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Y1-2ND SEM
MLSP 112
Clinical Microscopy
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ROUTINE URINALYSIS
Sample Collection :
Containers
,
Labels
,
Requisition
Types of Specimen:
Special
Conditions
and
Methods
of
Collection
Physical Examination:
Color
,
Clarity
Chemical Examination:
Reagent
Strip
(
10
parameters
),
SSA
,
Benedict's
Urinalysis is often used:
Prior to
surgery
Preemptive screening during
pregnancy
checkup
Part of a routine
medical
or
physical
exam
To monitor the effects of
treatment
Doctor suspects that the patient have certain conditions, such as:
●
Diabetes
●
Kidney
Disease
●
Liver
Disease
●
Urinary
Tract
Infection
SPECIMEN CONTAINER
Specimens must be collected in clean, dry,
leak-proof
disposable container.
SPECIMEN CONTAINER
Containers should have a
wide
mouth
to facilitate collections from female patients.
SPECIMEN CONTAINER
Container capacity should be
50
mL and should be made of
clear
material to allow for determination of
color
and
clarity.
LABELS:
Labels must be attached to the
container
and not on the
lid.
Specimens must be labeled properly with:
1.
Patient’s
name
2.
Identification
number
3.
Date
and
time
of collection
4.
Age
&
Gender
Requisition slips
must accompany specimens delivered to the laboratory.
REQUISITION SLIP:
Information on the form must
match
the information on the specimen label.
SPECIMEN REJECTION:
Specimens in
unlabeled
containers
Nonmatching
labels and requisition forms
Specimens contaminated with
feces
or
toilet
paper
Containers with contaminated
exteriors
Specimens of
insufficient
quantity
Improperly
transported
specimen
Unpreserved
Specimen submitted more than
2
hours from the time of collection
Random Specimen
Most
commonly
received
specimen
Easiest to
collect
Useful for
routine
screening
test
First Morning Specimen
First voided
specimen upon waking
Ideal screening
specimen
Concentrated
specimen
Midstream Specimen
Clean external
genital
area
First
and
last
stream of urine voided: Midstream collected
Specimen of choice for bacterial
culture
in routine circumstances
It provides a specimen that is less contaminated by
epithelial
cells
and
bacteria.
Catheterized Specimen
Insertion of catheter directly into
bladder
via
urethra
Most commonly requested test using this specimen is ba
cterial c
ulture
Suprapubic Aspiration
Insert needle through
suprapubic
abdominal
area directly into bladder
Optimum specimen for
bacterial
culture
:
invasive
procedure
Provides a sample for bacterial culture that is completely free of
extraneous
contamination
CHANGES IN AN UNPRESERVED URINE:
INCREASE:
pH
Bacteria
Odor
Nitrite
Color
CHANGES IN AN UNPRESERVED URINE:
DECREASE:
Clarity
Glucose
Ketones
Bilirubin
Urobilinogen
Cells
and
Casts
Trichomonas
CHANGES IN UNPRESERVED URINE
(
COLOR
)
modified/ darkened
due to oxidation or reduction of metabolites
CHANGES IN UNPRESERVED URINE
(
CLARITY
)
Decreased
due to bacterial growth and precipitation of amorphous material
CHANGES IN UNPRESERVED URINE
(
ODOR
)
Increased
Bacterial multiplication causing breakdown of urea to ammonia
CHANGES IN UNPRESERVED URINE
(
pH
)
Increased
Breakdown of urea to ammonia by urease-producing bacteria/loss of CO2
CHANGES IN UNPRESERVED URINE
(
Glucose
)
Decreased
Glycolysis and Bacterial Use
CHANGES IN UNPRESERVED URINE
(
Ketones
)
Decreased
Volatilization and Bacterial metabolism
CHANGES IN UNPRESERVED URINE
(
Bilirubin
)
Decreased
Exposure to light/photo-oxidation to biliverdin
CHANGES IN UNPRESERVED URINE
(
Urobilinogen
)
Decreased
Due to oxidation to urobilin
CHANGES IN UNPRESERVED URINE
(
Nitrite
)
Increased
Due to the multiplication of nitrate-reducing bacteria
CHANGES IN UNPRESERVED URINE
(
Red
and
White
Blood
Cells
and
Casts
)
Decreased
Due to disintegration in dilute alkaline urine
CHANGES IN UNPRESERVED URINE
(
Bacteria
)
Increased
Due to its multiplication
CHANGES IN UNPRESERVED URINE
(
Trichomonas
)
Decreased
Due to the loss of motility, death
TYPES of Urine Specimen (and their purpose)
Random
Routine Screening
TYPES of Urine Specimen (and their purpose):
First Morning
Routine Screening
Pregnancy Tests
Orthostatic Protein
TYPES of Urine Specimen (and their purpose):
24-hour
(
or
timed
)
Quantitative Chemical Tests
TYPES of Urine Specimen (and their purpose):
Catheterized
Bacterial Culture
TYPES of Urine Specimen (and their purpose):
Midstream
clean-catch
Routine Screening
Bacterial Culture
TYPES of Urine Specimen (and their purpose):
Suprapubic Aspiration
Bladder Urine for bacterial culture
Cytology
TYPES of Urine Specimen (and their purpose):
Three-glass
Collection
Prostatic Infection
PHYSICAL EXAMINATION
(
COLOR
)
The color of urine varies from almost
colorless
to
black.
Normal urine color may vary from
pale yellow
to
dark yellow.
PHYSICAL EXAMINATION
(COLOR)
Care should be taken to examine the specimen under a good light source, looking down through the container against a
white
background.
PHYSICAL
EXAMINATION (
COLOR
)
The
yellow
color of urine is caused by the presence of a pigment,
Urochrome.
PHYSICAL EXAMINATION (COLOR)
Urochrome
is a product of endogenous metabolism and under normal conditions the body produces it at a constant rate.
URINE COLOR
CHART
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