Lab Act Urinalysis (Physical and Chemical

Exam) Biomedic-3
By: Yani Triyani
Dept of Clinical Pathology UNISBA
2016-2017
The purpose and function of Clinical Pathology
 Confirming or rejecting diagnosis
 Providing guidelines in patient management
 Establishing a prognosis
 Detecting disease through case finding or screening
 Monitoring follow up therapy
URINALYSIS STEPS
Pre analytic

Analytic

Post analytic

QUALITY CONTROL (QC):

URINALYSIS STEPS
 PRE-ANALYTIC : patient preparation, samples collection, samples handling, labelling,
refrigeration, preservatives of urine specimens.
 ANALYTIC: principle of procedures, measurements, interpretation, conventional & rapid and
sophisticated
 POST-ANALYTIC: recording, reporting, use of units : conventional unit and international unit
 QUALITY CONTROL (QC):calibration, control solution to get good and reliable results
Pre-Analytic
 Specimen collection
 Requisition form  must accompany with specimen delivered to the lab; the form include :
patient’s name, I.D number, date and time of collection and additional information : age, location,
physician’s name, type of specimen/method, interfering medication and clinical information
 Container  clean, dry, leak proof, disposable
 All specimens must be properly labeled  must be attach to the container, not to the lid, should
not become detached if the container is refrigerated
 The information on form requisition  match with the inform on the label
Specimen collection tool
Urine container
Labelling urine specimen
Name (min 2 initial, ex: Deni Darmawaty)

Sex : female

Date (day, month, year)

Time collection:

Adress and telp number :

Pre-Analytic
Two Type of Specimen
 Based on Time :
 Random specimen
 First morning/fasting specimen
 2-hours post prandial specimen
 Timed urine (12-hours, 24-hours specimen)
 Based on method :
 Midstream Clean-Catch specimen
 Catheterized specimen
 Suprapubic aspiration
Pre-Analytic
3. Specimen Handling
Folowing collection  should be delivered to the lab promptly and
tested within 1-2 hours
If it can’t delivered  must be refrigerated or add with chemical
preservative
Analytic Stage
 Method :
 Manual/ Conventional
 Automatic
 Classification :
 Screening Test
 Confirmatory test
Types of Clinical laboratory Examination
Screening Test (urinalysis):

Physical exam

chemical dipstick urinalysis

microscopic

Confirmatory Test:

Culture urine

24 h quantitative proteinuria

Oval fat bodies, etc

PHYSICAL ASSESSMENT OF URINE

COLOUR:

Normal: yellow ( primarily from the presence of urochrome)

Abnormal :

yellow brown ( bilirubin)

dark red (erythrocytes, hemoglobin, porphyrin product)

red brown ( myoglobin, erythrocytes, hemoglobin)

clear red ( hemoglobin, porphyrin product)

cloudy red ( erythrocytes)

Green (biliverdin)

ANALYTIC
Physical Examination
 Volume
 Color
 Clarity
 Odor
 Specific Grafity
 pH
Physical Examination
 Volume :

Interpretation :
 Normal : 1200 – 1500 ml/daily

(600 – 2000 ml/daily)

 Abnormal condition :
 Oliguria
 Polyuria
 Anuria
Physical Examination
 Color :

Variation of color  normal metabolic functions, physical

activity, ingested materials, pathologic conditions
Interpretation :
 Normal : light yellow  amber
 Abnormal : see next tabel
Variation color of urine
URINE COLOUR
Physical Examination
 Clarity :

Interpretation :
Urine
Term
Clarity

No visible
Clear aprticulates,
transparent

Few
particulates,
print easily
Hazy
seen
through
urine

Many
particulates,
print
Cloudy
blurred
through
urine

Print can’t
be seen
Turbid
through
urine

May
precipitate
Milky
or be
clotted

Clarity
Physical Examination
 Spesific gravity :
 Method :
 Urinometer
 Refractometer
 Reagents Strip
 Interpretation :
 Normal : 1.003 – 1.035 (1.015 – 1.025)
 Abnormal :
 Hypostenuric
 Hyperstenuric
  REFRACTOMETER

- URINOMETER

1,000

1,020

1,040
Schematic representation of the refractometer scales

of measurement.

This measurement represents a reading of 1.014.

Physical Examination
 pH :
 Method :
 Reagent strip
 Lithmus paper
 Interpretation :
 Normal : 4.5 – 8.0 (5.0 – 6.0)
 Abnormal :
 Acid
 Alkaline
Chemical Exam of Urine
CONVENTIONAL
RAPID - SOPHISTICATED
pH : Lakmus
SG : Urinometry, Refractometry
Protein:Bang (sulfosalysilic acid)
Glucose : Benedict (redox)
Urobilinogen : Schmidt
Urobilin : Schlessinger
Bilirubin : Foam test, Harrison,
Hawkinson
Ketones : Rothera, Gerhardt
Blood : Benzidine
REAGENT STRIPS :
COMBUR, URISCAN, MULTISTIX
READER :
visual or by using an automated ins-
trument (photometry)
PRINCIPLE OF THE METHODS
 IN GENERAL :

agent + reagent colour change (read visually or

photometrically by automated
instrument)
Except for SG that was based on pKa change in relation
to ionic concentration. SG is depend on solutes that
disperse in solution
CHEMICAL DIPSTICK URINALYSIS
Dipsticks Urine
The Reagent Strip Is Dipped Into A Specimen And

Removed Quickly, Dragging The Edge Of The Strip Along The Lip Of The

Container To Remove Excess Urine.

Mundt LA, Shanahan K. 2016. Textbook of Urinalysis and Body Fluids. Page 90
Reference book
Textbook of Urinalysis and Body Fluids. Mundt LA, Shanahan K,
3th ed. 2016. Wolters Kluwer Health / Lippincott Williams &
Wilkins
Section II, Chapter 6-8.