DIAG 2735 4 - Chemical Analysis

DIAG 2735 4 - Chemical Analysis - Chemical Analysis of the...

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Chemical Analysis of the Urine Specimen
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Chemical Analysis Chemical reagent strip Enzymes Hormones Metabolites Protein and protein metabolites Pigments Sugars, ketones, and mucopolysaccarides Minerals
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Leukocytes (page 6) Present with bacterial invasion or inflammation May be seen without RBCs Mostly neutrophils Increased Fever Exercise In casts indicates renal disease
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Leukocytes (continued) Gross pyuria Greater than 30 per hpf = acute infection May indicate abscess Causes Acute and chronic pyelonephritis Acute and chronic GMN Infection of tract Obstruction Tumors and stones
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Nitrites (page 4) Indicates bacteria present (abnormal) With WBCs indicates UTI Without WBCs indicates contamination Best specimen is morning Requires culture E. Coli most common
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pH (page 3) Acid pH < 7.0 Happens due to protein metabolism May be due to glucosuria of diabetes Clinically significant crystals form Most urine averages pH 6.8
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pH (continued) Alkaline pH > 7.0 From eating green leafies Alkali earth metals (Ca, K, Na, Mg etc.) E. Coli thrives in alkaline urine Casts dissolve in alkaline urine
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Protein (page 3) Most important indicator of renal disease Normal amount is 150 mg/day Happens when basement membrane swells Loses (-) electric charge which repels protein 1/3 albumin, 1/3 Tamm-Horsfall, 1/3 others Tamm-Horsfall is secreted by
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Protein (continued) Benign causes Rarely exceeds 1 g/day Exercise Postural (hyperlordosis, poorly supported liver present during day not at night Dehydration Sunburn
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Protein (continued) Minimal proteinuria < 1 g/day Chronic or intermittent pyelonephritis Obstructive nephropathy Tumors Stones Inactive GMN Polycystics disease
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Protein (continued) Moderate Proteinuria = 1-3 g/day Seen with diseases of heavy proteinuria Toxic nephropathy Radiation nephritis Multiple myeloma Bence Jones proteins
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Protein (continued) Bence Jones proteins Multiple myeloma (plasmacytoma) Acute lymphocytic leukemia Lymphoma Mets of lung, colon, prostate, breast Dissolve and precipitate varying temperatures
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Protein (continued) Heavy proteinuria > 3 g/day Renal causes Acute and chronic GMN Systemic causes Toxemia of pregnancy Diabetes Lupus Sickle cell disease Malignant hypertension Congestive heart failure
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Protein (continued) Persistent proteinuria 1-2 g/day Consistent Follows healing of renal disease
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Glucose (page 4) Hallmark of diabetes mellitus Polyuria and polydipsia Renal threshold is 180 mg/dl Should not be in urine specimen May appear with endocrine disorders May be due to drugs Other pathologies Eating after a fast
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Ketones (page 4) Incomplete fat metabolism Seen with uncontrolled diabetes mellitus
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This note was uploaded on 11/23/2011 for the course DIAG 2735 taught by Professor Josephr.forese during the Winter '11 term at Life Chiropractic College West.

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DIAG 2735 4 - Chemical Analysis - Chemical Analysis of the...

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