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Human urine is the effluent fluid that is disposed from the kidney. It is highly reflective in its properties, of the state of health of each individual. Urinalysis is a routine / basic investigation. Involves: Physical and chemical examination of urine. Includes microscopic exam. Cheap, Fast and Simple. Evaluation, diagnoses and monitoring health status.
Human urine is the effluent fluid that is disposed from the kidney. It is highly reflective in its properties, of the state of health of each individual. Urinalysis is a routine / basic investigation. Involves: Physical and chemical examination of urine. Includes microscopic exam. Cheap, Fast and Simple. Evaluation, diagnoses and monitoring health status.
Human urine is the effluent fluid that is disposed from the kidney. It is highly reflective in its properties, of the state of health of each individual. Urinalysis is a routine / basic investigation. Involves: Physical and chemical examination of urine. Includes microscopic exam. Cheap, Fast and Simple. Evaluation, diagnoses and monitoring health status.
WGH, Ilesa. Introduction The Human urine is the effluent fluid that is disposed from the kidney.
Thus, It is highly reflective in its properties, of the state of health of each individual. Urinalysis A routine/ basic investigation.
Involves: Physical & chemical examination of urine. Complete urinalysis: Includes microscopic exam.
Cheap, Fast & Simple.
Evaluation, diagnoses & monitoring health status. Indications: To: 1. Evaluate the general health status (Routine test)
2. Diagnose & monitor renal disorders.
3. Monitor for hyperglycemia/ Diabetes Mellitus.
4. Screen for drug abuse (e.g. steroids in athletes).
5. Pregnancy test Analysis Can be performed:
Bedside.
Side laboratory.
Chemical pathology laboratory. How is urinalysis done? 1. Obtain Consent & Cooperation of Patient & Parent. 2. Urine collection: a) Freshly voided urine
b) Timing: Any time of the day. Early morning is most valuable: Being most concentrated, it is more reliably measures kidney function.
c) Clean the genitalia: cotton wool, water. i. *Soap & disinfectant may contaminate urine. ii. *Methylated spirit is astringent & kills germs in urine. Procedure: a) Collect mid-stream (clean catch) or terminal urine samples.
b) Other methods of collection: i. Catheterisation. ii. Supra-pubic aspiration.
Collect sample in a clean, transparent containers: i. Urinalysis ii. MCS Precautions: Read immediately (Max: 15 min) as Chemistry changes.
Otherwise refrigerate urine.
Put the dipstick into the urine
May use Urinometer to measure S.G The Normal Urine Vs Abnormality: Colour & Clarity Normal Appearance:
Haemoglobinuria: G6PD Def Bilirubinuria: Hepatitis Foods & drugs: Rifampicin. Amino-acidurias. In-born errors of Metabolism. Cloudy/ Turbid : Suggest UTI. Normal Urine Vs. Coca-Cola Urine The Normal Urine Vs Abnormality Odour & Sediments Normal Appearance:
Odour: Slight ammonical odour.
Sediments: Nil.
Abnormalities:
Odour: Has fishy odour in UTI particularly in Proteus Sp.
Sediments:
The Normal Urine Vs Abnormality Volume, S.Gravity & pH Vol: 1 - 2mls/ Kg/ hour.
S. Gravity: a simple measure of concentrating ability of kidneys = 1.015 1.025.
pH: If Alkaline = UTI Urinometer (Hygrometer) Urine Chemistry: Proteinuria Proteinuria: About 150mg/ 24hours, (usually Albumin). This amount is usually not dipstix detectable. Trace, 1+, 2+ ARF, CRF, UTI, Exercise 3+/ 4+ Nephrotic Syn. Trace: 10 29 mg/ dL
1+: 30 99 mg/ dL
2+: 100 299 mg/ dL
3+: 300 999 mg/ dL
4+: 1 g/ dL Dipsticks (Combi-9 Dipstix) Urine Chemistry: Sugar Glucose: Nil. Glycosuria reflects hyperglycemia: DM Monitor Patients on IV glucose infusion Other Reducing Substances: Usually absent. E.g. Galactosuria. Clinitest: ROYGBIV Normal (0%): Blue
Glycosuria: Green: % Yellow: % Orange: 1% Red: 2% suggestive of (RBS 15 mmol/ L) Urine Chemistry: Normal Vs AbN Bilirubin: Nil. Conjugated hyperbilirubinaemia.
Nitrite: Not usually detectable. Presence indicative of UTI (Proteus sp). Urine Microscopy Cells: RBC: 0 2/ hpf WBC: 0 5/ hpf but > 5/ hpf: Pyuria. Epithelial Cells: Few, more in newborn
Organisms: Nil.
Casts: Small fibrous objects formed when protein & other materials deposit in the kidney tubules & coll. ducts. Hyaline cast: 0-1/ hpf; found in Nephrotic Syn. Red cell/ granular: Nil; found in AGN. Limitation A limitless test, Simple, Cheap, Easil reproducible. Protein + Glucose: N50 Protein + Glucose + pH: N75 Combi-9: N150 Microscopy: N225 Full Urinalysis: N375.
Limitation: We often forget to do it. Conclusion Must be done on all patients.
The findings must be followed with appropriate investigations. Best combined with other tests .e.g. E/ U + Cr & 24Hour urinalysis. Thank you!