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URINE FULL EXAMINATION AND MICROSCOPIC EXAMINATION (URINE FEME)

WHY IS IT DONE?
To check for a disease or infection of the urinary tract To check the treatments of conditions such as diabetes, kidney stones, UTI and kideny and liver diseases Part of a regular physical examination Measures - the number and variety of red and white blood cells -the presence of bacteria or other organisms -the presence of substances, such as glucose, that usually shouldn't be found in the urine -the pH, which shows how acidic or basic the urine is -the concentration of the urine

URINE MICROSCOPIC EXAMINATION


Done when physical and chemical findings show abnormality Verify results produced from the urine analyzers Performed on urine sediment In healthy people, the urine contains small number of cells and other formed elements from the entire urinary tract, and epithelial cells from kidney , ureter, bladder and urethra Presence and amounts of RBCs, WBCs, crystals, casts and yeasts

URINE FULL EXAMINATIONS


A regular urinalysis includes the following tests: Color Normal color- pale to dark yellow Intensity of the color indicates concentration of urine Reddish brown due to the presence of blood or food like blackberries Clarity Opacity or tubidity- determines cloudiness of urine Presence of bacteria, sperm, mucus, blood or crystals can make urine appear cloudy

Cont
Odor Normal: slightly nutty Some diseases causes a change in the order, also consumption of certain food. E.g- E.coli bacteria infection can cause a foul odor and in diabetes or starvatin, theres a sweet or fruity odor

Specific gravity
pH Normal: 4.5-8 Alkaline- vomitting, kidney disease, UTI Acidic- Emphysema, uncontrolled diabetes, aspirin overdose, severe diarrhoea, dehydration, starvation or over consumption of alcohol

Cont
Protein Glucose Ketones

Bilirubin
Urobilinogen Nitrites Leukocyte esterase (WBC esterase)

Proteins
A protein urine test measures the amount of proteins, such as albumin, found in a urine sample.

Urine albumin; Proteinuria, Albuminuria Urine protein may be tested using a random sample of urine and a dipstick test, or it may require a 24-hour urine sample.
Why It's Done When kidney disease is suspected. Regular screening test. Normally, protein is not found in urine when a routine dipstick test is performed. This is because the kidney is supposed to keep large molecules, such as protein, in the blood and only filter out smaller impurities. Even if small amounts of protein do get through, they are normally reabsorbed by the body and used as a source of energy. Some proteins will appear in the urine if the levels of protein in blood become high, even when the kidney is functioning properly. If the kidney is diseased, protein will appear in the urine even if blood levels are normal.

Proteins. cont
Normal Values 0 to 8 mg/dL. For a 24-hour urine collection, the normal value is less than 150 mg per 24 hours What Abnormal Results Mean? Amyloidosis Bladder tumor Congestive heart failure Dehydration Diabetic Nephropathy Glomerulonephritis Heavy metal poisoning Malignant hypertension Multiple myeloma Nephrotic syndrome Damage to the kidneys from certain drugs (nephrotoxic drugs) Polycystic kidney disease Urinary tract infection

Glucose
The glucose urine test measures the amount of sugar (glucose) in a urine sample. The presence of glucose in the urine is called glycosuria or glucosuria. Commonly used to screen for diabetes Normal Values: nil What does abnormal values/ increased values mean: -Diabetes Mellitus, Adrenal gland problem, liver damage, brain injury - glucose release from the kidneys into the urine (renal glycosuria) -Pregnancy (normal) Note:- not very accurate as urine is stored in bladder for hours before it is taken for testing

Pus Cells
Medical term : Pyuria

Probably the most common occurrence of pyuria can be attributed to the existence of a urinary tract infection.
In pyruria, pus cells/ HPF (high power field) Males: 5-8 Females: upto 10

Identified after centrifuge and sedimentation Normal Values: nil Other indications: - pyelonephritis, urethratitis, uretitis, cystitis,... - culture must be done to rule out infection.

What affects the test?


Menstrual period.

Medicines, such as diuretics, erythromycin, trimethoprim (Trimpex), or high doses of vitamin C (ascorbic acid) taken with an antibiotic, such as tetracycline.
Having an X-ray test with contrast material in the past 3 days. Not getting urine sample to lab in 1 hour. Note:-If an abnormal result is found during a urine test, more tests may be done, such as a urine culture, X-ray of the kidneys (intravenous pyelogram [IVP]), or cystoscopy.