INTRODUCTION TO URINALYSIS

URINE

Serves as a biopsy for the kidney, hence, anything that is happening in your kidney and body reflect to the _____

5th BC Hippocrates wrote a book on

"Uroscopy"

Middle Ages

Physicians were trained on the "Art of Uroscopy"

1140 AD

Color charts were developed to describe significance of 20 different colors

1627: Thomas Bryant

published a book on charlatans called "písse prophets"

1st medical licensure laws in England

pisse prophets

1694: Frederik Dekker

discovered albuminuria by boiling urine.

17th century

invention of the microscope by Anton quantifying the microscopic sediment (Addis count) Van Leeuwenhoek; Thomas Addis developed

Addis count

you have to count everything, every cells, and every formed elements found in the urine

1827: Richard Bright

introduced urinalysis as part of a doctor's routine patient examination

In Urinalysis how long is Manual

30 mins

In Urinalysis how long is Automated

6 mins

4 parts of Routine Urinalysis

(SPECIMEN EVALUATION)

Have to evaluate whether to accept or reject the specimen

4 parts of Routine Urinalysis

(PHYSICAL EXAMINATION)

Check for the volume, color, odor, and specific gravity

4 parts of Routine Urinalysis

(CHEMICAL EXAMINATION)

Checking different parameters that might be present in the urine

Among the difference substances under the chemical examination the most normally seen in the urine that will never be negative is urobilinogen (either normal or increased)

Protein is not usually detectable in the urine

4 parts of Routine Urinalysis

(SEDIMENT EXAMINATION)

Microscopic examination

Gold standard ↬ All the physical and chemical can be confirm in this examination

(Urine Formation) How many Ml Filtered plasma of average daily urine output

170,000 mL to 1,200ml

Normal Urine output

600-2000mL

Average urine Output

1200-1500mL

Glomerulus

filters blood (remove all toxic and unwanted substances in our body)

URINE COMPOSITION

Has organic and inorganic substances

95% water + 5% solutes

Urea

highest composition of urine among in different solutes

25\.0-35.0g

60%-90% of nitrogenous material; derived from metabolism of amino acids into ammonia

Sodium chloride

the highest in inorganic (depends on the salt concentration of our body)

It will give the Urine a Dark Color

Urobilin

SPECIMEN INTEGRITY

specimens should tested within 2 hours

A specimen that cannot be delivered and tested within 2 hours should be refrigerated or have an appropriate chemical preservative added.

SPECIMEN PRESERVATION (Refrigeration)

(2°C to 8°C)

Thymol

preservation of glucose and formed elements

Formalin

formed elements (addis count)

Sodium Chloride

drugs for drug test

Saccomanno Fixative

made up of alcohol and carbowax

Urine Specific Gravity (SG)

Polyuria

not a possible urine

distilled water; REJECT

1\.000

but has no diabetes insipidus, no recent water intake; possibly diluted; REJECT

(TYPES OF URINE SPECIMEN COLLECTION)

RANDOM URINE

Very easy to collect; can collect anytime of the day

Take note of the time of voiding

(TYPES OF URINE SPECIMEN COLLECTION)

First Morning Urine

Other term: 8-hour specimen

Concentrated specimen

Can detect formed elements

(TYPES OF URINE SPECIMEN COLLECTION)

FASTING SPECIMEN (SECOND MORNING)

A fasting specimen differs from a first morning specimen by being the **second voided specimen after a period of fasting**.

(TYPES OF URINE SPECIMEN COLLECTION)

TWO-HOUR POSTPRANDIAL SPECIMEN

Specimen is tested for **glucose**, and the results are used primarily for **monitoring insulin therapy in persons with diabetes mellitus**.

(TYPES OF URINE SPECIMEN COLLECTION)

GLUCOSE TOLERANCE SPECIMENS

The urine is tested for glucose and ketones, and the results are reported along with the blood test results as an aid to interpreting the patient's ability to metabolize a measured amount of glucose and are correlated with the renal threshold for glucose.

(TYPES OF URINE SPECIMEN COLLECTION)

TIMED SPECIMEN

If you want to quantify results

Measuring the exact amount of urine. A carefully timed specimen must be used to produce accurate **quantitative results**

(TYPES OF URINE SPECIMEN COLLECTION)

CATHETERIZED SPECIMEN

Used for patients who cannot collect samples (unconscious)

The most commonly requested test on a _________________ is a bacterial culture.

(TYPES OF URINE SPECIMEN COLLECTION)

MIDSTREAM CLEAN-CATCH SPECIMEN

Can be used for urine culture

↬ Downside: still contains the bacterial cell

is less contaminated by epithelial cells and bacteria and, therefore, is more representative of the actual urine than the routinely voided specimen. Patients must be provided with appropriate cleansing materials, a sterile container

(TYPES OF URINE SPECIMEN COLLECTION)

SUPRAPUBIC ASPIRATION

_______ provides a sample for bacterial culture that is **completely free of extraneous contamination.**

The specimen can also be used for **cytologic examination**.

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(TYPES OF URINE SPECIMEN COLLECTION)

PROSTATITIS SPECIMEN

Three-Glass Collection

If there are inflammations on prostate gland

(TYPES OF URINE SPECIMEN COLLECTION)

Stamey-Mears four-glass localization method

(Initial voided urine (VB1) )

for urethral infection

(TYPES OF URINE SPECIMEN COLLECTION)

Stamey-Mears four-glass localization method

(midstream urine (VB2) )

UTI

(TYPES OF URINE SPECIMEN COLLECTION)

Stamey-Mears four-glass localization method

(midexpressed prostatic secretions (EPS) )

secretion itself is the one checked

(TYPES OF URINE SPECIMEN COLLECTION)

Pre- and post-massage test (PPMT)

A positive result is significant bacteriuria in the post-massage specimen of greater than 10 times the pre-massage count.

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(TYPES OF URINE SPECIMEN COLLECTION)

DRUG SPECIMEN COLLECTION

most vulnerable part of a drug-testing program.

The chain of custody (COC) is the process that provides this documentation of proper sample identification from the time of collection to the receipt of laboratory results.

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