Pathological components of urine

Transcription

1 Pathological components of urine

2 Physical examination of urine colour of urine very bright, colourless yellow-brown orange cause polyuria with enormous drink, diabetes mellitus, kidney failure water deficiency, enormous water loos chrysarobin, chrysophanic acid yellow flavins, vitamin B 2 brick-brown antipyrine, amidopyrine red uroerythrin, porphyrins, haemoglobin, myoglobin brown-red urobilinogen, often with bilirubin brown bilirubin, haematin, methaemoglobin green tetralin olive green thymol, hydroquinon, catechol blue-green methylene blue

3 Physical examination of urine smell of urine cause flavin ( like mill chocolate ) lactoflavin medication ( vitamin B 2 ) garlic garlic, phosphorus poisoning asparagus asparagic acid maggi ( soup ingredient ) excretion of valine, leucine, isoleucine violets terpentyne sweet chloroform, acetone bitter almonds kyanide - intoxication tabacco fume nicotine poisoning pears chloralhydrate shoe polish nitrobenzole poisoning ammonia bacteria saprogenous saprogenous bacteria at proteinuria

4 Physical examination of urine foam colourless yellow to yellow-brown bublles in fresh urine cause proteins in urine or contaminated test tube bilirubin in urine urinary tract infection together with glycosuria

5 Physical examination of urine turbidity whitish white yellow white-yellow fume, red, rusty white red white parts red-brown sediment

6 Physical examination of urine Volume properly collected urine + accurately measured volume right examination in urine control of 24 hours collection; excretion of creatinine/24 h

7 Physical examination of urine Density measured by urinometer (densitometer), do not touch the wall of test tube, at appropriate temperature fresh urine without sediment

8 Chemical examination of urine ph indicatory paper strip ph meter aciduria ph < 5.4 meal rich on animal proteins alkaliuria ph > 6.5 lactovegetabilic meal

9 Chemical examination of urine proteins (proteinuria) diagnostic paper strip sulphosalicylic acid coagulate generation Heller s test with conc. HNO 3 finding arb.units old classif. conc. [g/l] clear 0 - about 0.1 light opalescence heavy opalescence flakes precipitate and more

10 Chemical examination of urine saccharides (glucose, glucosuria) diagnostic paper strip Fehling s reaction, Benedikt s reaction (reduction of Cu 2+ ) Nylander s reaction (reduction of Bi 3+ ) causes: o all situations with hyperglycemia more than 10 mmol/l, such as diabetes mellitus, hepatopathy, acute pancreatitis o increased resorption in the gut o renal glycosuria

11 Chemical examination of urine ketone bodies (ketonuria) diagnostic paper strip (acetoacetate) Lestradet s test, Legal s test causes: o serious diabetes mellitus o long-term starvation, limited income of saccharide o often vomit

12 Chemical examination of urine haemoglobin (blood, haematuria, haemoglobinuria) diagnostic paper strip peroxidase reaction Heitz Boyer s test (oxidation of phenolphtalein) causes: o kidney disorder o urinary tract disorder o trombocytopathy

13 Chemical examination of urine urobilinogen (urobilinogenuria) diagnostic paper strip Ehrlich s reaction causes: o increased haemoglobin degradation o liver disorder (hepatitis, liver tumour)

14 Chemical examination of urine bilirubin diagnostic paper strip reaction with iodine solution (Rosin s test) reaction with conc. HNO 3 (Gmelin s test) o bilirubin is by iodine oxidized to green biliverdin o bilirubin is by HNO 3 oxidized to blue bilicyanin

15 Chemical examination of urine bilirubin direct = conjugated, permeate to urine indirect = non-conjugated, does not permeate to urine, can permeate across blood brain barrier haem biliverdin bilirubin urobilinogen urobilin, stercobilin

16 Chemical examination of urine nitrites nitrates in urine could be, by acting of pathogenic bacteria, reduced to nitrites that are indirect evidence of urinary tract infection positive reaction give e.g. E. coli, Salmonella, Aerobacter

17 Chemical examination of urine leukocytes (pyuria) symptom of kidney or urinary tract inflammation causes: o pyelonephrititis o urinary tract inflammation o tumour disorder

18 Examination of urinary sediment sediment components: organic: epithelial cells, cylinders (casts) non-organic: crystals microorganisms

19 Erythrocytes

20 Leukocytes

21 Renal tubular epithelia triangle shape

22 Transitional epithelia round shape with large oval nucleus

23 Squamous epithelia large flat cell with central oval nucleus

24 Hyaline cast

25 Granular cast

26 Waxy cast

27 Uric acid crystals

28 Oxalate crystals

29 Triple phosphate crystals

30 Cystine crystals

31 Bacteria stained by blue colour

32 Yeast specie candida albicans

33 Trichomonade characterised by movement (membrane and crop)