Bio

• Urine

  • An ultrafiltrate of plasma from which glucose, amino acids, water and other substances essential to body metabolism have been reabsorbed
  • Carries waste products and excess water out of the body
• Composition of urine

  • Water (95-97%)
  • Dissolved solids (3-5%)
  • Urea (half)
  • Other compounds (inorganic: Cl-, Na, K, trace amounts of: sulfate, HCO3 etc.)
  • Other compounds (organic: creatinine, uric acid)

  
• Why urinalysis

  • General evaluation of health
  • Diagnosis of disease or disorders of the kidneys or urinary tract
  • Diagnosis of other systemic disease that affect kidney function
  • Monitoring of patients with diabetes
• Factors affecting urine components

  • Dietary intake
  • Body metabolism
  • Endocrine function such as blood pressure, metabolism, body temperature and heart rate
• Types of urine specimens

  • First morning specimen
  • Random urine specimen
  • Timed collection

  
• Composition and concentration of urine changes during 24hr
• Urine concentration varies according to water intake and physical activities
• Macroscopy analysis of urine

  • Physical examination
  • Chemical examination

  
• Color

  • Many things affect urine color, including fluid balance, diet, medicines, and diseases
  • Color intensity of urine correlates to concentration
  • Darker color means more concentrated sample
  • Amber yellow (normal) - Urochrome (derivative of urobilin, produce from bilirubin degradation, is pigment found in normal urine)
  • Colorless - High dilution
  • Abnormal colors: Silver or milky appearance - Pus, bacteria or epithelial cells
  • Reddish brown - Blood (Hemoglobin)
  • Orange, green, blue or red - medications

  
• Odor

  • Normal - aromatic due to the volatile fatty acids
  • On long standing - ammonical (decomposition of urea forming ammonia which gives a strong ammonical smell)
  • Sweet - Diabetes
  • Fruity - Ketonuria
• Appearance

  When urine is clear that mean urine is free from WBC, RBC, Bacteria, epithelial cell

  
• Volume

  • The daily output of urine is between (1000-2000)ml per day
  • Physiologically the output of urine increase with higher fluid intake, like tea, coffee etc. and decrease due to heavy sweat
  • The output of urine greatly increase (>2500 ml /day - polyuria) and in condition like fevers, diarrhea, acute nephritis etc., the urine output decreases (500 ml/day - oliguria) in conditions like acute tubular necrosis, surgical shock etc.

  
• Specific gravity

  • Measures the amount of substances dissolved in urine
  • Indicates how well kidneys are able to adjust amount of water in urine
  • Higher SG: more fluids and solid material is dissolved in urine
  • When you drink a lot of fluid, your kidneys make urine with a high amount of water in it which has a low specific gravity
  • When you do not drink fluids, your kidneys make urine with a small amount of water in it which has a high specific gravity
  • Normal values: (1.002 - 1.035) on random sample

  
• pH

  • Measure acidity or alkalinity (basic) of urine
  • Normal urine pH: 5-7
  • Increased acidity in urine: due to diabetes or medications
  • On standing urine become alkaline as a result of ammonia release due to urea decomposition
  • Urine sample must be fresh

  
• Abnormal chemical examination of urine

  • Protein
  • Glucose
  • Blood (RBC)
  • Ketone body (fitty acid catabolism)
  • Nitrite
  • Bilirubin (obst.jaundice)

  
• Urine strip

  • Filter paper or plastic which has chemical substance (reagent) coated on it on different piece of cotton
  • It gives color when react with substance in urine
  • The produced color is compared with chart color visually

  
• Tests included in urine strip

  • Glucose
  • Bilirubin
  • Ketone
  • Specific Gravity
  • Blood
  • Protein
  • Urobilinogen
  • Nitrite
  • Leukocyte
  • pH

  
• Honey


  Consists of fructose and glucose

  
• Carbohydrates occur in every living organism
• Carbohydrates


  • Sugar and starch in food
  • Cellulose in wood, paper and cotton
• Carbohydrate derivative from glucose


  Carbohydrates are synthesized by green plants during photosynthesis

  
• Photosynthesis


  Sunlight provides the energy to convert CO2 and H2O into glucose plus oxygen
• Carbohydrates


  Classified as simple or complex
• Simple carbohydrates


  • Monosaccharides like glucose and fructose

  
• Complex carbohydrates


  Made of two or more simple sugars linked together by acetal bonds
• Complex carbohydrates


  • Sucrose (glucose + fructose)
  • Amylopectin (12-20 glucose units)

  
• Classification of carbohydrates


  • According to number of carbon atoms
  • According to terminal functional group
  • According to number of sugar subunits

  
• Carbohydrates classified by number of carbon atoms

  • Trioses (3 carbon atoms)
  • Pentoses (5 carbon atoms)
  • Hexoses (6 carbon atoms)

  
• Carbohydrates classified by terminal functional group

  • Aldoses (aldehyde group)
  • Ketoses (ketone group)
• Carbohydrates classified by number of sugar subunits

  • Monosaccharides (single sugar unit)
  • Disaccharides (two monosaccharide units)
  • Polysaccharides (many monosaccharide units)

  
• Disaccharides


  • Sucrose (glucose + fructose)
  • Lactose (glucose + galactose)
  • Maltose (glucose + glucose)

  
• Polysaccharides


  • Starch
  • Cellulose
  • Glycogen

  
• Qualitative tests for carbohydrates

  • Molisch test
  • Benedict's test
  • Barfoed's test
  • Seliwanoff's test
  • Bial's test
  • Iodine reaction test
• Molisch test principle


  Carbohydrates undergo dehydration to give furfural derivatives which condense with alpha naphthol to form colored products. Pentoses yield furfural, hexoses yield 5-hydroxy methyl furfurals.

  
• Molisch test procedure


  Add carbohydrate solution to ethanolic alpha naphthol, then carefully add concentrated sulphuric acid

  
• Benedict's test principle


  Carbohydrates with free aldehyde or ketone groups (reducing sugars) react with cupric ions to form a red cuprous oxide precipitate

  
• Benedict's test procedure


  Heat Benedict's reagent, add carbohydrate solution, boil for 2 minutes