Chemical examin

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Transcript of Chemical examin

The chemical constituents frequently tested in urine are:

• Protein

• Glucose

• Ketones

• Bile derivatives

• Blood

• Nitrites

• Ascorbic acid.

Causes of proteinuria:

A- Physiological proteinuria. (Usually transient)• Excessive ingestion of protein.• Convulsions.• Oestrus.• In case of equine due to high amount of mucoproteins.• Gravid uterus

B- Pathological proteinuria 1- Pre renal causes: Hb-uria ( Babesia, Anaplasma) Myoglobinuria Circulatory disease ( C.H.F.) Myloma (Bence Jones protein)

2- Renal causes: Glomerular or tubular causes Amylodosis, glomerulonephritis, renal neoplasia, nephrotoxines,

Fanconi syndrome.

2- Post renal causes: Inflammation in urogenital tract ( cystitis, vaginitis, urethritis) Hemorrhage ( bad catheterization, stones)

Methods for testing proteinuria Semi-quantitative tests Quantitative methods

1. Heat and acetic acid test.

2. Sulfosalicylic acid test.

3. Heller's test (using nitric acid)

4. Reagent strips method

1. Esbach's albuminometer method.

(picric acid + citric acid)

1. Turbidimeteric method

Bence-Jones proteinuria

• Bence-Jones proteins are light chains of γ-globulins excreated incase of B-cell tumor (multiple myloma)

• This protein detected by two ways :• Electrophoresis.

• Heat test (these proteins are precipitated when heating to (56 OC) and disappeared when reaching boiling but reappear on cooling to lower temperature again.

what’s the true and false proteinuria?

Causes of glucosuria:Physiological glucosuria

(Transient )

Pathological glucosuria

1- Heavy CHO- meal.

2- General anesthesia.

3- Emotional stress.

4- Corticosteroids.

5- glucose fluid therapy.

6- Pregnancy.

1- Diabetes mellitus.

2- Acute and chronic pancreatitis

3- Hyperthyroidism.

4- Hyperadrenocortasism.

5- Hyperpitutarism.

6- Renal glucosuria.

False +ve glucosuria

• in using as urine preservative.

• Presence of reducing sugars (Lactose, maltose). • Ascorbic acid.

Methods for testing glucosuria

1- Fehling and Benedict test

2- Urine strips

Ketone bodies include : Acetone, acetoacetic and b-hydroxybutyric acid

• Causes of ketonuria:1- Sever stage of Diabetes mellitus.

2- pregnancy toxemia in sheep.

3- bovine ketosis.

4- Sever starvation or malnutrition.

Methods for testing ketonuria– Rothera's test.

– Gerhardt's test.

– Reagent strip test.

The three bile derivatives excreted in urine are :* Urobilinogen. (normally excreted in urine in small amount). * Bile salts, Bile pigments (bilirubin). (appear in urine in liver disease only).

Tests for urobilinogen

Tests for bile salts Tests for bile pigments

(bilirubin) 1- Ehrlich's test.

2 -Urine strips

1- Hay's test.

2- Urine strips

1- Fouchet's test.

2- Foam test.

3- Urine strips

Causes of increased urobilinogen in urine* Hemolytic jaundice.* Hemolytic anemia.

Causes of absence of urobilinogen in urine* Obstructive jaundice.* Polyuria.* Severe diarrhea.* Administration of enteric antibiotic.* newborn animals* Exposure to lightCauses of bilirubinuria* Obstructive jaundice.* Hepatic jaundice

Presence of erythrocytes, hemoglobin and myoglobin will produce positive blood reaction.

• Tests for detection of blood in urine are:

• Benzidine test.

• Orthotoluidine test.

• Reagent strip test

N.B* If blood in the last drops of urine ……….. the source is bladder.

* If the urine is red throughout ………………the source is kidney.

* If the first portion of urine is red ………… the source is urethra.

ItemsHematouriaHemoglobinuriaMyoglobinuria

Def.Presence of intact RBCs in urin

Presence of Hb- in urin

Presence of myoglobin in urin

Col.Bright redBrownish-redbrown

Centrifug.Cell ppt. and clear supernatant

No change

turbidityturbidTransparent

Add. Of sat. amm. Sulphate soln.

_ _ _ _ _ _ clear supernatant & ppt. in bottom

No change

GoTNormal↑↑

CPK, creatinin

Normal↑

Interpretation:

A. Hematuria: Pyelonephritis, Acute nephritis, Ureteritis, Cystitis.

Pyelitis, vaginitis, Urolithiasis, Sweet clover disease, thrombocytopenia, parasits as Capillaria & Schistosoma.

B. Hb-uria: Leptospirosis, Post parturient hemoglobinuria, Babesiosis, Bacillary Hb-uria (Cl. Hemolyticum), Incompatible blood transfusion.

C. Myoglobinuria: Sever muscular destruction (deficiency of Vit. E & Selenium), Monday disease.

Normally nitrate present in urine but there is no nitrite.

The nitrite present in urine as a result of bacterial action which

reduced nitrate to nitrite as (Klebsiella, Proteus and Pseudomonas.)

Tests for detection of nitrite in urine : Urine strip

Its presence in urine has no significance, but it will give false positive glucosuria so, the Benedict test should be done for detection of glucose.

Tests for detection of ascorbic acid in urine : Urine strip