Urine Routine Test

Urine Routine Test

Urine Routine Test, A urine analysis is a test that examines the Physical, chemical, and microscopic examination of your urine. Routine urine cultures can look for a urinary tract infection (UTI) and see which germs are causing it.

Table of Content:

• What is Urine analysis?
• Physical Examination of Urine.
• What are the parameters of Urine analysis?
• Volume, Color, Apperance, ph, ordor
• Specific gravity

1. what is Polyuria?
2. What is Anuria?
3. what is oliguria?
4. what is nocturia?

Urine Analysis:

• Physical examination test.
• Chemical examination test.
• Microscopic examination.

Diagnose:

It is used to diagnose a serious disease like:

• Kidney disease
• Liver disease
• Diabetes
• UTI

Sample Collection:

The urine Sample must be tested in the Lab within 2 hrs of collection to get the correct results if the urine sample is left standing at room temperature for long after the group, the following changes occur.

Cause Of False Result:

It can cause false results due to the growth of back

• Increased pH.
• Decreased Glucose.
• Loss of ketone bodies.
• Formation of Crystals.
• Damage of cellular elements.

Urine Analysis:

Urine Samples:

• Midstream Morning sample
• Random Sample
• 24-hour urine Sample

Prevention of Urine:

2N HCL,
Con. Sulphuric Acid,
Toluence,
Thymal,
10%. Acetic Acid,

Physical Examination of Urine:

It is the first part of routine urine analysis. It is done by direct observation and it gives hints for subsequent urine analysis.

Volume:

Color:

Urine gets its color from the Pigment urochrome Urobilin and Uroerythrin.

Colourless:

Lage fluid intake, climbers millitus, diabetes insipid a clear urine can also indicate a liver problem like liver cirrhosis and viral hepatitis if you are not Consuming large amounts of water and have ongoing clear urine.

Color:

Appearance:

Normal fresh urine is clear and transparent in appearance.

Odor:

(Smell) Some abnormal odor accounted conditions:

pH:

Normal:

4.8 7.5 Means (6) on standing Alkaline (Formation of ammonia from bacterial decomposition of urea).

Specific Gravity:

Specific gravity (SG) = Density of Urine (Density of water):

If the urine has a lot of solutes if the wine is concentrated then the specific gravity will be of the urine is very dilute, which means it has a lot of water and hence urine is very dilute.

• Concentrated Urine: Specific gravity high:
• Dilute Urine: Very Dilute:

What is the role of Specific gravity in Urine analysis:

Specific gravity function of tubular:

Buoyancy Principle:

When the solute concentration is high the level of the solution Increase and the urinometer is pushed upward due to high SG. if the solute Concentration is low variometer sinks into the urine due to low SG Urinometer is calibrated at IS’C.

Temperature Correction:

• (adding 0.001 for every 3°c rise above 15°C)
• Or
• (Substracting 0.001 for every 3 degrees below 15°C)

Note the reading:

Room Temperature: 15°C Value +3= value x 0.001= Value + Urinometer reading.

Urine meter reading: 1.010

• Room temp – 21°C.
• 21-15= 6
• 6/3= 2
• 2 X 0.001= 0.002
• 0.002+1.010= 1.021
• In case the temperature is higher then add
• In case the temperature is lower Substrate

Total Solids:

Total Solids: last two digits of specific gravity X 2.66 Long’s coefficient Gm/L.

Abnormal Constituents of Urine:

Chemical Tests:

Glucose:

• Glucose or any other sugar is not normally excreted In healthy individuals.
• Glucose is completely reabsorbed by renal tubular epithelial cells.
• Rate of glucose absorption (Tubulas maximum for glucose): 350 mg/min.
• The renal threshold for glucose is 180 mg/dl Glycosuria: Excretion of glucose in the urine.

How to perform the Glucose test in Urine:

Benedict Test:

Benedict Test Principle:

Substances producing positive benedict’s Test Lactose, galactose, fructose, pentoses Home gentistic acid, creatinine (high conec.) ascorbic, and, salicylic acid.

Benedict Regent:

• Sodium Citrate
• Sodium Carbonate
• Copper Sulphate

Procedure:

Take 5ml of Benedict reagent and add 8 drops of Urine. Mix and boil,

Observation:

• Blue (Nil)
• Green (+)
• Yellow (++)
• Red (+++)
• Dark Red (++++)

Benedict Test Interpretation:

Glycosuria: Presence of glucose in Urine:

Ketone Bodies:

ketone bodies test is the severe Uncontrolled Diabetes mellitus starvation:

Rothera’s test, Gerhardt’s test: Acetone, Acetoacetate, Acetoacetate:

Tags:

• Fatty Acid
• Acetyl
• Acetoacetate
• Acetone, B-hydrosey butyric Acid,

Rothera’s Test:

Procedure:

• Take 5ml of Urine, and Satucate it with ammonium sulfate.
• Add a drop of freshly prepared Sodium nitroprusside and Mix.
• Add 3 ml of strong ammonia carefully by the side of the tube.

Observation:

• A deep purple ring is observed at the junction of two layers.

Interference:

• Acetone Acetoacetate Present:

Gerhardt Test:

Procedure:

• Take 3ml of Urine Add ferric chloride dropwise

Observation:

• No Portwine color (red color)

Interference:

• Acetoacetate is absent

Protein:

Normal Protein excretion:

• <150mg/day (albumin <30 mg/day) No detection by routine test.

Glomerular:

• Fenestrated Capillary layer.

Filtration:

• (Holes 70-100mm)

Membrane:

• Basement membrane
• Laminin enacting, type IV collagen Heparin
• Epithelial cell layer
• Filtration Salt (10-40mm)

Proteinuria:

• Proteinuria, < 150mg/dl
• Albumin, < 30mg/dl

Presence of Proteins in Urine:

Albumin: 30mg – 300 mg/day. Microalbuminuria:

Physiological:

• Severe exercise
• High Protein diet
• Pregnancy

Pathological Pre-renal:

• Intraabdominal turners
• Renal
• Glomerulonephritis
• Nephrotic syndrome
• Diabetic nephropathy
• Hypertensive nephropathy
• Post-renal
• Inflammation in the lower
• Urinary tract

How to Perform the Test:

• Heat Coagulation test
• Heller’s test
• Sulpho salicylic acid test

Heat Coagulation Test:

Principle:

Denaturation of Proteins Disruption of Secondary, tertiary, and quaternary Structure of proteins.

Interference:

In this process, the albumin is present.

Procedure:

• Fill 3/4 of the tube with a Urine sample.
• Heat the upper part of the flame till turbidity appears & urine start boiling.

Observation:

• White Preapitate In the upper portion Intensity on adding acetic acid.

Heller’s Test:

Principle:

Denaturation of Protein by concentrated acid.

Interference:

In this Process the Protein is present.

Procedure:

Take 3ml of Conc. HNO3, Add 3ml of Urine slowly by the side of the test tube.

Observation:

A white ring at the junction of two solutions.

Sulphosalicyclic Acid Test:

Principle:

The acid reduces the pH of the medium, where proteins exist in cationic form, from the complex with an anionic form of acids.

Interference:

Protein is Present.

Procedure:

Take 3ml of urine, Add dropwise sulpha sulindac, and observe white ppt.

Blood: Benzidine Test:

A Pinch of benzidene Powder + 3ml glacial acetic acid + 3ml H2 Or

• Part 1 1 ml Urine
• Part 2 1 ml DW

Observation:

The blue or bluish-green color appears immediately.

Interference:

• Blood is present,
• second Part: Control tube no change in color

Benzidine test Interpretation:

Hematuria:

• Acute glomerulonephritis Trauma to Urinary Treat, Urine Stones.
• Chowly red

Hemoglobinuria:

• Excretion of free Hb followed by homily Malaria, Severe burns, Hemolytic jaundice, and Enteric fever.
• Clear red.

Bile Salts:

Bile salts are one of the primary components of bile. Bile is a greenish-yellow fluid made by your liver and stored in the gallbladder.

Hay’s Sulphur Test:

Principle:

Bile salts lower the surface tension of urine, and hence sulfur sinks to the bottom.

Interference:

Bile Salts Present.

Procedure:

• Take 3ml of urine in a test tube and sprinkle a Pinch of sulfur Powder.
• Control: 3ml water + 3 Pinch of sulfur Powder.

Observation:

Test: Sulphus Powder sinks to the bottom Control: Sulphur Powder floats.

Bile Pigments: Bilirubin, Biliverdin:

The bile pigments are formed by the decomposition of the porphyrin ring and contain a chain of four pyrrole rings. Bilirubin, for example, the brownish-yellow pigment that gives feces its characteristic color, is the end product of the breakdown of heme from destroyed red blood cells.

• Bilirubin: Unconjugated:
• Indicator: water insoluble
• Bilirubin: Conjugated
• Direct: Water-soluble

Fouchet’s Test:

Principle:

Bile pigments absorbed on ppt of Basoy. Ferric chloride in Fouchet’s reagent oxidizes bilirubin into green biliverdin.

Interference:

Bile Pigments Present.

Procedure:

Take 5ml of urine + 1ml MgSoy +2ml 10%.
Backe Filter and the precipitate few drops of Fouchet’s reagents.

Observation:

Color changes from yellow to Pista green.

Interpretation: Hay’s Sulphur test/Fouchel’s Test:

Summary

Microscopic Examination of Urine:

Microscopic examination of Urine consists of microscopic elements clarified as ORGANISED ELEMENTS. They are RBCs, WBCs, Epithelial cells, cast, and bacteria.

UNORGANISED ELEMENTS:

They are crystals and amorphous materials.

Collection of Sample:

• A mide stream freshly voided sample is the best Specimen.
• Its Provides an acidic and concentrated sample that preserves the formed elements (RBCs, WBCs, Cast).
• The specimen should be examined fresh or after 2 hrs of collection.
• Cells and cast begin to disintegrate within 2-3 Hrs at room temperature.
• If there is a delay in the examination of urine keep the sample refrigerated.

Method to get the sediment of Urine:

Take 5-10ml of Urine in a test tube. Centrifuge for 5 min at 300 Rpm. Discard the supernatant. Place drops of sediment urine on a clean glass slide. Place a coverslip over it and examine it under a microscope.

Normal Urine:

• Uric Acid
• Calcium oxalate
• Hippuric
• Calcium phosphate
• Triple phosphate
• Calcium Carbonate
• Ammonium bitrate

Organisms:

• Bacteria
• Yeast cells
• Micro filaria
• Haematobium Trichomonas
• Vaginitis

Crystal In Urine:

Acidic:

• Calcium oxalate
• Uric acid
• Tyrosine cholesterol
• Sulphonamide

Alkaline:

• Ammonium Phosphate
• Triple Phosphate
• Calcium Carbonate
• Ammonium bitrate
• Calcium phosphate

Red Blood cells:

• Non-nucleated biconcave disks measuring approx 7um in diameter.
• Hematuria presence of Abnormal no of RBCs in Urine.
• Cells / Hpf is considered Abnormal.
• Hypotonic (diluted wine) Rbis swell up and lyse.
• Hypertonic (Gncentrated wine) the Rbcs crenate.

Causes of Red Blood Cells in Unine:

• Urinary tract stone.
• Stone in the urinary bladder.
• Infection Prostate infection.
• Acute tubular necrosis.
• Toxic reaction due to drugs.