General Urine Examination (G.U.E)

_ Urine analysis:

Urine examination is usefully to detect disease affecting the kidney .Gross inspection of the urine (macroscopic analysis) which includes assessment of physical characteristics and  chemical analysis and microscopic analysis for formed elements

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_Macroscopic Examination of the urine

Normaly , urine is pale to dark yellow (straw) or clear in color an abnormal color dose not necessarily indicate disease ,varity of food and drugs can cause change in color .the abnormal cases of urine spacimen involved :

1-colorless urine (dilute)

 -Diabetes mellitus (D.M)

-Diabetes Insipidus (D.I)

 -Over hydration

2-Milky urine

-Purulent genitourinary tract diseases

3-Orange –yellow urine

-Dehydrated

-Bilirubin

-Tetracycline

4-Red urine :

-Hematuria

-Hematoglobinuria

-Beet rot ingestion

-Rifampicin

5-Green urine:

-Jaundice

-Phenol poisoning

6-Black urine:

-Sever hemoglobinuria

-Melanoma

-Iron

7-Opacity:

-Pink cloudy (urate)

-White cloudy (phosphate)

- Urine PH

The PH of urine normaly range frome 4.5-7.5 (usually 5.5-6.5) .urine PH should be measured with PH meter on afreshly voided urine sample as on standing diffusional loss of CO2 or bacterial contamination may occur changing the PH value.

-Increased (Alkaline urine )

1-Stale ammoniacal sample

2-Bacteriuria

3-Renal failure

  4-Drugs (antibiotic &Bicarbonate)

Decreased (Acidic urine)-

1-Dibetes mellitus (DM)

2-Starvatuon

3-Diarrhea

4-Drugs (Ammonium chloride)

-Spesific Gravity of urine

It depends upon the concentration of various solutes in the urine it determined the ability of kidney to concentrate or dilute urine  it precisely measured with help of a refractometer normal  specific gravity of urine range frome 1.008 to 1.030)

-Increased specific gravity

1- Dehydration

2- D.M

3-Diarrhea

4-Fever

5- Cogestive heart failure

- Decreaseed specific gravity

1-Overhydration

2-D.I

3-Diuretics

4-Glomerulonephritis

5-Pyelonephritis

Chmical examination of urine and dipstick analysis of urine :

Tests of  Protein:

1- Heat and acetic acid test

Take atest tube 2l3rd full with urine boil upper portion of urine for 2 minutes (the lower part not heating for comparison) .Now turbidity or cloudiness can arise because of phosphates carbonates or protein add afew drops of 10% acetic acid persistence or development of turbidity implies proteinuria

Results

-Ve      No cloudness

+Ve      Definite cloudness but no granularity and no flocculation

++         Granular cloudness but on flocculation the cloud is dense but ont opaqe

+++       Dense opaqe cloud clearly flocculated

++++    Dense precipitation nad often its solid

2- Sulfosalicylic acid test

Chemical analysis with 3% sulfosalicylic acid is very sensitive precipitation

+   Proteinuria =30mgldl

++Proteinuria =100mgldl

+++  Proteinuria =300 mgldl  

++++  Proteinuria = 1gmldl

3-Dipstick method

This methods are reliable and easy to perform Dipslick should be done on whole urine but semi-quantitative test should be done the supernatant of centrifuged urine since the cell suspended in normal urine can produse afalsely high estimation of protein.

Test for Glucose

Bendicts test1

This method the cupric ions is reduce to the CU2O by the glucose if present .if the glucose concentration 0.1% or less there are no precipitation was seen after cooling specimen .add 8 drops of urine (0,5 ml) to 5 ml of bendict heating the tube untile boiling and exam

Results

- ve         Blue color

+             Green (< or =0.5 % glucose)

++           Greenish yellow (0.5-1 % glucose )

+++         Yellow  (1-2 % glucose )

++++       Orang to brick red (over 2% glucose )

2- Dipstick method

Glycosuria is generally suggestive of diabetes mellitus dipstick utilizing glucose oxidase reaction are specific for glucose and not detect other reducing suger such as galactose and fructose false negative glycosuria may be seen with vitamine C and tetracycline

-Ketones

They are detected by Rothrase test result formation of purple ring indicat (+ve) or detected by dipetick containing sodium nitroprusside .

-Bil pigment

They are detected by Harrison test this test very sensitive and reliable Fouchet used as reagent in this test Agreen color indicate positive result (+ve) or bilirubinuria .