Gluk BiLi Keton

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Sedimen
Bloo

INTRODUCE OF URINALISIS
Urine is produced by the kidney to maintain constant plasma osmotic
concentration; to regulate pH, electrolyte and fluid balances and to
excrete some 50 grams of waste solids(mostly urea and sodium
chloride)
Some normal urine constituents excreted (in g/24 hours):
* Urea 25-30
* Amino acids 3
* Uric acid 0.6-0.7 * Sodium 1-5 (NaCl 15.0)
* Creatinine 1.0-1.2 * Potassium 2-4
* Hippuric acid 0.7
* Calcium 0.2-0.3
* Ammonia 0.7 * Magnesium 0.1

* Chloride 7
* Phosphate 1.7-2.5
* Sulfate 1.8-2.5

Gluk BiLi Keton

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Sedimen
Bloo

INTRODUCE OF URINALISIS
The color and appearance of the urine specimen is
recorded.
Usual colors are colorless, straw, yellow.
less commonly pink, red, brown.
Usual appearances (opacity) are clear or hazy; less
commonly turbid, cloudy and opaque.

Gluk BiLi Keton

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Sedimen
Bloo

INTRODUCE OF URINALISIS

Gluk BiLi Keton

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Sedimen
Bloo

INTRODUCE OF URINALISIS

Gluk BiLi Keton

Sedimen
Bloo

Bj

GLUKO
Chemical
Principle
SA
Glucose Oxidase
Glucose + 2 H2O + O2
Peroxidase
3 H2O2 + KI

Gluconic Acid + 2 H2O2

KIO3 + 3 H2O

+ Kromogen
Read at 30 seconds
RR: Negative

BAGAIMANA
INTERPRETASINYA
????
APAKAH JIKA POSITIP

GLUK
FALSE POSITIP ????
OSA
Asam Askorbat 5 mg/dL 40 mg/dL
Glukosa

The presence of glucose

indicates that the filtered load
of
glucose
exceeds
the
maximal tubular reabsorptive
capacity for glucose

Gluk BiLi Keton

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Sedimen
Bloo

INTRODUCE OF URINALISIS

KETON

Chemical Principle

Acetoacetic Acid + Nitroprusside

Colored Complex
Read at 40 seconds
RR: Negative

BAGAIMANA INTERPRETASINYA ????

APAKAH JIKA POSITIP SELALU GLUKOSA

Gluk BiLi Keton

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Sedimen
Bloo

INTRODUCE OF URINALISIS
The presence of Sulfhydryl groups can make False Positip.
Detectable levels of ketone may occurs in urine during
physiological stress condition such as Fasting, pregnancy and
frequent strenuous Exercise.
Urine testing only detects Acetoacetic Acid, not the other
ketones, Acetone or beta-hydroxybuteric acid. In KetoAcidosis
(insulin deficiency or starvation), it can be present in large
amounts in the urine before any elevation in plasma levels.

Click to Look Biochemistry Proses

Glu
k

History of BiLiruin

pH

BILIRUBIN
Bilirubin
+
Garam diazonium
dichloroanilin

Colored Complex
Shade of tan
Read at 60 seconds
sensitivity: 0,4 - 0,8 mg/dL

BAGAIMANA

BILIRUBIN

BM=584.66214

C33H36N4O6

Normal Adult urine contains about 0,02 mg/dl of

bilirubin. Event trace amount of bilirubin are
sufficiently abnormal to require further
investigation.
0,1 mg/dl maybe found in the earliest phases of
liver disease. Jika dgn kandungan yg lebih kecil
dari 0,1 spt pd fase awal viral hepatitis
ICTOTEST Reagen Tablet adalah yg lebih baik.
Indican (indoxyl sulfate) can produce a yelloworange to red color that may interfere with the
result.
Metabolite of Lodine (etodolac) may cause false
Glu History of BiLiruin
positive.

pH

Glu
k

History of BiLiruin

urobilinogen
Urobilinogen
+
Diethyl amino benzaldehyde

Colored Complex
Pink-Red Colour
Read at 60 seconds
Sensitivity: 0.2 -2.0 mg/dL

pH

urobilinogen
Urine urobilinogen is increased in any condition that
causes an increase in production or retention of
bilirubin.
Normally present in urine at concentration 1 mg/dL (1
Ehrlich Unit/dL), 2,0 mg/dL represents the transition
from normal to abnormal and should be evaluated
further for hemolytic and hepatic desease.
Asam Salisilat , Asam Amino benzoat, & Sulfonamid dpt
memberikan warna yg tdk wajar.
False negatip terjadi jk ada kehadiran Formalin.
Bagaimana Jika Bili +++, Tapi Urobilin + ???
Bagaimana Jika Bili - , Tapi Urobilin + ???

History of BiLiruin
BiLi

Sedimen

UROBILINOGEN
Lihat Latar Belakang Terbentuk
Urobilinogen
FALSE POSITIP :
p-Amino Benzoic Acid
p-Amino Salicylic
Sulfonamid

Dapat menditeksi pd kadar min. 0,2

mg/dL atau 3,2 umol/L atau 0,2 EU/dL.
(Nilai
normal 0,2 - 1 mg/dL=3,2 - 16
Click
to Back

Gluk BiLi Keton

Specific

Bj

Sedimen

Gravity

Chemical Principle
X+ Polymethyl vinyl ether / maleic
anhydride
X-Polymethyl vinyl ether / maleic
anhydride + H

BAGAIMANA

Gluk BiLi Keton

Specific

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Sedimen

Gravity

A specific gravity of <1.010 is consistent with a concentrating

defect.
A specific gravity of >1.025, in the absence of protein, glucose
and other large molecular weight substances such as contrast
media, usually indicates normal renal concentration and makes
chronic renal insufficiency unlikely.
normal..1,0161,022
Ketoacidosis and protein higher more than 100 mg/dL may
cause elevated result.

Gluk BiLi Keton

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Sedimen

Blood
Chemical
Principle
Diisopropylbenzene
dihydroperoxide
Peroksidase
+
Tetramethylbenzidine
APAKAH JIKA POSITIP SELALU SEL ERITROSIT

The presence of large numbers of RBCs in the urine sediment

establishes the diagnosis of hematuria. If the stick is more
strongly, possibility of hemoglobinuria or myoglobinuria should
be considered.
The presence of Capoten (Captopril) cause decreased
reactivity,
Microbial Peroksidase, Hypochlorite can make False Positip.
0,015 0,062 mg/dL Hb 5 -20 cell/L

Gluk BiLi Keton

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Leucocyte
Chemical
Hidrolisa
Granulocytic
Principle
Leucocyte

[Esterase]

Diazo salt

Ester Pyrrole amino

acid
3-hydroxy-5-phenyl
pyrrole

Purple colored
complex

APAKAH JIKA POSITIP SELALU SEL

Sedimen

Glu
k

BiL Keto Bj
n
i

Blo
od

pH

Leucocyte
Elevated glucose 160 mmol/L (3 g/dL) or
Elevated SG, high concentrations of oxalic
acid,
tetracycline,
Cephalexin
[keflex],
cephalothin [keflin] may caused decreased
test results.
5 15 cells/plp can be detected.
Tingginya konsumsi obat akan dapat
memberikan reaksi false negative

Glu
k

BiL Keto Bj
n
i

Blo
od

pH

Leucocyte

IKeflin

Keflek

Gluk BiLi Keton

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Sedimen

Nitrit
Chemical
Principle Nitrat dari
Gram negative
Bacteria

makanan
Suasana
Asam
NITRIT
Arsanilic Acid
Garam
Diazo

Tetra hidrobenzo
quinolin
Komplek warna
pink

APAKAH Selalu
positip jika
Bakteri positip
??

Gluk BiLi Keton

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Sedimen

Nitrit
Normally no Nitrit is detectable in urine,
many enteric gram negative organisms give
positip result when their number is Greater
than 105/ml (0,075 mg/dL nitrit or greater).
Memberikan reaksi positive terhadap nitrit
dari lamanya masa inkubasi m.o
di
kandung kemih (min 4 jam
masa
inkubasi).

Gluk BiLi Keton

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Nitrit

ISONIAZ
ID
KLORAMPENIK
OL

Sedimen

Gluk BiLi Keton

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Sedimen

Potential of
hydrogen
Methyl Red (at high concentration; low pH) and Bromthymol Blue (at
low concentration; high pH), to form a colored complexes.
(dual indicator system)
Read up to 2 minutes
R.R.: 4.5-8.0

Phosphates will precipitate in an alkaline urine, and uric acid

will precipitate in an acidic urine.

Gluk BiLi Keton

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Sedimen

protein

Adanya protein (anion) akan bereaksi dgn

indikator Tetra Bromphenol Blue

Alkaline urine, Ammonium, Chlor

hexidine memberikan hasil false
positip. High SG may give false
negative results.
Lebih Sensitif terhadap Albumin drpd
Jenis Protein yg lain (globulin, Bence

Intrumen
UL

Blo pH
od

Protein
In normal urine less than 150 mg of total
protein is excreted per day (<15 mg/dl).
Proteinuria is indicated at greater than 500
mg of total protein per day (>30 mg/dL).

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Kembal

Gluk BiLi Keton

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Sedimen

Gluk BiLi Keton

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Sedimen

Gluk BiLi Keton

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Sedimen