Activity #4

MICROSCOPIC EXAMINATION OF THE URINE

OBJECTIVES: At the end of this activity, the students shall:

1. Apply the correct techniques in focusing specimen under the microscope
2. Demonstrate the proper skills in the microscopic urine examination including specimen preparation, centrifugation,
sediment preparation and reporting of results
3. Identify the microscopic elements seen in normal and abnormal urine samples
4. Correlate microscopic findings in its appropriate format

Care of the microscope:

1. Carry microscope with two hands. Take hold of the handle with one hand, and the other hand supporting the base
2. Always hold the microscope in vertical position
3. Clean the lenses with lens paper. Clean the oil immersion lens after each use
4. Never leave the slide on the stage of the microscope nor on the table after examination
5. Store the microscope with low power objective in position and the stage centered.

MATERIALS:
Slides & coverslips

BRIGHTFIELD MICROSCOPY OF UNSTAINED URINE

Subdued light is needed to delineate the more translucent formed elements of the urine such as hyaline casts,
crystals and mucus threads.
Procedure:
1. Mix the urine thoroughly and place about 10-15 ml in a centrifuge tube.
2. Centrifuge for 5 minutes at 1500 to 2500 rpm or at a 400-450 relative centrifugal force for 5 min
3. Pour off the supernatant fluid. Volume of urine and sediment left in the tube should be 0.5 to 1.0 ml
4. Mix the sediment by flicking the end of the tube with the finger, then place a drop (20 ul or 0.02 ml) on a
microscope slide and cover with a cover glass (22x22 mm)
5. Examine with the low power objective to obtain an overall picture of the deposit. Use the HPO to examine
objects more closely.
Manner of reporting (old method of reporting)
a. RBC and WBC - average cells/HPF
- TNTC (too numerous to count)
b. Casts - average casts/LPF
c. Epithelial cells - +, ++, +++, ++++
- Maybe reported as rare, few, moderate, abundant or plenty
d. Crystals - +, ++, +++, ++++
- Maybe reported as rare, few, moderate, abundant or plenty
e. Yeast, bacteria, trichomonas- few, moderate, plenty/ hpf
f. Sperm cells - report in male only
Reporting of crystals and epithelial cells
+ Or rare 1 for every 5 fields
++ Or few 2-5/ field
+++ Or moderate 6-10/field
++++ Or plenty more than 10/field

Microscopic quantitation: 10 fields (new method)

Epith cells/LPF Crystals/HPF
None: 0 None: 0
Rare: 0-5 rare: 0-2
Few: 5-20 few: 2-5
Moderate 20-100 Moderate 5-20
Many >100 Many >20

Bacteria /HPF Mucus thread/ LPF

None 0 Rare: 0-1
Rare 0-10 Few 1-3
Moderate 50-200 Moderate 0-10
Many >200 Many >10

Formed elements Field reporting

Casts /LPF 0, 0-2, 2-5, 5-10, >10
RBCs/ WBCs /HPF 0, 0-2, 2-5, 5-10, 10-25, 25-50, 50-100, >100