 1. Diabetes insipidus 2. Renal failure 3. Poly urea  B. Chemical and Biochemical Composition A viable dry reagent strips (dipstick) are used for the routine chemical tests of urine. Reagent strips (dipstick) are plastic strips that have one or more chemically impregnated test site on an absorbent pad. A chemical reaction occurs when the chemicals on the test strip come in contact with urine The reaction causes a color change in the absorbent pad. This color is compared to a color chart printed on the side of the reagent strip bottle. The intensity of the color is usually proportional to the amount of the substance present in the urine B. Chemical and Biochemical Composition  B. Chemical and Biochemical Composition  Glucose:)Glucosurea) “The normal concentration of glucose in blood is between 70-99 mg/dL (fasting), and less than 140 mg/dL two hours after eating. The kidney doesn’t allow glucose to be released from the blood to urine, except if the concentration increases to about 160-180 mg/dL in blood, which is called the renal threshold. Certain diseases, like diabetes, can cause glucose to be released in the urine (glucosuria).”  Proteins (albumin): The presence of increase amount of protein in the urine can be an important indicator of renal disease. Albumin is smaller than most other proteins and is typically the first protein that is seen in the urine when kidney dysfunction begins to develop.  B. Chemical and Biochemical Composition  Bilirubin test : Urine bilirubin can aid in the diagnosis of liver dysfunction, including conditions like hepatitis and biliary obstruction.”  Urobilinogen test : Bilirobin is transformed through the action of bacterial enzyme in to urobilinogen after it enters the intestines. urobilinogen is one of the most sensitive tests available to determine liver function. Increased urinary urobilinogen occur in prehepatic jaundice (hemolytic anemia), hepatitis, hepatic necrosis and others.  B. Chemical and Biochemical Composition  Ketones: The urine reagent strip test for ketones detects acetoacetic acid. In ketoacidosis due to insulin deficiency or starvation it can be present in large amount in the urine before any elevation is seen in plasma levels.  Blood: the presence of large numbers of RBCs in the urine sediment establish the diagnosis of hematuria.  B. Chemical and Biochemical Composition  Uric acid test : Uric acid concentration in urine above and below normal are known as hyperuricosuria and hypouricosuria. such abnormal concentration of uric acid are not medical condition , but are associated with a variety of medical condition. High concentration may be caused arthritis (Gout), Cardiovasecular disease , Diabetes, Metabolic syndrome.  C. Microscopic examination of urine Urine : is examined microscopically to refers to all solid materials suspended in the urine specimen. Normal sediment : 1. WBC cells 2. Red cells 3. Casts and crystals 4. Yeast cells 5. T. vaginalis motile trophozoite 6. S. haematobium eggs 7. Bacteria 8. Epithelial cells 9. Spermatozoa  C. Microscopic examination of urine 1. White blood cells (pus cells): The number of WBCs in urine sediment is normally low (or very few). When the number is high, it indicates an infection or inflammation somewhere in the urinary tract and called (pyuria). Interpretation of the results 2-3 → trace 7-10 → + 15- 20 → ++ 25- 30 → +++ Upper 30 → ++++ (full fields)  C. Microscopic examination of urine 2. Red blood cells (RBCs): Normally, no red blood cells should be found in urine, except in certain physiological conditions like during menstruation. The presence of red blood cells in urine is called hematuria, which is an indicator of a potential health problem such as kidney damage or urinary tract tumors. Hemoglobinuria is a different condition, where hemoglobin is present in the urine due to the breakdown of red blood cells.  C. Microscopic examination of urine 3. Epithelial Cells: Epithelial cells are typically found in small quantities in urine. These cells come from the lining of the urinary tract or reproductive organs. In women, their presence can be normal in some cases, such as after menstruation or due to hormonal changes during pregnancy. In men, the presence of epithelial cells in urine is generally considered abnormal and may indicate a urinary tract infection (UTI), inflammation in the urinary tract, or kidney diseases.  C. Microscopic examination of urine 4. Casts: formed from abnormal protein secreted by kidney cells.The presence of casts in urine indicator for renal. 5. Yeast cells : Can be seen this cells in the urine of person suffering from diabetic , immunosuppression and can be found in urine of women with vaginal candidiasis.  C. Microscopic examination of urine 6. Parasite: a. Trichomonas vaginalis trophoziote: Trichomonas vaginalis is one of the causative agents of vaginitis in women and some time seen in the men's urine. b. Schistosoma haematobium eggs : can be excreted in urine after about 4-6 weeks of Sch. 7. Crystals: Urine : contains many dissolved substances (solutes) – waste chemicals that the body needs to eliminate. These solutes can form crystals, solid forms of a particular substance. Crystals may be associated with formation of urinary tract stones. The PH of urine is an important to identify the crystals.  C. Microscopic examination of urine Crystals:  Crystals in acidic urine : a) Amorphous urates b) Uric acid c) Calcium oxalate d) Sodium acid urate  Crystals in alkaline urine : a) Amorphous phosphates b) Calcium phosphate c) Ammonium blurate d) Triple phosphates e) Calcium carbonate THANK YOU FOR LISTINING