In this activity, you will use dipsticks to test for abnormal You will analyze t
ID: 3512982 • Letter: I
Question
In this activity, you will use dipsticks to test for abnormal You will analyze the results by comparing the color of the test pads chemicals in your urine sample. Individual dipsticks have a with a color chart. Depending on the test, results must be taken single test pad to detect one chemical; combination dipsticks have immediately or after a brief peri several test pads to identify several chemicals simultaneously. The minutes. Carefully review the times required for each test before test pads on the dipstick react with the urine and change color proceeding. Gently swirl your sample to suspend any particles that settled to the bottom of the collection cup. 2 Immerse a dipstick into the urine. If you are using a combination dipstick, be sure that all the test pads are completely submerged in the urine. 3 Remove the dipstick and place it on a paper towel with the test pads facing up. 4 After the appropriate time has elapsed, read the results of each test by comparing the color on the test pad with the color chart that is available. Record your results in Table 30.3 TABLE 30.3 Chemical Analysis of a Urine Sample Results Your Sample Characteristic pH Nitrites Bilirubin Urobilinogen Leukocytes Erythrocytes/ Normal 4.5-8.0 Negative* Negative Positive Negative Negative 1 blood Protein Glucose Ketone bodies Negative Negative Negative A negative result does not necessarily indicate a complete absence of the substance, but it does indicate that its concentration is too low to be detected. MAKING CONNECTIONS Diabetes mellitus is a disease in which the pancreatic islets do not produce enough insulin or the insulin receptors on cell membranes are missing or malfunctioning. In either case, cells are unable to take up glucose from the blood. Explain why glucosuria and ketonuria can be symptoms of diabetes mellitusExplanation / Answer
Chemical analysis of Urine sample:
pH: The pH of urine can be either acidic or basic. Normally urine is slightly acidic with pH around 6. The alteration of pH is dependent on the diet and underlying diseases
Nitrites: Normal sample of urine contains nitrates. Presence of nitrites implies that there may be a urinary tract infection, where nitrates are converted to nitrites by microorganisms
Bilirubin: Presence of bilirubin is an indication of Jaundice
Urobilinogen: The normal concentration of urobilinogen level is 0.2-1 mg/dl. Urobilinogen is produced from bilirubin by intestinal bacteria present in the duodenum
Leukocytes: Leukocytes if present in urine it signifies that there is an inflammation to urinary tract or kidenys due to urinary tract infection
Erythrocytes: Leukaemia, kidney disorders or other hematological disorders leads to excretion of erythrocytes in urine
Protein: Diabetes or severe hypertension, certain drugs like Non Steroidal AntiInflammatory Drugs, Lithium carbonate, Captopril, Opioids may lead to excretion of albuminuria or proteinuria
Glucose: Discussed below
Ketone bodies: Discussed below
ANSWER TO MAKING CONNECTIONS SECTION IN THE QUESTION
Reason for Glycosuria in Diabetes mellitus:
Normal urine do not contain glucose. Glycosuria is a condition in which glucose is exceted in urine. Glucose is present in the glomerular filtrate in the same concentration as in blood plasma. When blood glucose level is increased, the glomerular filtrate contains more glucose. This excess amount of glucose in not reabsorbed and is excreted in urine leading to glycosuria.
Causes of glycosuria: Diabetes mellitus, Renal glycosuria, Alimentary glycosuria, Glycosuria of pregnancy, Advanced glomerulonephritis
Apart from the dipstick methods shown above glucose can also be determined by:
Benedict's test: Benedicts reagent when treated with urine sample and boiled for 2-3 minutes gives brick red to orange precipitate depending upon the glucose level present
Fehling's test: Fehling's reagent will also a give a similar brick red color when glucose is present in the sample
KETONURIA:
Excretion of ketone bodies in the urine is refered to as Ketonuria. Ketone bodies are Acetoacetic acid, Beta-Hydroxybutyric acid, Acetone.
Causes of Ketonuria: Diabetes mellitus and Starvation
Ketone bodies are water soluble and can be easily transported from liver to various tissues. Acetoacetate and Beta hydroxy butyrate can serve as important source of energy for skeletal muscle cardiac muscle, renal cortex and other peripheral tissues
The tissues which lack mitochondria cannot utilise ketone bodies. The production of ketone bodies and their utilization is more significant during inadequate supply or availability of glucose. The presence of ketone bodies in urine is very low in normal individuals and cannot be detected by routine tests like Rothera's test. When the rate of synthesis and utilization of ketone bodies is more, it leads to ketonemia and subsequent excretion in urine leads to ketonuria.
Impaired carbohydrate metabolism and increased lipolysis in Diabetes mellitus, leads to accumulation of acetyl coA and its further conversion to ketone bodies. Insulin inhibits the ketogenesis and glucagon stimulates ketogenesis, lower levels of insulin and high glucagon levels also account for ketogenesis during Diabetes mellitus. Ketone body excretion may rise to 500mg/gay in severe diabetes. Non pathologic ketonuria is seen after consumption of high fat diet
Characteristic Normal Your sample pH 4.5-8.0 6 Nitrites Negative Negative Bilirubin Negative Negative Urobilinogen Positive Positive Leukocytes Negative Negative Erythrocytes/ Blood Negative Negative Protein Negative Negative Glucose Negative Negative Ketone bodies Negative Negative