CLINICAL MICROSCOPY o Depends on the pH and the

presence of dissolve solids

SPECIMEN COLLECTION
1. Type of specimen
 Early morning urine
o Most preferred sample
particularly for protein analysis
o WHY? More concentrated from
overnight retention in the
bladder.  Volume
o Random urine o Indicate balance between fluid
 Collected any time of ingestion and water lost from
the day; for routine lungs, sweat and intestines
analysis Volume Description
o Fasting/post-prandial urine 10-12 mL aliquot Optimal volume for
 For glucose accurate ru
750-2,000 mL/24 hour Normal adult volume
determination
Polyuria Excessive urine excretion
o Timed urine
Oliguria Scanty urine excretion
 For clearance test
Anuria Absence of urine output
2. Method of collection
 Clean midstream catch
 Specific gravity
 Catheterization o Normal values: 1.005-1.030
3. Specimen handling
o Indication of the density of a
 Must be analyzed within 1 hour of
fluid depending on the
collecting the specimen
concentration of dissolved total
 If delayed: Ref at 2-8 oC for not more solids
than 8 hours o Marker of the amount of
4. Effects of unpreserved urine
hydration/dehydration of an
 Bacterial multiplication will cause false individual
positive (+) nitrite test o The darker the urine, the higher
 pH alkalinization: leads to cast its specific gravity
degeneration and red cell lysis o URINOMETER AND
REFRACTOMETER,
PROCEDURES IN ROUTINE URINALYSIS
CHEMICAL
1. Physical examination
o CLINICAL CORRELATIONS
 Color
Clinical Correlation
o A rough indication of the state
^ SG Diabetes mellitus, congestive heart
of hydration of an individual
failure, dehydration, adrenal
o The darker the color of the
insufficiency, liver disease, and
urine, the more concentrated it nephrosis
will be
v SG Diabetes insipidus, pyelonephritis, and
 Odor glomerulonephritis
o Has little diagnostic significance
and is not included in the  pH
routine laboratory result
o Refers to the logarithm of the
o Urine is aromatic
hydrogen ion concentration
o Suggestive of the freshness of
o Normal pH of urine: 4.5-8.0
the urine sample
o CHEMICAL TEST
 Acidity (pH <7)
 Turbidity  Alkalinity (pH >7)
o Also known as clarity or 2. Chemical examination
transparency  Reagent Strip Method
o Refers to the degree of
cloudiness in a urine
 o Contains test pads impregnated
with reagents that specifically
react with a test analyte and
register a specified color change

3. Microscopic examination
 1-2 drops of urine sediment from a
centrifuged urine is placed on a glass
slide
 Cover slip is then placed on top of the
slide Miscellaneous elements
 Both LPO and HPO are used Spermatozoa Often encountered in urine of both
 WBC and RBC are counted male and female but are usually not
 Crystals and other elements are graded reported (sexual intercourse or
(count) nocturnal emissions)
 CELLULAR ELEMENTS Yeast cells Budding RBC-like cells (diabetes
o Average of at least 10 (Candida mellitus and vaginal moniliasis)
albicans)
microscopic fields
Parasites Enterobius vermicularis,
a. RBC : “hematuria” Trichomonas vaginalis,
 Average count per high power schistosoma haematobium
field Bacteria Gram (-) coliforms Escherichia
 Glomerulonephritis, severe coli and Proteus sp.
exercise, menstrual blood Mucus Threads Protein material produced by
contamination and renal calculi glands and epithelial cells in the
obstruction genitourinary tract
b. WBC : “pyuria”
 Average count per high power Thread-like structures with low
field refractive index requiring
 Pyelonephritis, UTI and observation under subdued light
inflammation
c. Epithelial cells
 Cells sloughed off the lining of
the nephrons and urinary tract
d. Crystals : “crystalluria”
 Formed by the precipitation of
the urine salts subjected to Spermatozoa Fungi - Candida Albicans Trichonomas
changes in pH, temperature or
concentration
 May collect and aggregate
together to form renal stone or
“calculus”

e. Casts
 Formed within distal convulated
tubule and collecting duct
 Hyaline, granular and cellular