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Lecture 8

Lecture 8 - Urinanalysis.docx

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Western University
Biochemistry 3386B

Lecture 8UrinalysisObjectives1Proper Methods for urine specimen collection and handling Urine can be collected randomly single collection morning or timed several collected over timeIf microscopic examination is to be done it must be within 2 hours of collection so that leukocytes or renal casts dont disintegrate and recycled after 4 hours or microculture growth or metabolite pollution may occur Cloudiness may occur in fridge nitrate and phosphate precipitation persistent cloudiness may be bacterial growthKetone smelldiabetes Red colourcandiesfoodmedication but usually blood Poryphria may cause red wine coloured urineRefrigerated urine may be dipsticked post 2 hrs but no microscopic examination can be done Urine is tested at room temp2Principles of Dipstick tests and their chemical reactionsClinitek 500 provides consistency to readings Adjustable to accomade densities color intensities and acidities and provides constant timing between measurementsGlucosenormal is negative positive in diabetesspecific to glucose glucose oxidasethere may be a minute amount with normal blood glucosemay be positive during pregnancy for temporary gestational diabetesvitamin C or high ketone may produce false negative sensitive to specific gravity and temp Clinitest tablet may detect other reducing sugarsBilirubinNormal negativealways conjugated bilirubin Suggests jaundice chronic hepatitis hepatocirrhosis or hyperbilirubinemia Unusual colors may suggest bile pigment presence that mask bilirubin reactionKetonesNormal is negative Produced by oxidation of fatty acids may be present due to pregnancy stress exercise fasting hyperemesis gravidarum febrile states alcohol intoxication or abnormal carb and lipid metabolism DKA produces large quanitiesreacts with acetoacetic acid High specific gravity and low ph affects resultshighly pigmented urine may produce false positiveSpecific Gravitynormal 1 1025 measures concentrationtests concentrating ability of renal tubules polydipsia and diabetes insipidis may produce low spec gravityhigh values with dehydration adter illness or sever exercise Affected by high pH adjustment can be made for acidic urine automatically by clinitek 500
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