Physical Examination Of Urine

GROSS PHYSICAL EXAMINATION of URINE

Ecxamination of Urine is a very important subject in laboratory testing. Urine examination is very common and need details knowledge and throu observation and examination. It gives an idea about urinary problems of the patient. It is a mirror of kidney disease. so, every doctor, lab technician shoud know the basics of urine examination in details. 

here is first post- Physical examination of Urine. next post will discuss other parameter. so follow and subscribe: https://swapanlifeline.blogspot.com

1. 1) Volume

a.      Normal vol. 600-2000ml.  night urine <400 ml

b.      Oliguria= <500 ml/24 hrs

c.       Polyurea - > 2000 ml/24 hrs

d.      Nocturia - >500 ml at night

e.      Anuria <100ml/24 hrs

f.        Increased vol-

                                                              i.       excessive intake

                                                            ii.      drugs [ caffine, alcohol],

                                                          iii.      diuretics

                                                           iv.      diabetes insipidus

                                                             v.      diabetes mellitus

                                                           vi.      progressive chronic renal failure

g.      decreased volume

                                                              i.      prerenal- hgg/ dehydration /CCF/ sepsis/ anaphylaxis

                                                            ii.      post renal- AGN/ ATN / nephrotoxic agent/ CRF /

1. 2)      Colour :  normal is clear /pale yellow/ straw
2. 
   

a.      Normal colour is due to

– Urochrome, Urobilin, Uroerythryn

b.      Abnormal colour

§  Red –hematuria/ hemoglobinuria/ porphyrin/ myoglobin/ beets/ mens

§  Cloudy- phos[hate/ urate/ bacteria/ pus/ contamination

§  Deep yellow- bile pigment in obs. Jaundice/ vit. B complex

§  Yellow- acreflavin dye

§  Yellow-green : bilirubin-biliverdin

§  Yellow-brow : bilirubin-biliverdin (beer brown)

§  Milky : pus/ chyle/ lipid

§  Brown : hgg/ porphyria

§  Black : alcaptonuria

§  Blue green : indicans dye/ pseudomonas infection

§  Blue : indigo caramine dye

1. 3)      Odour :  slightly sweetish, mild ammonical on standing

a.      Fruty : ketoacidosis

b.      Fishy : proteus infection

c.       Ammonical : E. Coli infection

d.      Rancid : tyrosinemia

e.      Mousy : PKU

f.        Rotting fish : trimethyl aminuria

1. 4)      Specific gravity : normal 1.016-1022 due to mainly Urea, NaCl, Sulphate, Phosphate

Increased	Decreased : dilute urine	Fixed (isosthenuria) : 1.010
Glycosuria Albuminuria Oliguria Hematuria Excessive sweating	Water intake CGN Benign nephrosclerosis Diabetis insipidus Polyurea	Severe renal damage ADH deficiency Polycystic kidney malignant HTN

a.       Method of examination :

                                                              i.      Urinometer :  at least 40ml urine required.

1.      Pour 40ml urine in cylinderà urinometer lower gently àtake time to settleà take reading

2.      Correction : urinometer calibrated at 20⁰C.  Add 0.001 for each 3^Oc increase , substract 0.001 for for 3^Oc decrease .

3.      If urine quqntity in less, dilute with equal vol of water & multiply readingx2.

                                                            ii.      Reagent strip : Multistrix- colour change due to Na/K ion (> in conc. Urine) than H ion.

                                                          iii.      Refractometer : a few drops of urine is placed on glass surface, look through refractometer light source.

1. 5)      Appearance : normally clear

a.      Cloudy in

                                                              i.      Amorphous phosphate

                                                            ii.      Amorphous urates

                                                          iii.      Pus

                                                           iv.      Fat/ chyle