Physical Examination of Urine

MODULE 1 Urinalysis 1. Physical examination of urine a. Quantity/volume It is the amount of urine a person excretes in 24 hours. Normal urine volume increases due to large water intake, cold environments, hypothermia, diuretic drugs, or in certain diseases such as diabetes. This volume will decrease due to water intake mild, hot/dry environment, hyperthermia or acute glomerulonephritis. Normal urine volume ranges from 600-2500ml/24 hours. b. Smell The presence of volatile organic acids causes urine to smell aromatic. When After leaving it, it will gradually smell of ammonia due to ammonia fermentation. In diabetes severe mellitus, urine usually smells of acetone. c. Color Normal urine is clear light yellow due to the presence of urochrome, urobilin, uroerythrin (a pigment that may come from melanin). The color of urine becomes darker with body temperature increase. Urine may change color to: • Greenish yellow due to the presence of bilirubin • Red due to the presence of blood/hemoglobin • Milky white due to the presence of pus (pus) or lots of fat droplets • Black due to the presence of homogentisic acid in alkaptonuria or the presence of derivatives phenol in carbolic poisoning. d. Froth When shaken, the urine will foam. Under normal conditions, the foam will gradually appear disappear. If there is bilirubin, the foam appears yellow and will last a long time, This is caused by a decrease in the surface tension of water e. Turbidity If you let it sit, your urine will gradually become cloudy. This is caused by settling mucus or urine becomes alkaline so that phosphate/carbonate precipitates. In urine turns into alkaline due to fermentation and urea is converted into ammonia. f. Flavor In people with diabetes mellitus, urine tastes sweet (watch for ants) g. pH Normal urine has a pH ranging from 4.8 to 7.5, although it is generally acidic (±6). After eating, urine is alkaline because a lot of HCl is excreted in the stomach. If a lot eat foods that contain protein, then the urine will be acidic because there is a lot of it contains phosphates and sulfates. If you eat a lot of vegetables/fruit, your urine will become alkaline because it contains a lot of sodium and calcium. In conditions of fever, acidity urine will increase. Increased fat catabolism will increase excretion of matter ketones are acidic. h. Specific gravity The specific gravity of urine depends on water intake, air humidity and environmental temperature body and type of disease. Normal urine specific gravity ranges from 1.0031.030 gr/L 2. Urine chemistry examination a. Urea Urea is the final product of protein catabolism, so the final result is comparable to protein intake. Urea is formed in the liver and excreted in the kidneys. Even though it's deep The blood is quite large, but not toxic. High levels of urea in urine describe kidney function. b. Ammonia In fresh urine, ammonia is present in small amounts. Around 0.7g/day in the form of ammonia salts c. Keratin and creatinine Creatinine is a material that is normally constantly present in urine, whereas keratin No. Creatinine comes from the end result of keratin metabolism or keratin phosphate contained in muscles. Creatinine excretion is influenced by work effectiveness and the amount of muscle mass as well excretory function of the kidneys d. Sulfate Sulfate in urine mainly comes from the catabolism of S-containing amino acids e. Phosphate In urine, phosphate is found in the form of alkaline phosphate (Na and K-phosphate salts) and phosphate earth (Ca and Mg-phosphate salts) which precipitate in alkaline urine f. Minerals (Na, K, Ca, Mg) Na excretion depends on intake and body needs. K excretion depends on intake and tissue damage. Adrenal cortex hormones also influence the excretion of Na and K. Ca and only small amounts of Mg are found in urine. Disorders of bone metabolism will affects urinary Ca excretion g. Urobilinogen and urobilin Urobilinogen and urobilin are the final products of bilirubin degradation. Excretion is possible increased or decreased in certain diseases. h. Gout Uric acid is the result of the final oxidation of purines in the body. Uric acid is less soluble water, but with alkali forms easily soluble salts i. Amino acid The kidneys have a high threshold, so there is little excretion of amino acids. Urinary excretion of amino acids is increased in tubular absorption disorders (disorders congenital) and people who are poisoned with CCl4 and CHCl3 j. Chloride The excretion form is NaCl. The amount excreted is proportional to intake. C. Experimental Principle 1. Physical properties of urine In normal urine you will find the following physical characteristics: - Color - Volume - Smell - Froth - Turbidity - Specific gravity - pH 2. Glucose in urine In this experiment, a change in green color indicates the glucose level 1%, red glucose level 1.5%, orange glucose level 2%, yellow glucose level 5%. 3. Albumin in urine This experiment uses the principle of the Hellers Nitric Acid Test. When a ring forms White color between the urine contact area with nitric acid indicates a positive reaction. 4. Ammonia in urine If urea in urine is heated it will oxidize and produce an aromatic odor it smells like ammonia D. Tools and materials Tool Material 1. Beaker glass 2. Measuring cup 3. Urine BJ 4. Test tube 5. Tube clamp 6. dropper pipette 7. spirit lamp 8. measuring pipette 9. bulbs 1. pH indicator 2. urine 3. matches 4. spirit 5. Benedict 6. nitric acid E. Work procedures a. Physical properties of urine 1. Pour the collected urine into a measuring cup know the volume 2. Put BJ's urine into a measuring cup or beaker measure the specific gravity of the urine and let BJ the urine floating, then read the scale indicated on the urine BJ 3. Observe other physical characteristics of urine such as odor, color, pH, turbidity, foam b. Glucose in urine 1. Boil 5ml of Benedict's solution in a test tube 2. Add 8 drops of urine to the solution and heat it for 1-2 minutes 3. Observe the color changes that occur c. Albumin in urine 1. Put 5 ml of concentrated nitric acid into a test tube 2. Tilt the test tube then drop the urine with it Use the pipette slowly so that the urine drops through along the tube 3. Observe the color changes that occur d. Ammonia in urine 1. Put 2ml of urine into a test tube 2. Heat it using a spirit lamp 3. Smell the smell it gives off e. Evaluation 1. Results of observations of the physical properties of urine Day / Date of observation 1. Color 2. Volumes 3. Smell 4. Froth 5. Turbidity 6. Specific gravity 7. pH