theory urinalysis
Post on 01-Jun-2018
240 Views
Preview:
TRANSCRIPT
-
8/9/2019 Theory Urinalysis
1/23
HUMAN ANATOMY AND PHYSIOLOGY
EXPERIMENT REPORT
Urinalysis
Made by:
Vita Isti!"a# $%&'&&($&'
An))i Dya# Aristi $%&'&&&$*'
Ria Lestari $%&'&&&$+,
S#elena N-)ra#a R De.i $%&'&&&$+/
Ir"a 0itriyani $%&'&&&$/(
1IOLOGY EDU2ATION PROGRAMS ,(&&
1IOLOGY MAYORS
0A2ULTY O0 MATHEMATI2S AND S2IEN2E
3A4ARTA STATE UNIVERSITY
,(&$
-
8/9/2019 Theory Urinalysis
2/23
THEORY
THE URINARY SYSTEM
Functions of the Kidneys
Metabolism constantly produces a variety of waste products that can poison the body if not
eliminated. The most fundamental role of the idneys is to eliminate these wastes and
homeostatically re!ulate the volume and compositionof the body fluids. "ll of the followin!
processes are aspects of idney function#
$ They filter blood plasma% separate wastes from the useful chemicals% and eliminate the
wastes while returnin! the rest to the bloodstream.
$ They re!ulate blood volume and pressure by eliminatin! or conservin! water as
necessary.
$ They re!ulate the osmolarity of the body fluids by controllin! the relative amounts of
water and solutes eliminated.
$ They secrete the en&yme renin% which activates hormonal mechanisms that controlblood pressure and electrolyte balance.
$ They secrete the hormone erythropoietin% which controls the red blood cell count and
o'y!en(carryin! capacity of the blood.
They function with the lun!s to re!ulate the )*O+ and acid(base balance of the body
fluids.
They contribute to calcium homeostasis throu!h their role in synthesi&in! calcitriol
,vitamin - ,see chapter /.
They deto'ify free radicals and dru!s with the use of pero'isomes.
-
8/9/2019 Theory Urinalysis
3/23
0n times of starvation% they carry out !luconeo!enesis1 they deaminate amino acids
,remove the 2H+ !roup% e'crete the amino !roup as ammonia ,2H3% and synthesi&e
!lucose from the rest of the molecule.
E'cretion
E'cretion is the process of separatin! wastes from the body fluids and eliminatin! them. 0t is
carried out by four or!an systems#
4. The respiratory system e'cretes carbon dio'ide% small amounts of other !ases% and
water.
+. The inte!umentary system e'cretes water% inor!anic salts% lactic acid% and urea in the
sweat.
3. The di!estive system not only eliminates food residue ,which is not a process of
e'cretion but also actively e'cretes water% salts% carbon dio'ide% lipids% bile pi!ments%
cholesterol% and other metabolic wastes.5. The urinary system e'cretes a broad variety of metabolic wastes% to'ins% dru!s%
hormones% salts% hydro!en ions% and water.
6ross "natomy
The idneys lie a!ainst the posterior abdominal wall at the level of vertebrae T4+ to 73. The
ri!ht idney is sli!htly lower than the left because of the space occupied by the liver above it.
Each idney wei!hs about 489 ! and measures about 4+ cm lon!% : cm wide% and +.: cm
thic;about the si&e of a bar of bath soap. The lateral surface is conve' while the medial
surface is concave and has a slit% the hilum% where it receives the renal nerves% blood vessels%lymphatic vessels% and ureter. The left adrenal !land rests on the superior pole of that idney%
while the ri!ht adrenal !land is more medial% between the hilum and pole. The idneys%
adrenal !lands% ureters% and urinary bladder are retroperitoneal;they lie between the
peritoneum and body wall.
The idney is protected by three layers of connective tissue# ,4 a fibrous renal+
fascia% immediately deep to the parietal peritoneum% which binds the idney and associated
or!ans to the abdominal wall1 ,+ the adipose capsule% a layer of fat that cushions the idney
and holds it in place1 and ,3 the renal capsule% a fibrous sac that is anchored at the hilum and
encloses the rest of the idney lie a cellophane wrapper% and protects the idney fromtrauma and infection. *olla!en fibers e'tend from the renal capsule% throu!h the fat% to the
renal fascia. The renal fascia is fused with the peritoneum on one side and the deep fascia of
the lumbar muscles on the other. Thus the idneys are suspended in place. 2evertheless% they
drop about 3 cm when you !o from a supine to a standin! position% and under some
circumstances they become detached and drift even lower% with patholo!ical results.
The ureter is a tubular continuation of the renal pelvis that drains the urine down to the
urinary bladder.
The 2ephron
-
8/9/2019 Theory Urinalysis
4/23
Each idney contains about 4.+ million functional units called nephrons ,2EF(rons "
nephron consists of two principal parts# a renal corpuscle where the blood plasma is filtered
and a lon! renal tubule that processes this filtrate into urine.
The Renal *orpuscle
The renal corpuscle consists of a ball of capillaries called a !lomerulus: ,!lo(MERR(
you(lus% enclosed in a two(layered !lomerular ,uamous epithelium% while the visceral layer consists of
elaborate cells called podocytes/ wrapped around the capillaries.
URINE 0ORMATION I: GLOMERULAR 0ILTRATION
The idney converts blood plasma to urine in three sta!es# !lomerular filtration%
tubular reabsorption and secretion% and water conservation ,fi!. +3.?. "s we trace fluid
throu!h the nephron% we will refer to it by different names that reflect its chan!in!composition# ,4 The fluid in the capsular space% called !lomerular filtrate% is similar to blood
plasma e'cept that it has almost no protein. ,+ The fluid from the pro'imal convoluted
tubule throu!h the distal convoluted tubule will be called tubular fluid. 0t differs from the
!lomerular filtrate because of substances removed and added by the tubule cells. ,3 The fluid
will be called urine once it enters the collectin! duct.
6lomerular Filtration Rate
6lomerular filtration rate ,6FR is the amount of filtrate formed per minute by the
two idneys combined. For every 4 mmH! of net filtration pressure% the idneys produce
about 4+.: m7 of filtrate per minute. This value% called the filtration coefficient ,Kf% depends
on the permeability and surface area of the filtration barrier. Kf is about 49@ lower in women
than in men. For the reference male%
-
8/9/2019 Theory Urinalysis
5/23
6FRA 2F) ' Kf A 49 ' 4+.:A 4+: m7Bmin
0n the reference female% the 6FR is about 49: m7Bmin. This is a rate of 4?9 7Bday in
males and 4:9 7Bday in females;impressive numbers considerin! that this is about :9 to 89
times the amount of blood plasma in the body and e>ually e'ceeds the amount of filtrate
produced by all other capillaries combined. Obviously only a small portion of this is
eliminated as urine. "n avera!e adult reabsorbs CC@ of the filtrate and e'cretes 4 to + 7 of
urine per day.
Re!ulation of 6lomerular Filtration
6FR must be precisely controlled. 0f it is too hi!h% fluid flows throu!h the renal
tubules too rapidly for them to reabsorb the usual amount of water and solutes. Drine output
rises and creates a threat of dehydration and electrolyte depletion. 0f 6FR is too low% fluid
flows slu!!ishly throu!h the tubules% they reabsorb wastes that should be eliminated in the
urine% and a&otemia may occur. The only way to adust 6FR from moment to moment is to
chan!e !lomerular blood pressure. This is achieved by three homeostatic mechanisms# renal
autore!ulation% sympathetic control% and hormonal control.
URINE 0ORMATION II: TU1ULAR REA1SORPTION AND SE2RETION
The pro'imal convoluted tubule ,)*T reabsorbs about 8:@ of the !lomerular filtrate%
while it also removes some substances from the blood and secretes them into the tubule for
disposal in the urine. The importance of the )*T is reflected in its relatively !reat len!th and
prominent microvilli% which increase its absorptive surface area. 0ts cells also contain
abundant lar!e mitochondria that provide "T) for active transport. Your )*Ts alone accountfor about 8@ of your restin! "T) and calorie consumption.
Tubular reabsorption is the process of reclaimin! water and solutes from the tubular
fluid and returnin! them to the blood. The )*T reabsorbs a !reater variety of chemicals than
any other part of the nephron. There are two routes of reabsorption# ,4 the transcellular4:
route% in which substances pass throu!h the cytoplasm and out the base of the epithelial cells
and ,+ the paracellular48 route% in which substances pass between the epithelial cells. The
ti!htG unctions between tubule epithelial cells are >uite leay and allow si!nificant amounts
of water% minerals% urea% and other matter to pass between the cells. Either way% such
materials enter the e'tracellular fluid ,E*F at the base of the epithelium% and from there they
are taen up by the peritubular capillaries.
Tubular secretion in the distal convoluted tubule is discussed shortly. 0n the pro'imal
convoluted tubule and nephron loop% it serves two purposes#
4. aste removal. Drea% uric acid% bile acids% ammonia% catecholamines% and a little
creatinine are secreted into the tubule. Tubular secretion of uric acid compensates for
its reabsorption earlier in the )*T and accounts for all of the uric acid in the urine.
Tubular secretion also clears the blood of pollutants% morphine% penicillin% aspirin% and
other dru!s. One reason that so many dru!s must be taen three or four times a day is
-
8/9/2019 Theory Urinalysis
6/23
to eep pace with this rate of clearance and maintain a therapeutically effective dru!
concentration in the blood.
+. "cid(base balance. Tubular secretion of hydro!en and bicarbonate ions serves to
re!ulate the pH of the body fluids
The 2ephron 7oop
The primary function of the nephron loop is to !enerate a salinity !radient that
enables the collectin! duct to concentrate the urine and conserve water.
-
8/9/2019 Theory Urinalysis
7/23
URINE 0ORMATION III: 5ATER 2ONSERVATION
The idney serves not ust to eliminate metabolic waste from the body but to prevent
e'cessive water loss in doin! so% and thus to support the body=s fluid balance. "s the idney
returns water to the tissue fluid and bloodstream% the fluid remainin! in the renal tubule
becomes more and more concentrated. 0n this section% we e'amine the idney=s mechanisms
for conservin! water and concentratin! the urine.
The -istal *onvoluted Tubule
hen the nephron loop returns to the corte'% it coils a!ain and forms the distal
convoluted tubule ,-*T. This is shorter and less convoluted than the )*T% so fewer sections
of it are seen in histolo!ical sections The -*T is the end of the nephron. The -*Ts of several
nephrons drain into a strai!ht tubule called the collectin! duct% which passes down into the
medulla. 2ear the papilla% several collectin! ducts mer!e to form a lar!er papillary duct1
about 39 of these drain from each papilla into its minor caly'.
The *ollectin! -uct
The collectin! duct ,*- be!ins in the corte'% where it receives tubular fluid from
numerous nephrons. "s it passes throu!h the medulla% it usually reabsorbs water and
concentrates the urine. hen urine enters the upper end of the *-% it has a concentration of
499 to 399 mOsmB7% but by the time it leaves the lower end% it can be up to four times as
concentrated. This ability to concentrate wastes and control water loss was crucial to the
evolution of terrestrial animals such as ourselves .
Two facts enable the collectin! duct to produce such hypertonic urine# ,4 the
osmolarity of the e'tracellular fluid is four times as hi!h deep in the medulla as it is in the
corte'% and ,+ the medullary portion of the *- is more permeable to water than to 2a*l.
Therefore% as urine passes down the *- throu!h the increasin!ly salty medulla% water leaves
the tubule by osmosis% most 2a*l and other wastes remain behind% and the urine becomes
more and more concentrated.
Drine Iolume
"n avera!e adult produces 4 to + 7 of urine per day. "n output in e'cess of + 7Bday is
called diuresis or polyuria4C ,)O7(ee(YOD(ree(uh. Fluid intae and some dru!s can
temporarily increase output to as much as +9 7Bday. *hronic diseases such as diabetes ,see
ne't can do so over a lon! term. Oli!uria+9 ,oll(ih(6DE(ree(uh is an output of less than :99
m7Bday% and anuria+4 is an output of 9 to 499 m7Bday. 7ow output can result from idney
disease% dehydration% circulatory shoc% prostate enlar!ement% and other causes. 0f urine
output drops to less than 599 m7Bday% the body cannot hi!h concentration of !lucose in the
blood. "bout 4@ to 3@ of pre!nant women e'perience !estational diabetes% in which
pre!nancy reduces the mother=s insulin sensitivity% resultin! in hyper!lycemia and !lycosuria.
0n renal diabetes% blood !lucose level is not elevated% but there is a hereditary deficiency of
!lucose transporters in the )*T% which causes !lucose to remain in the tubular fluid. -iabetes
-
8/9/2019 Theory Urinalysis
8/23
insipidus results from "-H hyposecretion. ithout "-H% the collectin! duct does not
reabsorb as much water as normal% so more water passes in the urine.
-iuretics are chemicals that increase urine volume. They are used for treatin!
hypertension and con!estive heart failure because they reduce the body=s fluid volume and
blood pressure. -iuretics wor by one of two mechanisms;increasin! !lomerular filtration
or reducin! tubular reabsorption. For e'ample% caffeine% in the former cate!ory% dilates the
afferent arteriole and increases 6FR. "lcohol% in the latter cate!ory% inhibits "-H secretion.
"lso in the latter cate!ory are many osmotic diuretics% which reduce water reabsorption by
increasin! the osmolarity of the tubular fluid. Many diuretic dru!s% such as furosemide
,7asi'% produce osmotic diuresis by inhibitin! sodium reabsorption.
" urine test checs different components of urine% a waste product made by the
idneys. " re!ular urine test may be done to help find the cause of symptoms. The test can
!ive information about your health and problems you may have.
Drinalysis can be part of a routine e'amination and is fre>uently performed upon
admission to the hospital and before sur!ery. The test can also follow a preliminary rapid
urine test that produced abnormal results% so that urinalysis can be used to chec those results.
*omplete urinalysis is done in a laboratory. 0t is usually made up of 3 parts#
$ "ssessment of the color% clarity and concentration of the urine
$ E'amination of the chemical composition of the urine with a test strip
$ E'amination of the urine usin! a microscope to identify bacteria% cells and cell parts
The idneys camera tae out waste material% minerals% fluids% and other substances
from the blood to be passed in the urine. Drine has hundreds of different body wastes. hat
you eat% drin% how much you e'ercise% and how well your idneys wor can affect what is in
your urine. More than 499 different tests can be done on urine. " re!ular urinalysis often
includes the followin! tests.
2!l!r. Many thin!s affect urine color% includin! fluid balance% diet% medicines% and diseases.
How dar or li!ht the color is tells you how much water is in it. Iitamin < supplements can
turn urine bri!ht yellow. Jome medicines% blacberries% beets% rhubarb% or blood in the urine
can turn urine red(brown.
2larity. Drine is normally clear.
-
8/9/2019 Theory Urinalysis
9/23
-
8/9/2019 Theory Urinalysis
10/23
1a8teria% yeast cells% or parasites. There are no bacteria% yeast cells% or parasites in urine
normally. 0f these are present% it can mean you have an infection.
S-a"!-s 8ells6The presence of s>uamous cells may mean that the sample is not as pure as
it needs to be. These cells do not mean there is a medical problem% but your doctor may as
that you !ive another urine sample.
hy 0t 0s -one
" urine test may be done#
To chec for a disease or infection of the urinary tract. Jymptoms of a urine infection
may include colored or bad(smellin! urine% pain when urinatin!% hard to urinate% flan
pain% blood in the urine ,hematuria% or fever.
To chec the treatment of conditions such as diabetes% idney stones% a urinary tract
infection ,DT0% hi!h blood pressure ,hypertension% or some idney or liver diseases. "s part of a re!ular physical e'amination.
How To )repare
-o not eat foods that can color the urine% such as blacberries% beets% and rhubarb%
before the test. -o not e'ercise strenuously before the test.
Tell your doctor if you are menstruatin! or close to startin! your menstrual period.
Your doctor may want to wait to do the test.
-
8/9/2019 Theory Urinalysis
11/23
0f the collection cup has a lid% remove it carefully and set it down with the inner
surface up. -o not touch the inside of the cup with your fin!ers.
*lean the area around your !enitals.
o " man should retract the foresin% if present% and clean the head of his penis
with medicated towelettes or swabs.o " woman should spread open the !enital folds of sin with one hand. Then use
her other hand to clean the area around the urethra with medicated towelettes
or swabs. Jhe should wipe the area from front to bac so bacteria from the
anus is not wiped across the urethra.
-
8/9/2019 Theory Urinalysis
12/23
2larity 2ormal# *lear
"bnormal# *loudy urine can be caused by pus ,white blood cells% blood
,red blood cells% sperm% bacteria% yeast% crystals% mucus% or
aparasiteinfection% such as trichomoniasis.
Od!r 2ormal# Jli!htly nutty odor
"bnormal# Jome foods ,such as aspara!us% vitamins% and antibiotics ,such
aspenicillin can cause urine to have a different odor. " sweet%
fruity odor may be caused by uncontrolled diabetes. " urinary
tract infection ,DT0can cause a bad odor. Drine that smells lie
maple syrup can mean maple syrup urine disease% when the
body cannot brea down certain amino acids.
S7e8i9i8
)raity2ormal# 4.99:(4.939
"bnormal# " very hi!h specific !ravity means very concentrated urine%
which may be caused by not drinin! enou!h fluid% loss of too
much fluid ,e'cessive vomitin!% sweatin!% or diarrhea% or
substances ,such as su!ar or protein in the urine. Iery low
specific !ravity means dilute urine% which may be caused by
drinin! too much fluid% severe idney disease% or the use
of diuretics.
7H 2ormal# 5.8(?.9
"bnormal# Jome foods ,such as citrus fruit and dairy products and
medicines ,such as antacids can affect urinepH. " hi!h
,alaline pH can be caused by severe vomitin!% a idney
disease% some urinary tract infections% andasthma. " low
,acidic pH may be caused by severe lun!disease
,emphysema% uncontrolled diabetes% aspirinoverdose% severe
diarrhea% dehydration% starvation% drinin! too much alcohol% ordrinin! antifree&e ,ethylene !lycol.
Pr!tein 2ormal# 2one
"bnormal# )rotein in the urine may mean idney dama!e% an
infection%cancer% hi!h blood pressure% diabetes%systemic lupus
erythematosus ,J7E% or!lomerulonephritisis present.
)rotein in the urine may also mean that heart failure%leuemia%
poison ,lead or mercury poisonin!% orpreeclampsia,if you are
pre!nant is present.
http://www.webmd.com/hw-popup/white-blood-cell-leukocytehttp://www.webmd.com/hw-popup/red-blood-cell-erythrocytehttp://www.webmd.com/hw-popup/parasitehttp://www.webmd.com/hw-popup/trichomoniasishttp://www.webmd.com/drugs/drug-8686-Penicillin+V+Potassium+Oral.aspx?drugid=8686&drugname=Penicillin+V+Potassium+Oralhttp://www.webmd.com/hw-popup/urinary-tract-infectionhttp://www.webmd.com/hw-popup/urinary-tract-infectionhttp://www.webmd.com/hw-popup/amino-acidhttp://www.webmd.com/digestive-disorders/digestive-diseases-diarrheahttp://www.webmd.com/hw-popup/diuretichttp://www.webmd.com/hw-popup/diuretichttp://www.webmd.com/hw-popup/phhttp://www.webmd.com/hw-popup/asthmahttp://www.webmd.com/hw-popup/asthmahttp://www.webmd.com/lung/picture-of-the-lungshttp://www.webmd.com/hw-popup/emphysema-8115http://www.webmd.com/drugs/mono-3-ASPIRIN+-+ORAL.aspx?drugid=1082&drugname=Aspirin+Oralhttp://www.webmd.com/a-to-z-guides/dehydration-adultshttp://www.webmd.com/cancer/http://www.webmd.com/cancer/http://www.webmd.com/hw-popup/high-blood-pressure-hypertensionhttp://www.webmd.com/hw-popup/high-blood-pressure-hypertensionhttp://www.webmd.com/hw-popup/lupushttp://www.webmd.com/hw-popup/lupushttp://www.webmd.com/hw-popup/glomerulonephritishttp://www.webmd.com/hw-popup/heart-failure-8021http://www.webmd.com/hw-popup/heart-failure-8021http://www.webmd.com/hw-popup/leukemiahttp://www.webmd.com/hw-popup/leukemiahttp://www.webmd.com/hw-popup/preeclampsiahttp://www.webmd.com/hw-popup/white-blood-cell-leukocytehttp://www.webmd.com/hw-popup/red-blood-cell-erythrocytehttp://www.webmd.com/hw-popup/parasitehttp://www.webmd.com/hw-popup/trichomoniasishttp://www.webmd.com/drugs/drug-8686-Penicillin+V+Potassium+Oral.aspx?drugid=8686&drugname=Penicillin+V+Potassium+Oralhttp://www.webmd.com/hw-popup/urinary-tract-infectionhttp://www.webmd.com/hw-popup/urinary-tract-infectionhttp://www.webmd.com/hw-popup/amino-acidhttp://www.webmd.com/digestive-disorders/digestive-diseases-diarrheahttp://www.webmd.com/hw-popup/diuretichttp://www.webmd.com/hw-popup/phhttp://www.webmd.com/hw-popup/asthmahttp://www.webmd.com/lung/picture-of-the-lungshttp://www.webmd.com/hw-popup/emphysema-8115http://www.webmd.com/drugs/mono-3-ASPIRIN+-+ORAL.aspx?drugid=1082&drugname=Aspirin+Oralhttp://www.webmd.com/a-to-z-guides/dehydration-adultshttp://www.webmd.com/cancer/http://www.webmd.com/hw-popup/high-blood-pressure-hypertensionhttp://www.webmd.com/hw-popup/lupushttp://www.webmd.com/hw-popup/lupushttp://www.webmd.com/hw-popup/glomerulonephritishttp://www.webmd.com/hw-popup/heart-failure-8021http://www.webmd.com/hw-popup/leukemiahttp://www.webmd.com/hw-popup/preeclampsia -
8/9/2019 Theory Urinalysis
13/23
Gl-8!se 2ormal# 2one
"bnormal# 0ntravenous ,0Ifluids can cause !lucose to be in the urine. Too
much !lucose in the urine may be caused by uncontrolled
diabetes% anadrenal !landproblem% liver dama!e%braininury%certain types of poisonin!% and some types of idney diseases.
Healthy pre!nant women can have !lucose in their urine% which
is normal durin! pre!nancy.
4et!nes 2ormal# 2one
"bnormal# Ketones in the urine can mean uncontrolled diabetes% a very
low(carbohydrate diet% starvation or eatin! disorders ,such
as anore'ia nervosaorbulimia%alcoholism%or poisonin! from
drinin! rubbin! alcohol ,isopropanol. Ketones are often foundin the urine when a person does not eat ,fasts for 4? hours or
lon!er. This may occur when a person is sic and cannot eat or
vomits for several days. 7ow levels of etones are sometimes
found in the urine of healthy pre!nant women.
Mi8r!s8!7i
8 analysis2ormal# Iery few or no red or white blood cells or casts are seen. 2o
bacteria% yeast cells% parasites% or s>uamous cells are present. "
few crystals are normally seen.
"bnormal# Red blood cells in the urine may be caused by idney or bladder
inury% idney stones% a urinary tract infection ,DT0%
inflammation of the idneys ,!lomerulonephritis% a idney or
bladder tumor% or systemiclupuserythematosus ,J7E. hite
blood cells ,pus in the urine may be caused by a urinary tract
infection% bladder tumor% inflammation of the idneys% systemic
lupus erythematosus ,J7E% or inflammation in the va!inaor
under the foresin of the penis.
-ependin! on the type% casts can mean inflammation or dama!e
to the tiny tubes in the idneys% poor blood supply to the
idneys% metal poisonin! ,such as lead or mercury% heartfailure%or abacterial infection.
7ar!e amounts of crystals% or certain types of crystals% can mean
idney stones% dama!ed idneys% or problems withmetabolism.
Jome medicines and some types of urinary tract infections can
also increase the number of crystals in urine.
-
8/9/2019 Theory Urinalysis
14/23
The presence of s>uamous cellsmay mean that the sample is
not as pure as it needs to be. These cells do not mean there is a
medical problem% but your doctor may as that you !ive another
urine sample.
hat "ffects the Test
Reasons you may not be able to have the test or why the results may not be helpful include#
0f you are havin! your menstrual period.
Tain! medicines% such as diuretics% erythromycin% trimethoprim ,Trimpe'% or hi!h
doses of vitamin * ,ascorbic acid taen with an antibiotic% such as tetracycline.
Havin! an P(ray test with contrast material in the past 3 days.
2ot !ettin! the urine sample to the lab in 4 hour.
hat To Thin "bout
Jome urine tests can be done usin! a home test it. For more information% see the
topic Ketones or Home Test for Drinary Tract 0nfections.
0n some cases% the amount of urine you mae in +5 hours may be measured. Most
adults mae about 4 >t ,4 7 to + >t ,+ 7 per day. *hildren mae about 9.3 >t ,9.3 7
to 4.8 >t ,4.: 7 per day.
Other substances that may be checed durin! a urine test include#
o
-
8/9/2019 Theory Urinalysis
15/23
0f an abnormal result is found durin! a urine test% more tests may be done% such as a
urine culture% P(ray of the idneys ,intravenous pyelo!ram L0I)% or cystoscopy. For
more information% see the topics Drine *ulture% 0ntravenous )yelo!ram ,0I)% and
*ystoscopy.
Other urine tests
-ru!s can also be detected in urine for a certain time after they are used. *annabis
can be detected% dependin! on the type of test used% up to several wees after it has been
taen# dru!s lie cocaine% ecstasy or heroin for up to : days. -ifferent tests are also used in
detectin! dru! use# rapid tests% which can help !ive police fast results in the field% and other
tests% that need to be done in laboratories. Drine samples are also used when !ivin! athletes
dru! tests to chec whether someone has used banned substances.
-0"uate% or because the bodys cells do not respond properly to
insulin% or both. )atients with hi!h blood su!ar will typically e'perience polyuria ,fre>uent
urination% they will become increasin!ly thirsty ,polydipsia and hun!ry ,polypha!ia.
There are three types of diabetes#
4 Type 4 -iabetes
The body does not produce insulin. Jome people may refer to this type as insulin(dependent diabetes% uvenile diabetes% or early(onset diabetes. )eople usually develop type 4
diabetes before their 59th year% often in early adulthood or teena!e years.
4 Type 4 diabetes is nowhere near as common as type + diabetes. "ppro'imately 49@ of all
diabetes cases are type 4.
)atients with type 4 diabetes will need to tae insulin inections for the rest of their
life. They must also ensure proper blood(!lucose levels by carryin! out re!ular blood tests
and followin! a special diet.
-
8/9/2019 Theory Urinalysis
16/23
Overwei!ht and obese people have a much hi!her ris of developin! type + diabetes
compared to those with a healthy body wei!ht. )eople with a lot of visceral fat% also nown
as central obesity% belly fat% or abdominal obesity% are especially at ris.
-
8/9/2019 Theory Urinalysis
17/23
and !rowth. Most of what we eat is broen down into !lucose. 6lucose is a form of su!ar in
the blood ( it is the principal source of fuel for our bodies.
hen our food is di!ested% the !lucose maes its way into our bloodstream. Our cells
use the !lucose for ener!y and !rowth. However% !lucose cannot enter our cells without
insulin bein! present ( insulin maes it possible for our cells to tae in the !lucose. 0nsulin is
a hormone that is produced by the pancreas. "fter eatin!% the pancreas automatically releases
an ade>uate >uantity of insulin to move the !lucose present in our blood into the cells% as
soon as !lucose enters the cells blood(!lucose levels drop.
" person with diabetes has a condition in which the >uantity of !lucose in the blood is
too elevated ,hyper!lycemia. This is because the body either does not produce enou!h
insulin% produces no insulin% or has cells that do not respond properly to the insulin the
pancreas produces. This results in too much !lucose buildin! up in the blood. This e'cess
blood !lucose eventually passes out of the body in urine. Jo% even thou!h the blood has
plenty of !lucose% the cells are not !ettin! it for their essential ener!y and !rowth
re>uirements.
How To -etermine hether You Have -iabetes% )rediabetes or 2either -octors can
determine whether a patient has a normal metabolism% prediabetes or diabetes in one of three
different ways ( there are three possible tests#
The "4* test
at least 8.:@ means diabetes
between :./@ and :.CC@ means prediabetes less than :./@ means normal
The F)6 ,fastin! plasma !lucose test
at least 4+8 m!Bdl means diabetes
between 499 m!Bdl and 4+:.CC m!Bdl means prediabetes
less than 499 m!Bdl means normal
"n abnormal readin! followin! the F)6 means the patient has impaired fastin! !lucose
,0F6
The O6TT ,oral !lucose tolerance test
at least +99 m!Bdl means diabetes
between 459 and 4CC.C m!Bdl means prediabetes
less than 459 m!Bdl means normal
"n abnormal readin! followin! the O6TT means the patient has impaired !lucose tolerance
,06T
Researchers from the Mayo *linic "ri&ona in Jcottsdale showed that !astric bypasssur!ery can reverse type + diabetes in a hi!h proportion of patients. They added that within
-
8/9/2019 Theory Urinalysis
18/23
three to five years the disease recurs in appro'imately +4@ of them. Yessica Ramos% M-.%
said The recurrence rate was mainly influenced by a lon!standin! history of Type + diabetes
before the sur!ery. This su!!ests that early sur!ical intervention in the obese% diabetic
population will improve the durability of remission of Type + diabetes. ,7in to article
)atients with type 4 are treated with re!ular insulin inections% as well as a special diet
and e'ercise. )atients with Type + diabetes are usually treated with tablets% e'ercise and a
special diet% but sometimes insulin inections are also re>uired. *omplications lined to badly
controlled diabetes#
Eye complications ( !laucoma% cataracts% diabetic retinopathy% and some others.
Foot complications ( neuropathy% ulcers% and sometimes !an!rene which may re>uire
that the foot be amputated
Jin complications ( people with diabetes are more susceptible to sin infections and
sin disorders Heart problems ( such as ischemic heart disease% when the blood supply to the heart
muscle is diminished
Hypertension ( common in people with diabetes% which can raise the ris of idney
disease% eye problems% heart attac and stroe
Mental health ( uncontrolled diabetes raises the ris of sufferin! from depression%
an'iety and some other mental disorders
Hearin! loss ( diabetes patients have a hi!her ris of developin! hearin! problems
6um disease ( there is a much hi!her prevalence of !um disease amon! diabetes
patients
6astroparesis ( the muscles of the stomach stop worin! properly Ketoacidosis ( a combination of etosis and acidosis1 accumulation of etone bodies
and acidity in the blood.
2europathy ( diabetic neuropathy is a type of nerve dama!e which can lead to several
different problems.
HH2J ,Hyperosmolar Hyper!lycemic 2onetotic Jyndrome ( blood !lucose levels
shoot up too hi!h% and there are no etones present in the blood or urine. 0t is an
emer!ency condition.
2ephropathy ( uncontrolled blood pressure can lead to idney disease
)"- ,peripheral arterial disease ( symptoms may include pain in the le!% tin!lin! andsometimes problems walin! properly
Jtroe ( if blood pressure% cholesterol levels% and blood !lucose levels are not
controlled% the ris of stroe increases si!nificantly
Erectile dysfunction ( male impotence.
0nfections ( people with badly controlled diabetes are much more susceptible to
infections
Healin! of wounds ( cuts and lesions tae much lon!er to heal
Met#!d!l!)y
E=a"inati!n !9 t#e a"!-nt !9 -rine
-
8/9/2019 Theory Urinalysis
19/23
E>uipment#
measurin! cup
urine container
Materials#
Drine +5 hours
How it ors#
4. *ollect of urine for +5 hours. note the amount of urine durin! the 4+(hour and 4+(hour
urine ni!ht and the amount of urine now. Record the measurements.
E=a"inati!n !9 -rine !d!r
E>uipment#
closed container
Materials#
Fresh urine without preservative
How it wors#
4. 0nsert fresh urine into the container and immediately identify the smell comin! out of
the urine.+. Record the results of the e'amination.
E=a"inati!n !9 -rine 8!l!r
E>uipment#
Test tube
Flashli!ht
Materials#
Fresh urine
How it wors#
4. )our the urine into a test tube filled up 3B5 of the tube. then tilt the tube
+. )rovide e'posure to the tube
3. Jpecify the color of the urine with the statement# colorless% pale yellow% dar yellow%
yellow% yellow red mi'ed% etc.
5. Record the results of the e'amination
Deter"ine t#e 8larity !9 t#e -rine
-
8/9/2019 Theory Urinalysis
20/23
E>uipment#
Test tube
Flashli!ht
Materials#
Fresh urine
How it wors#
4. )our the urine into a test tube filled up 3B5 of the tube. then tilt the tube
+. )rovide e'posure to the tube
3. -etermine the clarity of the urine with the statement# clear% somewhat clear% cloudy%
and very turbid
5. Record the results of the e'amination
Deter"ine t#e s7e8i9i8 )raity !9 -rine
E>uipment#
Drinometer
Drinometer !lass
Materials#
Drine
How it wors#
4. )our into a !lass urinometer urine. foam may be formed with a piece of paper thrown
away or drop ether
+. Enter urine into the urinometer !lass. to be free floatin! urinometer then there must be
>uite a lot of urine in a cup. if the amount is too little urine dilute urine with distilled
water a number of urine. to calculate its density% the second last number of readin!s
must be multiplied by two anyway.
3. uipment#
Dniversal indicator
Drine container
-
8/9/2019 Theory Urinalysis
21/23
Materials#
Fresh urine
How it wors#
4. Dniversal indicator of wet urine checed . wait for a few minutes .
+. 2ote the color chan!e occurs .
3. *ompare with the list of colors available on the acidity of universal indicator. Jpecify
a value correspondin! to the color.
5. Record the measurement results.
Pr!tein test .it# a8eti8 a8id
E>uipment#
test tube
burner ,uipment#
test tube
burner ,
-
8/9/2019 Theory Urinalysis
22/23
flashli!ht
blac cardboard
Materials#
Drine
-
8/9/2019 Theory Urinalysis
23/23
top related