Urinalysis

Urinalysis

1. Physical

   • Quantity
   • Quality
     • Colour
       • Conc. yellow
       • Cloudy
         • Cells
       • Frothy
         • Protein
       • Tea colour (red)
         • Blood
         • Myoglobin
         • Haemoglobin
         • Conjugated Bilirubin
         • Others: drugs (rifampicin), beet root
     • Smell
       • Ketone (fruity)

2. Chemical

   • pH / Specific Gravity
   • Glucose / ketone
   • Leukocyte / Nitrites
   • Blood / Protein
     • Proteinuria
       • Renal
         • Glomerulus, tubular
           • If diabetic nephropathy (hyalinosis of efferent arterioles) cause microalbuminaemia, give ACE-i, ↓ hyperfiltration
       • Non-renal
         • Multiple myeloma
           • Bence jones protein
         • Hyperdynamic
           • E.g.: fever, exercise, too much protein flow to glomerulus

3. Microscopy

   • Cells
   • Crystal
     • Urate acid
       • ↑ phosphate, ↓ calcium, ↑potassium - Tumour lysis syndrome
   • Microorganisms
   • Casts
     • Red blood cell
       • Glomerulus damaged, tubule too narrow forms cast
       • Bleeding from bladder won't form cast
     • White blood cell
       • Pyelonephritis, Acute interstitial nephritis
     • Fatty
       • Nephrotic
     • Hyaline
       • Dehydration
     • Epithelial / Granular
       • Acute tubular nephritis