history-urinalysis-uf-tests (AUBF) Flashcards
The study of urine was based on..
Drawing found in the cavement and in the Egyptian hieroglyphics
an Egyptian hieroglyphics
Edwin Smith Surgical Papyrus
the father of medicine
Hippocrates
the book hippocrates created
Uroscopy
2 determination of diabetes (Hippocrates)
Ant Testing and Taste Testing - honey like taste
Discovered a test by boiling urine
Frederick Dekkers
A test of boiling urine
Albuminuria
People offering health predictions without medical credentials for a healthy fee
Charlatans / Pisse Prophets / Quack Doctors
he published a book about charlatans and passing of the first medical licensure laws in England
Thomas Bryant
he invented microscope and first to observe bacteria and protozoa
Anton Van Leeuwenhoek
he developed a method for quantitating microscopic urinary sediments in 17th century
Thomas Addis
cellular elements are counted
Addis Count
he introduced urinalysis as part of doctor’s routine patient examination
Richard Bright
he constructed the 1st microscope with convex objective and concave eyepiece
Zacharias Janssen
he suggested the use of convex lenses on both objective and eyepiece in compound microscope.
Johannes Kepler
constructed the Kepler’s Microscope which he enlarged the view of the object
Christopher Schamir
became the prototype of modern microscopes
Kepler’s Microscope
Invented a simple but effective 2-lens eyepiece microscope
Christian Huggens
introduced higher numerical apertures for microscope objectives
Charles Spurer
invented darkfield microscope
Francis Wenham
invented phase contrast microscope
Fritz Zernicke
invented centrifuge microscope
E.N Harvey and A.L. Leomis
invented electron microscope
Knoll, Ruska and Rudenbergh
invented more powerful EM
Haws Mahl
operated through the reflection of light
Light Microscope
made up of 1 or 2 lenses
Simple Microscope
made up of many lenses
Compound Microscope
specimen is illuminated by a special condenser that provides oblique light.
Darkfield Microscope
enables contrast to be added to normally invisible objects making them quite visible through a microscope
Phase Contrast Microscope
Light travels in a sine-wave form with characteristic amplitude, or wave height and wavelength.
Phase Contrast Microscope
produces a 3D image
Stereoscope Microscope
detect chemical bonding between certain substances
Fluorescence Microscope
operated using beam of electrons to create an image of the specimen
Electron Microscope
ability of the microscope to render fine detail of an object visible
Magnification
ability of the microscope to distinguish 2 small or closely adjacent images
Resolving Power
designation of amount of light entering the objective from a point in the microscopic field
Numerical Aperture
ration of the velocity of light in this medium is compared with that in a vacuum
Refractive Index
testing of urine with procedures commonly performed in expenditure, reliable, accurate, safe and cost-effective manner
Urinalysis
2 types of nephrons
cortical and juxtamedullary nephrons
cortical nephrons is approximately…
85% of the nephrons
it is situated in the cortex of kidney and responsible for the removal of waste products and reabsorption of nutrients
Cortical Nephrons
a nephron that have longer loops of henle and produces enzyme
Juxtamedullary Nephrons
the primary function of Juxtamedullary Nephrons
concentration of urine
renal functions
renal blood flow
glomerular filtration
tubular reabsorption
tubular secretion
how many kidneys do human have
2 kidneys
color of kidney
dark red
shape of kidney
bean-shaped organs
3 regions of the internal structure of the kidney
cortex - outer layer
medulla
renal pelvis - expansion of the upper ureter
how many nephrons are there in each kidney
1 to 1.5 million
the function unit of kidney
nephrons
components of glomerulus
coiled capillary lobes
located w/in bowman’s capsule
serves as nonselective filter of plasma substance
components of glomerular filtrate
water
glucose
electrolytes
amino acid
urea
uric acid
creatinine
ammonia
Proximal Convulated Tubules reabsorbs..
reabsorbs large amount of water, sodium chloride, bicarbonate, potassium, calcium, phosphate, CHON, glucose and other necessary substances back into the bloodstream
the glucose if totally reabsorbed at concentrations of..
160-180 mg/dl
Proximal Convoluted Tubule secretes
Sulfate, glucoronides, hydrogen ion and drugs.
2 loops of henle
Descending and Ascending Loop of Henle
it reabsorbs water back into the bloodstream and does not reabsorb solutes.
Descending Loop of Henle
it reabsorbs sodium, chlorine, calcium and magnesium and does not reabsorb water
Ascending Loop of Henle
Distal Convoluted Tubule reabsorbs
sodium and potassium
D. conv tubule secretes
K, NH3 and H+
it is composed of transitional epi cells
Urethral Epithelial Cells
the Urethral Epithelial Cells lines the..
renal calyces
renal pelvis
ureters
bladder
urethra
what can be seen in normal patients or after catheterization which is an increased numbers are seen in UTI
Urethral Epithelial Cells
volume of filtered plasma
approximately 170,000 ml
volume of the average urine output when filtered plasma is converted
1,200 to 1,500 ml
urine formation pathways
- glomerulus
- bowman’s capsule
- proximal convoluted tubule
- loop of henle
- distal convoluted tubule
- collecting tubules
- ureter
- urinary bladder
- urethra
in nephrotic syndrome, the renal tubular epithelial cells absorb and become engaged with fat known as
Oval Fat Bodies
indicates lipid droplets contained in the cell
Maltese cross
high urine production
polyuria
the amount of abnormal increase in polyuria
> 2500 ml per 24 hours
polyuria is associated with..
diabetes mellitus and diabetes insipidus
also, use of diuretics, caffeine or alcohol which suppress the excretion of ADH
what suppresses the excretion of ADH
use of diuretics, caffeine or alcohol which suppress the excretion of ADH
polyuria is seen in:
diabetes mellitus
diabetes insipidus
chronic nephritis
nervous conditions
excessive fluid intake
absorption of large quantity of edema fluid
low urine production
oliguria
the decrease volume which amounts to..
<500 ml per 24 hours
cause by dehydration and seen in a state of dehydration
oliguria
causes of oliguria
excessive water loss
vomiting
diarrhea
perspiration or severe burns
oliguria is seen in:
acute nephritis/glomerulonephritis
calculus or tumor of the kidney
severe diarrhea
dehydration (vomiting, fever, sweating)
uremia
shock
transfusion reactions
toxic agents such as mercury
complete suppression of urine formation
anuria
anuria may result..
any serious damage to the kidneys or from a decrease in the flow of blood to the kidney
anuria is seen in:
acute nephritis
poisoning with mercury
transfusion reactions
toxic agents
complete obstruction
collapse
volume amount in anuria
<1000 ml per 24 hours for 3 consecutive days
increased urine volume at night
nocturia
involuntary voiding of urine at night
enuresis
secreted by the adrenal cortex
aldosterone
aldosterone increase reabsorption of
Na or Sodium
it is secreted by the posterior pituitary gland
ADH or Vasopressin
the ADH or Vasopressin regulates reabsorption of..
water in the distal tubules
ADH deficiency results in
Diabetes Mellitus
it is secreted by the kidneys and stimulates production of erythrocytes
Erythropoietin
95-97% main composition of urine
Water
3-5% main composition of urine
solids
gram of organic and inorganic substance in urine
35g organic substances and 25g inorganic substances
the major organic constituent of the urine
urea
the amount of urea in urine
25 g/liter
a metabolic waste product produced by the liver from the breakdown of protein and amino acids
urea
the major inorganic constituent of urine
chloride
amount of chloride in urine
9 g/liter
amount of Na in urine
4 g/liter, primary from salt, varies by intake
amount of K in urine
2 g/liter, combined with Chlorine and other salts
the product of creatine metabolism by muscles
creatinine
the amount of creatinine in the urine
1.5 g/liter
it combines with sodium to buffer the blood
phosphate
the amount of phosphate in the urine
2 g/liter
a product of nucleic acid in food and cells
uric acid
amount of uric acid in urine
0.6 g/liter
it regulates the blood and tissue fluid acidity
ammonium/ammonia
the amount of ammonium/ammonia in the urine
0.6 g/liter
it combines with chloride, sulfate, and phosphate
calcium
the amount of calcium in urine
0.2 g/liter
urine may also contain
hormones, vitamins, medications
urine may also contain formed elements such as
cells
cast
crystals
mucus
bacteria
the test used to determine whether a particular fluid is urine
Urine-Creatinine Test
two content of urine to determine that the fluid is really urine
urea and creatinine
____ of urine is directly proportional to its _____
concentration ; specific gravity
if the urine is dark therefore;
concentration is great as well as the specific gravity.
factors affecting urine concentration
dietary intake
physical activity
body metabolism
endocrine function
body position
the more fluid intake the greater the ___
urine volume
factors affecting urine volume
fluid intake
fluid loss from non-renal sources
variations in the secretion of ADH
necessity to excrete increased amount of dissolved solids
reasons for urinalysis
Aid in diagnosis of disease
Screen asymptomatic populations for undetected disorder
Monitor the progress of diseases and the effectiveness of therapy
approx. ___% of the blood leaves the left ventricle of the hearts enters the ____ by way of ____
20-25% ; kidneys ; renal arteries
amount of blood passing through kidneys
1200 ml/min
amount of blood passing per kidney
600 ml/min
amount of filtered plasma on the glomerulus
120 ml/min
the amount that the filtered plasma on the glomerulus produces and is finally excreted as urine
1 ml/min
amount in dehydration and in excessive dehydration
o.3 ml in dehydration ; 15ml in excessive dehydration
methods of urine specimen collection
bottle method, gauze-pad method, catheterization method, midstream-catch method and suprapubic aspiration method.
uses receptacles to collect the specimen provided that it is clean, dry and steriled
Bottle Method
used to collect specimen and then centrifuged.
Gauze-Pad Method
used for bacterial culture where a clean rubber tuber is inserted through the urethral orifice to the urethral canal, then to the bladder to collect a pure urine specimen.
Catheterization Method
a urine collection used for routine screening and the urine collection is at the middle part of single continued normal urination and is considered less traumatic method.
midstream catch method
what strong bacterial cleaning agent should not be used in midstream-catch method
hexachlorophene or povidone-iodine
bladder urine for bacterial culture
Suprapubic Aspiration Method
a type of urine specimen collected at any time for routine and qualitative urine analysis
random specimen
collection is timed or scheduled for a particular due to the needs of the situation, tests and substance being determined.
timed specimen
used for quantitative chemical test urine is collected within 24 hours
24 hr specimen
collected within 12 hours
12 hour specimen
8 pm to 8 am urine collection
12-hr specimen (night)
urine sample at 8 am is discarded and all samples are voided until 8 pm
12-hr specimen (day)
specimen collected between 2pm to 6pm
afternoon specimen
it is best evaluated from specimens obtained between 2 and 4 pm
afternoon specimen
the first morning urine specimen is used for
pregnancy test, routine screening and orthostatic protein.
concentrated specimen, detection of chemicals and formed elements
first morning urine specimen
for diabetic monitoring and screening, there will be no any metabolites from food ingested before the beginning of the fasting period
fasting specimen
void urine shortly before routine meal and collect a specimen 2 hours after eating (for diabetic monitoring)
2-hour postprandial
a preservation that prevents bacterial growth and preserve formed elements
refrigeration
the formed elements that are preserved through refrigeration
casts, rbcs, wbcs, epithelial cells and acid ph.
preservation of urine that prevents:
- conversion of urea to ammonium carbonate
- destruction of glucose by yeast/bacteria
- false positive albumin tests due to the presence of bacterial protein
- degeneration/destruction of organized sediments
Chemical Preservation
organized sediments
pus, blood and casts
ideal preservative for steroids
toluene
preserves urinary sediments well
formalin 40%
a small crystal is added to 3-4 ounces of urine
thymol
good preservative for aldosterone ; not an ideal preservative
chloroform
ideal for glucose analysis (glucose tolerance test or as an aid in regulating the insulin dosage of a diabetic patient)
sodium fluoride or benzoic acid
used for regent strip testing
sodium benzoate
used in specimens forwarded to distant laboratories and is considered as an excellent preservatives and is good for long-term preservation.
phenol
preserved 24-hr urine specimens
hydrochloric acid (10 ml cone)
special preservative for the detection of catecholamines, calcium, nitrogen, inorganic constituents
sulfuric acid (1ml cone)
keeps pH at about 6.0 and bacteriostatic at 18g/L
boric acid
can be used for culture transport and the sample can be kept for 24 hours w/o ref
boric acid
the normal amount of urine in adult
800-1600 ml/24hours
normal amount of urine in children 6-12 years
500-1500 ml/24hours
normal amount of urine in children 1-6 years
300-1000 ml/24hours
urine obtained by a catheter immediate after the patient has emptied the bladder voluntarily
residual urine
amount of urine that remains in the bladder after voluntary urination
residual urine
normal urine color
straw to amber yellow
yellow pigment of urine is due to
urochrome (named by Thudichum)
pink pigment of urine is due to
uroerythrin (ppt of amorphous urates)
orange-brown color is due to
urobilin (oxidation product of urobilinogen)
the sg of amber urine
high SG and small quantity
sg of colorless to straw
low SG and large quantity
the aromatic odor of urine is due to
urinod or volatile organic acids
the normal transparency of urine
clear (fresh specimen)
normal clarity of urine
nubecula - faint cloud in urine forms after standing it for some time due to mucus, leukocytes or epithelial cells.
faint cloud in urine forms after standing it for some time due to mucus, leukocytes or epithelial cells.
nubecula
the ratio of the weight of a substance to the weight of an equal volume of a reference substance
specific gravity
density of a solution compared with the density of a similar volume of distilled water at a similar temperature
specific gravity
measurement of the concentration of solutes and the concentrating and diluting power of the kidney
specific gravity
specific gravity is a very complicated function that involves:
osmosis
counter current
ultra-filtration and
secretion mechanisms
urine sg is high, usually above 1.010
hypersthenuric
urine sg is normal, fixed at about 1.010
isosthenuric
urine sg is low, usually less than 1.007
hyposthenuric
low sg is related to:
chronic nephritis and diabetes insipidus
high sh is related to:
diabetes mellitus, acute nephritis and fever
determines the concentration of dissolved particles in a specimen by measuring refractive index
Refractometer Method
comparison of the velocity of light in air with the velocity of light in a solution.
refractive index
consists of weighted float attached to a scale that has been calibrated in terms of urine SG
urinometer
less accurate method
urinometer