Report

Course PhysioLab - Medical Physiology Laboratory

Lesson Kidney and Urine – Lab
Group leader iemendoza2022@plm.edu.ph

Group Activity

Ivy MENDOZA GROUP LEADER Jean Marcus SAHAGUN Odezza Gloralice MAON Rome Limuel TAGUIC

STEPHANIE LEIGH ONG Arianne Nicole Niño MANUEL Katherine Grace NOLASCO Ana Modelle VELASQUEZ

Anhiro Prince RODRIGUEZ

Lesson started Feb 21, 2023, 2:53 PM

Micturition – Activity

Bladder capacity results

Variable Volunteer 1 Volunteer 2 Volunteer 3
Name Sam Maria John
Weight before drinking (kg) 72.4 61.3 85.9

Micturition – Challenge

Label the structures in the intravenous pyelogram image below. Which of these are involved in micturition?

Bladder
Kidney
Kidney
Vertebra
Ureter
Ureter

Vertebra

Bladder
©
 Label the transverse abdominal CT scan.

Adipose tissue Liver Gall Bladder Stomach Pancreas

Aorta
Aorta
Unlock all highlight colors
Gall Bladder
Like this color? You can upgrade to get all colors!
Upgrade Kidney Kidney
Want to add more highlights?
Liver
Basic plan is limited to 8 highlights per article. Upgrade your plan for unlimited highlights!
Upgrade Muscle Spleen
Pancreas
Spine Adipose tissue

Spleen
Stomach

Spine Muscle

Urine testing – Challenge

The substances on the left are sometimes detected in urine. Match them to the condition their presence may indicate.

Bilirubin Leukocytes

Blood Nitrate

Glucose Ketones

Ketones Bilirubin

Leukocytes Very dilute urine

Nitrate Glucose

Protein Protein

Urobilinogen Blood

Very dilute urine Urobilinogen

Urine testing – Procedure

Why is it important to get a midstream sample of urine (MSSU)?

A midstream sample of urine (MSSU) is important during a urine test because it helps to ensure that the sample
collected is a clean catch. A clean catch means that the urine sample collected is less likely to be contaminated by
bacteria from the skin or genital area, which can a ect the results of the urine test.
When a person urinates, the rst portion of urine that is released can contain contaminants such as bacteria, skin cells,
and debris from the genital area. By collecting a midstream sample of urine, the initial portion is allowed to pass before
collecting a portion of urine from the bladder, which is less likely to be contaminated.
MSSU is particularly important when testing for urinary tract infections (UTIs) as contamination can lead to false
positive results. By obtaining a clean catch, the test results are more accurate, leading to more appropriate treatment if
an infection is present.
Overall, obtaining a midstream sample of urine is an important step in ensuring the accuracy and reliability of a urine
test.

Why is it important to immediately replace the lid on the urine test strips container?

It is important to immediately replace the lid on the urine test strips container during a urine test because exposure to
moisture and air can a ect the accuracy of the test results. Urine test strips are designed to react with certain
chemicals in the urine to produce a color change, indicating the presence or absence of certain substances in the urine.
When the lid of the container is left o , moisture in the air can react with the chemicals on the test strips, leading to
false readings. Additionally, exposure to air can cause the test strips to become oxidized, which can also interfere with
the accuracy of the test results.
To ensure the most accurate results possible, it is recommended that the lid of the urine test strips container be
replaced immediately after removing a strip for testing. This helps to prevent moisture and air from a ecting the test
strips and ensures that the results are reliable.

Urine testing: Peter – Activity

Peter's urine test results

Substance Degree * Value and units **
Glucose Neg
Bilirubin Neg
Ketones Neg
Speci c gravity + 1.015
Blood Neg
pH 6.5
Protein Neg
Urobilinogen Normal 3.2 umol/L
Nitrite Neg
Leukocytes Neg
Comment on the urine test strip results for Peter.

The result of his urine analysis is within normal, except for speci c gravity. The high speci c gravity can be attributed to
dehydration.

Are these results consistent with Peter's medical history and physical examination ndings?

Yes, Peter is t and healthy.

Urine testing: Kylie – Activity

Kylie's urine test results

Substance Degree * Value and units **
Glucose Neg
Bilirubin Neg
Ketones Neg
Speci c gravity + 1.015
Blood Neg
pH 7.0
Protein Neg
Urobilinogen 16 umol
Nitrite Signi cantly pink
Leukocytes Neg

Comment on the history and ndings following the physical examination of Kylie.

The result of her urine test is within normal except for speci c gravity and presence of nitrite.

Comment on and interpret the test strip results. Are they consistent with your provisional diagnosis based on the history
and physical examination ndings?

The presence of nitrite in the urine indicates bacterial infection in the urinary system. However, such infection must
also be accompanied with the presence of leukocyte in the urine. The high speci c gravity may be attributed to
dehydration.
 
Urine testing: Billy – Activity

Billy's urine test results

Substance Degree * Value and units **
Glucose ++ 500 mg/dL or 28 mmol/L
Bilirubin Neg
Ketones Large 80 mg/dl or 8 mmol
Speci c gravity 1.010
Blood Neg
pH 5.5
Protein Neg
Urobilinogen Normal 16 umol/L
Nitrite Neg
Leukocytes Neg

Comment on the history and ndings following the physical examination of Billy.

The result is within normal limits except for glucose, ketone bodies, and speci c gravity

Comment on and interpret the test strip results. Are they consistent with your provisional diagnosis based on the history
and physical examination ndings?

Yes, the result is consistent with the  provisional diagnosis of diabetes with ketone acidosis.

Urine testing: Barry – Activity

Barry's urine test results
Substance Degree * Value and units **
Glucose Neg
Bilirubin ++
Ketones Neg
Speci c gravity 1.2
Blood Neg
pH 6.5
Protein Neg
Urobilinogen ++ 55 umol/L
Nitrite Neg
Leukocytes Neg

Comment on the history and ndings following the physical examination of Barry.

Because of Billy's risk factor, alcoholism, there is repeated injury to the liver, reducing its function to conjugated
bilirubin and increasing plasma levels of bilirubin, which can be discharged in the urine and oxidized to produce
urobilinogen via bacterial proteases. Too much bilirubin can also lodge in the skin, causing jaundice.
 

Comment on and interpret the test strip results. Are they consistent with your provisional diagnosis based on the history
and physical examination ndings?

The patient's urine strip reading reveals a simultaneous and double positive response with both bilirubin and
urobilinogen, indicating that the patient has liver impairment.
 

Micturition – Analysis

Bladder capacity results

Variable Volunteer 1 Volunteer 2 Volunteer 3
Name Sam Maria John
Weight before drinking (kg) 72.40 61.30 85.90
Weight before urinating (kg) 73.3 62.3 86.7
Weight change (kg) 0.90 1.00 0.80
Weight after urinating (kg) 72.5 61.3 85.8
Weight change (kg) 0.80 1.00 0.90
Time uid held (min) 68 59 75
Urine volume (mL) 800 850 900
Urine color pale yellow pale yellow pale yellow
How much does 1 liter (34 oz) of water weigh?

One liter (34 oz) of water weighs approximately 1000 grams or 1 kilogram. This is because the density of water is 1
gram per milliliter, and there are 1000 milliliters in a liter. Therefore, 1 liter of water weighs 1000 grams or 1 kilogram,
which is equivalent to 2.2 pounds.

What relationship did weight change have to water intake and urine volume? How are these relationships best
explained?

Weight change is directly related to water intake and urine excretion. Similarly, urine volume is directly proportional to
water intake because an increase in water consumption leads to an increase in circulating blood volume, which
increases renal blood ow and hence urine volume excretion.

After drinking the water, was the urge to urinate consistent up until you urinated? If not, how did this sensation change?
Explain your observations.

In general, the sensation of the urge to urinate after drinking water can vary depending on several factors, such as the
individual's bladder capacity, hydration level, and other health conditions.
Typically, after drinking water, a person may feel the urge to urinate fairly quickly, within 30 minutes to an hour. This is
because water is quickly absorbed into the bloodstream and then ltered through the kidneys, which produce urine.
However, the urge to urinate may not be consistent throughout this period, as it may come and go based on factors
such as body position, physical activity, and other factors.
In some cases, a person may not feel the urge to urinate immediately after drinking water, especially if they have a
larger bladder capacity or are well-hydrated. Additionally, some health conditions, such as bladder problems or urinary
tract infections, can a ect the sensation of the urge to urinate.

Healthy urine – Challenge

Match the speci c gravity result shown below to the interpretation.

1.000 – 1.002 Greater than 1.035

1.002 – 1.030 1.030 – 1.035

1.010 – 1.030 1.010 – 1.030

1.030 – 1.035 1.002 – 1.030

Greater than 1.035 1.000 – 1.002

Healthy urine – Activity

What is the di erence between quantitative and qualitative measurements? Are the urine test strip measurements
quantitative or qualitative?

Qualitative measurements are descriptive and non-numeric, typically used to classify or identify properties,
characteristics, or qualities of an object or substance. Examples are the color, texture, or odor of a substance. On the
other hand, quantitative measurements are numerical and involve measuring the amount, quantity, or degree of a
substance or phenomenon. Quantitative measurements can be expressed in units, such as grams, meters, or seconds.
Examples are the weight, length, or time duration of an object.
Urine test strip measurements can be both quantitative and qualitative, depending on the test being performed. The
urine test strips are used to detect the presence or absence of certain substances in the urine, such as glucose,
ketones, and blood. Some tests on the urine test strips give a qualitative result, indicating the presence or absence of a
substance, while other tests provide a quantitative result, indicating the concentration of the substance present in the
urine. For example, the pH test on a urine test strip provides a qualitative measurement, indicating whether the urine
is acidic or alkaline. In contrast, the test for glucose on a urine test strip can provide a quantitative measurement,
indicating the concentration of glucose present in the urine.

Do you think the results are as accurate as the results that would be obtained by a hospital laboratory?

While urine test strips can be a useful screening tool, the accuracy of the results obtained with urine test strips may not
always be as precise as those obtained from a hospital laboratory. The accuracy of the urine test strip results can
depend on various factors, such as the quality of the test strip, the timing of the test, and the user's technique in
performing the test. The results can also be a ected by factors such as medications, certain foods, and other
substances that may interfere with the test.
In contrast, hospital laboratories typically use more sophisticated testing methods, such as chromatography, mass
spectrometry, or enzyme-linked immunosorbent assays (ELISA), which can provide more accurate and reliable results.
The laboratory tests are often more sensitive and speci c, allowing for detection of lower levels of substances in the
urine and reducing the risk of false positive or false negative results.

Speci c gravity tests the concentration of the urine. A high speci c gravity indicates dehydration and possibly renal
failure. Can you list two conditions (one normal and one abnormal) that might be indicated by a low speci c gravity?

Overhydration or excessive uid intake: When a person drinks a lot of uids, their urine may become diluted, resulting
in a low speci c gravity. This can be a normal condition and is not usually a cause for concern.
Diabetes insipidus: This is a condition characterized by the inability of the kidneys to concentrate urine, leading to
excessive urine production and dehydration. A low speci c gravity is one of the diagnostic criteria for diabetes
insipidus, as the urine is not being concentrated properly due to a lack of antidiuretic hormone (ADH) or a problem with
the kidneys' response to ADH.
 

Healthy urine – Analysis

Comment on the color of the urine samples. Why is the color of urine from some volunteers quite yellow and other
volunteers almost as pale as water?

The regular color of urine varies. It depends on how much water you drink. Fluids dilute the yellow pigments in urine.
So the more you drink, the clearer your urine looks. When you drink less, the yellow color becomes stronger.
As a general rule of thumb, it's usually a good sign for your health when the color of urine is a pale shade of yellow or
clear. Dark yellow urine can be normal, but it may come from dehydration from hard exercise, working or living in a hot
place, or not drinking enough uids of the volunteers.

Why is it important for you to know what "normal" urine looks like?

Health monitoring: By knowing what "normal" urine looks like, you can monitor changes in urine color, clarity, and odor
that may indicate potential health issues, such as infections, kidney disease, or other conditions. For example, changes
in urine color or odor may indicate the presence of blood, protein, or bacteria in the urine.
By regularly monitoring your urine, you may be able to detect potential health problems early, before they become
more serious or di cult to treat. Early detection of kidney disease, for example, can help prevent or delay the
progression of the disease. The color of urine can also be an indicator of hydration status. If your urine is consistently
darker than normal, it may be a sign that you are not drinking enough uids and are dehydrated. Lastly, knowing what
"normal" urine looks like can help medical professionals diagnose certain conditions or diseases. For example, a
urinalysis may be used to detect the presence of certain substances in the urine, such as glucose, ketones, or protein,
which may indicate conditions such as diabetes or kidney disease.

List some medical conditions in which a color change in the urine may be observed.

Dehydration: When a person is dehydrated, their urine may become darker in color, sometimes appearing amber or
brown.
Urinary tract infections (UTIs): UTIs can cause urine to appear cloudy or dark, or to have a strong, foul odor.
Kidney stones: The presence of kidney stones in the urinary tract can cause urine to appear pink or red due to the
presence of blood.
Liver disease: In some cases of liver disease, such as hepatitis or cirrhosis, urine may appear darker in color,
sometimes appearing brown or tea-colored.
Hemolytic anemia: This is a condition in which red blood cells are destroyed more rapidly than they are produced,
leading to the presence of hemoglobin in the urine and causing it to appear red or brown.
Porphyria: This is a rare genetic disorder that a ects the production of heme, a component of hemoglobin. People
with porphyria may experience changes in urine color, such as purple, reddish-brown, or tea-colored urine.
Certain medications or foods: Some medications, such as phenazopyridine, which is used to treat urinary tract
infections, can cause urine to appear orange or red. Certain foods or food dyes, such as beets or food coloring, can also
cause urine to change color temporarily.
 

Popup - Notebook
 Re ection notebook:

Popup - Convert from pounds to kilograms

Enter your weight in pounds to see it in kilograms.

Pounds (lb) Kilograms (kg)