This is a draft cheat sheet. It is a work in progress and is not finished yet.
Clinical Findings:
• If blood glucose is normal but urine glucose is high ⇒ Glucose is not being reabsorbed ⇒ Problem with proximal tubule ⇒ will also cause a high phosphatemia
• Conjugated bilirubin in urine ⇒ liver disease or common bile duct is obstructed ⇒ No urobilinogen
• Unconjugated bilirubin isn't water soluble, can't be found in the urine
• Leukocytes ⇒ Can be caused by a kidney infection/UTI
• Nitrite ⇒ Indicative of gram negative kidney infection
• Protein ⇒ Should never be in urine ⇒ Glomerular damage ⇒ Should always be checked in HTN and DM patients
• pH abnormality ⇒ Diabetic Ketoacidosis
• Blood:
➤ Macroscopic ⇒ Red colour in urine
➤Microscopic ⇒ Not visible to the naked eye
➤ If blood is present in urine ⇒ test for pyruvate, test for myoglobin/haemoglobin
▷ Myoglobin = muscle breakdown (Rhabdomyolysis), i.e. after heavy exercise
• Specific Gravity ⇒ Reflects hydration, will be elevated if anything is present in urine, i.e. glucose, etc.
• Ketones ⇒ Found in anorexics, starvation, diabetes, etc. ⇒ breakdown of fat
➤ Ketones can cross the blood brain barrier in pregnant women ⇒ Can hurt the foetus |
Children present with Kussmaul's breathing, metabolic acidosis ⇒ Respiratory alkalosis, there is a spike in presentations in 20 year olds
What would be the next test be after detecting a high glucose in urine?
➤ A blood glucose test
Diabetics and patients with Hypertension need urine analysis often
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Clinical Findings:
• If blood glucose is normal but urine glucose is high ⇒ Glucose is not being reabsorbed ⇒ Problem with proximal tubule ⇒ will also cause a high phosphatemia
• Conjugated bilirubin in urine ⇒ liver disease or common bile duct is obstructed ⇒ No urobilinogen
• Unconjugated bilirubin isn't water soluble, can't be found in the urine
• Leukocytes ⇒ Can be caused by a kidney infection/UTI
• Nitrite ⇒ Indicative of gram negative kidney infection
• Protein ⇒ Should never be in urine ⇒ Glomerular damage ⇒ Should always be checked in HTN and DM patients
• pH abnormality ⇒ Diabetic Ketoacidosis
• Blood:
➤ Macroscopic ⇒ Red colour in urine
➤Microscopic ⇒ Not visible to the naked eye
➤ If blood is present in urine ⇒ test for pyruvate, test for myoglobin/haemoglobin
▷ Myoglobin = muscle breakdown (Rhabdomyolysis), i.e. after heavy exercise
• Specific Gravity ⇒ Reflects hydration, will be elevated if anything is present in urine, i.e. glucose, etc.
• Ketones ⇒ Found in anorexics, starvation, diabetes, etc. ⇒ breakdown of fat
➤ Ketones can cross the blood brain barrier in pregnant women ⇒ Can hurt the foetus |
Children present with Kussmaul's breathing, metabolic acidosis ⇒ Respiratory alkalosis, there is a spike in presentations in 20 year olds
What would be the next test be after detecting a high glucose in urine?
➤ A blood glucose test
Diabetics and patients with Hypertension need urine analysis often
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Introduction:
W |
Wash Hands |
I |
Introduce Yourself + Patient's Identity |
P |
Permission |
P |
Patient Position + Pain |
E |
Explaination |
Instructions:
Put on gloves and place tissue paper on desk |
Identify urine sample and check patient identity matches |
Inspects urine and comments on colour |
Comment on obvious blood |
Examine for cloudiness/sediment |
Ensure to mention this |
Check expiry date on dipsticks |
Take out dipstick and immediately close container |
Immerse all pads of dipsticks in urine |
Do not spill urine |
Remove dipstick and start timer |
Place dipstick horizontally on tissue paper |
Compare pads to the container at the correct times without touching against the container |
Dispose of waste appropriately in medical waste bin |
Wrap urinalysis stick in tissue, fold into glove, fold both into second glove |
Wash hands |
Report abnormalities present in urine, link to appropriate clinical case, and answer any relevant questions |
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