1. Introduction , Physical test ,Chemical test.
URINALYSIS:
Introduction , Physical test ,Chemical test.

2. Background:
(Relatively) readily collected and easily available specimen
Contains information about the body’s major metabolic fxns
inexpensive

3. Background: Dietary intake Physical activity Body metabolism
There is some factors affect in composition:
Dietary intake
Physical activity
Body metabolism
Endocrine functions
Body position

4. Background:Urine Composition :
Organic
Urea
Creatinine
Uric acid
Urobilinogen
Other substances
Hormones
Vit & meds
Inorganic
Cl2, K, Na
Formed elements
Cells & casts
Crystals
Mucus
bacteria

5. Background: Bottle method BD Vacutainer Gauze method / pediatric bag
Collection technique / method:
Bottle method
BD Vacutainer
Gauze method / pediatric bag
Catheterization
Suprapubic aspiration

6. Background: First morning specimen Random Fractional Timed
Types of Specimen:
First morning specimen
Random
Fractional
Timed

7. Physical test :

8. Physical test : Color Transparency / clarity Specific gravity
Osmolality
Odor
Volume

9. Physical test : Urine color
Pigments
Uroerythrin
-responsible for red or pink color
Urobilin
- Brown color
Urochrome
- responsible for urine yellow color

10. Urine color : Bilirubin (yellow foam) Protein (white foam)
Blue / green
Chromogenic microorganisms (Pseudomonas)

11. Urine color: Red / pink / brown Blood ,Hemoglobin , Myoglobin
Brown / black
Melanin ,Homogentistic acid
Purplish
Klebsiella & Providencia

12. Urine clarity: Squamous EC Mucus Semen Feces Vaginal creams
Non-pathologic causes of turbidity:
Squamous EC
Mucus
Semen
Feces
Vaginal creams

13. Urine clarity: WBC’s Bacteria Non-squamous EC Yeast Abnormal crystals
Pathologic causes of turbidity:
WBC’s
Bacteria
Non-squamous EC
Yeast
Abnormal crystals
Lymph fluid
lipids

14. Specific gravity: How is urine specific gravity measured?
Urinometry / hydrometry
Refractometry
Harmonic oscillation densitometry
Reagent strip
Falling drop / dogramaci method

15. Specific gravity: Refractometer or TS meter Normal Value of sp. Gr:
1.015 to (24 hr Urine)

16. Osmolality:
A measure of the number of solute particles per unit of solvent
Affected only by the number of particles present and not their density
Used to assess renal concentrating ability
Evaluation: sodium & chloride
Measured via freezing point depression

17. Odor: Freshly voided – faint aromatic, nutty odor
Upon standing – ammoniacal
No odor – acute tubular necrosis
Unusual odors -
Infections – putrid/foul/ammoniacal
Diabetic ketones - fruity
Diet (e.g. Mercaptan)
Contamination – doubtful (e.g. bleach)

18. Volume : Normal volume: Polyuria: - urine is more than 2000 ml
Adult: 800 to 1800 mL / 24 hours
Children: 6 yrs – 300 to 1000
7 to 12 – 500 to 1500
Polyuria: - urine is more than 2000 ml
Oliguria: less than 500 ml
Anuria: complete absence (up to 50 mL0
Nocturia: less than 500 mL per night

19. Chemical test

20. Chemical test Reagent Strips :
Narrow pieces of material impregnated or covered with a substance used to produce a chemical reaction. The strips are used in detecting, measuring, producing.

21. Chemical test :
Reagent Strips :

22. Chemical test : -Bilirubin - Urobilinogen - Leukocytes - pH - Blood
- Nitrite
- Protein
- glucose
- Ketones
-Bilirubin
- Urobilinogen
- Leukocytes

23. Indicators: methyl red, bromthymol blue Sensitivity: 5 – 9
Chemical test : pH
Indicators: methyl red, bromthymol blue
Sensitivity: 5 – 9

24. Chemical test :
Blood :
Reagents: H2O2, tetramethylbenzidine, or orthotoluidine
Sensitivity: 5-20 RBCs; mg/dL Hgb

25. Reagents: citrate buffer at pH 3 Sensitivity: 5-20 mg/dL albumin
Chemical test :
Protein:
Reagents: citrate buffer at pH 3
Sensitivity: 5-20 mg/dL albumin

26. Affecting factors: ≥50 mg/dL ascorbic acid may inhibit the reaction
Chemical test :
Glucose :
Sensitivity: 0.1 g/dL
Affecting factors: ≥50 mg/dL ascorbic acid may inhibit the reaction

27. Affecting factors: highly volatile; bacteria can degrade
Chemical test :
Ketones :
Sensitivity: 5-10 mg/dL
Affecting factors: highly volatile; bacteria can degrade

28. Chemical test :
Bilirubin :
Sensitivity: mg/dL

29. Sensitivity: 0.2-8 Erlich units
Chemical test :
Urobilinogen :
Sensitivity: Erlich units
Affecting factors: unstable; fresh specimen required; FN – formalin

30. Sensitivity: 5-15/hpf intact or lysed leukocytes w/ esterases
Chemical test :
Leukocytes/LE :
Sensitivity: 5-15/hpf intact or lysed leukocytes w/ esterases

31. Chemical test :
Nitrite:
Sensitivity: ≥105 bacteria/mL

32. Questions ?