Chapter 3 Flashcards
Wrote a book on “uroscopy”
5th century BCE
Instruction in urine examination as part of their training
Middle ages
Development of 20 different color charts
1140 CE
He discovered albuminuria by
boiling of urine
Frederick Dekkers
There is a progress from “ant
testing” and ”taste testing” for glucose
1694
passing of the first medical licensure law in England
1627
Examined and quantified urinary sediment
Thomas Addis
The invention of microscope led to the examination and
quantitation of urinary sediment by Thomas Addis
17th century
introduced the concept of urinalysis as
part of routine patient examination
Richard Bright
Richard Bright introduced the concept of urinalysis as
part of routine patient examination
1827
the number and complexity of the tests performed in a
urinalysis had reached a point of impracticality, and
urinalysis began to disappear from routine examinations.
1930s
kidneys continuously form this as an
ultrafiltrate of plasma
Urine
Reabsorption of water and filtered substances
essential to body function converts into how much volume of filtered plasma?
Approximately 170,000 mL
Average daily urine output
1200 mL
Composition of urine
95% water
5% solutes
Factors affecting urine composition
dietary intake
physical activity
body
metabolism
endocrine functions
Organic substances in urine
Urea
Creatinine
Uric acid
Inorganic substances in urine
Chloride
Sodium
Potassium
Other substances found in urine
Hormones
Vitamins
Medications
Other substances found in urine
Hormones
Vitamins
Medications
Urine may also contain:
Cells
Casts
Crystals
Mucus
Bacteria
Primary organic component in normal urine
Urea
Product of metabolism of creatine by muscles
Creatinine
Product of breakdown of nucleic acid in food and cells
Uric acid
Product of metabolism of protein and amino acids
Urea
Primary inorganic component found in normal urine
Chloride
Found in combination with sodium (table salt) and many other inorganic substances
Chloride
Primarily from salt, varies by intake
Sodium
Combined with chloride and other salts
Potassium
Combines with sodium to buffer the blood
Phosphate
Regulates blood and tissue fluid acidity
Ammonium
Combines with chloride, sulfate, and phosphate
Calcium
Water is a major body constituent; therefore, the amount excreted is
usually determined by the _______
Body’s state of hydration
Factors that influence urine volume:
Fluid intake
Fluid loss from nonrenal sources
Variations in the secretion of ADH
The need to excrete increased amounts of dissolved solids, such as
glucose or salts.
Average daily output (range)
1200-1500 mL/day
Average daily urine output that is still considered normal
600-2000 mL/day
abnormal decrease in urine output
Oliguria
Oliguria in infants
<1 mL/kg/hr
Oliguria in children
<0.5 mL/kg/hr
Oliguria in adults
less than 400 mL/day
It is seen commonly when the body enters a state of dehydration as a result of excessive water loss from vomiting, diarrhea, perspiration, or severe burns
Oliguria
Cessation of urine flow
Anuria
may result from any serious damage to
kidneys or from a decreased blood flow to the kidneys
Anuria
Increase in the nocturnal excretion of urine (>500 mL at night)
Nocturia
Clinical significance of nocturia
Prostatic cancer
abnormal increase in daily urine output
Polyuria
Polyuria in children
2.5-3 mL/kg/day
Polyuria in adults
> 2.5 L/day
It is often associated with Diabetes Mellitus and Diabetes Insipidus
Polyuria
caused by a defect either in the pancreatic production of insulin or in the function of insulin, which results in an increased concentration of body glucose
Diabetes mellitus
Specific gravity of urine specimen from a patient with Diabetes mellitus
Increased
