presentation of urine & stool analysis
TRANSCRIPT
بسم الله الرحمن بسم الله الرحمن الرحيمالرحيم
Urine AnalysisUrine Analysis
By
Dr. Ahmed Badr
IndicationsIndications
Change in the color of urine (GN,UTI, Hepatitis,Acute hemolytic crisis) Dysuria (UTI)
Generalized edema (NS) FUO (UTI)
Polyuria (DM,DI)
Items to be checkedItems to be checked
Physical Color Aspect Reaction Sp. gravity Volume
Chemical Proteins Glucose Ketones Bilirubin Urobilinogen Hb Microscopic
RBC WBC Casts Crystals Epithelial cells Ova Parasites
Items to be checkedItems to be checked
Physical
Color (amber yellow)
Aspect (Clear)
Reaction (pH =5-7)
Specific gravity (1015-1025)
Volume (1-3cc/kg/hr)
Chemical
Proteins (Nil) Proteinuria+++
Glucose (Nil) DM
Ketones (Nil) DKA
Bilirubin (Nil) Cholestasis
Urobilinogen (traces) Hemolytic J
Hb (Nil) Acute H. crisis
Microscopic RBC (0-5 /HPF) Hematuria
WBC (0-5 /HPF) Pyuria Infection/GN Casts (Tubular structures Glomerular/Tubular)
Hyaline casts Normal Red cell casts GN
White cell casts PN / GN Crystals (Ca oxalate, triple phosphate)
Epithelial cells Ova (Bilharzial)
Parasites (Entrobius)
•PSGN (Hematuria)Hematuria: RBC > 5/HPFRBCs castsColor: Smoky± Proteinuria± Pyuria (WBCs > 5/HPF)
•UTI (Pyuria = WBCs > 5/HPF)Pyuria only = CystitisPyuria + WBCs casts = Pyelonephritis
•Bilirubinuria: Hepatitis, Biliary atresia & Cholestasis•Diabetes (Glucosuria)•DKA (Glucosuria + Ketonuria)•Nephrotic (Proteinuria): Usually proteinuria only [MCNS]•Acute hemolytic crisis (Hemoglobinuria)
PleasePlease Comment On The Following Urine Comment On The Following Urine AnalysisAnalysis
Physical Color smoky Aspect Turbid
Reaction 6 Sp. gravity 1030 Volume 30 cc
Chemical Proteins++ Glucose Nil Ketones Nil Bilirubin Nil
Urobilinogen traces Hb Nil
Microscopic RBC >100 /HPF
WBC 50-60/HPF Casts
Hyaline casts++ Red cell casts+++
Please Comment On The Following Urine Please Comment On The Following Urine AnalysisAnalysis
Physical Color Yellow Aspect Turbid
Reaction 6.5 Sp. gravity 1030 Volume 40 cc
Microscopic RBC 3-5 /HPF
WBC 70-80/HPF Casts
Hyaline casts+ Crystals Nil
Epithelial cells++ Ova Nil Parasites Nil
Chemical Proteins+
Glucose Nil Ketones Nil Bilirubin Nil
Urobilinogen traces Hb Nil
Please Comment On The Following Urine Please Comment On The Following Urine AnalysisAnalysis
Physical Color Dark Yellow
Aspect Turbid Reaction 6
Sp. gravity 1020 Volume 30 cc
Chemical Proteins Nil Glucose Nil Ketones Nil
Bilirubin+++ Urobilinogen traces
Hb NilMicroscopic RBC 3-5 /HPF
WBC 3-5/HPF Casts Nil
Crystals Ca oxalate+ Epithelial cells++
Ova Nil Parasites Nil
PleasePlease Comment On The Following Urine Comment On The Following Urine AnalysisAnalysis
Physical Color yellow Aspect Turbid
Reaction 7 Sp. gravity 1025 Volume 30 cc
Chemical Proteins+
Glucose Nil Ketones Nil Bilirubin Nil
Urobilinogen traces Hb NilMicroscopic
RBC 10-12 /HPF WBC >100/HPF
Casts White cell casts++
Crystals Nil Epithelial cells++
Ova Nil Parasites Nil
Please Comment On The Following Urine Please Comment On The Following Urine AnalysisAnalysis
Physical Color Yellow
Aspect Clear Reaction 5.5
Sp. gravity 1018 Volume 40 cc
Chemical Proteins++++
Glucose Nil Ketones Nil Bilirubin Nil
Urobilinogen traces Hb Nil
Microscopic RBC 2-3 /HPF
WBC 2-3/HPF Casts
Hyaline casts++ Crystals Nil Epithelial cells Nil Ova Nil
Parasites Nil
Please Comment On The Following Urine Please Comment On The Following Urine AnalysisAnalysis
Physical Color Yellow
Aspect clear Reaction 6
Sp. gravity 1030 Volume 40 cc
Chemical Proteins Nil Glucose++
Ketones+++ Bilirubin Nil
Urobilinogen traces Hb Nil
Microscopic RBC 1-2 /HPF
WBC 2-3/HPF Casts Nil Crystals Nil
Epithelial cells+ Ova Nil Parasites Nil
Urine AnalysisPhysical Color smokyAspect Turbid
Chemical Proteins ++ Glucose Nil Ketones Nil Bilirubin Nil
Microscopic
RBC >100 /HPF
WBC 50-60/HPF
Hyaline casts ++
Red cell casts +++
Crystals few Ca oxalate
Epithelial cells NilA- Hypertension may be a complication.A- Hypertension may be a complication.B- Serum Albumen is usually below 2mg/dl.B- Serum Albumen is usually below 2mg/dl.C- It is not uncommon to find elevated C- It is not uncommon to find elevated BUNBUN..D- Buffy eyes are D- Buffy eyes are not uncommon not uncommon ..
Q- 14 Urine Analysis
Physical Color Yellow Aspect Clear
Chemical Proteins++++
Glucose Nil Ketones Nil
Microscopic
RBC 2-3 /HPF
WBC 2-3/HPF
Hyaline casts ++ Crystals few Ca oxalate
Epithelial cells Nil
A- Acute renal failure is constant.A- Acute renal failure is constant.B- Blood pressure is usually not affected.B- Blood pressure is usually not affected.C- Serum cholesterol is increased.C- Serum cholesterol is increased.D- The starting dose of steroid is 0.5 mg/kg .D- The starting dose of steroid is 0.5 mg/kg .
Q-14 Urine AnalysisPhysical Color YellowAspect Turbid
Chemical Proteins + Glucose Nil Ketones Nil
Microscopic
RBC 3 - 5 /HPF
WBC 70 - 80 /HPF
Hyaline casts +
Crystals Nil
Epithelial cells ++
A- Females affected more than males.A- Females affected more than males.B- Tender loin is expected.B- Tender loin is expected.C- Prolonged fever may be a presentation.C- Prolonged fever may be a presentation.D- Urine culture should be done.D- Urine culture should be done.
Stool AnalysisStool Analysis
By
Dr.Ahmed Badr
IndicationsIndications
Gastroenteritis
Dysentry (Diarrhea +tenesmus +Blood& Mucous)
Maldigestion / Malabsorption
Parasites
Bleeding per rectum
Items to be checkedItems to be checked
Macroscopic Color
Consistency
Reaction
Mucous
Blood
Microscopic RBCs
WBCs
Fat globules
Protozoa(cysts)
Protozoa(vegetative)
Ova
Bacteria
Macroscopic
Color (Brownish, yellowish, greenish) ?? (Clay, Red, Black) Consistency (soft, loose, watery, hard)
Reaction (Alkaline) ?Acidic (Lactose intolerance) Mucous (Nil) Dysentry Blood (Nil)
Microscopic
RBCs (1-3/HPF) WBCs (1-3/HPF) Fat globules (Nil) Protozoa(cysts) (Nil) Protozoa(vegetative) (Nil) Ova (Nil) Bacteria (Nil)
ProtozoaProtozoa
Ova
Giardia Lamblia
Trematodes
Cestodes
Nematodes
Entameba histolytica
Bilharziasis
Fasciola
Taenia(S&S)H.nanaD.latum
AscarisAnkylostoma
Entrobius
Please Comment On The Please Comment On The FollowingFollowing Stool AnalysisStool Analysis
Macroscopic
Color Brownish
Consistency loose
Reaction Alkaline
Mucous++++
Blood++
Microscopic RBCs >100/HPF WBCs 20-25/HPF Fat globules ++ Protozoa(cysts) Nil Protozoa(vegetative) E.histolytica Ova Nil
Please Comment On The Please Comment On The FollowingFollowing Stool AnalysisStool Analysis
Macroscopic Color Yellowish brown
Consistency Soft Reaction Alkaline
Mucous++ Blood+++
Microscopic RBCs >100/HPF WBCs >100/HPF Fat globules + Protozoa(cysts) (Nil) Protozoa(vegetative) (Nil) Ova (Nil) Bacteria Gram –ve Bacilli
Please Comment On The Please Comment On The FollowingFollowing Stool AnalysisStool Analysis
Macroscopic Color Brown
Consistency formed Reaction Alkaline
Mucous Nil Blood Nil
Microscopic RBCs 1-2/HPF WBCs 1-2/HPF Fat globules + Protozoa(cysts) Nil Protozoa(vegetative) Nil Ova Oxyuris
Stool Analysis
MacroscopicConsistency Loose
Reaction Alkaline
Mucous ++++
Blood ++
Microscopic RBCs >100/HPF
WBCs 20-25/HPF
Protozoa E. histolytica
Ova Nil
A- Mebendazole is the drug of choice.
B- The patient is usually asymptomatic.
C- Rectal swab is indicated.
D- Jujenal aspiration is essential for diagnosis.
Q-15 Stool Analysis
Macroscopic
Consistency Formed
Reaction Alkaline
Mucous Nil
Blood Nil
Microscopic
RBCs 0-1/HPF
WBCs 0-1/HPF
Protozoa Nil
Ova Ankylostoma
A-A- Eggs may not be seen in stools of patient Eggs may not be seen in stools of patient with severe anemia. with severe anemia. B- HSM is a common finding.B- HSM is a common finding.C- Leukocytosis in CBC is expected.C- Leukocytosis in CBC is expected.D- Peri-anal itching is very common.D- Peri-anal itching is very common.
Q15- Stool Analysis
MacroscopicConsistency Formed
Reaction Alkaline
Mucous Nil
Blood Nil
Microscopic RBCs 0-1 / HPF WBCs 0-1 / HPF
Protozoa Nil
Ova Schistosoma mansoni
A- praziquantel is the drug of choice.
B- Blood transfusion is commonly needed.
C- Spleen never enlarge in such patient.
D- Bleeding varices is one of the most serious complication of that illness.
Stool AnalysisMacroscopic Consistency Loose
Reaction Alkaline
Mucous ++++
Blood ++
Microscopic
RBCs >100/HPF
WBCs 20-25/HPF
Protozoa(vegetative) E. histolytica
Ova Nil
1) albendazol is the drug of choice
2) Crampy abdominal pain is common.
3) Extra intestinal affection does not occur.
Stool AnalysisMacroscopic Consistency Watery
Reaction Alkaline
Mucous Nil
Blood Nil
Microscopic
RBCs 1-2/HPF
WBCs 0-1/HPF
Protozoa (cyst) Giardia
Ova Nil
1) Perianal itching is common.
2) Hepatic affection could occur.
3) Metronidazol is the drug of choice.
Stool AnalysisMacroscopic Consistency Formed
Reaction Alkaline
Mucous Nil
Blood Nil
Microscopic
RBCs 0-1/HPF
WBCs 0-1/HPF
Protozoa Nil
Ova Ankylostoma
1) Serum iron is usually decreased.
2) Cotrimoxazol is the drug of choice.
3) All members of the family with or without symptoms should be treated at the same time.
Stool AnalysisMacroscopic Consistency Formed
Reaction Alkaline
Mucous Nil
Blood Nil
Microscopic
RBCs 0-1/HPF
WBCs 0-1/HPF
Protozoa Nil
Ova Schistosoma mansoni
1) Long standing cases may be associated with HSM.
2) Never affect females.
3) Metronidazol is the drug of choice.
Stool AnalysisMacroscopic Consistency Watery
Reaction Alkaline
Mucous Nil
Blood Nil
Microscopic
RBCs 1-2/HPF
WBCs 1-2/HPF
Protozoa Nil
Ova Nil
1) Dehydration may occur.
2) It is always bacterial in origin.
3) It never occur in the 1st year of life.
Stool AnalysisMacroscopic Consistency Loose
Reaction Alkaline
Mucous +++
Blood +++
Microscopic
RBCs >100/HPF
WBCs >100/HPF
Protozoa Nil
Ova Nil
1) Fever may be present.
2) Dehydration is commom.
3) Metronidazol is the drug of choice.