URINALISIS budi terbaru
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Transcript of URINALISIS budi terbaru
URINALISIS
BUDI I
FKUAJ
2009
GLUKOSA
• GLUKOSURIA :adanya glukosa dalam urin
TUBULAR MAXIMUM REABSORPTIVE CAPACITY( Tm ) GLUKOSA RATA2 350MG/MIN
WANITA: 250 – 360 MG/MIN
LAKI2 : 295 - 455 MG/MIN
• Glukosa darah > 160 – 180 mg/dl
glukosuria
• Sebab glukosuria:• Prerenal- hiperglikemia + glukosuria
• DM• Kelainan hormona
» Hiperthiroid» Acromegaly» Stress,anxiety,cushing disease
• Liver disease• Pancreatic disease• Drugs(e.g thiazide,steroid )
• Renal – gangguan reabsorpsi dari tubulus akan glukosa
• Fanconi syndrome• Keracunan logam berat• Genetik• kehamilan
• PEMERIKSAAN
• DASAR: » Reduksi» oksidasi
• REDUKSI:• COPPER REDUCTION TEST
» BENEDICT» CLINITEST TABLET
• OKSIDASI REAGENT STRIP TEST
glukose oksidase
GLUKOSA + O2 GLUCONIC ACID + H2O2
peroksidase
H2O2 + chromogen oxidized chromogen + H2O
Oksidasi lebih sensitif dan spesifik
Keton
• Ketonuria: adanya keton dalam urin
• Keton bodies:• Asetoasetat 20 %• Beta hidroksibutirat 78 %• Aseton 2 %
• Sebab ketonuria: • Gangguan metabolisme karbohidrat:
DM,kelaparan,latihan yang berat,diet• Mobilisasi trigliserida
• Pemeriksaan:– Rothera– Gerhardt– Reagent strip
Bilirubin
• Bilirubinuria:adanya bilirubin di urin
• Normal:kadar diurin 0,02 mg/dl( tak terdeteksi pada pemeriksaan rutin )
• Cara pemeriksaan: test busa
test Harrison
reagent strip
UROBILINOGEN
• Normal ada diurin 0,5 – 2,5 mg/hari
• Cara pemeriksaan:cara Wallace Diamond
cara Watson-Schwartz
reagent strips
DARAH
• DARAH: HEMATURIA
HEMOGLOBINURIA
MYOGLOBINURIA
• CARA PEMERIKSAAN: REAGENT STRIP
SEDIMEN
• URIN YANG DIPAKAI:SEGAR
PEKAT
• URIN PAGI
• CARA PEMERIKSAAN:
KWALITATIF
KWANTITATIF
• TANPA PEWARNAAN
• DENGAN PEWARNAAN:
• DENGAN PEWARNAAN:
• SUPRAVITAL:STERNHEIMER-
MALBIN
TOLUIDINE BLUE
• ASAM ASETAT
• SUDAN III
• PRUSSIAN BLUE
• NORMAL: • ERITROSIT 0-1/LPB• LEKOSIT 0-5/LPB• SILINDER HYALIN 0-1/LPK GRANULER• EPITHEL SQUAMOUS +,++,+++ TUBULUS RENALIS• KRISTAL OKSALAT +,++,+++ TRIPELFOSFAT
Silinder
• Dibentuk : tubulus distalis dan
collecting tubulus
• Core matrix : uromodulin (glikoprotein,da
hulu Tamm-Horsfall protein)
diproduksi sel tubulus renalis
dari tubulus distalis
hyaline cast and red blood cell
white cell cast and WBC
red cell and RBC
finely granular casts
broad coarsely granular cast
yeast cells
oval fat body and a fiber
fibers
hypotonic urine containing WBC,RBC,2 renal epithelial cell and a transitional epithelial cell
epithelial cell,WBC,RBC and bacteria
white cells,a few red cells,and bacteria
renal epithelial cells
numerous white cells and a few transitional epithelial cells
squamous epithelial cells and calcium oxalates
white cells cast,finely granular cast,and uric acid crystals
finely granular casts and WBC
convoluted waxy cast
epithelial cell cast
mixed cast,yeast cells,and a WBC
finely granular cast and yeast
hyaline cast that is bent back upon itself,and many RBC
hyaline casts
red cells cast
red cell cast 2
white cell cast
many white cell casts and many WBC
finely granular cast
triple phosphate crystals and amorphous phosphates
calcium oxalates, amorphous urates,and a piece of debris