examination of urine 1&2
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8/7/2019 Examination of Urine 1&2
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BY .Beshoy William LouizUNDER SUPERVISION :- DR.DR. Marwa Elbiltagy
8/7/2019 Examination of Urine 1&2
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� The simple examination of the Urine.
� To detect some of the normal organic
constituents of urine.� To detect some of the normal inorganic ions
present in urine.
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� Urine formation :-
The basic steps in urine
formation are :1. Filtration. ( Glomerular)2. Reabsorption.(Tubular)3. Secretion. .(Tubular)
4. Excretion.
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� The main f unction of kidney is Homeostasis
which means :
-maintain internal environment constant-excretion of all metabolic west product.
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� In a healthy adult about 650 ml of plasma
(1200 ml of blood ) pass through f unctioning
renal excretory tissue every minute, andabout 125 ml of glomerular filtrate is formed.
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� Water passes freely from the plasma through the glomeruli , and those unbound
constituents of the plasma that have a molecular weight of less than about 70,000are present in the glomerular filtrate at the
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� Substances of a higher molecular weight thanabout 70,000 do not pass freely through the
glomeruli and are present in the glomerlarfiltrate at a lower concentration than in
plasma
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� The renal tubules conserve water and soluble constituent of the body by reabsorption using
both passive ( high conc.To low conc. )� And the active transport ( useATP + carrier )
from the glomerular filtrate.
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� Volume :
The normal 24 hours Urine volume of an adult is
between 750 and 2000 ml . This depend on
the fluid intake
loss of fluid by other routes.
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� In Disease :
Oliguria :
Urine output less than 500ml/day Causese :
deficient intake of water ,
or excessive loss of fluid by other routes ,
�
for example : by :haemorrhage , diarrhea
vomiting
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� Polyuria
Urine output more than 2000m/day.
Physiological causes chronic renal insufficiency .
Polyuria of low osmolality is also found in diabetes
insipidus
Polyuria occur as an osmotic diuresis in any disease where there is an increased excretion of metabolites(diabetes mellitus ).
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� Polyuria
Physiological causes
Excessive water intake Diuretic as tea, Cola, Coff ee
Excessive salt intake
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� Colour :
Due to urinary pigments (urochromes).
Pale (low specific gravity ) to dark yellow (high specific gravity)
Coloured urines occur in :
certain disease
metabolic disorders,
af ter the administration of many drugs:
Beta carotine supplement ( orange urine )
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� Appearance :
Casts : The tubules secrete an
1-glycoprotein (Tamm-
Horsf all protein ) , which , in the presence of albumin , comes out of solution in gel form as casts.
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� Appearance :
Mucus protein :
This may be from semen or from vaginal discharge. Pathologically , it may be due to disease of the lowerurinary tract or pus.
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Appearance :
Crystals :
These are not normally pathological Uric acid ( reddish yellow) & calcium oxalate
(colourless ) fromacid urine
phosphate ( whitish) from alkaline urine .
Pathological
cystine crystals
dark reddish deposit of blood.
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� Smell:
unpleasant smell : urine inf ected withGram-
negative organisms . ammonical smell: urine inf ected with urea
splitting organisms
maple syrup disease (H.W)
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� pH:
Normal between 5.5 and 8
Alkalosis : Vegetarine diet
Bacterial inf ection
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