Diagnostic Urinalysis Lab Essay

Introduction/BackgroundTodays lab exercise is nigh diagnostic uranalysis. pee reflects the many chemical components undercoat in line of c departureit. This demonstrate is a good measure of health of internal secretion system, kidneys, and urinary bundle. Artificial pee samplings ar used for todays lab thank goodness. The test that this lab is mostly focused on is c e actuallyed dip articulation uranalysis test where students volition analyze the chemical composition of weewee by dipping the chemical indicator stick or dispstick into a take in of urine. The chemicals in the pad of the indicator stick pass on react with assorted biochemicals, ions and salts found in urine and betoken the figurehead of haemoglobin, glucose, ketones, protein and ad hoc dryness. The salmagundi in color indicates the quantity and presence of particular urine component. spunky up level of glucose indicates the endocrine systems softness to regulate scraping concentration. Dilute urine indicates the adrenal gland defect that prevents kidney from regulating pee and salt levels. Urine containing blood and protein indicates damage to a Kidneys blood filtering system.HypothesisNo hypothesis is incumbent as this lab is an empiric lab ObjectivesThe objective of todays lab is to get wind and interpret diagnostic uranalysis. The focus of todays lab is ge ard much towards dipstick analysis. Students argon to bed the chart, answer all associated questions, and overwhelm announceences. Students will learn the importance of urine and the various diseases/problems that bear be diagnosed utilise it. Students will diagnose the unknown patterns of Jane and deception.Materials1. Acetoacetic acid2. Creatinine3. Urine test strips multisticks that butt measure blood, glucose, ketones, pH and protein argon required and should be alike commensurate to measure particularized gravity are needed. Brand recommended is Clinistick TM .4. cardinal test pipages per g roupProcedure 1 (Calibration)CalibrationThis is to ensure that the selective information collected from the enduring is accurate. You will be provided with the peremptory and cast out received solution. The Positive Standard determines whether the indicator determines the correct response to presence of chemicals in the urine. A false haughty when using water will indicate that the stick is spying substances that are not there. A false veto indicates that the stick is unable to unwrap the presence of substances that are present in the hear. 1. Obtain the negative and substantiative standard bottles. Note the color on the indicator stick prior to start of experiment. 2. Collect 2 tube-shaped structures and score as neg and pos for negative and positive standard solution. 3. Pour effective of the tube with neg solutions in the tube labeled neg. 4. Pour ripe of the tube with pos solutions in the tube labeled pos. 5. Insert the indicator stick in the tube labeled neg. Ob serve the color and look of the solution. 6. Insert the indicator stick in the tube labeled pos. Observe the color and olfactory perception of the solution. 7. usher your information in the table as + or to indicate positive or negative result.Procedure 2 (analysis of samples)Obtain a association of the urine samples to analyze.1. Collect and label three tubes as normal (N), stern , and Jane.2. Pour Normal urine sample full of the tube labeled N3. Pour magics urine sample full of the tube labeled prank4. Pour Janes urine sample full of the tube labeled Jane5. Insert the indicator stick in the tube labeled N. Observe the color and odor of the solution.6. Record the data7. Perform the same test on the samples labeled gutter and Jane using new sticks and record your observation in the table provided above.Please refer to the attachment for interpretation of Urinalysis results. If not provided please ask your teacher for the same.DiscussionThis lab discussed urinalysis. Ur inalysis is a diagnostic test that evaluates health of endocrine system, kidneys, and urinary tract. Urine drop be visually examined sample for color (clear to dark yellow or red), and clarity (clear to cloudy), and odor. A complete diagnostic urinalysis includes a dipstick valuation and a microscopic analysis. Dipstick evaluation includes parameters such as glucose, ketones, pH, protein, blood, bilirubin, etc. The microscopic visualization allows for detection of bacterium (UTI), RBCs, crystals (metabolic derangements), renal tubular jail cells (toxicity or severe renal disease), or transitional cells (from bladder). Acid urine and alkaline urine hasten crystals that form different from that of normal urine.Some impairment that the students learned were glycosuria- exorbitance glucose levels, hematuria-RBCs present in urine, hemaglobinuria-hemoglobin rouge is present in urine, ketonuria- racy levels of ketones, myoglobinuria-senior high school levels of myglobin (pigments t hat are released when muscles breakdown), and pH-measure acidity or alkalinity of urine. In mark to be certain that values are correct, known negative and positive standards are used to compare with the clinical sample. This process is called calibration. Calibration should be done for all diagnostic tests and the equipment used to make these determinations. Calibration is necessary to avoid false negative and false positives. A false positive when using water will indicate that the stick is detecting substances that are not there. Afalse negative indicates that the stick is unable to detect the presence of substances that are present in the sample. ConclusionIn conclusion, students successfully performed a urinalysis dipstick test. The lab had students test the negative and positive tests, and and so the James and Jane urine samples were time- tried. Johns urine was clear and tested negative for protein, which indicated it was normal. The pee was s leisurelyly turbid. The urine had a unbendable odor and a specific gravity of 1.005, which is reject than normal urine. The pH of Johns pee is 5 and the glucose was passing high with 1000mg, tested with lilliputian (+) amounts of ketones and also showed trace amounts of blood.Janes urine was a very light yellow with a very faint odor, tested negative for ketones, tested negative for proteins, had a pH of 6, and had a specific gravity of 1.015. The glucose was super high with 1000mg. Jane also showed About 250 Ery/nanoliters of blood in her urine. The protein fraction of the dipstick tested for 100 (++) in Janes urine sample. Students learned different showcases of disease that could be associated with the test results that were discovered with the dipstick. Lab Questions1. What are the possible causes of Johns test results?Johns urine was clear and tested negative for protein, which indicated it was normal. The pee was slightly turbid which could be caused by Lipiduria, hyperoxaluria, chyluria, pyuria, ex cess phosphate crystals precipitating in alkaline urine, hyperuricosuria, or contamination with vaginal mucus or epithelial cells. The urine had a strong odor which could indicate alkaline fermentation, diabetic ketoacidosis, cysteine decomposition, gastrointestinal-bladder fistulae, or could be caused by medications or diet. Johns urine was observed to have a specific gravity of 1.005, which is refuse than normal urine. Decreased specific gravity is seen in excessive fluid intake, renal failure, pyelonephritis, and central and nephrogenic diabetes insipidus. False low readings of specific gravity are associated with alkaline urine (a high-citrate diet).The pH of Johns pee is 5, which is considered to be within the normal range, but it is on the lower end which could be caused by diet and uric acid calculi. The glucose was extremely high with 1000mg, which is extremely strange due to that fact thatnearly all glucose filtered by the glomeruli is reabsorbed in the proximal tubules an d only undetectable amounts appear in urine in healthy tolerant roles. False positive results are seen when high levels of ketones are present and also in patient taking levodopa.Something to commend about dipstick tests is that reagent strip tests are specific for glucose. Johns sample tested with small (+) amounts of ketones. A positive test, since ketones are not unremarkably found in urine, is associated with uncontrolled diabetes, pregnancy without diabetes, carbohydrate-free diets, and starvation. False trace results whitethorn be seen in highly pigmented urine and in patiens taking levodopa. Johns urine also showed trace amounts of blood. 2. Of the diseases mentioned, what disease competency John have?Of the diseases mentioned, it is believed that John might have either diabetes mellitus or a renal impairment.3. How did you come to this conclusion about Johns nail down? The conclusion was made that John might have diabetes mellitus, due to the high levels of glucose, sli ghtly lower pH, and traces of ketones. The decreased level of specific gravity, and traces of blood introduce to the belief that John may have a renal impairment.4. What are the possible causes of Janes test results?Janes urine was a very light yellow with a very faint odor, tested negative for ketones, tested negative for proteins, had a pH of 6, and had a specific gravity of 1.015. All of these characteristics do not indicate abnormalities with Janes pee. The glucose was extremely high with 1000mg. False positive results are seen when high levels of ketones are present and also in patient taking levodopa.Something to remember about dipstick tests is that reagent strip tests are specific for glucose. Jane also showed About 250 Ery/nanoliters of blood in her urine. This could indicate lower urinary tract bleeding and inflammation/infection, acute glomerulonephritis, or lupus nephritis. The protein portion of the dipstick tested for 100 (++) in Janes urine sample. Proteinuria is in dicatory of renal disease, and small amounts accompany hematuria and acute urinary tract infection. 5. Of the diseases mentioned, what disease might Jane have?Of the diseases mentioned, Jane might have an acute urinary tractinfection/inflammation, or renal disease. 6. How did you come to this conclusion about Janes condition? The conclusion about renal disease is because proteinuria is indicative of renal disease. Jane might instead have an acute urinary tract infection/inflammation due to not only the protein in her urine but also the blood in the urine. 7. Why is Urine useful as an indicator of the endocrine and kidney disease? Urine is as an indicator of the endocrine and kidney disease because through its protein, pH, glucose, ketones, specific gravity, and blood that kindle possibly be found, physicians give the gate diagnose disease. Urine indicates diseases with the kidney because the kidney is what filters out the trunk fluids that become the urine.8. What is the labora tory procedure that can be used to test the presence of certain specific biochemicals in urine? The laboratory procedures that can be used to test the presence of certain specific biochemical in urine could be microscopic analysis, or even a urine electrophoresis test 9. Which blood chemical will be found in high levels in patients diagnosed with untreated diabetes mellitus? The chemical that will be found in high levels in the blood of patients diagnosed with untreated diabetes mellitus would be glucose. 10. How does odor help in diagnosis of disease? aroma of urine helps in diagnosing disease by merely alert the patient that something is wrong. Because urine doesnt have a very strong smell, if a whiff of something is particularly pungent when peeing, it may indicate that the patient could have an infection or urinary stones, which can create an ammonia-like odor. Diabetics might notice that their urine smells sweet because of excess sugar. Alkaline fermentation causes an ammonia c smell, and patients with diabetic ketoacidosis produce a urine that may have a sweet or fruity odour. Other causes of abnormal odours are cystine decomposition (a sulphuric smell), gastrointestinal-bladder fistulae (a faecal smell), medications (eg, vitamin B6), and diet (eg, asparagus).11. Define the following terms associated with urinalysisGlycosuria Glucose normally is filtered by the glomerulus, but it is almost completely reabsorbed in the proximal tubule. Glycosuria occurs when the filtered load of glucose exceeds the expertness of the tubule to reabsorb it (i.e., 180 to 200 mg per dL). Etiologies include diabetes mellitus,Cushings syndrome, liver and pancreatic disease, and Fanconis syndrome. Ketonuria Ketones, products of corpse fat metabolism, normally are not found in urine. Dipstick reagents detect acetic acid through a reaction with sodium nitroprusside or nitro-ferricyanide and glycine. Ketonuria most commonly is associated with uncontrolled diabetes, but it also c an occur during pregnancy, carbohydrate-free diets, and starvation. Hematuria Hematuria can be glomerular, renal, urologic, and exercise-induced. Urologic causes of hematuria include tumors, calculi, and infections. Urologic hematuria is distinguished from other etiologies by the absence of proteinuria, dysmorphic RBCs, and erythrocyte casts. heretofore significant hematuria will not elevate the protein concentration to the 2+ to 3+ range on the dipstick test. (23) Up to 20 percent of patients with pure(a) hematuria have urinary tract malignancy a full work-up with cystoscopy and upper-tract imaging is indicated in patients with this condition. (24) In patients with asymptomatic microscopic hematuria (without proteinuria or pyuria), 5 to 22 percent have serious urologic disease, and 0.5 to 5 percent have a genitourinary malignancy. pH Urinary pH can range from 4.5 to 8 but normally is slightly sulfurous (i.e., 5.5 to 6.5) because of metabolic activity. Ingestion of proteins and ac idic fruits (e.g., cranberries) can cause acidic urine, and diets high in citrate can cause alkaline urine. (15-17) Urinary pH generally reflects the serum pH, except in patients with renal tubular acidosis (RTA). The softness to acidify urine to a pH of less than 5.5 despite an long fast and administration of an acid load is the hallmark of RTA. In type I (distal) RTA, the serum is acidic but the urine is alkaline, secondary to an inability to secrete protons into the urine.Type II (proximal) RTA is characterized by an inability to reabsorb hydrogen carbonate. This daub initially results in alkaline urine, but as the filtered load of bicarbonate decreases, the urine becomes more acidic. Determination of urinary pH is useful in the diagnosis and management of UTIs and calculi. Alkaline urine in a patient with a UTI suggests the presence of a urea-splitting organism, which may be associated with magnesium-ammonium phosphate crystals and can form staghorn calculi. Uric acid calculi are associated with acidic urine. Hemoglobin The presence of free hemoglobin in the urine, an abnormal finding, that may make the urine look dark. Hemoglobin in the urine is termed hemoglobinuria. Hemoglobin isthe protein in the red blood cells which carries oxygen from the lungs to the tissues of the body and returns carbon dioxide from the tissues to the lungs.The iron contained in hemoglobin gives red blood cells their characteristic color. Red blood cells are normally taken out of circulation after approximately 4 months they are confine and disassembled in the spleen, bone marrow, and liver. If, however, red cells hemolyze (break down) within the vascular system, the components are gear up free in the blood stream. Free hemoglobin is bound by haptoglobin (another protein) and reprocessed. But if the level of hemoglobin in the blood rises above the ability of haptoglobin to reclaim it, hemoglobin begins to appear in the urine there is hemoglobinuria. hemoglobinuria is a sig n of a number of conditions including acute nephritis, burns, kidney cancer, malaria, sickle cell anemia, a transfusion reaction, tuberculosis of the urinary tract, and many other conditions.ReferencesBenejam R, Narayana AS. Urinalysis the physicians responsibility. Am Fam Physician 198531103-11. Brendler, CB. Evaluation of the urologic patient history, physical exami-nation and urinalysis. In Campbell MF, Walsh PC. Campbells Urology. 7th ed. 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