Urine Analysis

By

Dr. Ahmed Badr

Indications
Change in the color of urine (GN,UTI, Hepatitis,Acute hemolytic crisis) )Dysuria (UTI Generalized edema (NS) )FUO (UTI ) Polyuria (DM,DI

Items to be checked
Physical Color Aspect Reaction Sp. gravity Volume Microscopic RBC WBC Casts Crystals Epithelial cells Ova Parasites Chemical Proteins Glucose Ketones Bilirubin Urobilinogen Hb

Items to be checked
Physical )Color (amber yellow )Aspect (Clear )Reaction (pH =5-7 )Specific gravity (1015-1025 )Volume (1-3cc/kg/hr

Chemical +++Proteins (Nil) Glucose (Nil) Ketones (Nil) Bilirubin (Nil) Urobilinogen (traces) Hb (Nil)

Proteinuria DM DKA Cholestasis Hemolytic J Acute H. crisis

Microscopic RBC (0-5 /HPF) Hematuria WBC (0-5 /HPF) Pyuria Infection/GN )Casts (Tubular structures Glomerular/Tubular Hyaline casts Normal Red cell casts GN White cell casts PN / GN )Crystals (Ca oxalate, triple phosphate Epithelial cells )Ova (Bilharzial )Parasites (Entrobius

PSGN (Hematuria) Hematuria: RBC > 5/HPF RBCs casts Color: Smoky Proteinuria Pyuria (WBCs > 5/HPF) UTI (Pyuria = WBCs > 5/HPF) Pyuria only = Cystitis Pyuria + WBCs casts = Pyelonephritis Bilirubinuria: Hepatitis, Biliary atresia & Cholestasis Diabetes (Glucosuria) DKA (Glucosuria + Ketonuria) Nephrotic (Proteinuria): Usually proteinuria only [MCNS] Acute hemolytic crisis (Hemoglobinuria)

Please Comment On The Following Urine Analysis

Physical Color smoky Aspect Turbid Reaction 6 Sp. gravity 1030 Volume 30 cc
Microscopic RBC >100 /HPF WBC 50-60/HPF Casts ++Hyaline casts +++Red cell casts Chemical ++Proteins Glucose Nil Ketones Nil Bilirubin Nil Urobilinogen traces Hb Nil

Please Comment On The Following Urine Analysis

Physical Color Aspect Reaction Sp. gravity Volume Yellow Turbid 6.5 1030 40 cc Chemical +Proteins Glucose Nil Ketones Nil Bilirubin Nil Urobilinogen traces Hb Nil

Microscopic RBC 3-5 /HPF WBC 70-80/HPF Casts +Hyaline casts Crystals Nil ++Epithelial cells Ova Nil Parasites Nil

Please Comment On The Following Urine Analysis

Physical Color Dark Yellow Aspect Turbid Reaction 6 Sp. gravity 1020 Volume 30 cc Microscopic RBC 3-5 /HPF WBC 3-5/HPF Casts Nil +Crystals Ca oxalate ++Epithelial cells Ova Nil Parasites Nil Chemical Proteins Nil Glucose Nil Ketones Nil +++Bilirubin Urobilinogen traces Hb Nil

Physical Color yellow Aspect Turbid Reaction 7 Sp. gravity 1025 Volume 30 cc

Please Comment On The Following Urine Analysis

Chemical +Proteins Glucose Nil Ketones Nil Bilirubin Nil Urobilinogen traces Hb Nil

Microscopic RBC 10-12 /HPF WBC >100/HPF Casts ++White cell casts Crystals Nil ++Epithelial cells Ova Nil Parasites Nil

Please Comment On The Following Urine Analysis

Physical Color Aspect Reaction Sp. gravity Volume Yellow Clear 5.5 1018 40 cc Chemical ++++Proteins Glucose Nil Ketones Nil Bilirubin Nil Urobilinogen traces Hb Nil

Microscopic RBC 2-3 /HPF WBC 2-3/HPF Casts ++Hyaline casts Crystals Nil Epithelial cells Nil Ova Nil Parasites Nil

Please Comment On The Following Urine Analysis

Physical Color Aspect Reaction Sp. gravity Volume Yellow clear 6 1030 40 cc Chemical Proteins Nil ++Glucose +++Ketones Bilirubin Nil Urobilinogen traces Hb Nil

Microscopic RBC 1-2 /HPF WBC 2-3/HPF Casts Nil Crystals Nil +Epithelial cells Ova Nil Parasites Nil

Physical Microscopic Color smoky RBC >100 /HPF Aspect Turbid WBC 50-60/HPF Chemical Hyaline casts ++ Proteins ++ Glucose Nil Red cell casts +++ Ketones Nil Crystals few Ca oxalate Bilirubin Nil Epithelial cells Nil A- Hypertension may be a complication. B- Serum Albumen is usually below 2mg/dl. C- It is not uncommon to find elevated BUN. D- Buffy eyes are not uncommon .

Urine Analysis

Q- 14 Urine Analysis Physical Color Yellow Aspect Clear Microscopic RBC 2-3 /HPF WBC 2-3/HPF

Chemical Hyaline casts ++ ++++Proteins Crystals few Ca oxalate Glucose Nil Epithelial cells Nil Ketones Nil A- Acute renal failure is constant. B- Blood pressure is usually not affected. C- Serum cholesterol is increased. D- The starting dose of steroid is 0.5 mg/kg .

Physical Color Aspect Chemical Proteins Glucose Ketones

Q-14 Urine Analysis

Yellow Turbid + Nil Nil Microscopic RBC WBC 3 - 5 /HPF 70 - 80 /HPF Nil

Hyaline casts + Crystals

Epithelial cells ++ A- Females affected more than males. B- Tender loin is expected. C- Prolonged fever may be a presentation. D- Urine culture should be done.

Stool Analysis
By

Dr.Ahmed Badr

Indications
Gastroenteritis Dysentry (Diarrhea +tenesmus +Blood& )Mucous Maldigestion / Malabsorption Parasites Bleeding per rectum

Items to be checked
Macroscopic
Color Consistency Reaction Mucous Blood

Microscopic
RBCs WBCs Fat globules )Protozoa(cysts )Protozoa(vegetative Ova Bacteria

Macroscopic Color (Brownish, yellowish, greenish) ?? (Clay, Red, Black) Consistency (soft, loose, watery, hard) Reaction Mucous Blood (Alkaline) (Nil) (Nil) ?Acidic (Lactose intolerance) Dysentry

Microscopic RBCs (1-3/HPF) WBCs (1-3/HPF) Fat globules (Nil) Protozoa(cysts) (Nil) Protozoa(vegetative) (Nil) Ova (Nil)
Bacteria (Nil)

Entameba histolytica

Protozoa

Giardia Lamblia
Trematodes Cestodes Nematodes
Bilharziasis Fasciola Taenia(S&S) H.nana D.latum

Ova

Ascaris Ankylostoma Entrobius

Please Comment On The Following Stool Analysis

Macroscopic Color Brownish Consistency loose Reaction Alkaline ++++Mucous ++Blood Microscopic RBCs >100/HPF WBCs 20-25/HPF Fat globules ++ Protozoa(cysts) Nil Protozoa(vegetative) E.histolytica Ova Nil

Please Comment On The Following Stool Analysis

Macroscopic Color Yellowish brown Consistency Soft Reaction Alkaline ++Mucous +++Blood Microscopic RBCs >100/HPF WBCs >100/HPF Fat globules + Protozoa(cysts) (Nil) Protozoa(vegetative) (Nil) Ova (Nil) Bacteria Gram ve Bacilli

Please Comment On The Following Stool Analysis

Macroscopic Color Brown Consistency formed Reaction Alkaline Mucous Nil Blood Nil Microscopic RBCs 1-2/HPF WBCs 1-2/HPF Fat globules + Protozoa(cysts) Nil Protozoa(vegetative) Nil Ova Oxyuris

Stool Analysis
Macroscopic
Consistency Loose Reaction Alkaline Mucous ++++ Blood ++

Microscopic
RBCs WBCs Protozoa Ova >100/HPF 20-25/HPF E. histolytica Nil

A- Mebendazole is the drug of choice. B- The patient is usually asymptomatic. C- Rectal swab is indicated. D- Jujenal aspiration is essential for diagnosis.

Q-15 Stool Analysis

Macroscopic Consistency Formed Reaction Alkaline Mucous Nil Blood Nil Microscopic RBCs 0-1/HPF WBCs 0-1/HPF Protozoa Nil Ova Ankylostoma

A- Eggs may not be seen in stools of patient with severe anemia. B- HSM is a common finding. C- Leukocytosis in CBC is expected. D- Peri-anal itching is very common.

Q15- Stool Analysis

Macroscopic
Consistency Formed Reaction Alkaline Mucous Nil Blood Nil

Microscopic
RBCs 0-1 / HPF WBCs 0-1 / HPF Protozoa Nil Ova Schistosoma mansoni

A- praziquantel is the drug of choice. B- Blood transfusion is commonly needed. C- Spleen never enlarge in such patient. D- Bleeding varices is one of the most serious complication of that illness.

Stool Analysis
Macroscopic
Consistency Reaction Mucous Blood Loose Alkaline ++++ ++

Microscopic
RBCs >100/HPF WBCs 20-25/HPF Protozoa(vegetative) E. histolytica Ova Nil

1) albendazol is the drug of choice 2) Crampy abdominal pain is common. 3) Extra intestinal affection does not occur.

Stool Analysis
Macroscopic
Consistency Reaction Mucous Blood Watery Alkaline Nil Nil

Microscopic
RBCs WBCs Protozoa (cyst) Ova 1-2/HPF 0-1/HPF Giardia Nil

1) Perianal itching is common. 2) Hepatic affection could occur. 3) Metronidazol is the drug of choice.

Stool Analysis
Macroscopic
Consistency Reaction Mucous Blood Formed Alkaline Nil Nil

Microscopic
RBCs WBCs Protozoa Ova 0-1/HPF 0-1/HPF Nil Ankylostoma

1) Serum iron is usually decreased. 2) Cotrimoxazol is the drug of choice. 3) All members of the family with or without symptoms should be treated at the same time.

Stool Analysis
Macroscopic
Consistency Reaction Mucous Blood Formed Alkaline Nil Nil

Microscopic
RBCs WBCs Protozoa Ova 0-1/HPF 0-1/HPF Nil Schistosoma mansoni

1) Long standing cases may be associated with HSM. 2) Never affect females. 3) Metronidazol is the drug of choice.

Stool Analysis
Macroscopic
Consistency Reaction Mucous Blood Watery Alkaline Nil Nil

Microscopic
RBCs WBCs Protozoa Ova 1-2/HPF 1-2/HPF Nil Nil

1) Dehydration may occur. 2) It is always bacterial in origin. 3) It never occur in the 1st year of life.

Stool Analysis
Macroscopic
Consistency Reaction Mucous Blood Loose Alkaline +++ +++

Microscopic
RBCs WBCs Protozoa Ova >100/HPF >100/HPF Nil Nil

1) Fever may be present. 2) Dehydration is commom. 3) Metronidazol is the drug of choice.