Urine microscopic examination

Differential Diagnosis of Acute Renal Failure on the Basis of Urine Microscopic Examination Findings... 

If the test is positive, the urine is examined microscopically for red blood cells. If no red blood cells are found, a tentative diagnosis of myoglobinuria is made, serum chemistries are obtained, and the patient is held to rule out rhabdomyolysis. If the uric acid and creatinine kinase (CK) values are normal, and the patient is asymptomatic, he/she is discharged from the hospital. Routine toxicology tests include urinary PCP, serum alcohol, and hypnotic screen. 

A standard urinalysis should be obtained in the initial assessment of a patient. Microscopic examination of the urine should be performed by preparation of a Gram stain of unspun or centrifuged urine. The presence of at least one organism per oil-immersion field in a properly collected uncentrifuged specimen correlates with more than 100,000 bacteria/mL of urine. 

Most clinical laboratories have established a standard battery of tests that includes most or all of the basic parameters listed in Table 20.12. If a dipstick is used to test the urine for several parameters, it is useful to use one that measures occult blood, even if a microscopic examination will count the number of red blood cells per high-power field. The means of obtaining the specimen should be indicated (i.e., normal voiding sample, clean catch, midstream, catheterization, suprapubic tap, or cytoscopy), especially in clinical trials in which an antidiuretic or antibiotic (or other relevant drug) is being tested. 

It is usually unnecessary to obtain a microscopic examination on all urinalyses unless there are reasons to believe that important information and data may be lost. This is particularly true after it has been demonstrated that the test treatment does not affect the parameters measured in the microscopic evaluation of urine. 

The type of urine specimen to be collected is dictated by the tests to be performed. Untimed or random specimens are suitable for only a few chemical tests usually, urine specimens must be collected over a predetermined interval of time, such as 1,4, or 24 hours. A clean, early morning, fasting specimen is usually the most concentrated specimen and thus is preferred for microscopic examinations and for the detection of abnormal amounts of constituents, such as proteins, or of unusual compounds, such as chorionic gonadotropin. The clean timed specimen is one obtained at specific times of the day or during certain phases of the act of micturition. Bacterial examination of the first 10 mL of urine voided is most appropriate to detect urethritis, whereas the midstream... 

Examination of the urine is often the first step in the assessment of a patient suspected of having, or confirmed to have, deterioration in kidney function. In the laboratory, urine is examined visually, chemically, and microscopically. New instrumental techniques are also being used to examine urine. 

Microscopic examination of the sediment obtained from the centrifugation of a fresh urine sample wiU show the presence of a few cells (erythrocytes, leukocytes, and cells derived from the kidney and urinary tract), casts (composed predominantly of Tamm-HorsfaU glycoprotein [THG]), and possibly fat or pigmented particles. An increase in red cells or casts unplies hematuria, possibly caused by glomerular disease white cells or casts imply the presence of white cells in the tubules. Inflammation of the upper urinary tract may result in polymorphonuclear leukocytes and various types of casts, and in lower urinary tract inflammation the casts will not be present. In acute glomerulonephritis, hematuria may... 

Microscopic examination of the urine for leukocytes is also used to determine the presence of pyuria. The presence of pyuria in a symptomatic patient correlates with significant bacteriuria. Pyuria is defined as a white blood cell (WBC) count of greater than 10 WBCs/mm of urine. A count of 5 to 10 WBCs/mm is accepted as the upper limit of normal. It should be emphasized that pyuria is nonspecific and signifies only the presence of inflammation and not necessarily infection. Thus patients with pyuria may or may not have infection. Sterile pyuria has long been associated with urinary tuberculosis, as well as chlamydial and fungal urinary infections. 

Stored plant drugs are often found to be contaminated by rat and mice hairs, urine and faeces. Infested drugs are not recognised as official by the British Pharmacopoeia which states in the General Notices that Vegetable drugs are required to be free from insects and other animal matter and from animal excreta . Insects and rodent hairs (an indicator of rodent faecal contamination) can be recovered by preferential wetting of their exoskeletons by paraffin. Microscopical examination can establish the type of insect or rodent involved. 

Urine microscopy The microscopic examination of the urine sediment provides enhanced diagnostic efficiency. Hematuria The normal number of erythrocytes in resuspended urine sediment is no more than 1 to 2 per high-powered field. When an abnormal number... 

Tests in this list are grouped by the following types blood, electrodiagnostic, endoscopy, fluid analysis, manometric, microscopic examination, nuclear scan, other studies, sputum, stool, ultrasound, urine, and x-ray. 

Initial urinalysis will typically be heme positive on dipstick, but with scant formed red blood cells on microscopic examination. Later, as oliguria progresses, an active urine sediment with red blood cells and casts will often emerge. Quantitative measurement of urine hemoglobin may rise to 3 g/L during significant hemolysis, and in some instances may exceed 10 g/L. 

In addition, separate groups of male and female rats (six per sex per group) were fed diets containing 197, 1966 and 3932 mg/kg of the flavour cocktail for a period of 6 weeks. A control group of 12 male and 12 female rats was maintained on a basal diet for 6 weeks. At the end of the 6-week period, all animals were killed, and organ weight measurements and macroscopic and microscopic examinations were performed. Biochemical tests on blood and urine were conducted on this... 

A sterile sample of urine was obtained and an immediate urinalysis was performed. It revealed, on microscopic examination, the presence of bacteria, red blood cells, and debris. There was no evidence of the presence of albumin or glucose. The urine was submitted to the laboratory for culture and sensitivity tests and blood was sent for complete blood count and blood chemistries. 

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