PHYL141L - Lab Report #4 PDF

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Kylie Fiaui PHYL 142L Section 5 Kawasaki 4 April 2019

Urinalysis Effects of a high-protein diet and physical exertion on urinalysis.

Abstract

Urinalysis is a key factor in testng individuals for drugs and diseases. It is among one of the simpler ways to do so and is used everyday in hospitals, clinics, and labs across the country. In this experiment urinalysis is used to compare two urine samples to normal levels. One in which is simulated, the other is provided by a subject minutes before the lab is conducted. By having the subject record their diet from the 24 hours prior to the sample being give, a hypothesis was formulated. The diet of the subject consisted of whey protein, bahn mi, quinoa, spicy ahi poke, french fries, chicken nuggets, and an uncrustable peanut butter and jelly sandwich. Which then led to the assumption that there would be a lot of protein in the urine. The subject had explained they were protein packing, due to their regular visits to the gym, which also can influence the levels of protein in urine. The hypothesis of this experiment was proven correct in respect that other results were found as well. Protein in the subjects urine was at a level of 30 (.3) + where in many cases of normal urine, protein would be absent. The subject also displayed levels of ketone bodies in their urine when normal values would be negative. The ketone count of 5 (0.5) ± can also be attributed to diet and the exercise conducted by the subject. Lastly, bilirubin was found in the urine which came as a surprise. Because bilirubin is not supposed to be in urine at all, it was not even considered to be present beforehand. Although, because the levels were fairly low, at 1 (17) + it was ruled out as due to diet.

Introduction Urinalysis is the testing of urine for physical , chemical, inorganic and organic components for the presence of diseases or drugs. When testing urine, it is important to first note any physical

characteristics of the urine. For instance, the color, transparency, and odor. Fresh urine is typically clear and pale yellow, sometimes even amber in color. The normal yellow color is due to urochrome, “a pigment metabolite that arises from the body’s destruction of hemoglobin and travels to the kidney as bilirubin or bile pigments” (Marieb et al., 2016). Just by observation, the transparency of this color, whether it be cloudy or not can help indicate a urinary tract infection. The odor of urine can vary due to diet, diseases, and some drugs. However, it is typically found to be be slightly aromatic if considered a normal sample. Two more physical characteristics that cannot be observed without actually testing the urine are pH and specific gravity. The average pH for urine is 6.0, however it can range from 4.5 to 8.0. Diet also is a factor in whether the pH of urine is high in acidity or not. High protein diets cause higher acidic levels in urine, whereas vegetarian diets increases alkalinity in urine. Specific gravity is the “relative weight of a specific volume of liquid compared with an equal volume of distilled water” (Marieb et al., 2016). And because urine has dissolved solutes, it weighs more than water which causes specific gravity to range from 1.001 to 1.030. The only inorganic compound that can be found by using the Rapid Response Urinalysis Reagent Test Strips is nitrites. Nitrites are forms of bacteria often degrading nitrates into nitrites. Nitrites can also be indicators of urinary tract infections. Organic compounds that can be found by using Rapid Response Urinalysis Reagent Test Strips are glucose, protein, ketone bodies, RBCs/hemoglobin, bilirubin, leukocytes, and urobilinogen. Glucose in urine is sugar. If there is an excessive amount of glucose in the urine it is due to diabetes and will make the urine smell sweet. If there is only a small amount found in the urine, it can be due to diet. Meaning, if the subject ate a lot of sweets that day, glucose would show up in their urine. Protein in the urine can be due to high physical exertion, toxins, or kidney

damage. Because proteins are too big to enter urine they do so in small quantities which makes albumin the most abundant blood protein. Ketone bodies in the urine occur when fat is burned, lowering pH levels. This can potentially result in acidosis. Ketone bodies also can be a sign of diabetes but also be due to a subject’s diet. RBCs or hemoglobin in the urine will indicate irritation of the urinary tract organs which then causes bleeding. This is not a good thing and can often be a sign of an infection, kidney damage, internal bleeding, or kidney stones. Bilirubin is the main component of bile, which means it should not be in urine at all. If present, it can indicate liver damage, bilirubinuria, hepatitis, and even gallstones. In short, leukocytes in urine show the presence of a urinary tract infection or gonorrhea. Lastly, urobilinogen is formed by the breaking down of RBCs. Too little or too much urobilinogen in urine can indicate liver malfunction. This can be linked to jaundice or hepatitis.

Materials and Methods ● Synthetic Urine ● Urine of a Subject ● Detailed Description of Subject’s Diet Over the Course of 24 Hours ● 2 Beakers ● 2 Rapid Response Urinalysis Reagent Test Strips ● Paper Towels ● Gloves ● 2 Pipettes

Pour a small amount of synthetic urine into one of the beakers and set aside. Next, have the

subject urinate into the beaker and set side by side with the synthetic beaker. Record physical traits such as color, transparency, and odor. Next, lay out a few paper towels to lay down the urinalysis strips on after they have been submerged in urine. After putting on gloves, take one strip for each of the two beakers and submerge it in the liquid. If there is not enough urine to cover the entire strip, use separate pipettes for each beaker and carefully drop urine onto the remaining strip. Once both strips are covered in urine, carefully place them side by side on the paper towels. Using the Rapid Response Urinalysis Reagent Test Strips bottle, compare values of pH, specific gravity, nitrites, glucose, protein, ketone bodies, RBCs/hemoglobin, bilirubin, leukocytes, and urobilinogen. To do this, compare and contrast the color on the bottle corresponding with the color on the strip to find the color closest to the one on the bottle.

Results Table 1: Urinalysis results within the control urine and experimental urine compared to the values of normal urine. Urinalysis Results Observation/Test

Normal Values

Standard Urine Specimen

Unknown Urine Specimen

Color

Pale Yellow

Medium Yellow

Dark Yellow

Transparency

Clear

Clear

Clear

Odor

Aromatic

No Odor

Strong Odor

pH

4.5-8.0

6

5

Specific Gravity

1.001-1.030

1.010

1.030

Nitrites

Absent

Absent

Absent

Glucose

Negative

Negative

Negative

Protein

Negative

Negative

30 (.3) +

Ketone Bodies

Negative

Negative

5 (0.5) ±

RBCs/Hemoglobin

Negative

Negative

Negative

Bilirubin

Negative

Negative

1 (17) +

Leukocytes

Absent

Absent (15±)

Absent (15±)

Urobilinogen

Present

Absent

Absent

Figure 1: Diet of subject providing experimental urine over the course of 24 hours prior to donation. Diet of Experimental Urine: -

Whey Protein

-

Bahn Mi

-

Quinoa

-

Spicy Ahi Poke

-

French Fries

-

Chicken Nuggets

-

Uncrustable Peanut Butter and Jelly Sandwich

Discussion From the results, it is concluded that experimental urine provided by the subject was very different in comparison to the control and normal values. Just from observation it was found that the experimental urine was much darker in color. It had an amber effect, which can actually be normal, especially since the sample was taken early in the morning. This would mean the subject may have not drank enough water or what he had tried to hydrate himself with did not make it through his system in time for the sample to be taken. Unlike the synthetic urine, the experimental urine had a very strong odor. It was described as a very unpleasant bodily odor like smell. Which can be explained by the subjects diet. Having not quite a balanced diet in the last 24 hours could have affected the smell, as well as it being one of the first times the body had urinated in a while after sleeping the night before. The pH, specific gravity, glucose, and nitrites all fell under normal values. However, once tested for proteins, the value was abnormally high. With a 30 (.3) + count for proteins, the hypothesis was proven correct. It was anticipated that the protein in the subjects urine would show presence of proteins because of the physical exercise and protein digested beforehand. But, because protein is usually too big to enter the urinary tract, it was not anticipated that so much would be found. However, once again the diet of the subject can be greatly dependent on why this happened. Having consumed so much protein through Whey and chicken, the subject added onto the protein that would have shown up just due to exercise. It is also important to keep in mind that “urine protein excretion typically increases over the course of normal pregnancy” (Kattah, 2017). Although, in this case the subject providing experimental urine was male so it did not apply that proteins would show up in urine due to pregnancy. Another abnormality found in the experimental urine was the ketone bodies. In most normal

cases urine is negative for ketone bodies, meaning there would not be any present. However, in the case of the subject there was a count of 5 (0.5) ±. This was not anticipated prior to the experiment because ketone bodies can sometimes result in acidosis due to a lowering of the pH and also diabetes. The subject providing urine has no record of having diabetes so presence of ketone bodies was not something that was taken seriously into consideration, a mistake made by the group. Although, like much of the explanations discussed, this can also be due to diet. However, it is more likely that the ketone bodies were present due to exercise. The subject had explained they went to the gym twice over the course of 24 hours which would result in fat burning. Ketone bodies occur in urine when fat is burned which then lowers pH, explaining why they showed up in the subject’s urine. Lastly, the subject’s urine showed small levels of bilirubin. Bilirubin should not be in urine at all as it can indicate liver damage, bilirubinuria, hepatitis, and even gallstones. And because its main component is bile, the discovery of bilirubin in the urine was a shock. Though its values were considerably low at 1 (17) + so it was ruled out as a pressing issue. It was something that as a group was deemed as something the subject should consider keeping in mind during their next check up. As for the control urine, there was no diet provided, and in some other cases where levels of protein or ketone would be higher, much like the experimental urine, a diet would be fairly simple to formulate just by results. But in the case of the control urine tested, almost all categories tested were the same as the normal values. The color and odor were the only inconsistencies compared to normal values. The color was deemed as medium yellow. Meaning it was observed to have a tint of amber, which is considered to be around the healthy range. The odor of the control urine was also noted as having no distinctive smell. In the case of a normal

sample, it is supposed to be aromatic, meaning there is sort of a pleasant or distinctive smell. But because a synthetic urine was tested and not an actual human specimen, it can be inferred that the difference in odor is due to not being able to simulate exact smells.

Conclusion Overall, urinalysis is useful in many cases of detecting drugs and diseases in adults and adolescents, but also in infants. A group of medical doctors and physicians noticed that urinary tract infections account for “∼90% of all serious bacterial infections (defined as UTIs, bacteremia, and bacterial meningitis) in febrile infants 60 days of age and younger” (Hemmy, 2018). So their plan of action was to increase the accuracy of urinalysis testing for febrile infants 60 days and younger. What they found was that their study exhibited the perfect sensitivity and specificity for diagnosing UTIs in febrile infants 60 days and younger with and without concurrent bacteremia.

Resources Hemmy, D. (2018). Accuracy of the Urinalysis for Urinary Tract Infections in Febrile Infants 60 Days and Younger. The Journal of Emergency Medicine, 54(5), 743-744. doi:10.1016/j.jemermed.2018.03.015. Kattah, A. (2017). Spot urine protein measurements in normotensive pregnancies, pregnancies with isolated proteinuria and preeclampsia. American Journal of Physiology: Regulatory, Integrative, and Comparative Physiology, 313(4). doi:10.1152/ajpregu.00508.2016 Marieb, E. & Smith, L. (2016). Urinalysis. In Human Anatomy and Physiology Laboratory

Manual (12th ed., pp. 609-613). New York, New York: Pearson Learning Solution....