Body Fluids Analysis - Topic 13 PDF

Analysis of Body Fluids  Course Outline Saliva Milk Gastric juice Urine Stool – Properties – Normal components – Abnormal constituents – Associated pathological condition – Tests  Course Objectives At the end of th...

Analysis of Body Fluids  Course Outline Saliva Milk Gastric juice Urine Stool – Properties – Normal components – Abnormal constituents – Associated pathological condition – Tests  Course Objectives At the end of the lesson, you should be able to: enumerate the physical properties of some body fluids; identify the normal abnormal constituents of body fluids; determine the associated pathological condition if abnormal components are present in body fluids; and describe tests on body fluids.  References Ferrier, D. (2017). Lippincott Illustrated Reviews: Biochemistry. (7th ed.) Philadelphia, USA: Wolters Kluwer. Moore, J. T. & Langley, R. (2008). Biochemistry For Dummies. Hoboken, NJ: Wiley Publishing, Inc. *feel free to share e-materials ☺ SALIVA  Functions Moistens food/lubrication Acts as neutralizer of food intake Defense due to washing mechanism and lysozymes Important in taste – amylase (salivary amylase) – initiates digestion Salivary lipase – initiates fat digestion Normal Output 1-1.5L per day pH Level 6.4-7 pH level Specific Gravity higher than water because of the presence of solutes  Normal Constituents Carbohydrates Proteins Nitrates Glucose Thiocyanate Inorganic phosphate Chloride  Water Electrolytes Mucus – consists of mucopolysaccharides and glycoproteins Antibacterial compounds – consist of thiocyanate, hydrogen peroxide and IgA Amylase – starts the digestion of starch and lipase fat before the food is even swallowed Lysozyme – acts to cause lysis in bacteria Lipase – fat digestion MILK  Properties pH: 6.6 to 6.9 specific gravity: 1.126 to 1.036 color: white to yellowish (due to casein, fat and pigments) Enzymes Vitamins lipase protease Vit A amylase Vit D catalase Vit E phosphatase lactase Vit K peroxidase Pigments Lactose The appearance of milk is white. This is due to major light rays reflected by carbohydrate the colloidally dispersed constituents of the milk in milk – calcium caseinate and calcium phosphate. digested by Lactoflavin – imparts a yellow color with green lactase fluorescence Carotene – imparts a more or less yellow tinge  Fat palmitic and stearic acid Homogenization is the process by which fat globules in fluid milk are broken into sizes small enough that they will not rise in the milk to form cream under normal milk storage conditions. This is important for processing, storage and consumption of cow's milk. Protein Water the primary provides an protein in milk is aqueous casein medium for the major suspension of globulins are organic beta-lactoglobulin and components of alpha-lactalbumin milk  Minerals calcium and phosphorus are the major minerals found in milk minor minerals are Zn, Fe,Cu, Mn and Co Minerals contribute to the buffering capacity of milk, the maintenance of milk pH, the ionic strength of milk and milk's osmotic pressure.  What makes breast milk better than commercial infant formula? Human milk contains living cells, hormones, active enzymes, immunoglobulins and compounds with unique structures that cannot be replicated in infant formula. Breast milk is perfectly suited to nourish infants and protect them from illness. Human milk transfers to the infant a mother's antibodies to disease. About 80% of the cells in breast milk are macrophages and immunoglobulins. GASTRIC JUICE  Functions The gastric acid plays a role in digestion, by activating digestive enzymes  Properties Amount – 2L/day Color – colorless Odor – odorless pH – 0.8 to 5  Normal Components hydrochloric acid pepsinogen intrinsic factor gastrin mucus bicarbonate chyme traces of bile Name of the Purpose Reagent/s (+) Result test Boa's test To detect Boa's reagent Red hydrochloric acid Uffelman's test To detect lactic Uffelman's Yellow acid reagent (ferric chloride + solution of phenol) Strauss test To detect lactic Ferric chloride Strong greenish acid yellow Gmelin's test Presence of bile Concentrated Green, blue or pigment nitric acid violet Benzidine test Presence of Benzidine Blue or Green blood reagent + H2O2 URINE  COLOR – yellow to deep amber (normal) ODOR – mildly aromatic but becomes ammonia upon standing (normal) SPECIFIC GRAVITY – a laboratory test that measures the concentration of particles in the urine (1.01-1.035) PH – normal pH is 4.6-8 TRANSPARENCY – urine is transparent but becomes cloudy upon standing Normal urine output per day is 1-2 liters.  Normal Urine Components Organic Urea derived from ammonia Creatinine normal constituents of the blood Uric Acid product of catabolism of nucleic acids Urobilinogen bile pigment Other CHO, pigments FA, enzymes, substances hormones Inorganic Na2, K+ Cl-, Mg2+ SO2+ derived from amino acid H2PO4-, HPO4-, PO43- serves as buffer NH4+ derived from protein Ca2  ABNORMAL COMMENTS CONSTITUENTS Albumin Albuminuria – increases permeability of endothelial-capsular membrane due to injury/disease Glucose Glucosuria – indicates diabetes mellitus or stress RBC Hematuria – indicates pathological condition WBC Pyuria – indicates and infection Ketone bodies Ketosis – indicates DM, starvation, anorexia, or too little carbohydrate in the diet Bilirubin Bilirubinuria Urobilinogen Urobilinogenuria – indicates hemolytic anemia, hepatitis, biliary obstruction, jaundice, cirrhosis, congestive heart failure. Casts Tiny material that are hardened and assumed the shape of the lumen in which they are formed Microbes Infection  Name of Test Purpose Reagent/s (+) Result Nitroprusside To detect NH4OH, Purple tinge test presence of (NH4)2SO4 acetone Benedict’s test To detect Benedict’s presence of reagent glucose Heller’s test To detect HNO3 Fluffy zone presence of (sometimes albumin which precipitate) Benzidine test To detect Benzidine Blue ring presence of reagent blood Gmelin’s test To detect HNO3 Green, blue, presence of or violet bile pigments rings Pettenkoffer’s To detect H2SO4 Red ring test presence of bile acid and salts STOOL  Physical Characteristics Stool Color Normal – Adult: brown – Infant: yellow  Abnormal – Clay or white: absence of bile pigment (bile obstruction) or diagnostic study using barium – Black or tarry: Drug (e.g. iron), bleeding from upper gastrointestinal tract (e.g. stomach, small intestine), diet high in red meat and dark green vegetables (e.g. spinach) – Red: bleeding from lower gastrointestinal tract (e.g. rectum), some foods (e.g. beets) – Pale: malabsorption of fats, diet high in milk and milk products and low in meat Stool Consistency Normal: formed, soft, semisolid, moist Abnormal: hard, dry, constipated stool – Dehydration, decreased intestinal motility resulting from lack of fiber in diet, lack of exercise, emotional upset, laxative abuse Abnormal: diarrhea Increased intestinal motility (e.g. irritation of the colon by bacteria) Stool Odor Normal: aromatic, affected by ingested food and person’s own bacterial flora Abnormal: pungent – Infection, blood  Stool Color Bilirubin depending on the concentration of bilirubin, bile can vary from almost black to light yellow in color  If the intestinal contents travel at a normal speed, stool is light to dark brown. intestinal contents travel more rapidly, chemical changes to bilirubin – and/or the lack of them – may turn the stool green. no bilirubin (bile) in the stool, the stool is a gray, clay-like color.; the most common causes of blockage are tumors of the bile ducts or pancreas. Pancreatic enzymes If not present, fat is not fully digested, stool may become a yellowish color, appears “greasy” and smells bad - pancreatic tumors Pancreatitis due to damage from excessive ingestion of alcohol, pancreatic cells are destroyed, no enzymes If there is both blood and undigested fat in the stool, the stool may become silver. Food Iron and bismuth-containing medications, for example, Pepto Bismol, turn the stool black. Beets and possibly some other red vegetables and fruits can turn stool a reddish color. Food dyes used for coloring foods also may color the stool.  Normal constituents small amounts of undigested roughage sloughed dead bacteria and epithelial cells fat Protein dried constituents of digestive juices (e.g. bile pigments) inorganic matter (e.g. calcium, phosphates)  Abnormal Components Pus: bacterial infection Mucus: inflammatory condition Parasites Blood: gastrointestinal bleeding Large quantities of fat: malabsorption Foreign objects: accidental ingestion  Tests Stool Guaiac Test detects the presence of fecal occult blood It involves feces, a thick piece of paper attached to a thin film coated with guaiac (extracted from trees in the genus Guaiacum), and hydrogen peroxide Gmelin Test a qualitative test for the pigments in bile; test solution is mixed with nitric acid containing nitrous acid; reaction is positive if color appears at the acid-solution junction