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{{Biopsy}}
 
{{Biopsy}}
A '''urinalysis''' (or "UA") is an array of tests performed on [[urine]] and one of the most common methods of [[medical]] [[diagnosis]].<ref name="pmid15791892">{{cite journal |author=Simerville JA, Maxted WC, Pahira JJ |title=Urinalysis: a comprehensive review |journal=American family physician |volume=71 |issue=6 |pages=1153–62 |year=2005 |month=March |pmid=15791892 |doi= |url=http://www.aafp.org/afp/20050315/1153.html |accessdate=}}</ref> A part of a urinalysis can be performed by using urine dipsticks, in which the test results can be read as color changes.
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{{PsyPerspective}}
  +
  +
[[File:Pyuria2.JPG|thumb|200px|[[White blood cell]]s seen under a microscope from a urine sample.]]
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A '''urinalysis''' (or "UA") is an array of tests performed on [[urine]] and one of the most common methods of [[medical diagnosis]].<ref name="pmid15791892">{{cite journal |author=Simerville JA, Maxted WC, Pahira JJ |title=Urinalysis: a comprehensive review |journal=American family physician |volume=71 |issue=6 |pages=1153–62 |year=2005 |month=March |pmid=15791892 |doi= |url=http://www.aafp.org/afp/20050315/1153.html |accessdate=}}</ref> A part of a urinalysis can be performed by using urine dipsticks, in which the test results can be read as color changes.
   
 
==Medical urinalysis==
 
==Medical urinalysis==
[[Image:Urinalysis.jpg|right|thumb|Example of a Urinalysis report.]]
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{| class="wikitable" align="right"
+
|-
  +
!colspan=4| Reference ranges for urine tests
  +
|-
  +
! Measurement
  +
! Lower limit
  +
! Upper limit
  +
! Unit
  +
|-
  +
| Urinary [[specific gravity]]
  +
| 1.003 <ref name="pmid15791892"/><ref name=southwest/>
  +
| 1.030<ref name="pmid15791892"/><ref name=southwest/>
  +
| g/mL
  +
|-
  +
| [[Osmolality]]
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| 800<ref name=uppsala/>
  +
| n/a<ref name=uppsala/>
  +
| m[[Osmole (unit)|Osm]]/kg
  +
|-
  +
| [[Urobilinogen]]
  +
| 0.2<ref name=southwest>[http://pathcuric1.swmed.edu/PathDemo/nrrt.htm Normal Reference Range Table] from The University of Texas Southwestern Medical Center at Dallas. Used in Interactive Case Study Companion to Pathologic basis of disease.</ref>
  +
| 1.0 <ref name=southwest/>
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| [[Ehrlich unit]]s <br> or mg/dL
  +
|-
  +
| Free [[catecholamine]]s,<br> [[dopamine]]
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| 90 <ref name="urlUniversity of Colorado Laboratory Reference Ranges">{{cite web |url=http://clinlab.uch.edu/asp/test_review/reference_ranges_all.asp |title=University of Colorado Laboratory Reference Ranges |format= |work= |accessdate=2008-10-21}}</ref>
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| 420 <ref name="urlUniversity of Colorado Laboratory Reference Ranges"/>
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| μg/d
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|-
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| [[Red blood cell]]s (RBCs)
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| 0<ref name=southwest/><ref name="urlmedical.history.interview: Lab Values">{{cite web |url=http://sitemaker.umich.edu/medical.history.interview/lab_values |title=medical.history.interview: Lab Values |format= |work= |accessdate=2008-10-21}}</ref>
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| 2<ref name=southwest/> - 3<ref name="urlmedical.history.interview: Lab Values"/>
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|rowspan=3| per <br>[[High Power Field]]<br> (HPF)
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|-
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| [[Urinary_cast#Red_blood_cell_casts|RBC casts]]
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| n/a
  +
| 0 / negative<ref name=southwest/>
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|-
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| [[White blood cell]]s (WBCs)
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| 0<ref name=southwest/>
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| 2<ref name=southwest/>
  +
|-
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| [[pH]] || 5<ref name=southwest/> || 7<ref name=southwest/> || (unitless)
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|-
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| Protein || 0 || trace amounts<ref name=southwest/> ||
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|-
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| [[Glucose]] || n/a || 0 / negative<ref name=southwest/> ||
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|-
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| [[Ketone]]s || n/a || 0 / negative<ref name=southwest/> ||
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|-
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| [[Bilirubin]] || n/a || 0 / negative<ref name=southwest/> ||
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|-
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| [[Blood]] || n/a || 0 / negative<ref name=southwest/> ||
  +
|-
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| [[Nitrite]] || n/a || 0 / negative<ref name=southwest/> ||
  +
|-
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| [[Leukocyte]]s || n/a || 0 / negative<ref name=southwest/> ||
  +
|-
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| [[Sodium]] (Na) - per day || 150<ref name=uppsala> Reference range list from Uppsala University Hospital ("Laborationslista"). Artnr 40284 Sj74a. Issued on April 22, 2008</ref> || 300<ref name=uppsala/> || mmol / 24hours
  +
|-
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| [[Potassium]] (K) - per day || 40<ref name=uppsala/> || 90<ref name=uppsala/> || mmol / 24hours
  +
|-
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| [[Calcium]] (Ca) - per day || 2.5<ref name=uppsala/> || 8.0<ref name=uppsala/> || mmol / 24hours
  +
|-
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| [[Phosphate]] (P) - per day || n/a<ref name=uppsala/> || 38<ref name=uppsala/> || mmol / 24hours
  +
|-
  +
| [[Creatinine]] - per day || 4.8<ref name=uppsala/> || 19<ref name=uppsala/> || mmol / 24hours
  +
|}
 
A typical medical urinalysis usually includes:
 
A typical medical urinalysis usually includes:
   
 
*a description of color and appearance.
 
*a description of color and appearance.
*[[specific gravity (kidney)|specific gravity]] - normally 1.010 to 1.030. This test detects ion concentration of the urine. Small amounts of protein or ketoacidosis tend to elevate results of the [[specific gravity]].
+
*[[specific gravity (kidney)|specific gravity]] - normally 1.003 to 1.030<ref name="pmid15791892"/>. This test detects ion concentration of the urine. Small amounts of protein or ketoacidosis tend to elevate results of the specific gravity. Specific gravity is an expression of the weight of a substance relative to the weight of an equal volume of water. Water has a specific gravity of one. The specific gravity of your urine is measured by using a urinometer. Knowing the specific gravity of your urine is very important because the number indicates whether you are hydrated or dehydrated. If the specific gravity of your urine is under 1.007, you are [[hydrated]]. If your urine is above 1.010, you are [[dehydrated]].
*[[pH]] - normally 4.8 to 7.5.
+
*[[pH]] - normally 5 to 7.<ref name=southwest/>
*[[ketone bodies]] - normally negative (absent)
+
*[[ketone bodies]] - normally negative (absent). When there is [[carbohydrate]] deprivation, such as starvation or high protein diets, the body relies increasingly on the [[metabolism]] of fats for energy. This pattern is also seen in people with the disease diabetes mellitus, when a lack of the hormone [[insulin]] prevents the body cells from utilizing the large amounts of [[glucose]] available in the blood. This happens because insulin is necessary for the transport of glucose from the blood into the body cells. The metabolism of fat proceeds in a series of steps. First, [[triglycerides]] are [[hydrolyzed]] to fatty acids and [[glycerol]]. Second the fatty acids are hydrolyzed into smaller intermediate compounds (acetoacetic acid, betahydroxybutyric acid, and acetone). Thirdly, the intermediate products are utilized in aerobic [[cellular respiration]]. When the production of the intermediate products of fatty acid metabolism (collectively known as ketone bodies) exceeds the ability of the body to metabolize these compounds they accumulate in the blood and some end up in the urine ([[ketonuria]]).
*[[protein]] - normally negative (absent)
+
*[[proteins]] - normally negative (absent)
  +
*Albustix Test - Since proteins are very large molecules (macromolecules), they are not normally present in measurable amounts in the glomerular filtrate or in the urine. The detection of proteins in your urine may indicate that the [[permeability]]{{dn}} of the glomerulus is abnormally increased. This may be caused by renal infections or it may be caused by other diseases that have secondarily affected the kidneys such as [[diabetes mellitus]], [[jaundice]], or [[hyperthyroidism]].
  +
*[[nitrites]]
 
*[[urobilinogen]]
 
*[[urobilinogen]]
*[[bilirubin]]
+
*[[Bilirubin]] - The fixed phagocytic cells of the spleen and bone marrow destroy old red blood cells and convert the heme groups of hemoglobin to the pigment bilirubin. The bilirubin is secreted into the blood and carried to the liver where it is bonded to (conjugated with) glucuronic acid, a derivative of glucose. Some of the [[conjugated]] bilirubin is secreted into the blood and the rest is excreted in the bile as bile pigment that passes into the small intestine. The blood normally contains a small amount of free and conjugated bilirubin. An abnormally high level of blood bilirubin may result from: an increased rate of red blood cell destruction, liver damage, as in hepatitis and cirrhosis, and obstruction of the common bile duct as with gallstones. An increase in blood bilirubin results in jaundice, a condition characterized by a brownish yellow pigmentation of the skin and of the [[sclera]] of the eye.
  +
*Icotest - The test used to detect the destruction of old Red Blood Cells (RBC) in the urine.
 
*[[glucose]] - normally negative (absent)
 
*[[glucose]] - normally negative (absent)
  +
*[[Benedict's Test]] - Although glucose is easily filtered in the glomerulus, it is not present in the urine because all of the glucose that is filtered is normally reabsorbed from the renal tubules back into the blood.
  +
*[[Hemoglobin]] Test - [[Hemolysis]] in the blood vessels, a rupture in the [[capillaries]] of the [[glomerulus]], or [[hemorrhage]] in the urinary system may cause [[hemoglobin]] to appear in your urine.
 
*[[red blood cell|RBC]] number
 
*[[red blood cell|RBC]] number
 
*[[white blood cell|WBC]] number
 
*[[white blood cell|WBC]] number
 
*[[Human chorionic gonadotropin|hCG]] - normally absent, this hormone appears in the urine of [[pregnancy|pregnant]] [[woman|women]]. Home [[pregnancy test]]s commonly detect this substance.
 
*[[Human chorionic gonadotropin|hCG]] - normally absent, this hormone appears in the urine of [[pregnancy|pregnant]] [[woman|women]]. Home [[pregnancy test]]s commonly detect this substance.
   
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===Microscopic examination===
  +
[[Image:Urinary phase-contrast microscopy.jpg|right|thumb|A urine sample is about to be examined under a phase-contrast microscope using a Neubauer [[counting chamber]]. The urine is under the cover slide, in the upper segment formed by the H-shaped grooves.]]
  +
The numbers and types of [[cell (biology)|cell]]s and/or material such as [[urinary casts]] can yield a great detail of information and may suggest a specific diagnosis.
  +
*[[Hematuria]] - associated with [[kidney stone]]s, [[infection]]s, [[tumor]]s and other conditions
  +
*[[Pyuria]] - associated with [[Urinary tract infection|urinary infections]]
  +
*[[eosinophiluria]] - associated with [[allergic interstitial nephritis]], [[cholesterol embolism|atheroembolic disease]]
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*[[urinary casts#Red blood cell casts|Red blood cell casts]] - associated with [[glomerulonephritis]], [[vasculitis]], [[malignant hypertension]]
  +
*[[urinary casts#White blood cell casts|White blood cell casts]] - associated with [[acute interstitial nephritis]], exudative [[glomerulonephritis]], severe [[pyelonephritis]]
  +
*(heme) granular casts - associated with [[acute tubular necrosis]]
  +
*[[crystalluria]] -- associated with [[acute urate nephropathy]] (or "Acute uric acid nephropathy", AUAN)
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*[[calcium oxalatin]] - associated with [[ethylene glycol]] toxicity
   
 
==See also==
 
==See also==
*[[Drug usage screening]]
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*[[Uroscopy]], the ancient form of this analysis
*[[Medical diagnosis]]
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*[[Medical technologist]]
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*[[Proteinuria]]
   
 
==References==
 
==References==
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==External links==
 
==External links==
  +
{{Commons category|Urinalysis}}
 
*[http://www.labtestsonline.org/understanding/analytes/urinalysis/glance.html Lab Tests Online: Urinalysis]
 
*[http://www.labtestsonline.org/understanding/analytes/urinalysis/glance.html Lab Tests Online: Urinalysis]
   
 
{{Urine tests}}
 
{{Urine tests}}
{{Abnormal clinical and laboratory findings}}
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{{Abnormal clinical and laboratory findings for urine}}
   
[[Category:Medical diagnosis]]
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[[Category:Urine]]
[[Category:Nephrology]]
 
 
[[Category:Urine tests| ]]
 
[[Category:Urine tests| ]]
   
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[[da:Urinprøve]]
 
[[da:Urinprøve]]
 
[[de:Urinuntersuchung]]
 
[[de:Urinuntersuchung]]
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[[es:Análisis de orina]]
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[[ko:소변 검사]]
 
[[he:בדיקת שתן]]
 
[[he:בדיקת שתן]]
 
[[pl:Badanie moczu]]
 
[[pl:Badanie moczu]]
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[[ru:Клинический анализ мочи]]
 
[[ru:Клинический анализ мочи]]
 
[[sv:Urinprov]]
 
[[sv:Urinprov]]
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[[ta:சிறுநீர் சோதனை]]
 
[[ur:تجزیۂ بول]]
 
[[ur:تجزیۂ بول]]
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[[zh:尿液分析]]
 
-->
 
-->
 
{{enWP|Urinalysis}}
 
{{enWP|Urinalysis}}

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File:Pyuria2.JPG
White blood cells seen under a microscope from a urine sample.

A urinalysis (or "UA") is an array of tests performed on urine and one of the most common methods of medical diagnosis.[1] A part of a urinalysis can be performed by using urine dipsticks, in which the test results can be read as color changes.

Medical urinalysisEdit

Reference ranges for urine tests
Measurement Lower limit Upper limit Unit
Urinary specific gravity 1.003 [1][2] 1.030[1][2] g/mL
Osmolality 800[3] n/a[3] mOsm/kg
Urobilinogen 0.2[2] 1.0 [2] Ehrlich units
or mg/dL
Free catecholamines,
dopamine
90 [4] 420 [4] μg/d
Red blood cells (RBCs) 0[2][5] 2[2] - 3[5] per
High Power Field
(HPF)
RBC casts n/a 0 / negative[2]
White blood cells (WBCs) 0[2] 2[2]
pH 5[2] 7[2] (unitless)
Protein 0 trace amounts[2]
Glucose n/a 0 / negative[2]
Ketones n/a 0 / negative[2]
Bilirubin n/a 0 / negative[2]
Blood n/a 0 / negative[2]
Nitrite n/a 0 / negative[2]
Leukocytes n/a 0 / negative[2]
Sodium (Na) - per day 150[3] 300[3] mmol / 24hours
Potassium (K) - per day 40[3] 90[3] mmol / 24hours
Calcium (Ca) - per day 2.5[3] 8.0[3] mmol / 24hours
Phosphate (P) - per day n/a[3] 38[3] mmol / 24hours
Creatinine - per day 4.8[3] 19[3] mmol / 24hours

A typical medical urinalysis usually includes:

  • a description of color and appearance.
  • specific gravity - normally 1.003 to 1.030[1]. This test detects ion concentration of the urine. Small amounts of protein or ketoacidosis tend to elevate results of the specific gravity. Specific gravity is an expression of the weight of a substance relative to the weight of an equal volume of water. Water has a specific gravity of one. The specific gravity of your urine is measured by using a urinometer. Knowing the specific gravity of your urine is very important because the number indicates whether you are hydrated or dehydrated. If the specific gravity of your urine is under 1.007, you are hydrated. If your urine is above 1.010, you are dehydrated.
  • pH - normally 5 to 7.[2]
  • ketone bodies - normally negative (absent). When there is carbohydrate deprivation, such as starvation or high protein diets, the body relies increasingly on the metabolism of fats for energy. This pattern is also seen in people with the disease diabetes mellitus, when a lack of the hormone insulin prevents the body cells from utilizing the large amounts of glucose available in the blood. This happens because insulin is necessary for the transport of glucose from the blood into the body cells. The metabolism of fat proceeds in a series of steps. First, triglycerides are hydrolyzed to fatty acids and glycerol. Second the fatty acids are hydrolyzed into smaller intermediate compounds (acetoacetic acid, betahydroxybutyric acid, and acetone). Thirdly, the intermediate products are utilized in aerobic cellular respiration. When the production of the intermediate products of fatty acid metabolism (collectively known as ketone bodies) exceeds the ability of the body to metabolize these compounds they accumulate in the blood and some end up in the urine (ketonuria).
  • proteins - normally negative (absent)
  • Albustix Test - Since proteins are very large molecules (macromolecules), they are not normally present in measurable amounts in the glomerular filtrate or in the urine. The detection of proteins in your urine may indicate that the permeability
  1. redirect Template:Ambiguous link
of the glomerulus is abnormally increased. This may be caused by renal infections or it may be caused by other diseases that have secondarily affected the kidneys such as diabetes mellitus, jaundice, or hyperthyroidism.  
  • nitrites
  • urobilinogen
  • Bilirubin - The fixed phagocytic cells of the spleen and bone marrow destroy old red blood cells and convert the heme groups of hemoglobin to the pigment bilirubin. The bilirubin is secreted into the blood and carried to the liver where it is bonded to (conjugated with) glucuronic acid, a derivative of glucose. Some of the conjugated bilirubin is secreted into the blood and the rest is excreted in the bile as bile pigment that passes into the small intestine. The blood normally contains a small amount of free and conjugated bilirubin. An abnormally high level of blood bilirubin may result from: an increased rate of red blood cell destruction, liver damage, as in hepatitis and cirrhosis, and obstruction of the common bile duct as with gallstones. An increase in blood bilirubin results in jaundice, a condition characterized by a brownish yellow pigmentation of the skin and of the sclera of the eye.
  • Icotest - The test used to detect the destruction of old Red Blood Cells (RBC) in the urine.
  • glucose - normally negative (absent)
  • Benedict's Test - Although glucose is easily filtered in the glomerulus, it is not present in the urine because all of the glucose that is filtered is normally reabsorbed from the renal tubules back into the blood.
  • Hemoglobin Test - Hemolysis in the blood vessels, a rupture in the capillaries of the glomerulus, or hemorrhage in the urinary system may cause hemoglobin to appear in your urine.
  • RBC number
  • WBC number
  • hCG - normally absent, this hormone appears in the urine of pregnant women. Home pregnancy tests commonly detect this substance.

Microscopic examinationEdit

File:Urinary phase-contrast microscopy.jpg
A urine sample is about to be examined under a phase-contrast microscope using a Neubauer counting chamber. The urine is under the cover slide, in the upper segment formed by the H-shaped grooves.

The numbers and types of cells and/or material such as urinary casts can yield a great detail of information and may suggest a specific diagnosis.

See alsoEdit

ReferencesEdit

  1. 1.0 1.1 1.2 1.3 Simerville JA, Maxted WC, Pahira JJ (March 2005). Urinalysis: a comprehensive review. American family physician 71 (6): 1153–62.
  2. 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 Normal Reference Range Table from The University of Texas Southwestern Medical Center at Dallas. Used in Interactive Case Study Companion to Pathologic basis of disease.
  3. 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 Reference range list from Uppsala University Hospital ("Laborationslista"). Artnr 40284 Sj74a. Issued on April 22, 2008
  4. 4.0 4.1 University of Colorado Laboratory Reference Ranges. URL accessed on 2008-10-21.
  5. 5.0 5.1 medical.history.interview: Lab Values. URL accessed on 2008-10-21.

External linksEdit

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[[Commons: Category:Urinalysis

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