MICROSCOPIC EXAMINATION OF URINE：尿镜检.docVIP

MICROSCOPIC EXAMINATION OF URINE I. Standardization A. Ensures accuracy and precision of examination B. There are 7 factors that should be standardized in the performance of the microscopic examination of urine: 1. Proper specimen a. Proper collection b. Rapid transport and prompt examination 2. Standard volume of urine evaluated ____________________ 3. Proper Centrifugation a. Speed ___________ b. Length of time __________ c. No brake 4. Standard volume of urine to resuspend sediment: 5. Standard volume of resuspended urine examined a. Glass slide with coverslip b. Commercial system: Kova, Count10 6. Consistent Examination: Field of View (FOV) a. Must evaluate a minimum of 10 representative fields 1) Increasing the number of fields evaluated increases the validity of the value reported 2) Elements must be evenly distributed throughout the slide, else prepare a new wetmount b. Low power: Examine coverslip perimeter c. High power: Examine center 7. Standardized report format and terminology a. Low power field (LPF): objective = ___________ 1) Squamous epithelial cells 2) Casts 3) Mucus b. High power field (HPF): objective = ___________ 1) RBC, WBC, transitional and renal epithelial cells 2) Bacteria, crystals 3) Yeast, sperm, trichomonads C. To ensure accuracy in reporting, the microscopic results should be correlated to the physical and chemical results Microscopic Elements Physical (color/clarity) Chemical (dipstick) Exceptions Red blood cells White blood cells Epithelial cells Casts Crystals Bacteria clarity, color clarity clarity clarity clarity, color clarity + blood + protein, leukocytes, nitrite + protein pH + nitrite, pH Number, hemolysis Number, type of WBC and bacteria Number Number Number, type Number, type II. Staining and Microscopic Techniques (textbook, pg 183, table 8-2) A. Stains: used to enhance visualization, each having different advantages/disadvantages Sternheimer-Malbin a. C