Urinalysis - The Carter Center

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levels (hyperglycemia) and accompanying glycosuria and may be accompanied by changes in fat metabolism. Glucose is the sugar most commonly found in the urine, although other sugars , such as lactose, fructose , galactose, and pentose, may be found under certain condition. Normally, urine doesnot contain a sufficient amount of sugar to react with any of the popular enzyme or reducing tests. When sugar appears in the urine, it shows the abnormality caused by disease diabets mellitus.Hence urine sugar tests are extremly usefull in monitoring the treatment of diabetes. Clinical Significance The presence of detectable amount of glucose in the urine is known as glycosuria. Normally almost all the glucose, which passes from the blood into the glomerular filtrate, is reabsorbed back into the circulation by the kidney tubules ( proximal convoluted tubules ). Usually less than 15 - 20 mg/dl (0.8 mmol) is excreted in the urine. But this amount cannot be detected by the routine laboratory tests. The term glycosuria is usually used to describe the presence of more than the normal amount ( 15- 20 mg /dl ) of glucose in the urine. The occurrence of glucose in the urine is not normal if more than 15 - 20 mg/dl. The blood glucose concentration normally lies between 65 and 110 mg/dl. After a meal it may increase to 120 - 160 mg/dl. If the blood glucose concentration becomes too high (usually greater than 170 - 180 mg/dl), the excess glucose will not be reabsorbed into the blood and glucose start appearing in urine. The lowest blood glucose concentration that will result in glycosuria is termed as the renal threshold. The most common condition in which the renal threshold for glucose exceeds is diabetes mellitus. 39
40 Causes of Glycosuria • Physiological • Pathological Physiological Sometimes under physiological situations, glycosuria can occur a. After large ingestion of carbohydrates b. Anything that stimulates sympathetic nervous system such as excitement, stress etc. c. 15 to 20% cases of pregnancy may be associated with physiological glycosuria. d. Renal Glycosuria: In some persons, glycosuria is found when blood glucose is in normal range. This is known as renal glycosuria. This is again due to lowered renal threshold. Usually this is a benign condition . Pathological Glycosuria A. Diabetes mellitus The most common condition for glycosuria is diabetes mellitus, a metabolic disorder due to deficiencies of insulin. Glucose is not properly metabolized and blood glucose concentration rises, and when it is in range of 170 - 180 mg /dl , glucose starts appearing in urine. B. Glycosuria due to other endocrine disorders Deranged function of a number of endocrine disorders can cause hyperglycemia and this may result in glycosuria, e.g. - Hyperthyroidism - Hyperadrenalism - Hyperpitutarism - Some diseases of pancreas
Page 1 and 2: LECTURE NOTES For Medical Laborator
Page 3 and 4: Preface i Books on Medical history
Page 5 and 6: Contents iii Preface Aknowledgement
Page 7 and 8: v List of Table Table 1 Methods of
Page 9 and 10: Abbreviations vii ADH : Antidiureti
Page 11 and 12: ix This lecture note is prepared fo
Page 13 and 14: Components of the renal system are
Page 15 and 16: 4 collecting tubule. A number of th
Page 17 and 18: - Electrolytes - Cast parasites and
Page 19 and 20: Exercise 1. 8 Answer the Following
Page 21 and 22: 10 plastic tube with a plastic snap
Page 23 and 24: 12 24- Hour specimen - a specimen o
Page 25 and 26: • Distruction of glucose by bacte
Page 27 and 28: 16 2.3 Type of Examination in Routi
Page 29 and 30: 18 CHAPTER THREE Physical Examinati
Page 31 and 32: • Myxedema • Some type of tubul
Page 33 and 34: metabolic conditions, the color and
Page 35 and 36: - By letting it to stand for more t
Page 37 and 38: • Degree of cloudiness of the uri
Page 39 and 40: - Look for color change of red litm
Page 41 and 42: tubules of the nephron, depending o
Page 43 and 44: Specimen: It should be the first ur
Page 45 and 46: gravity is elevated because of the
Page 47 and 48: 36 Exercises Say True or False 1. U
Page 49: 38 constituents of urine. 4.1 Deter
Page 53 and 54: specimen and the results are graded
Page 55 and 56: unnecessary.The reaction for clinit
Page 57 and 58: 46 The overall reaction is : Glucos
Page 59 and 60: 2. Dip part of the tape into the ur
Page 61 and 62: metabolism or absorption, the body
Page 63 and 64: 4. If acetone or acetoacetate is pr
Page 65 and 66: immediately. For this reason, Gerha
Page 67 and 68: contains only traces of protein, in
Page 69 and 70: It requires large volumes ( 0.5 to
Page 71 and 72: due to urates, uric acid urea and b
Page 73 and 74: 62 Preparation of Acetic Acid Reage
Page 75 and 76: urine contains more than 100mg/dl p
Page 77 and 78: cell disease (hepatocellular diseas
Page 79 and 80: 68 1. Icotest Tablet Test The Ictot
Page 81 and 82: characteristic color with the other
Page 83 and 84: 72 Sensitivity Urobilistix detects
Page 85 and 86: Hemoglobinuria may occur with sever
Page 87 and 88: Since all these tests are based on
Page 89 and 90: peroxidase activity) catalyzes the
Page 91 and 92: 80 4.9 Determination of Nitrite Int
Page 93 and 94: The pink color is therefore related
Page 95 and 96: - Pancreatic insufficiency. - Intes
Page 97 and 98: 86 A. Ferric Chloride Test Principl
Page 99 and 100: 88 CHAPTER FIVE Microscopic Examina
Page 101 and 102:
• If it is difficult to deliver w
Page 103 and 104:
92 5.3 Urinary Sediments Classifica
Page 105 and 106:
Red blood cells are some what round
Page 107 and 108:
EPITHELIAL CELLS • Normally few e
Page 109 and 110:
98 CASTS • Formed by precipitatio
Page 111 and 112:
100 c. Waxy Casts (Renal Failure Ca
Page 113 and 114:
102 • Always the condenser should
Page 115 and 116:
104 • Large, measuring 275-399 x
Page 117 and 118:
106 Report of the Result The bacter
Page 119 and 120:
108 Some drug crystals in the urine
Page 121 and 122:
110 - Have various tiny squarish, b
Page 123 and 124:
112 - Size is about 20 μm. - Often
Page 125 and 126:
114 They can be confirmed by logos
Page 127 and 128:
116 Nucleus Cytoplasm Squameous epi
Page 129 and 130:
118 Reagent No.5 Bleach for Preserv
Page 131 and 132:
120 Reagent No.16 Saturated Sodium
Page 133 and 134:
122 III. Table 4: Correct and Incor
Page 135 and 136:
124 Glomeurlar Filtration Rate: The
Page 137 and 138:
126 Urinometer: A small glass instr
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Urinalysis - The Carter Center

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