Microscopic Examination of Urine (Reporting of Results)

10-15 fields

What is the minimum fields in examination sediments?

detects casts and ascertain general composition of sediments

What do the LPO detects?

Identification of specific types

What does HPO identifies?

1. Casts

2. Squamous Epithelial Cells

3. Abnormal Crystals

4. Mucus Threads

5. Amorphous materials (urates & phosphates)

Enumerate the sedimentsin manner of reporting under LPO

1. RBCs

2. WBCs

3. Non-epithelial cells (transitional and renal tubular)

4. Bacteria, yeast, protozoa, fat globules

5. Sperm cells

6. Normal crystals

Enumerate the manner of reporting under HPO

range/lpf

How do you report casts?

range/hpf

How do you report RBC/WBC?

rare, few, moderate, abundant

How do you report epithelial cells, mucus threads, crystals, amorphous materials, bacteria?

seen

How do you report sperm cells, yeast cells, flagellates?

All personnel should use the same:

• terminologies

• reporting format

• reference range

What should the personnel do to standardize results?

Report as: range per hpf

NV: 0-2/hpf

TNTC (too numerous to count) - cannot be counted

None seen - negative

Red Blood Cells

Report as: range per hpf

NV: 0-5/hpf

TNTC (too numerous to count) - cannot be counted

None seen - if negaitve

White Blood Cells

hematuria

What do you call the presence of large numbers of RBC?

pyuria or leukocyturia

What do you call the increase in number of WBC?

1. Squamous Epithelial Cells

2. Transitional Epithelial Cells

3. Renal Tubular Epithelial Cells

What are the specific types of epithelial cells?

Report as:

Negative (0/lpf)

Rare (0-5/lpf)

Few (5-20/lpf)

Moderate (20-100/lpf)

Abundant (cells cannot be counted)

Squamous Epithelial cells

Report as:

Negative (0/hpf)

Rare (0-5/hpf)

Few (5-20/hpf)

Moderate (20-100/hpf)

Abundant (cells cannot be counted)

Transitional Epithelial Cells

Report as:

NV: rare (0-2/hpf)

Negative (0/hpf)

Rare (0-5/hpf)

Few (5-20/hpf)

Moderate (20-100/hpf)

Abundant (cells cannot be counted)

Renal Tubular Epithelial Cells

counted using LPO but specific type is classified using HPO

How do you view casts under the microscope?

Chyluria or cylindruria

What do you call the increased number of casts in urine

Report as: range per lpf

NV: 0-2 per lpf (hyaline cast)

How do you report castss?

Tamm-Horsfall Mucoprotein

What composed of the urinary casts?

• interstitial nephritis

• pyelonephritis

WBC Cast

glumerulonephritis

RBC Cast

Acute Tubular Necrosis

Renal Tubular Epithelial Cell Cast

chronic renal failure

muddy brown = ATN

Granular Casst

formed in the distal nephron

Where do cast formed?

Nephrotic syndrome

Fatty Casst (Oval fat bodies)

Exercise

Diuretics

concentrated urine

Hyaline Cast

chronic renal failure

Broad or Waxy cast

1. Bacteria

2. Protozoa (flagellates)

3. Yeasts

Enumerate the type of microorganisms

• may appear as tiny round or rod shape objects

• viewed under HPO

What is the appearance of bacteria and what objective you can view it?

Report as:

Negative (0/hpf)

Rare (0-10/hpf)

Few (10-50/hpf)

Moderate (50-200/hpf)

Abundant (>200/hpf)

Bacteria report as

Report as: seen

If negative report as: Negative

Protozoa reporting - viewed under HPO

Report as: Seen

If negative report as: Negative

Yeast cells reporting - under HPO

Report as: Seen

If negative report as: Negative

Sperm cells reporting - HPO

Lining the urinary tract

viewed under LPO

What is mucus threads?

Report as:

Negative (0/lpf)

Rare (0-3/lpf)

Few (3-10/lpf)

Moderate (10-20/lpf)

Abundant (>20/lpf)

Mucus Threads report as

1. Amorphous urates

2. Amorphous phosphates

3. Amorphous carbonates

Enumerate the types of amorphous materials

Report as:

Negative (0/lpf)

Rare (0-2/lpf)

Few (2-5/lpf)

Moderate (5-20/lpf)

Abundant (>20/lpf)

How do you report amorphous materials?

• Uric Acid

• Calcium Oxalate

• Sodium Urates

• Hippuric Acid

What are the type of normal crystals in acid urine?

Report as:

Negative (0/hpf)

Rare (0-2/hpf)

Few (2-5/hpf)

Moderate (5-20/hpf)

Abundant (>20/hpf)

How do you report normal crystals in acid and alkaline urine?

Report as:

Negative (0/lpf)

Rare (0-2/lpf)

Few (2-5/lpf)

Moderate (5-20/lpf)

Abundant (>20/lpf)

Reporting of Abnormal crystals

Range - Lower Value & Higher Value

How do you determine the range?