Clinical Microscopy

Cards (112)

  • ROUTINE URINALYSIS
    1. Sample Collection : Containers, Labels, Requisition
    2. Types of Specimen: Special Conditions and Methods of Collection
    3. Physical Examination: Color, Clarity
    4. Chemical Examination: Reagent Strip (10 parameters), SSA, Benedict's
  • Urinalysis is often used:
    1. Prior to surgery
    2. Preemptive screening during pregnancy checkup
    3. Part of a routine medical or physical exam
    4. To monitor the effects of treatment
    5. 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 bacterial culture
  • 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