ANALYSIS

OF
BLOOD
AND
URINE
Submitted by: NIACINTH LOREDO

Submitted to: KEVIN DE GUZMAN

 What is the
difference between
oxyhemoglobin
and
reduced hemoglobin
in
terms of structure?
Hemoglobin is the carrier of O2 and CO2 in the blood. Hemoglobin is a molecule made
up of two chains α and β chains each chain has iron atom at the center see the
structure below. Marked with Fe. Iron here is in +2 oxidation state. Ready to take up the
oxygen molecule. Hemoglobin is present in RBCs and when they reach Oxygen rich
region in lungs specifically Alveoli, iron changes its oxidation state to +3 and then the
hemoglobin gets converted to oxyhemoglobin. Oxyhemoglobin delivers O2 in the region
where there is requirement for it and in turns takes up the CO2 to remove it from body.
Thus oxyhemoglobin is nothing but the hemoglobin carrying O2. Oxyhemoglobin is
the oxygen-loaded form of hemoglobin, the predominant protein in red blood cells.
Hemoglobin is a protein molecule that binds to oxygen. Hemoglobin forms an unstable,
reversible bond with oxygen. In its oxygen-loaded form, it is called oxyhemoglobin and
is bright red. In the oxygen-unloaded form it is called deoxyhemoglobin and is purple-
blue. hemoglobin, also spelled haemoglobin, iron-containing protein in the blood of
many animals—in the red blood cells (erythrocytes) of vertebrates—that
transports oxygen to the tissues. Hemoglobin forms an unstable reversible bond with
oxygen. In the oxygenated state, it is called oxyhemoglobin and is bright red; in the
reduced state, it is purplish blue. Hemoglobin develops in cells in the bone marrow that
become red blood cells. When red cells die, hemoglobin is broken up: iron is  salvaged,
transported to the bone marrow by proteins called transferrins, and used again in the
production of new red blood cells; the remainder of the hemoglobin forms the basis
of bilirubin, a chemical that is excreted into the bile and gives the feces their
characteristic yellow-brown color. Oxyhemoglobin is the normal, oxygen-carrying form
of hemoglobin in which iron is in the reduced (ferrous) state. Methemoglobin is a
nonfunctional form of hemoglobin in which ferrous iron is oxidized to ferric iron.
Methemoglobin is nonfunctional because it cannot bind oxygen. In healthy animals,
approximately 1% of oxyhemoglobin is converted to methemoglobin daily.
Methemoglobin reductase reduces methemoglobin back to oxyhemoglobin. Rarely,
methemoglobin reductase deficiency occurs as a congenital defect in dogs and
produces significant methemoglobinemia and cyanosis. The oxyhemoglobin method for
hemoglobin concentration measures only oxyhemoglobin, whereas the usual
cyanmethemoglobin method measures all types of hemoglobin, including
methemoglobin. A high oxyhemoglobin concentration is preserved despite a decrease
in partial pressure of oxygen in the blood (Pao2) until the Pao2 falls below 60 mm Hg, at
which point the pulse oximeter reading reflects the decreasing Pao2 with a rapid
decrease in oxygen saturation.
 Why does blood
coagulate? Briefly
describe the mechanism
of blood clotting .
Clotting factors are proteins found in blood that work together to make a blood clot.
Blood vessels shrink so that less blood will leak out. Tiny cells in the blood called
platelets stick together around the wound to patch the leak. Blood proteins and platelets
come together and form what is known as a fibrin clot. The clot acts like a mesh to stop
the bleeding. Bleeding causes a biological "domino effect" in which a series of steps are
set in motion. When your body detects a bleed, the clotting factors are switched on in a
particular order, one after the other. Each factor activates the next until they form a clot.
This is known as the coagulation cascade.1 Intrinsic and extrinsic pathways are 2
separate pathways that lead to the formation of a clot. The intrinsic pathway is activated
early in the coagulation cascade, known as the initiation phase. The extrinsic pathway
activates during the amplification phase of the coagulation cascade—increasing the
number of platelets at the site of a bleed. You can imagine the process like a row of
dominoes. Each factor signals the next, all working together like a row of dominoes
falling into each other. If a single domino is missing in a row, dominoes will stop falling.
In the same way, if a single factor is missing from the clotting process (like factor VIII or
factor IX), the coagulation cascade gets interrupted and a proper clot will not form when
you have a bleed. When certain blood-clotting factors are deficient or missing in a
person with a bleeding disorder, the blood does not clot as it should, and it takes longer
for a clot to form and for bleeding to stop. Hemostasis is the mechanism that leads to
cessation of bleeding from a blood vessel. It is a process that involves multiple
interlinked steps. This cascade culminates into the formation of a “plug” that closes up
the damaged site of the blood vessel controlling the bleeding. It begins with trauma to
the lining of the blood vessel. Hemostasis facilitates a series of enzymatic activations
that lead to the formation of a clot with platelets and fibrin polymer. This clot seals the
injured area, controls and prevents further bleeding while the tissue regeneration
process takes place. Once the injury starts to heal, the plug slowly remodels, and it
dissolves with the restoration of normal tissue at the site of the damage. he hemostatic
cascade is meant to control hemorrhage and be a protective mechanism. At times, this
process is triggered inadvertently while the blood is within the lumen of the blood vessel
and without any bleeding. This situation leads to a pathologic phenomenon of
thrombosis, which can have catastrophic complications by obstructing blood flow
leading to ischemia and even infarction of the tissues supplied by the occluded blood
vessels. In this way, a physiologic process becomes a pathologic process leading to
morbidity and/or mortality. Some of the examples include Antiphospholipid antibody
syndrome, Factor 5 Leiden mutation, Protein C deficiency, protein S deficiency,
Prothrombin gene mutation, etc.
Why must a 24-hour period
sample of urine be used for
examination if a detailed
composition is
to be determined?
 A 24-hour urine collection is a simple lab test that measures what’s in your urine. The
test is used to check kidney function. A 24-hour urine collection is done by collecting
your urine in a special container over a full 24-hour period. The container must be kept
cool until the urine is returned to the lab. Urine is made up of water and dissolved
chemicals, such as sodium and potassium. It also contains urea. This is made when
protein breaks down. And it contains creatinine, which is formed from muscle
breakdown. Normally, urine contains certain amounts of these waste products. It may
be a sign of a certain disease or condition if these amounts are not within a normal
range or if other substances are present. A 24-hour urine collection helps diagnose
kidney problems. It is often done to see how much creatinine clears through the
kidneys. It’s also done to measure protein, hormones, minerals, and other chemical
compounds. Conditions that can cause kidney disease include is diabetic nephropathy
because this happens when someone has uncontrolled diabetes. It causes high levels
of protein (albumin) in the urine and can lead to kidney damage. High blood pressure
because abnormally high blood pressure can lead to lasting (permanent) kidney
damage. A 24-hour urine collection may be done on an outpatient basis. This means
you go home the same day. Or it may be done during a hospital stay. Procedures may
vary depending on the condition and the healthcare provider's practices. Generally, a
24-hour urine collection follows this process: You will be given 1 or more containers for
collecting and storing your urine. A brown plastic container is typically used. A special
pan that fits in the toilet or a urinal may be used to collect the urine. You will need to
transfer the urine from the collecting container to the storage container. You will need to
keep it cold. The 24-hour collection may start at any time during the day after you
urinate. But your healthcare provider may tell you when to start. It is common to start
the collection the first thing in the morning. It is important to collect all urine in the
following 24-hour period. Don't save the urine from your first time urinating. Flush this
first specimen, but note the time. This is the start time of the 24-hour collection. All
urine, after the first flushed specimen, must be saved, stored, and kept cold. This
means keeping it either on ice or in a refrigerator for the next 24 hours. Try to urinate
again at the same time, 24 hours after the start time, to finish the collection process. If
you can’t urinate at this time, it is OK. Once the urine collection has been completed,
the urine containers need to be taken to the lab as soon as possible. If you are doing
the urine collection at home, you will be given instructions on how and where to take it.
Depending on your specific health problem, you may be asked to repeat the collection
over several days. There is no special type of care after a 24-hour urine collection. But
your healthcare provider may give you other instructions after the procedure, depending
on your particular situation
What is meant by
glucosuria?
Albuminuria?
More than the normal amount of albumin in the urine. Albuminuria can be a sign that
protein is leaking through the kidney, most often through the glomeruli, or a sign of
significant kidney disease. It may also be the harmless result of vigorous exercise. Also
known as proteinuria. Glycosuria, glucose in the urine, results from the glomerular
filtration of more glucose than the renal tubule can absorb. It occurs in all normal
individuals in amounts up to 25 mg/dl. Abnormally increased glycosuria [more than 25
mg/dl in random fresh urine, results from either an elevated plasma glucose, an
impaired renal glucose absorptive capacity, or both. The plasma glucose concentration
above which significant glycosuria occurs is called the renal threshold for glucose. Its
value is variable, and deviations occur both above and below the commonly accepted
"normal" threshold of 180 mg/dl. In diabetic patients, the value is reported to vary from
54 to 300 mg/dl. Although glycosuria greater than 25 mg/dl is considered pathologic,
many commercial semi quantitative urine tests for glycosuria that are available to
patients fail to detect glycosuria until it reaches a level of 50–250 mg/dl. The association
between blood and urine glucose was first observed in the eighteenth century by
Matthew Dobson, an English physician. For many years urine glucose testing was the
major method used to monitor glycemic control in diabetes mellitus. Early methods of
urine glucose detection included evaporation of urine to reveal sugar crystals and urine
sugar fermentation by yeast. Methods based on copper reduction were developed by
von Fehling in the nineteenth century and by Benedict at the turn of the twentieth
century. In 1941, the Ames Company marketed Clinitest, a copper reduction method,
and followed it with Clinistix, a glucose oxidase-based determination. Since then,
several companies have marketed glucose oxidase-based tests. Measurement of
glycosuria is an indirect index of the blood glucose concentration, however, and tests for
urine glucose must be interpreted with caution. Technical issues such as test sensitivity
and variability of renal glucose threshold must be taken into account. Furthermore, the
social stigma sometimes associated with handling a body waste product (15) can be a
consideration in terms of patient acceptance of the monitoring technique. These
limitations, together with the development of home blood glucose monitoring, have led
to a decline in the use of urine glucose for monitoring in diabetes mellitus. Self-
monitoring of capillary blood glucose is now the preferred method. Nevertheless,
assessment of glycosuria produces usable data. It is an especially appropriate
monitoring tool in health care settings where socioeconomic or educational constraints
(17) preclude the use of more sophisticated techniques (e.g., home capillary blood
glucose monitoring, glycosylated hemoglobin measurement, and frequent plasma
glucose determinations). Selected patients continue to find urine glucose testing
convenient, noninvasive, inexpensive, and useful. Albuminuria is a sign of kidney
disease and means that you have too much albumin in your urine. Albumin is a protein
found in the blood. A healthy kidney doesn’t let albumin pass from the blood into the
urine. A damaged kidney lets some albumin pass into the urine. The less albumins in
your urine, the better. Kidney stones are small masses of salts and minerals that form
inside the kidneys and may travel down the urinary tract. Kidney stones range in size
from just a speck to as large as a ping pong ball. Signs and symptoms of kidney stones
include blood in the urine, and pain in the abdomen, groin, or flank. About 5% of people
develop a kidney stone in their lifetime. The kidneys regulate levels of fluid, minerals,
salts, and other substances in your body. When the balance of these compounds
changes, kidney stones may form. There are four types of kidney stones, each made of
different substances. Uric acid and cysteine are two compounds that may comprise
kidney stones. Factors known to increase the risk of kidney stones include dehydration,
family history, genetics, and the presence of certain medical conditions. Having one or
more family members with a history of kidney stones increases the risk of the condition.
Discuss the symptoms
and treatment of blood/
urine related diseases
.
a. Anemia
Anemia happens when you do not have enough red blood cells. The cells travel with
iron and hemoglobin, which is a protein that helps carry oxygen through the
bloodstream to your organs all through the body. When someone develops anemia,
they are said to be "anemic." Being anemic might mean that you feel more tired or cold
than you usually do, or if your skin seems too pale. This is due to your organs not
receiving the oxygen they need to do their jobs. Some people find out they are low in
iron when they go to donate blood. Anemia affects more than two billion people globally,
which is more than 30% of the total population. It is especially common in countries with
few resources, but it also affects many people in the industrialized world. Within the
U.S., anemia is the most common blood condition. An estimated three million
Americans have the disorder. Several signs and symptoms occur in all types of anemia,
such as fatigue, shortness of breath and feeling cold. Others include: Dizziness or
weakness, Headache, Sore tongue, Pale skin, dry skin, or easily bruised skin,
unintended movement in the lower leg (restless legs syndrome) and Fast heartbeat.
First, your healthcare provider will find out if the anemia is being caused by a poor diet
or a more serious health problem. Then, you can be treated for both the anemia and its
cause. Iron-deficiency anemia is treated with: Iron supplements taken by mouth, Foods
high in iron and foods that help your body absorb iron (like foods with Vitamin C), Iron
given through an intravenous (IV) infusion. (This is often a choice if you have chronic
kidney disease, or CKD.) and Transfusions of red blood cells. If your anemia is caused
by internal bleeding, your provider may need to do surgery to stop it. Surgical repair has
been used to cure anemia in people with the Para esophageal type of hiatal hernias,
with or without ulcers (called Cameron’s ulcers). Other types of anemia may require
other types of treatment. For instance, genetic disorders (like beta thalassemia and
sickle cell anemia) may require bone marrow transplant. If CKD is causing your anemia,
in addition to iron supplementation (through oral or IV means), treatment could also
include injections of erythropoietin (EPO). EPO is a hormone that tells the bone marrow
to make red blood cells. Anemia is also linked to cancer in some cases — both in terms
of anemia being a symptom and in terms of cancer treatment. Both radiation and
chemotherapy can cause anemia. It might be necessary to stall further cancer treatment
until the anemia is improved by iron, blood transfusions, getting necessary B vitamins
and/or getting shots of drugs to stimulate your body to produce EPO.
b. Leukopenia
Your blood is made up of different types of blood cells, including white blood cells
(WBCs), which are also known as leukocytes. WBCs are an important part of your
immune system. They help your body fight off diseases and infections. If you have too
few WBCs, you have a condition known as leukopenia. In this article, we take a closer
look at leukopenia, including types, symptoms, causes, and treatment. What’s
considered a low white blood cell count? WBC counts are typically reported as part of a
blood test called a complete blood count or CBC. The results can be reported as cells
per microliter (μL) of blood or as cells per cubic millimeter (mm3) of blood. Generally
speaking, when WBC numbers fall below these reference ranges, you have leukopenia.
Your doctor will order additional tests to determine what’s leading to your low WBC
levels. It’s important to point out that the exact reference ranges that are used can vary
based off the laboratory performing the test. Because of this, always refer to the
reference ranges that are listed on the report of your test results. There are several
different types of leukopenia, depending on which type of WBC is low in your blood.
Each WBC type has a different function in protecting your body from infections or
harmful substances. If your blood is low in neutrophils, you have a type of leukopenia
known as neutropenia. Neutrophils are the WBCs that protect you from many types of
infections, particularly those involving fungi or bacteria. Neutrophils make up 55 to 70
percent of your total WBC count. Because of this, leukopenia is often caused by a
decrease in neutrophils. In fact, some people use the terms “leukopenia” and
“neutropenia” interchangeably. Another common type of leukopenia is lymphocytopenia,
which is when you have too few lymphocytes. Lymphocytes are the WBCs that protect
you from a variety of infections and also from cancerous cells. You probably won’t
notice any signs of leukopenia. But if your WBC counts are very low, you may have
signs of infection, including: a fever of 100.4˚F (38˚C) or above, chills, sweating, sore
throat, cough or shortness of breath, an area of your body that’s become red, swollen,
or painful, an injury that’s draining pus, mouth sores or white patches in your mouth and
painful urination. If you have any of the symptoms above or experience frequent
infections, it’s important to contact a doctor promptly. Also, keep in mind that it’s
possible that a fever may be the only symptom of an infection. Seeking timely medical
care for infections is particularly important if you’re at risk for leukopenia. When
treatment is received early, it can help to prevent potentially serious complications.
Treatment for leukopenia depends on which type of WBC is low and what’s causing it to
be so. You may also need other treatments to take care of any infections that develop
from not having enough WBCs. Common treatments include: If you have an underlying
health condition that’s causing leukopenia, such as lupus or sarcoidosis, your doctor will
develop a treatment plan to manage it. This can help to return your WBCs to typical
levels and sometimes you may need to stop a treatment to give your body time to make
more WBCs. Your blood cell counts may naturally rise when treatment like radiation is
over or between chemotherapy sessions. The amount of time it takes for WBCs to
replenish varies from person to person. If you’re taking a medication that causes
leukopenia, your doctor may adjust the dose that you’re taking. They may also
recommend switching to a different medication, if possible.
c. Thrombocytopenia
People with thrombocytopenia have low platelet levels. Platelets aid blood clotting
(stopping bleeding). When platelet levels are low, you may bruise and bleed
excessively. Certain cancers, cancer treatments, medications and autoimmune
diseases can cause the condition. Platelet levels often improve when you treat the
underlying cause. Thrombocytopenia (THROM-bo-sigh-toe-PEE-ne-ah) occurs when
your blood platelet count is low. Platelets are also called thrombocytes. This type of
blood cell clumps together to form blood clots to help stop bleeding at the site of a cut or
wound. Another name for a blood clot is thrombus. Bone marrow is the soft, spongy
tissue inside bones that makes all blood cells including platelets. People who have
thrombocytopenia don’t have enough platelets to form a blood clot. If you get a cut or
other injury, you may bleed too much and the bleeding can be hard to stop. It’s
unknown how many people have thrombocytopenia. Many people have mild symptoms.
They might not even know they have the condition. The autoimmune form of
thrombocytopenia, immune thrombocytopenic purpura or ITP, affects approximately
three to four out of every 100,000 adults and children. Some people with mild cases of
thrombocytopenia don’t have symptoms. Often, one of the first signs is a cut
or nosebleed that won’t stop bleeding. Other signs of low platelet count include:
Bleeding gums, Blood in stool (black, tarry-looking), urine (hematuria) or vomit. Heavy
menstrual periods, Petechial (tiny red or purple dots on the lower legs that resemble a
rash), Purpura (purple, red or brown bruises) or bruising easily and rectal bleeding. You
might not need treatment if a low platelet count isn’t causing significant problems. Often,
healthcare providers can improve platelet counts by treating the underlying cause. This
approach may involve changing your medications. Other treatments include: Blood
transfusion to temporarily increase platelet levels in your blood. Platelets are transfused
only if the platelet count is extremely low. (Transfused platelets only last about three
days in the circulation.), Splenectomy or removal of the spleen and
Steroids (prednisone or dexamethasone), immunoglobulins (antibody proteins), and
other medications that reduce platelet destruction and stimulate platelet production.
People with severe thrombocytopenia are at risk for significant internal and external
blood loss, or hemorrhage. Internal bleeding into the digestive tract or brain (intercranial
hemorrhage) can be life-threatening. Having a splenectomy makes you more
susceptible to infections. Your spleen is part of your immune system. It helps your body
fight off germs. For this reason, patients who have to have their spleen remove are
given several vaccinations to help prevent infection

:
d. Enuresis
Enuresis is more commonly known as bed-wetting. Nocturnal enuresis, or bed-wetting
at night, is the most common type of elimination disorder. Daytime wetting is called
diurnal enuresis. Some children experience either or a combination of both. This
behavior may or may not be purposeful. The condition is not diagnosed unless the child
is 5 years or older. The main symptoms of enuresis include: Repeated bed-wetting,
Wetting in the clothes and Wetting at least twice a week for approximately three months.
Voluntary, or intentional, enuresis may be associated with other mental disorders, including
behavior disorders or emotional disorders such as anxiety. Enuresis also appears to run in
families, which suggests that a tendency for the disorder may be inherited (passed on from
parent to child, particularly on the father's side). In addition, toilet training that was forced or
started when the child was too young may be a factor in the development of the disorder,
although there is little research to make conclusions about the role of toilet training and the
development of enuresis. Treatment may not be needed for mild cases of enuresis,
because most children with this condition outgrow it (usually by the time they become
teens). Knowing when to begin treatment is difficult, because it is impossible to predict the
course of symptoms and when the child will simply outgrow the condition. Some factors to
consider when deciding to begin treatment are whether the child's self-esteem is affected
by the wetting and whether enuresis is causing impairment in functioning, such as causing
the child to avoid attending sleepovers with friends. When treatment is used, therapy aimed
at changing behavior is most often recommended. Behavior therapy is effective in more
than 75% of patients and may include: Using an alarm system that rings when the bed gets
wet can help the child learn to respond to bladder sensations at night. The majority of the
research on enuresis supports the use of urine alarms as the most effective treatment.
Urine alarms are currently the only treatment associated with persistent improvement. The
relapse rate is low, generally 5% to 10%, so that once a child's wetting improves, it almost
always remains improved. This technique uses regularly scheduled trips to the bathroom
timed at increasing intervals to help the child become used to "holding" urine for longer
periods. This also helps to stretch the size of the bladder, which is a muscle that responds
to exercise. Bladder training is typically used as part of an enuresis treatment program.
This may include providing a series of small rewards as the child achieves bladder control.
Medications may be used to decrease the amount of urine produced by the kidneys or to
help increase the capacity of the bladder or. Drugs commonly used
include desmopressin acetate (DDAVP), which affects the kidneys' urine production,
and imipramine (Tofranil), an antidepressant which has also been found useful for treating
enuresis. While drugs can be useful for managing the symptoms of enuresis, once they are
stopped, the child typically begins wetting again. When choosing medications for children,
the side effects and cost need to be considered; the medications may help improve the
child's functioning until behavioral treatments begin to work.
e. Nephrolith
Kidney stones are hard deposits made of minerals and salts that form inside your
kidneys. Diet, excess body weight, some medical conditions, and certain supplements
and medications are among the many causes of kidney stones. Kidney stones can
affect any part of your urinary tract—from your kidneys to your bladder. Often, stones
form when the urine becomes concentrated, allowing minerals to crystallize and stick
together. A kidney stone usually does not cause symptoms until it moves around within
the kidney or passes into one of the ureters. The ureters are the tubes that connect the
kidneys and bladder. If a kidney stone becomes lodged in the ureters, it may block the
flow of urine and cause the kidney to swell and the ureter to spasm, which can be very
painful. At that point, you may experience the following symptoms: Severe, sharp pain
in the side and back, below the ribs, Pain that radiates to the lower abdomen and groin,
Pain that comes in waves and fluctuates in intensity. I have a pain or burning sensation
while urinating. Other signs and symptoms may include: pink, red, or brown urine;
cloudy or foul-smelling urine, A persistent need to urinate, urinating more often than
usual or urinating in small amounts, nausea and vomiting. Fever and chills if an infection
is present. Pain caused by a kidney stone may change—for instance, shifting to a
different location or increasing in intensity—as the stone moves through your urinary
tract. Treatment for kidney stones varies depending on the type of stone and the cause.
Small stones with minimal symptoms. Most small kidney stones won't require invasive
treatment. You may be able to pass a small stone by: drinking water ilduting as much as
2 to 3 quarts (1.8 to 3.6 liters) a day will keep your urine dilute and may prevent stones
from forming. Unless your doctor tells you otherwise, drink enough fluid—ideally mostly
water—to produce clear or nearly clear urine. Pain relievers passing a small stone can
cause some discomfort. To relieve mild pain, your doctor may recommend pain
relievers such as ibuprofen (Advil, Motrin IB, and others) or naproxen sodium (Aleve).
Medical therapy Your doctor may give you a medication to help pass your kidney stone.
This type of medication, known as an alpha blocker, relaxes the muscles in your ureter,
helping you pass the kidney stone more quickly and with less pain. Examples of alpha
blockers include tamsulosin (Flomax) and the drug combination of dutasteride and
tamsulosin (Jalyn). Large stones and those that cause symptoms. Parathyroid glands
open the pop-up dialog box. Kidney stones that are too large to pass on their own or
cause bleeding, kidney damage, or ongoing urinary tract infections may require more
extensive treatment. Procedures may include: Using sound waves to break up stones
your doctor may recommend a procedure called extracorporeal shock wave lithotripsy
(ESWL) for certain kidney stones, depending on size and location. ESWL uses sound
waves to create strong vibrations (shock waves) that break the stones into tiny pieces
that can be passed in your urine. The procedure lasts about 45 to 60 minutes and can
cause moderate pain, so you may be under sedation or light anesthesia to make you
comfortable. ESWL can cause blood in the urine, bruising on the back or abdomen,
bleeding around the kidney and other adjacent organs, and discomfort as the stone
fragments pass through the urinary tract. Surgery to remove very large stones in the
kidney A procedure called percutaneous nephrolithotomy (nef-row-lih-THOT-uh-me)
involves surgically removing a kidney stone using small telescopes and instruments
inserted through a small incision in your back. You will receive general anesthesia
during the surgery and be in the hospital for one to two days while you recover. Your
doctor may recommend this surgery if ESWL is unsuccessful. Using a scope to remove
stones To remove a smaller stone in your ureter or kidney, your doctor may pass a thin
lighted tube (ureteroscope) equipped with a camera through your urethra and bladder to
your ureter. Once the stone is located, special tools can snare the stone or break it into
pieces that will pass through your urine. Your doctor may then place a small tube (stent)
in the ureter to relieve swelling and promote healing. You may need general or local
anesthesia during this procedure. Parathyroid gland surgery some calcium phosphate
stones are caused by overactive parathyroid glands, which are located on the four
corners of your thyroid gland, just below your Adam's apple. When these glands
produce too much parathyroid hormone (hyperparathyroidism), your calcium levels can
become too high and kidney stones may form as a result. Hyperparathyroidism
sometimes occurs when a small, benign tumor forms in one of your parathyroid glands
or you develop another condition that leads these glands to produce more parathyroid
hormone. Removing the growth from the gland stops the formation of kidney stones. Or
your doctor may recommend treatment of the condition that's causing your parathyroid
gland to overproduce the hormone.
.
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1990, Butterworths; Steven L. Cowart and Max E. Stachura, Glucosuria - Clinical
Methods - NCBI Bookshelf,
https://www.ncbi.nlm.nih.gov/books/NBK245/#:~:text=Definition,dl%20(1%E2%80%935)
(What is meant by glucosuria? Albuminuria?)

04/06/2020, Cleveland Clinic medical professional, Anemia,

https://my.clevelandclinic.org/health/diseases/3929-anemia
2005-2022, Health line Media a Red Ventures Company, What is Leukopenia, health
line, https://www.healthline.com/health/leukopenia#treatment
11/23/2020, a Cleveland Clinic medical professional, Thrombocytopenia,
https://my.clevelandclinic.org/health/diseases/14430-thrombocytopenia
December 08, 2020, Amita Shroff, MD, Enuresis: Symptoms, Causes, Diagnosis,
Treatment – WebMD, Medically Reviewed,
https://www.webmd.com/mental-health/enuresis
2022, Mayo Foundation for Medical Education and Research (MFMER), How does
Nephrolith affect urinary system?, MayoClinic, https://www.mayoclinic.org/diseases-
conditions/kidney-stones/symptoms-causes/syc-20355755
(Discuss the symptoms and treatment of blood/ urine related diseases: a. Anemia, b.
Leukopenia, c. Thrombocytopenia, d. Enuresis and e. Nephrolith)