HUSSEIN REIAD ALMAYTAH & FATIMA ALMARAKSHI

Routine department & body fluids

((report))

samples : urine , stool , Seminal fluid

Other fluid like (Synovial fluid, CSF, peritoneal fluid, pleural fluid)

instrument and equipment : light microscope , centrifuge , fume hood

incubator , hemocytometer , slides and cover slide , conical tube

micropipettes 20-200 µl ,dipstick ,wooden stick , disposable dropper .

SECTION OF URINALYSIS :

NOTE : NORMAL VALUE RANGES MAY VARY SLIGHTLY AMONG DIFFERENT

LABORATORIES

NORMAL URINE OUTPUT (MINIMUM):0.5-1 ML/KG/HR DAILY

OLIGURIA LESS THAN 500ML/24 HOURS

ANURIA LESS THAN 100ML/24 HOURS

LOW URINE OUTPUT : POTENTIAL CAUSES

PRERENAL -HEART FAILURE

-SHOCK

-VOLUME DEPLETION

- RENAL ARTERY COMPROMISE

RENAL -ACUTE TUBULAR NECROSIS

-END-STAGE RENAL DISEASE

-GLOMERULAR DISEASE

POST-RENAL

-NEUROGENIC BLADDER

-OBSTRUCTION OF URETER, BLADDER NECK

URINE SAMPLE TYPE : -RANDOM

-FIRST MORNING

-24HR COLLECTION

-MIDSTREAM(CLEAN CATCH )

URINALYSIS, MACROSCOPIC APPEARANCE STRAW OR YELLOW COLORED CLEAR

ABNORMAL

URINE COLORS DARK YELLOW

-CONCENTRATED URINE

-DRUGS ; HEPARIN

WARFARIN

CHLORZOXAZONE

DARK BROWN

-BILE PIGMENT

-HIGH BILIRUBIN CONCENTRATION

-RHABDOMYLOSIS(MYOGLOBINURIA)

-FAVA BEANS

- SULFONAMIDES,QUININ,CASCARA DRUGS

GREEN

-HARTNUP DISEASE

-INDICANURIA

-PSEUDOMONAS INFECTION

-ASPARAGUS

-CLORETS

ORANGE

-HYPERCAROTENEMIA

-DIABETES MELLITUS

-HYPERLIPIDEMIA

-HYPOTHYROIDISM

-PROPHYRIA

-BEETS

-BLACKBERRIES

RED

-BLOOD

-HEMOGLOBIN

-MYOGLOBIN

-PROPHYRINS

-RHUBARB, BLACKBERRIES ,BEETS FOODS

- TRAUMA

-PRIMARY AND SECONDARY RENAL DISEASE

-TB

-SCHISTOSOMIASIS

-PROSTATITIS

-CYSTITIS

-UTI

-COAGULOPATHY

PINK OR PURPLE

INFECTION

-KLEBSIELLA PNEUMONIAE

-P.AERUGINOSA

-E.COLI

-ENTEROCOCCUS SPP.

BLACK

-ALKAPTONURIA

-MALIGNANT MELANOMA

-METHEMOGLOBINURIA

-ACUTE INTERMITTENT PORPHYRIA

MILKY

-PYURIA

DIPSTICK CHART (CHEMICAL EXAMINATION )

TEST REMARKS SPECIFIC GRAVITY AN INDEX OF WEIGHT PER UNIT VOLUME REFLECT URINE CONC.

NORMAL 1.001-1.035

INCREASE IN :

-DEHYDRATION

-GLYCOSURIA

-PROTENURIA

DECREASE IN :

-COMPULSIVE WATER DRINKING

-DIABETES INSIPIDUIS

PH NORMAL URINE IS ACIDIC BUT IN RANGE 4.8-8.0

HIGH PH ( ALKALINE ) IN :

- INFECTION WITH UREA-SPLITTING

ORGANISMS EX.(PROTEUS)

- SYSTEMATIC ALKALOSIS

- RENAL TUBULAR ACIDOSIS

LOW PH (ACID URINE) IN :

METABOLIC ACIDOSIS

PROTEIN GLOMERULAR DISEASE PRODUCES PROTEINURIA BY ALLOWING FILTRATION

OF LARGER MOLECULES THAN NORMAL

SLIGHTLY INCREASED PROTEIN IN :

-PYELEONEPHRITIS

-BENIGN ORTHOSTATIC PROTENURIA

-IDIOPATHIC FOCAL GLOMERULONEPHRITIS

MARKED PROTEINURIA IN :

-DIABETES MELLITUS

-SLE

-RENAL VEIN THROMBOSIS

-AMYLOIDOSIS

DEGREE OF PROTEINURIA CAN BE QUANTIFIED BY A 24-HOUR

URINE COLLECTION

GLUCOSE GLUCOSE IS FILTERED IN THE GLOMERULUS THEN REABSORBED IN THE

PROXIMAL TUBULE.

IF SERUM GLUCOSE IS >180MG/DL THE FILTERED LOAD WILL

EXCEED THE CAPACITY FOR TUBULAR REABSORPTION AND GLUCOSE

WILL APPEAR IN THE URINE

GLUCOSURIA IN :

- D.M

- ACUTE TUBULAR DAMAGE

- FANCONI SYNDROME

KETONES KETONURIA INDICATES THAT CELLULAR METABOLISM IS DEPENDENT

UPON FATTY ACIDS RATHER THAN GLUCOSE FOR ENERGY

KETONURIA IN :

-DIABETIC KETO-ACIDOSIS

-FASTING/STARVATION

-ALCOHOLIC KETOACIDOSIS

BLOOD THE DIPSTICK TEST FOR HEME, WHICH IS FOUND IN BOTH

HEMOGLOBULIN AND MYOGLOBIN.

A DIPSTICK POSITIVE FOR BLOOD SHOULD BE FOLLOWED UP WITH

A MICROSCOPIC ANALYSIS.

HEMATURIA IN :

-INFECTION/INFLAMMATION OF BLADDER OR PROSTATE

-NEPHROLITHIASIS

-MALIGNANCY ( BLADDER , RENAL )

LEUKOCYTE

ESTERASE ( LE )

INDICATE THE PRESENCE OF LEUKOCYTE WHICH HAVE LIBERATED

ESTERASE

INFECTION OR INFLAMMATION WITHIN THE URINARY TRACT

NITRITE INDICATE THE PRESENCE OF BACTERIA WHICH HAVE REDUCED

NITRATE NITRITE

BILIRUBIN BILIRUBINURIA IN :

- HEPATIC DISEASE

- OBSTRUCTIVE BILIARY DISEASE

UROBILINOGEN NORMAL IN URINE <1MG/DL

INCREASED IN :

-HEMOLYTIC DISEASE

-HEPATIC DISEASE

BENCE-JONES

PROTEIN

NORMAL ( NOT FOUND)

IF PRESENT INDICATE OF MULTIPLE MYELOMA

MICROSCOPIC EXAMINATION RED BLOOD

CELLS

LESS THAN 5/HPF

IFMORE, SUGGESTS INFECTION

OR INFLAMMATION OF BLADDER

OR PROSTATE

NEPHROLITHIASIS

WHITE BLOOD

CELLS

LESS THAN 5\HPF

IF MORE, SUGGESTS INFECTION

OR UTI

*IN WOMEN THE UA MAY BE

CONTAMINATED BY VAGINAL

LEUKOCYTE

RENAL CELLS NONE SEEN

INCREASED NO. INDICATE

NECROSIS OF THE TUBULES

TRANSITIONAL

CELLS

NONE SEEN

SPINDLE OVAL SHAPE ,INCREASE

NO. INDICATE UTI

SQUAMOUS

CELLS

RARE. USUALLY NO CLINICAL

SIGNIFICANCE

LARGE , FLAT SHAPE

IN FEMALE SUGGEST

CONTAMINATION.

BACTERIA RODS OR COCCI , MOTLE IN

FRESH URINE .WITH WBC

INDICATES UTI .

YEAST OVAL ,SHOWING BUDDING

DUE TO : UTI BY YEAST OR

CONTAMINATION FROM

VAGINAL SECRETION .

HAYLINE CAST COLORLESS AND HOMOGENOUS

RBC CAST ORANGE RED TO BROWN

WBC CAST INDICATE INFLAMMATION

WITH RBC CAST INDICATE

GLOMERULONEPHRITIS

RENAL

TUBULAR CAST

LARGE SIZE , CELL ARRANGED IN

PARALLEL ROWS

GRANULAR

CAST

INCREASE IN URINE AFTER

STRENUOUS EXERCISE

WAXY CAST SMOOTH LOOKING WITH BLUNT

END AND SERRATED MARGINS

SHOW IN RENAL FAILURE

CRYSTALS IN ACID URINE :

URIC ACID ,CA++ OXALATE

AMORPHOUS URATES

IN ALKALINE URINE :

TRIPLE PHOSPHATE

CA++ PHOSPHATE

AMMONIUM BIURATE

PARASITE - T .VAGINALIS

-S. HAEMATOBIUM

- E .VERMICULARIS

PROCEDURE FOR EXAMINING THE URINARY SEDIMENT :

- CENTRIFUGE 10ML OF URINE IN A CONICAL TUBE FOR 5 MIN

- DECANT THE SUPERNATANT

- PLACE THE FORMED ELEMENT ON A SLIDE UNDER A COVER SLIP TO BE EXAMINED WITH HPF