Technical Tips in Clinical Microscopy Urine Screening for Metabolic Disorders
Laboratory The presence of black urine from a
Introduction to Urinalysis patient of any age should be reported to a A high urea and Creatinine content supervisor identifies a fluid as urine Homogentisic acid (Alkaptonuria) Never discard a specimen before checking Malignant melanoma with a supervisor Medications Specimens must be returned to room Melanin may react with sodium temperature before chemical testing is nitroferricyanide (acetone reagent done, enzymes best react at RT strip), producing red color When preserving a urine to be sent to It is important to differentiate the another lab, be sure to check with that lab presence of Homogentisic acid and concerning the preservative melanin when urine is observed to have Addition of urine formed before the turned black upon standing start of collection period will have false HA- darkening appears under elevation; Failure to include urine alkaline condition produced at the end of collective will melanin- darkens the urine upon have falsely decreased values exposure to air Check the applied bags approx every 15 Lesch-Nyhan disease should not be minutes until needed amount of sample confused with uromodulin-associated has been collected kidney disease LND- Uric acid appears early in life Renal Function UAKD- Uric acid appears later in Glucose appearing in urine of a patient life with normal blood glucose is a result of Renal disease tubular damage Vapor pressure osmometers- are used Uromodulin forms the matrix of urinary primarily to analyze serum and sweat casts seen in many renal disorders. microsamples for disorders not related to The presence of WBC casts is significant renal function, Cystic fibrosis. Used in for differentiating between cystitis chemistry (absent) and pyelonephritis (present) Physical Examination Molality- commonly used because the solute and the solvent are both expressed in the same unit Because ions such as Sodium, Chloride and Ammonium are important in evaluating renal concentrating ability, the reagent strip method provides additional info and not affected by Nonionizing substance like protein, glucose and urea and radiographic dye