AUBF MIDTERM- PHYSICAL EXAMINATION

It consists of a group of test performed as part of physical examination

Routine urinalysis

What are those involved for routine urinalysis?

• macroscopic analysis

• Microscopic analysis

Macroscopic analysis is used for?

• physical characteristics

• Chemical analysis

Microscopic analysis is used for?

• urine sediment is examined under microscope

• To identify the components of the urinary sediments

What are components of routine analysis

• specimen examination

• Physical examination

• Chemical examination

• Sediment examination

For Urine is accepted for examination

• proper labelling

• Enough volume

• Proper container

• Storage condition

• Proper preservation

• Not contaminated

• Proper transport of specimen

What examination is done first if requested

Bacteriologic examination

What standard volume requirement of urine that must be accepted?

• acute renal failure

• Pediatric patients

This depends on the amount of water that the kidneys excrete

Volume

It is a major body constituent

Water

Factors that influence urine volume

• fluid intake

• Fluid loss from nonrenal sources

• Variations in the secretion of antidiuretic hormone

• Need to excrete dissolved solid

Main determinant of urine volume is what?

Water

What is Normal average daily urine output of urine volume?

1200-1500 ml

Normal range of urine volume

600 to 200 ml

What is Volume container recommended of urinalysis

What recommended capacity of specimen container

50 ml

Drug container of capacity recommended

60 ml

Delivery time of specimen deliver to laboratory within

2 hours

The most routinely used method

Refrigeration

It either classified type 1 & 2 diabetes

Diabetes mellitus (DM)

Night urine generally not in excess of what?

400 ml

Decreased in urine output

Oliguria

What is normal urine output for infants?

Less than 1ml/kg/hr

What is normal urine output for children?

Less than 0.5 ml/kg/hr

What is normal urine output for adult?

Less than 400 ml/day

What are common seen oliguria?

• vomiting

• Diarrhea

• Perspiration or severe burns

Cessation of urine flow

Anuria

Normal urine of anuria?

< 100 ml/24 hrs

What causes for anuria?

Serious damage to the kidney

Increse in the nocturnal excretion of the urine

Nocturia

It excrete two or three times more urine during the day than night

Nocturia

Causes of nocturia

Pregnancy

Increases in daily urine volume

Polyuria

Normal values of polyuria for adults

> 2.5 L/day

Normal values of polyuria for children

2.5 to 3 ml/kg/day

Causes for polynuria

• diabetes mellitus

• Diabetes insipidus

• Artificially induced by diuretics, caffeine, or alcohol

This variation may be due to color of what?

• normal metabolic function

• Physical activity

• Ingested materials

• Pathologic conditions

Color of urine varies from almost what?

Colorless to black

What normal of color for urinalysis to physical examination?

Colorless to deep yellow

Common description of normal urine color

• pale yellow

• Yellow

• Dark yellow

Most common for Abnormal color

• Red/ Red brown

What color for caused by the presence of a pigment?

Yellow

It increased in urine that stands at room temperature

Urochrome

A major pigment that causes of urine become yellow

Urochrome

What is the color of urochrome

Yellow pigments

It increased during fever, thyroid condition, fasting states and starvation

Urochrome

A pink pigment that present in urine that have been refrigerated

Uroerythrin

It from the oxidation of urobilinogen

Urobilin

A dilute urine will be ____ , and a concentrated specimen will be _____

Pale yellow, dark yellow

What color for urine that is not fresh

Orange-brown color

Amorphous urates in an what?

Acid urine

Presents color of urobilin

Orange-brown color

It is a yellowish pigment that is produced when rbc break down

Bilirubin

It is important role in digestion and absorption of fats

Bilirubin

When bilirubin levels are elevated, it can cause of what?

Jaundice

A colorless, produced in the intestine when bilirubin is broken by bacteria

Urobilinogen

May not always signify a normal concentrated urine but can be caused by the presence of the abnormal pigment bilirubin

Dark yellow/amber/ orange

It may also be cause of the presence of an abnormal pigment called

Bilirubin

Small amount foam

Normal urine

Large amount of foam

Increased concentration of protein

A urine with bilirubin may also contain of what?

Hepatis virus

Photo-oxidation of bilirubin imparts a yellow-green color to the urine caused by the presence of what?

Biliverdin

A yellow-green pigments that is produced during the breakdown of heme in RBC

Biliverdin

Yellow pigment, responsible for the yellow color of urine and feces

Urobilin

What is brand name of phenazopyridine

Pyridium

What are two pigments that are present in the urine in much smaller quantities, and they contribute little to the color of normal, fresh urine

Uroerythrin, urobilin

What medications that cause an orange colored urine

• azulfidine

One of the most common caused of abnormal urine color is the presence of blood

Red/pink/brown

What are those two subtances that produce a red urine with a positive result in a chemical test for blood

Hemoglobin, myoglobin

An unsual color that blood produces in urine

Red color

Presence of RBCs urine

Red and cloudy

Presence of hemoglobin and myoglobin urine

Red and clear

A fresh urine containing blood that is brown also may indicate of what?

Glomerular bleeding

Breakdown of skeletal muscle produces of what?

Clear plasma

From breakdown of skeletal muscle produces clear plasma because it is more rapidly cleared from the plasma than hemoglobin

Myoglobinuria

What color of porphyrins

Red color

A product from the oxidation of porphobilinogen which is often referred to as what?

Post-wine urine

What color of fresh urine containing myoglobin that exhibits a more urine than containing hemoglobin

Reddish-brown color

Urine specimens containing porphyrins also may appear red, resulting from the oxidation of what

Pophobilinogen to porphyrins

What is Nonpathogenic causes of red urine

• menstrual

• contamination

• Ingestion of highly-pigmented foods

• Medications

Eating fresh beets causes a red color in what?

Alkaline urine

Ingestion of black berries can produce?

Red color in acidic urine

What are the medication that produce of red urine?

• Rifampin

• Phenolphthalein

• Phenindione

• Phenothiazine

It precense of RBC leading to oxidation of hemoglobin to methamoglobin in acidic acid

Brown urine

It recommend for urine specimen that having negative chemical test results for blood, inasmuch it contain melanin or hemogentisic acid

Brown/black

Melanin is an oxidation product of the colorless pigment called

Melanogen

A black color to alkaline urine form patients with the inborn error of metabolism called

Alkaptonuria

What are the medication of producing brown/black urines

• Levadopa

• Methyldopa

• Phenol derivatives

• Metronidazole

Liver and kidney disorders and muscle injury extreme exercise can result in a what color of urine?

Dark-brown

Nonpathogenic causes of dark-brown

• ingesting large amount of fava beans

• Rhubarb’

• Aloe

What parasite that can seen pathogenic causes of blue/green?

Pseudomonas spp.

What syndrome that children with has disorder of blue urine?

Blue diaper syndrome

It refers to the transparency or turbidity of urine specimen

Clarity

Most routinely at the same time

Clarity and color

Common terminolgy used to report clarity in include

• clear

• Hazy

• Cloudy

• Turbid

• Milky

Freshly avoided, normal urine is usually clear

Normal clarity

It causes of a white cloudiness in an alkaline urine

• amorphous phosphate

• Carbonate

It presence of squamos epithelial cells and mucus, particularly in specimen from women, can result in urine that is hazy but normal

Nonpathological turbidy

Nonpathological caues pf urine turbidity

• normal urine crystals

• Semen

• Fecal contamination

• Radiographic contrast media

• Talcum powder

• Vaginal creams

It produces a white ppt in the alkaline urine

Amorphous phosphate and carbonates

It is produce a pink-brick dust precipitate in acidic urine due to the presence of uroerythrin

Amorphous urates