University:
College
Course:
College Rehabilitation Medicine
Academic year:

2023
Views:

241

Pages:

4
Author:

Carlo M.

ANALYSIS OF URINE AND OTHER BODY FLUIDS LABORATORY 5. MODULE 4 - MICROSCOPIC URINE EXAMINATION OUTLINE • • Introduction Microscopic Urine Examination o Principle o Materials o Procedure o Results of the Test/s INTRODUCTION • • • The third part of routine urinalysis, after physical and chemical examination, is the microscopic examination of the urinary sediment. Its purpose is to detect and to identify insoluble materials present in the urine. The blood, kidney, lower genitourinary tract, and external contamination all contribute formed elements to the urine. These include red blood cells (RBCs), white blood cells (WBCs), epithelial cells, casts, bacteria, yeast, parasites, mucus, spermatozoa, crystals, and artifacts. Because some of these components are of no clinical significance and others are considered normal unless they are present in increased amounts, examination of the urinary sediment must include both identification and quantitation of the elements present. Microscopic analysis is subject to several procedural variations, including the methods by which the sediment is prepared, the volume of sediment actually examined, the methods and equipment used to obtain visualization, and the manner in which the results are reported. o Important in diagnosis for patients, basis for treatment and medication MICROSCOPIC URINE EXAMINATION PRINCIPLE • Microscopic Examination MATERIALS • • • • • Urine Specimen (minimum 10 mL) Centrifuge Microscope Slides Cover Slip Centrifuge Tube PROCEDURE 1. 2. 3. 4. Thoroughly mix the urine specimen. o Swirling motion (10-20 times) Pour 10mL of the urine into a centrifuge tube or any test tube used for that matter Centrifuge for 5 minutes @ 1500 rpm. o Longer centrifugation = more sediments Decant the supernatant fluid; sufficient urine remains in the test tube to suspend the sediment. o 0.5 - 1 mL sediments should remain o Resuspend sediments by shaking or tapping 6. Mix the supernatant and the sediment gently in the test tube and transfer a drop of the resuspended sediment on a slide. The drop should not overrun the coverslip and there should be no air bubbles since both tend to alter the result. Using the LPO first, then HPO, examine the sediment under the microscope for the presence of the following: o LPO - identification of abnormalities o HPO - identification & counting o Casts: report the average per low power field (lpf) of the specific type seen o Erythrocytes and Leukocytes: report the average number per 10 high power field (hpf) o Squamous Epithelial Cells: report as rare, few, moderate or many per low power field (lpf) o Transitional/Urothelial Cells: report as rare, few, moderate or many per high power field (hpf) o Renal Tubular Cells: report as average number per 10 high power field (hpf) o Normal Crystals / Abnormal Crystals / Microorganisms / Animal Parasites / Yeast Cells / Oval Fat Bodies : report as rare, few, moderate or many per high power field (hpf) o Mucus Threads : report as rare, few, moderate or many per low power field (lpf) RESULTS OF THE TEST/S