الفحص الكيميائى للتحليل البول chemical examination

 التحليل الكيميائى للبول chemical examination 

يحتوى البول الطبيعى على مكونات كيميائية متعددة 

1- مركبات نتروجنية (مركبات تحتوى على النتروجين)

مثل : البولينا - الكرياتنين - حمض البوليك - أمونيا - أحماض أمينية 

يتم تقدير البولينا والكرياتنيين وحمض البوليك بنفس طريقة تقديرهم فى الدم مع تخفيف عينة البول 

عن طريق جهاز الكيمياء وطريقة البامفلت

2- مركبات عضوية وغير عضوية مثل 

الكلوريدات - الكبريتات - الفوسفات - املاح الكالسوم - 

يتم تقدير الكالسيوم بنفس طريقة تقديره فى الدم مع تخفيف عينة البول 

عن طريق جهاز الكيمياء وطريقة البامفلت

Specific Gravity Test الكثافة النوعية للبول

 

الكثافة النوعية للبول 

الكثافة النوعية او الوزن النوعى : هي أحد الاختبارات الفيزيائية  التي يتم إجراؤها أثناء تحليل البول الروتيني.

الكثافة النوعية عبارة عن  كثافة (أو وزن) عينة البول مقارنةً بكثافة (وزن) الماء المقطر عند نفس درجة الحرارة.

Specific Gravity of urine | Urinometer-Refractometer

Specific gravity 

Specific gravity measurements are one of the physical examinations performed during a routine urinalysis.
Urine specific gravity is defined as the density (or weight) of the urine specimen as compared to the density (weight) of distilled water at the same temperature.
The density of the urine specimen is dependent on the
amount and size of the dissolved substances present
in the urine specimen. 
These include such substances as glucose, proteins, and electrolytes. The kidneys are responsible for selective reabsorption of essential chemicals and fluid after the blood is filtered. 
Abnormal specific gravity values may be an early indication of renal dysfunction. 
Low specific gravity urine is considered to be dilute with very few dissolved substances, whereas urine with a high specific gravity indicates that the urine is concentrated with increased amounts of dissolved substances. 

تحليل البول كامل urine analysis

تحليل البول كامل
تحليل البول كامل  Urine Analysis      

يعد فحص وتحليل البول من أهم الفحوصات المطلوبة كثيرا والتى يجب أن يعرف الاخصائى كل شئ عنه وفى الاونة الاخيره  يستخدم الاخصائى شرائط الغمس على نطاق واسع فى فحص البول لسهولة وسرعة إجراء الاختبارات المختلفة لكن ينصح بتحضير محاليل الفحص الكيميائية لاستخدامها فى حالة تلف الشرائط أو للتاكد من دقة الاختبارات.

POLYURIA AND POLYDIPSIA

CASE 1:

 POLYURIA AND POLYDIPSIA 

Physical Examination of Urine (Urine Clarity)

Urine Clarity

The word clarity is used to describe the transparency of the urine specimen. A normal urine specimen will be clear when examined in a clear container. The color and the clarity of the specimen are usually evaluated at the same time. As was explained in the section Urine Color, the terms used to describe urine clarity need to be standardized within a laboratory. Common descriptive terms used include
(clear,hazy, cloudy, or turbid)
Image shows the difference in specimen urine clarity

When evaluating urine clarity, it can be helpful to use an object or print behind the specimen the visibility of the object or print when viewed through the urine specimen will help to determine the clarity that should be reported. Common terms used to describe urine clarity and their clinical significance are listed here

Clear 
A clear specimen has no visible particles and is transparent. Most normal urine specimens appear clear.

 Hazy
Hazy specimens may have a few particles floating in the specimen and are not completely transparent. However, it is still relatively easy to see through a hazy specimen. Mucus and other cellular elements may cause the urine to appear hazy. 

Cloudy or turbid
A cloudy specimen will be difficult to see through because of the particles that are suspended in the specimen. Recently voided specimens may appear cloudy because of pyuria (the presence of white blood cells or pus), bacteria, mucus, red blood cells, sperm, yeast, or casts in the specimen.
 Fat particles suspended in the urine specimen will cause it to be excessively cloudy. Contamination caused by vaginal creams may also cause the urine specimen to appear cloudy. In addition, specimens that have been allowed to stand at room temperature for extended periods of time may develop a cloudy appearance because of the increase in the number of bacteria present in the specimen. Refrigerated specimens may also become cloudy; this is due to the presence of urates and phosphates in the urine specimen. When the specimen is allowed to cool, these waste products become visible as diffuse (amorphous) particles throughout the specimen, known as amorphous urates or amorphous phosphates.Amorphous urates are present in acidic urine, and may cause the cloudy urine to appear slightly pink. If there are so many amorphous urates present that the specimen cannot be viewed under the  microscope, the urine can be warmed to 60°C to clear the urine. Alkaline urine will result in the formation of amorphous phosphates, with a white, cloudy appearance. The amorphous phosphates can be cleared from the specimen if needed for microscopic examination by adding a drop of acetic acid to the specimen.

Urine clarity provides clues concerning the type and number of formed elements present in the specimen. A cloudy specimen has a high concentration of formed  elements, whereas a clear specimen usually has a low concentration. The chemical analysis and microscopic examination provide additional information about any chemicals or structures present in the specimen. A clear urine specimen is not always normal, as there may be  abnormal chemical constituents present that don’t cause the urine to appear abnormally cloudy.

You can see urine color from here

urine color 

Physical Examination of Urine ( Urine color )

Urine color
Normally, urine specimens may appear pale yellow  (also known as straw) to amber in color. Urochrome is  the substance that provides the traditional yellow color  observed in urine.  

Urochrome is a pigment that is released continuously as a product of hemoglobin breakdown and normal metabolism. Because the amount of urochrome  is consistent, the intensity of the yellow color in the  specimen will vary with the patient’s hydration status. Urine specimens that are more concentrated (such as the first morning void specimen) will  have a darker yellow color than those that are obtained later in the day, as the patient becomes more hydrated. 
The terms used to describe the color of urine may vary slightly among laboratories but it is important that they are standardized within each facility. such as
( pale yellow , yellow, dark yellow, and amber )
It is also important to evaluate urine color on a well-mixed specimen in a clear container so that the true color can be evaluated.

Image shows various colors of urine specimens

A noticeable change in urine color may be caused by
a pathological condition. However, certain foods, vitamins, or medications may also cause an abnormal color.
Table lists potential causes for various urine colorsThe most commonly encountered abnormal colors and their significance are listed here

Dark yellow to amber

 Although these colors are technically within the normal range, sometimes urine wil appear dark yellow or amber when bilirubin is present in the specimen. This may indicate liver dysfunction,such as in hepatitis, or other conditions that lead to increased red blood cell destruction. Recent strenuous exercise may also cause urine to appear dark yellow.

Orange
Urine may also appear orange when bilirubin levels are elevated in the specimen. However, a more common cause of bright orange urine is the presence of Pyridium (phenazopyridine), a medication used to treat recurrent urinary tract infections. This medication produces a potent orange pigment that will interfere with many of the testing procedures included in a urinalysis. 

Red to brown
 The presence of red blood cells (hematuria) in the urine specimen may cause it to appear pink, red, or even brown. Urinary tract infections or renal dysfunction may allow red blood cells to enter the urinary tract. The presence of hemoglobin from increased red blood cell lysis elsewhere in the body also leads to red urine specimens, although the urine is clearer than it is when intact red blood cells are present. Myoglobinis a by-product of muscle  destruction, and elevated levels may also cause the urine to appear reddish in color. Many medications, fresh beets, and fresh blackberries may also contribute to a red urine specimen.
Blue or green
 Urinary tract infections caused by Pseudomonas bacterial genus may cause the patient’s urine to appear green in color. Various medications may also cause a green or blue hue

Fluorescence
Multivitamins may cause the urine to “fluoresce,” although the urine color may be normal.

Brown or black
 Hemoglobin may turn brown in acidic urine that has been left standing for an  extended period of time. Brown or black urine may be evident for patients that have melanoma. This is caused by the presence of melanin and melanogen in the specimen.

You can see Urine Clarity from here

Urine Clarity