Urinalysis from http://www.diagnose-me.com/treat/T256810.html
MACROSCOPIC URINALYSIS
The first part of a urinalysis is direct visual observation. Normal, fresh urine
is pale to dark yellow or amber in color and clear. Normal urine volume is
750 to 2000ml in a 24-hour period.
Turbidity or cloudiness may be caused by excessive cellular material or
protein in the urine or may develop from crystallization or precipitation of
salts upon standing at room temperature or in the refrigerator. Clearing of
the specimen after addition of a small amount of acid indicates that
precipitation of salts is the probable cause of tubidity.
A red or red-brown (abnormal) color could be from a food dye, eating fresh
beets, a drug, or the presence of either hemoglobin or myoglobin. If the
sample contained many red blood cells, it would be cloudy as well as red.
URINE DIPSTICK CHEMICAL ANALYSIS
pH: The glomerular filtrate of blood plasma is usually acidified by renal
tubules and collecting ducts from a pH of 7.4 to about 6 in the final urine.
However, depending on the acid-base status, urinary pH may range from as
low as 4.5 to as high as 8.0. The change to the acid side of 7.4 is
accomplished in the distal convoluted tubule and the collecting duct.
Specific Gravity: Specific gravity (directly proportional to urine osmolality,
which measures solute concentration) measures urine density, or the ability
of the kidney to concentrate or dilute the urine over that of plasma.
Dipsticks are available that also measure specific gravity in approximations.
Most laboratories measure specific gravity with a refractometer.
Specific gravity between 1.002 and 1.035 on a random sample should be
considered normal if kidney function is normal. Since the specific gravity of
the glomerular filtrate in Bowman's space ranges from 1.007 to 1.010, any
measurement below this range indicates hydration and any measurement
above it indicates relative dehydration.
If the specific gravity is not over 1.022 after a 12 hour period without food
or water, renal concentrating ability is impaired and the patient either has
generalized renal impairment or nephrogenic diabetes insipidus. In endstage renal disease, specific gravity tends to become 1.007 to 1.010.
Any urine having a specific gravity over 1.035 is either contaminated,
contains very high levels of glucose, or the patient may have recently
received high density radiopaque dyes intravenously for radiographic studies
or low molecular weight dextran solutions. Subtract 0.004 for every 1%
glucose to determine non-glucose solute concentration.
Protein: Dipstick screening for protein is done on whole urine, but semiquantitative tests for urine protein should be performed on the supernatant
of centrifuged urine since the cells suspended in normal urine can produce a
falsely high estimation of protein. Normally, only small plasma proteins
filtered at the glomerulus are reabsorbed by the renal tubule. However, a
small amount of filtered plasma proteins and protein secreted by the
nephron (Tamm-Horsfall protein) can be found in normal urine. Normal total
protein excretion does not usually exceed 150mg/24 hours or 10mg/100ml
in any single specimen. More than 150mg/day is defined as proteinuria.
Proteinuria over 3.5gm/24 hours is severe and known as nephrotic
syndrome.
Dipsticks detect protein by production of color with an indicator dye,
Bromphenol blue, which is most sensitive to albumin but detects globulins
and Bence-Jones protein poorly. Precipitation by heat is a better
semiquantitative method, but overall, it is not a highly sensitive test. The
sulfosalicylic acid test is a more sensitive precipitation test. It can detect
albumin, globulins, and Bence-Jones protein at low concentrations.
In rough terms, trace positive results (which represent a slightly hazy
appearance in urine) are equivalent to 10mg/100ml or about 150mg/24
hours (the upper limit of normal). 1+ corresponds to about 200-500mg/24
hours, a 2+ to 0.5-1.5gm/24 hours, a 3+ to 2-5gm/24 hours, and a 4+
represents 7gm/24 hours or greater.
Glucose: Less than 0.1% of glucose normally filtered by the glomerulus
appears in urine (below 130mg/24 hours). Glycosuria (excess sugar in urine)
generally means diabetes mellitus. Dipsticks employing the glucose oxidase
reaction for screening are specific for glucos glucose but can miss other
reducing sugars such as galactose and fructose. For this reason, most
newborn and infant urines are routinely screened for reducing sugars by
methods other than glucose oxidase (such as the Clinitest, a modified
Benedict's copper reduction test).
Ketones: Ketones (acetone, aceotacetic acid, beta-hydroxybutyric acid)
resulting from either diabetic ketosis or some other form of calorie
deprivation (starvation), are easily detected using either dipsticks or test
tablets containing sodium nitroprusside.
Nitrite: A positive nitrite test indicates that bacteria may be present in
significant numbers in urine. Gram negative rods such as E. coli are more
likely to give a positive test.
Leukocyte Esterase: A positive leukocyte esterase test results from the
presence of white blood cells either as whole cells or as lysed cells. Pyuria
can be detected even if the urine sample contains damaged or lysed WBCs.
A negative leukocyte esterase test means that an infection is unlikely and
that, without additional evidence of urinary tract infection, microscopic exam
and/or urine culture need not be done to rule out significant bacteriuria.
MICROSCOPIC URINALYSIS
A sample of well-mixed urine (usually 10-15ml) is centrifuged in a test tube
at relatively low speed (about 2-3,000rpm) for 5-10 minutes until a
moderately cohesive button is produced at the bottom of the tube. The
supernate is decanted and a volume of 0.2 to 0.5ml is left inside the tube.
The sediment is resuspended in the remaining supernate by flicking the
bottom of the tube several times. A drop of resuspended sediment is poured
onto a glass slide and coverslipped.
The sediment is first examined under low power to identify most crystals,
casts, squamous cells, and other large objects. The numbers of casts seen
are usually reported as number of each type found per low power field (LPF).
Example: 5-10 hyaline casts/L casts/LPF. Since the number of elements
found in each field may vary considerably from one field to another, several
fields are averaged. Next, examination is carried out at high power to
identify crystals, cells, and bacteria. The various types of cells are usually
described as the number of each type found per average high power field
(HPF). Example: 1-5 WBC/HPF.
Red Blood Cells: Hematuria is the presence of abnormal numbers of red cells
in urine due to: glomerular damage, tumors which erode the urinary tract
anywhere along its length, kidney trauma, urinary tract stones, renal
infarcts, acute tubular necrosis, upper and lower uri urinary tract infections,
nephrotoxins, and physical stress. Red cells may also contaminate the urine
from the vagina in menstruating women or from trauma produced by
bladder catherization. Theoretically, no red cells should be found, but some
find their way into the urine even in very healthy individuals. However, if
one or more red cells can be found in every high power field, and if
contamination can be ruled out, the specimen is probably abnormal.
RBCs may appear normally shaped, swollen by dilute urine (in fact, only cell
ghosts and free hemoglobin may remain), or crenated by concentrated
urine. Both swollen, partly hemolyzed RBCs and crenated RBCs are
sometimes difficult to distinguish from WBCs in the urine. In addition, red
cell ghosts may resemble yeast. The presence of dysmorphic RBCs in urine
suggests a glomerular disease such as a glomerulonephritis. Dysmorphic
RBCs have odd shapes as a consequence of being distorted via passage
through the abnormal glomerular structure.
White Blood Cells: Pyuria refers to the presence of abnormal numbers of
leukocytes that may appear with infection in either the upper or lower
urinary tract or with acute glomerulonephritis. Usually, the WBCs are
granulocytes. White cells from the vagina, especially in the presence of
vaginal and cervical infections, or the external urethral meatus in men and
women may contaminate the urine.
If two or more leukocytes per each high power field appear in noncontaminated urine, the specimen is probably abnormal. Leukocytes have
lobed nuclei and granular cytoplasm.
Epithelial Cells: Renal tubular epithelial cells, usually larger than
granulocytes, contain a large round or oval nucleus and normally slough into
the urine in small numbers. However, with nephrotic syndrome and in
conditions leading to tubular degeneration, the number sloughed is
increased.
When lipiduria occurs, these cells contain endogenous fats. When filled with
numerous fat droplets, such cells are called oval fat bodies. Oval fat bodies
exhibit a "Maltese cross" configuration by polarized light microscopy.
Transitional epithelial cells from the renal pelvis, ureter, or bladder have
more regular cell borders, larger nuclei, and smaller overall size than
squamous epithelium. Renal tubular epithelial cells are smaller and rounder
than transitional epithelium, and their nucleus occupies more of the total cell
volume.
Squamous epithelial cells from the skin surface or from the outer urethra
can appear in urine. Their significance is that they represent possible
contamination of the specimen with skin flora.
Casts: Urinary casts are formed only in the distal convoluted tubule (DCT) or
the collecting duct (distal nephron). The proximal convoluted tubule (PCT)
and loop of Henle are not locations for cast formation. Hyaline casts are
composed primarily of a mucoprotein (Tamm-Horsfall protein) secreted by
tubule cells.
Even with glomerular injury causing increased glomerular permeability to
plasma proteins with resulting proteinuria, most matrix or "glue" that
cements urinary casts together is Tamm-Horsfall mucoprotein, although
albumin and some globulins are also incorporated.
The factors which favor protein cast formation are low flow rate, high salt
concentration, and low pH, all of which favor protein denaturation and
precipitation, particularly that of the Tamm-Horsfall protein. Protein casts
with long, thin tails formed at the junction of Henle's loop and the distal
convoluted tubule are called cylindroids. Hyaline casts can be seen even in
healthy patients.
Red blood cells may stick together and form red blood cell casts. Such casts
are indicative of glomerulonephritis, with leakage of RBCs from glomeruli, or
severe tubular damage.
White blood cell casts are most typical for acute pyelonephritis, but they
may also be present with glomerulonephritis. Their presence indicates
inflammation of the kidney, because such casts will not form except in the
kidney.
When cellular casts remain in the nephron for some time before they are
flushed into the bladder urine, the cells may degenerate to become a
coarsely granular cast, later a finely granular cast, and ultimately, a waxy
cast. Granular and waxy casts are be believed to derive from renal tubular
cell casts. Broad casts are believed to emanate from damaged and dilated
tubules and are therefore seen in end-stage chronic renal disease.
The so-called telescoped urinary sediment is one in which red cells, white
cells, oval fat bodies, and all types of casts are found in more or less equal
profusion. The conditions which may lead to a telescoped sediment are: 1)
lupus nephritis 2) malignant hypertension 3) diabetic glomerulosclerosis, and
4) rapidly progressive glomerulonephritis.
In end-stage kidney disease of any cause, the urinary sediment often
becomes very scant because few remaining nephrons produce dilute urine.
Bacteria: Bacteria are common in urine specimens because of the abundant
normal microbial flora of the vagina or external urethral meatus and because
of their ability to rapidly multiply in urine standing at room temperature.
Therefore, microbial organisms found in all but the most scrupulously
collected urines should be interpreted in view of clinical symptoms.
Diagnosis of bacteriuria in a case of suspected urinary tract infection
requires culture. A colony count may also be done to see if significant
numbers of bacteria are present. Generally, more than 100,000/ml of one
organism reflects significant bacteriuria. Multiple organisms reflect
contamination. However, the presence of any organism in catheterized or
suprapubic tap specimens should be considered significant.
Yeast: Yeast cells may be contaminants or represent a true yeast infection.
They are often difficult to distinguish from red cells and amorphous crystals
but are distinguished by their tendency to bud. Most often they are Candida,
which may colonize bladder, urethra, or vagina.
Crystals: Common crystals seen even in healthy patients include calcium
oxalate, triple phosphate crystals and amorphous phosphates.
Very uncommon crystals include: cystine crystals in urine of neonates with
congenital cystinuria or severe liver disease, tyrosine crystals with congenital
tyrosinosis or marked liver impairment, or leucine crystals in patients with
severe liver disease or with maple syrup urine disease.
Miscellaneous: General "crud" or unidentifiable objects may find their way
into a specimen, particularly those that patients bring from home.
Spermatozoa can sometimes be seen. Rarely, pinworm ova may
contaminate the urine. In Egypt, ova from bladder infestations with
schistosomiasis may be seen.
Methods of Urine Collection
Random collection taken at any time of day with no precautions regarding
contamination. The sample may be dilute, isotonic, or hypertonic and may
contain white cells, bacteria, and squamous epithelium as contaminants. In
females, the specimen may cont contain vaginal contaminants such as
trichomonads, yeast, and during menses, red cells.
Early morning collection of the sample before ingestion of any fluid. This is
usually hypertonic and reflects the ability of the kidney to concentrate urine
during dehydration which occurs overnight. If all fluid ingestion has been
avoided since 6pm the previous day, the specific gravity usually exceeds
1.022 in healthy individuals.
Clean-catch, midstream urine specimen collected after cleansing the external
urethral meatus. A cotton sponge soaked with benzalkonium hydrochloride is
useful and non-irritating for this purpose. A midstream urine is one in which
the first half of the bladder urine is discarded and the collection vessel is
introduced into the urinary stream to catch the last half. The first half of the
stream serves to flush contaminating cells and microbes from the outer
urethra prior to collection.
Catherization of the bladder through the urethra for urine collection is
carried out only in special circumstances, i.e., in a comatose or confused
patient. This procedure risks introducing infection and traumatizing the
urethra and bladder, thus producing iatrogenic infection or hematuria.
Suprapubic transabdominal needle aspiration of the bladder. When done
under ideal conditions, this provides the purest sampling of bladder urine.
This is a good method for infants and small children.
Urinalysis can help with the following:
Infections Cystitis, Bacterial bladder Infection
Urine culture and susceptibility testing add little to the eventual choice
of an antibiotic as treatment because of the limited number of possible
pathogens. Many patients, therefore, may receive an abbreviated laboratory
work-up using dipstick tests to screen for the presence of bacteria and white
blood cells.
If treatment does not improve symptoms, further testing should be done.
Cultures need to be performed when the diagnosis is unclear or when there
are other risk factors such as a history of recurrent infections. Cultures
should also be performed when symptoms such as fever, lower back pain or
signs associated with vaginitis are present.
During urinalysis, urine pH is determined. If elevated, lowering it will assist
in resolving the infection.
Laboratory Test Needed
Kidney Function That Should Be Checked
A urinalysis may show protein or other abnormalities. An abnormal
urinalysis may occur 6 months to 10 or more years before symptoms of
kidney failure appear. Some urine tests require only a few ounces of urine,
but others require collection of all urine produced for a full 24 hours. A 24hour urine test shows how much urine your kidneys produce in one day. The
test is sometimes used to measure how much protein leaks from the kidney
into the urine. However, protein leakage can also be accurately determined
in a small sample of urine by measuring its protein and creatinine
concentration.
A creatinine clearance test compares the creatinine in a 24-hour sample of
urine to the creatinine level in the blood, to show how many milliliters of
blood the kidneys are filtering out each minute (mL/min). The creatinine
clearance can also be estimated accurately from the serum creatinine alone
using well established prediction equations.
GLOSSARY
Acute
An illness or symptom of sudden onset, which generally has a short
duration.
Aspiration
Inhalation, or removal of fluids or gases from a cavity using suction.
Bacteria (Bacterial, Bacterium)
Microscopic germs. Some bacteria are "harmful" and can cause disease,
while other "friendly" bacteria protect the body from harmful invading
organisms.
Bilirubin
A waste product of hemoglobin recycling, it is primarily excreted in feces,
oxidizing into that familiar brown color (except for beets).
Calcium
The body's most abundant mineral. Its primary function is to help build and
maintain bones and teeth. The body also needs calcium to carry nerve
signals, keep the heart functioning, contract muscles, clot blood and
maintain healthy skin. Calcium helps control blood acid-alkaline balance,
plays a role in cell division, muscle growth and iron utilization, activates
certain enzymes, and helps transport nutrients through cell membranes.
Calcium also forms a cellular cement called ground substance that helps hold
cells and tissues together.
Candidiasis (Candida)
Infection of the skin or mucous membrane with any species of candida,
usually Candida albicans. The infection is usually localized to the skin, nails,
mouth, vagina, bronchi, or lungs, but may invade the bloodstream. It is a
common inhabitant of the GI tract, only becoming a problem when it
multiplies excessively and invades local tissues. Growth is encouraged by a
weakened immune system, as in AIDS, or with the prolonged administration
of antibiotics. Vaginal symptoms include itching in the genital area, pain
when urinating, and a thick odorless vaginal discharge. Candidiasis is also
known as: Candida; Candida albicans; Candida Related Complex; Chronic
Candida Syndrome; (Chronic) Systemic Candidiasis; Monilia; Candidiasis
Hypersensitivity Syndrome; Candidosis; (Chronic) Mucocutaneous
Candidosis; Thrush (oral or vaginal); Moniliasis; Polysystematic Candidiasis.
Chronic (Chronicity)
Usually referring to chronic illness: Illness extending over a long period of
time.
Chronic Renal Failure (Chronic Renal Insufficiency, Kidney Failure,
Renal Insufficiency)
(CRF) Irreversible, progressive impaired kidney function. The early stage,
when the kidneys no longer function properly but do not yet require dialysis,
is known as Chronic Renal Insufficiency (CRI). CRI can be difficult to
diagnose, as symptoms are not usually apparent until kidney disease has
progressed significantly. Common symptoms include a frequent need to
urinate and swelling, as well as possible anemia, fatigue, weakness,
headaches and loss of appetite. As the disease progresses, other symptoms
such as nausea, vomiting, bad breath and itchy skin may develop as toxic
metabolites, normally filtered out of the blood by the kidneys, build up to
harmful levels. Over time (up to 10 or 20 years), CRF generally progresses
from CRI to End-Stage Renal Disease (ESRD, also known as Kidney
Failure). Patients with ESRD no longer have kidney function adequate to
sustain life and require dialysis or kidney transplantation. Without proper
treatment, ESRD is fatal.
Copper
An essential mineral that is a component of several important enzymes in
the body and is essential to good health. Copper is found in all body tissues.
Copper deficiency leads to a variety of abnormalities, including anemia,
skeletal defects, degeneration of the nervous system, reproductive failure,
pronounced cardiovascular lesions, elevated blood cholesterol, impaired
immunity and defects in the pigmentation and structure of hair. Copper is
involved in iron incorporation into hemoglobin. It is also involved with
vitamin C in the formation of collagen and the proper functioning in central
nervous system. More than a dozen enzymes have been found to contain
copper. The best studied are superoxide dismutase (SOD), cytochrome C
oxidase, catalase, dopamine hydroxylase, uricase, tryptophan dioxygenase,
lecithinase and other monoamine and diamine oxidases.
Cystine
A nonessential amino acid but may be essential for individuals with certain
diseases or nutritional concerns. Cystine is a structural component of tissues
and hormones. Interconvertible with L-Cysteine.
Cytoplasm
The inner substance of a cell contained within the cell membrane other than
the nucleus.
Diabetes Insipidus
Excessive production of urine, usually due to insufficient production of
antidiuretic hormone.
Diabetes Mellitus (Diabetes, Diabetic, Diabetics)
A disease with increased blood glucose levels due to lack or ineffectiveness
of insulin. Diabetes is found in two forms; insulin-dependent diabetes
(juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms
include increased thirst; increased urination; weight loss in spite of
increased appetite; fatigue; nausea; vomiting; frequent infections including
bladder, vaginal, and skin; blurred vision; impotence in men; bad breath;
cessation of menses; diminished skin fullness. Other symptoms include
bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.
Distal
Anatomically located further away from a point of reference, such as an
origin or a point of attachment.
Endogenous
From within the body, either a native function or the product of the extended
colony. Normal flora in the colon are considered endogenous.
Epithelial
Referring to the cells that line and protect the external and internal surfaces
of the body. Epithelial cells form epithelial tissues such as skin and mucous
membranes.
Fructose
A simple sugar which occurs naturally in fruit or honey.
Glomeruli (Glomerulus)
Tiny tufts of capillaries which carry blood within the kidneys. The blood is
filtered by the glomeruli. The blood then continues through the circulatory
system, but a certain amount of fluid and specific waste products are filtered
out of the blood, to be removed from the body in the form of urine.
Glomerulonephritis
Inflammation of glomerulus. The glomerulus is part of a nephron, which in
turn is the basic functional (working) unit of a kidney. Millions of nephrons
acting together filter the blood to produce urine.
Glucose
A sugar that is the simplest form of carbohydrate. It is commonly referred to
as blood sugar. The body breaks down carbohydrates in foods into glucose,
which serves as the primary fuel for the muscles and the brain.
Glycosuria
Sugar in the urine, from hyperglycemia, diabetes, or most simply, sugar
binges.
Gram (gm, gms, Gramme, Grammes, Grams)
A metric unit of weight, there being approximately 28 grams in one ounce.
Granulocyte (Granulocytes)
A mature white blood cell with cytoplasm containing granules.
Hematuria
Blood in the urine.
Hemoglobin
The oxygen-carrying protein of the blood found in red blood cells.
Hypertension
High blood pressure. Hypertension increases the risk of heart attack, stroke,
and kidney failure because it adds to the workload of the heart, causing it to
enlarge and, over time, to weaken; in addition, it may damage the walls of
the arteries.
Kidneys (Kidney, Renal)
Bean-shaped organs, each about the size of a fist. They are located near the
middle of the back, just below the rib cage. The kidneys are sophisticated
reprocessing machines, each day handling about 50 gallons of blood to sift
out about half a gallon of waste products and extra water. The waste and
extra water become urine, which flows to the bladder through tubes called
ureters. The actual filtering occurs in tiny units inside the kidneys called
nephrons. Every kidney has about a million nephrons. In a nephron, a
glomerulus -- which is a tiny blood vessel, or capillary -- intertwines with a
tiny urine-collecting tube called a tubule. A complicated chemical exchange
takes place, as waste materials and water leave your blood and enter your
urinary system. The kidneys recycle chemicals such as sodium, phosphorus,
and potassium and thus regulate their levels. Renal: Pertaining to the
kidneys.
Leucine
A white, crystalline amino acid essential for optimal growth in infants and
nitrogen equilibrium in adults. It cannot be synthesized by the body and is
obtained by the hydrolysis of food protein during pancreatic enzyme
digestion.
Leukocyte (Leukocytes)
A white blood cell which appears 5,000 to 10,000 times in each cubic
millimeter of normal human blood. Among the most important functions are
destroying bacteria, fungi and viruses and rendering harmless poisonous
substances that may result from allergic reactions and cell injury.
Liver (Hepatic)
The largest and one of the most complex organs of the body, the liver is
responsible for much of the metabolism of fats, proteins and carbohydrates.
It is the site of much of the body's detoxification. It is connected very closely
with digestion and the regulation of blood sugar, among many other
functions. Found behind the ribs on the right side of the abdomen, it has
many important functions such as removing harmful material from the
blood, making enzymes and bile that help digest food, and converting food
into substances needed for life and growth. Hepatic: Pertaining to the liver.
Malignant (Cancerous)
Dangerous. Mainly used to describe a cancerous growth -- when used this
way, it means the growth is cancerous and predisposed to spreading.
Menstruation (Menses, Menstrual, Menstrual Cycle, Menstrual Cycles,
Menstrual Flow, Menstrual Phase, Monthly Cycle)
The periodic discharge of blood, tissue fluid and mucus from the
endometrium (lining of the uterus) that usually lasts from 3 - 5 days. It is
caused by a sudden reduction in estrogens and progesterone.
Milligram (mg, Milligrams)
0.001 or a thousandth of a gram.
Milliliter (mL)
0.001 or one thousandth of a liter.
Myoglobin
An oxygen-carrying muscle protein that makes oxygen available to the
muscles for contraction.
Necrosis
Death of one or more cells, or of a portion of a tissue or organ.
Nephritis
Kidney inflammation.
Ounce (Ounces, oz)
Approximately 28 grams.
Pelvis
The lower part of the abdomen between the hip bones. Organs in a woman's
pelvis include the uterus, vagina, ovaries, fallopian tubes, bladder and
rectum.
pH
A measure of an environment's acidity or alkalinity. The more acidic the
solution, the lower the pH. For example, a pH of 1 is very acidic; a pH of 7 is
neutral; a pH of 14 is very alkaline.
Pinworms (Enterobiasis, Enterobious vermicularis, Oxyuriasis,
Pinworm, Pinworm Infection, Seatworm, Threadworm)
Small intestinal parasitic worms that infect mainly children but which are
also common in families with children. Pinworms are about 1/2 an inch
(1.25cm) in length, white, thin and pointed at both ends. The most common
symptom is anal itching, as the worms come out at night to lay their eggs.
Protein (Proteins)
Compounds composed of hydrogen, oxygen, and nitrogen present in the
body and in foods that form complex combinations of amino acids. Protein is
essential for life and is used for growth and repair. Foods that supply the
body with protein include animal products, grains, legumes, and vegetables.
Proteins from animal sources contain the essential amino acids. Proteins are
changed to amino acids in the body.
Proteinuria
The presence of protein in the urine, sometimes a symptom of kidney
compromise.
Proximal
Nearer to a point of reference such as an origin, a point of attachment, or
the midline of the body.
Pyelonephritis (Pyelitis)
Inflammation of the renal pelvis. Pyelitis: An inflammation of the kidney
pelvis, the interface between the urine-secreting inner surface of the kidney
and the muscular ureter that drains into the bladder. It can be caused by
kidney stones or an infection that has progressed up from the lower urinary
tract. It alone is a serious condition; the next stage, pyelonephritis, since
it involves the whole kidney, is still worse.
Red Blood Cell (Erythrocyte, Erythrocytes, RBC, Red Blood Cells)
Any of the hemoglobin-containing cells that carry oxygen to the tissues and
are responsible for the red color of blood.
Serum
The cell-free fluid of the bloodstream. It appears in a test tube after the
blood clots and is often used in expressions relating to the levels of certain
compounds in the blood stream.
Sodium
An essential mineral that our bodies regulate and conserve. Excess sodium
retention increases the fluid volume (edema) and low sodium leads to less
fluid and relative dehydration. The adult body averages a total content of
over 100 grams of sodium, of which a surprising one-third is in bone. A
small amount of sodium does get into cell interiors, but this represents only
about ten percent of the body content. The remaining 57 percent or so of
the body sodium content is in the fluid immediately surrounding the cells,
where it is the major cation (positive ion). The role of sodium in the
extracellular fluid is maintaining osmotic equilibrium (the proper difference in
ions dissolved in the fluids inside and outside the cell) and extracellular fluid
volume. Sodium is also involved in nerve impulse transmission, muscle tone
and nutrient transport. All of these functions are interrelated with potassium.
Syndrome
A medical condition characterized by a collection of related symptoms (what
the patient feels) and signs (what a doctor can observe or measure).
Tyrosine
A nonessential amino acid but may be essential for individuals with certain
diseases or nutritional concerns. May be important for neurotransmitter
synthesis and mood regulation. May be useful for depression, allergies and
addictive states.
Urinary Tract (UT)
The kidneys and the lower urinary tract, which includes the ureters, bladder,
and urethra.
Vaginitis (Vaginosis)
An inflammation of the vagina, either from simple tissue irritation or from an
infection. Vaginosis: A vaginal infection characterized by a smelly discharge
and the presence of Gardnerella, Mycoplasma, or other anaerobic bacteria,
with thevlack of Lactobacillus species.
White Blood Cell (WBC, White Blood Cells)
A blood cell that does not contain hemoglobin: a blood corpuscle responsible
for maintaining the body's immune surveillance system against invasion by
foreign substances such as viruses or bacteria. White cells become
specifically programmed against foreign invaders and work to inactivate and
rid the body of a foreign substance. White blood cells are composed
primarily of neutrophils, monocytes and lymphocytes. Lymphocytes are
either T-cells or B-cells. T-cells (CD3 cells) are divided into T-helper (CD4
cells) and T-suppressor/cytotoxic (CD8 cells) cells.
Yeast
A single-cell organism that may cause infection in the mouth, vagina,
gastrointestinal tract, and any or all bodily parts. Common yeast infections
include candidiasis and thrush.