Blood for RBCs and RBC casts Protein for Casts/cells Nitrite for bacteria Leukocyte Esterase forWBCs and WBC casts Glucose for Yeast Turbidity to confirm cause
Describe the recommended methods for standardizing specimens?
KOVA (our system) Count -10 Quick-Read 10 R/S 2000
What is the recommended volume of urine needed?
10-15 mL, 12 mL preferred
Fresh urine is the best. What temperature is the desired?
How long should you centrifuge a urine specimen?
5 mins at 400 RCF RCF = 1,118 x 10^-5 x radius in cm x RPM^2 produces optimum amt of sediment w/o damaging formed elements DO NOT USE BRAKE ON CENTRIFUGE (disturbs sediment) use capped tubes to prevent aerosols
What is the microscope procedure for viewing urine?
observe 10 HPF under 10x and 40x light reduced b/c of refractive index of elements similar to urine low power (10x) detects casts high power (40x) identify count or grade of formed elements
How do you report out test results for urine?
casts reported as avg #/10 LPF RBCs, WBCs, epithelial, renal cells reported as avg #/10 HPF bacteria, mucous, and crystals reported as tr, 1+ to 4+
How is the sediment preparation done?
leave .5 ml to 1.0 ml of urine Kova pipette holds back 1.0 ml of urine mix sediment with Kova pipette
List the elements found in the urine
RBC, WBC, Glitter cells, renal tubular epithelial cells, tranisitional epiithelial cells, squamous epithelial cells, hylaine, course granular, finely granular, waxy, fat, red cell and white cell casts
What is the basic principle of the brightfield microscope?
Objects appear darker against light background Most commonly used type of microscope Sediment must be observed using decreased light by adjusting the rheostat not condenser Staining of sediment increases visualization of elements
What power do you want to use to view casts?
Briefly describe how to care for a microscope?
Carry microscope with two hands, supporting the base with one hand. Always hold the micropscope in a vertical poisiton. Only clean with lens tissue and commerical lens cleaner. Do not use 10 X and 40 X objectives with oil. Always remove slides with the lower power objective raised. Store with low power objective in position and the stage centered
What is the principle for the Phase Contrast micropscope?
enhances visualization of elements with low refractive indices, such as hyaline cast, mixed cellular cast, mucous threads, and Trichomonas
What is the principle for the polarizing micropscope?
procedure in which the maginified birefringent images appear bright colored against black background.
The resolution or splitting of a light wave into two unequally reflected or transmitted waves by an optically anisotropic medium such as calcite or quartz. Also called double refraction.
What are the steps for adjusting a phase contrast micropscope?
Focus the microscope in the bright field with a specimen slide. Select the low power condenser ring Select the corresponding ring objectives Remove ocular, insert adjustment telescope. Observe the dark and light rings called annuli With the adjusting screw on the telescope, center the light annulus or condenser over the dark annulus/objective. Replace ocular
dilute urine, absorbe water and swells. Can make a sparkling appearance called glitter cells for WBC
normal urine, same concentration in and out of cell
concentrated urine, cells shrink due to loss of water and appear crenated.
Name some normal sediments in urine
RBC, WBC, small cast such as hyaline or granular, muscus, sperm, artifacts, microorganisms
Cholestrol crystals is associated with this disorder?
How can you test to make sure that what you are seeing is radiographic dye?
This is associated with liver disorders, fine colorless to yellow needles that frequently clump and form rosettes. Usually inherited disorders of amino acid metabolism
This is yellow brown spheres that demonstrates concentric circles and radial striations
Hepatic disorder producing large amounts of bilirubin in the urine
What disorders happen with bilirubin crystals?
tubular damage, viral hepatitis
This type of crystal is seen with massive doseage of antibotics
This type of crystal is seen antibotics that are used to treat UTI's
Discuss amorphous crystals
Warm specimen to 37 C, add acedic acid if alkaline pH
You return from your lunch break to find that several urine specimens are waiting in the refrigerator to be tested. One of the specimens have a thick layer of pinkish-colored fluffy sediment in the bottom. What might this sediment be?
precipitated amorphous urate crystals
cystinuria - cystinosis - homocystinuria
What may cause protein to appear in the urine?
changes in glomerular blood flow or enhanced glomerular permeability
An ill patient give a urine specimen that is pale and greenish, contains a large amount of sugar, has a high specific gravity, low pH, and has ketone bodies. What is the diagnosis?
uncontrolled diabetes; excess glucose, abnormal color, and increased density indicate increased permeability of the glomerulus (nephropathy