AUBF-Lab-Stool Flashcards
The third part of the routine urinalysis is the ______ examination of the urinary sediment.
microscopic
Micro Exam of Urine: Its
purpose is to detect and to identify ______ material present in the urine.
insoluble
These contributes to the formed elements in urine.
blood
Kidney
lower genitourinary tract external contamination
Formed elements in the urine consists of (9)
RBCs
WBCs
epithelial cells
casts
bacteria
yeast
parasites
mucus
spermatozoa
crystals
artifacts
Because some of these components are of no clinical significance and others are
considered normal unless they are present in ______ amount, examination of the urinary sediment
must include both ______ and ______ of the elements present.
increased; identification and quantification
The ______ microscopic examination is the least standardized and most ______ part of the routine urinalysis.
urine; time consuming
Identify the Urinary Crystal: Acid
Yellow-brown
Alkali soluble
Uric Acid
Identify the Urinary Crystal: Acid
Brick-dust or
Yellow-brown
Alkali and heat
Amorphous urates
Identify the Urinary Crystal: Acid/neutral (alkaline)
Colorless (envelope)
Dilute HCI
Calcium oxalate
Identify the Urinary Crystal: Alkaline/neutral
White-colorless
Dilute acetic acid
Amorphous phosphates
Identify the Urinary Crystal: Alkaline/neutral
Colorless
Dilute acetic acid
Calcium phosphates
Identify the Urinary Crystal: Alkaline
Colorless “Coffin Lids”
Dilute acetic acid
Triple phosphate
Identify the Urinary Crystal: Alkaline
Yellow-brown “Thorny Apples”
Acetic acid with heat
Ammonium biurate
Identify the Urinary Crystal: Alkaline
Colorless “dumbbell”
Gas from acetic acid
Calcium carbonate
Identify the Abnormal Urinary Crystal:
Acid
Colorless
Ammonia, dilute HCI
Cystine
Identify the Abnormal Urinary Crystal:
Acid
Colorless (notched plates)
Chloroform
Cholesterol
Identify the Abnormal Urinary Crystal:
Acid/neutral
Yellow
Hot alkali or alcohol
Leucine
Identify the Abnormal Urinary Crystal:
Acid
Yellow
Acetic acid, HCI, NaOH, Ether,
Chloroform
Bilirubin
Identify the Abnormal Urinary Crystal:
Acid/neutral
Varied
Acetone
Sulfonamides
Identify the Abnormal Urinary Crystal:
Acid
Colorless
10% NaOH
Radiographic dye
Identify the Abnormal Urinary Crystal:
Acid/neutral
Colorless
Refrigeration from bundles
Ampicillin
What are the NORMAL urinary crystals found in urine? (8)
Uric Acid
Amorphous urates
Calcium oxalate
Amorphous phosphates
Calcium phosphates
Triple phosphate
Ammonium biurate
Calcium carbonate
What are the ABNORMAL urinary crystals found in the urine? (7)
Cystine
Cholesterol
Leucine
Bilirubin
Sulfonamides
Radiographic dye
Ampicillin
What are the CASTS seen in urine? (6)
Waxy Casts
Granular Casts
Fatty Casts
Granular WBC Casts
WBC & Renal Epithelial Casts Cells
WBC & RBC Casts
Microscopic Examination of Urine Procedure
- Bring pathologic urine samples in the laboratory
- Fill the test tube with % full of urine
**Take note of the color and chemical properties of the specimen by using a dipstick (for correlation only)
before centrifuging - Centrifuge at high speed for 5-10minutes
- Decant the supernatant fluid and allow throw tube to stand for some time
- Focus first under the low power objective and then examine well under the high power objective
Stool examination is often done for evaluation of?
gastrointestinal disorders
Stool examination can be used to diagnose several disorders such as?
Gl obstruction
obstructive jaundice
parasitic disease
dysentery
ulcerative colitis
increased fat excretion
An adult excretes ______ of fecal matter a day, of which as much as 75% may be _______.
100g to 200g; water
The feces are what remain of the ______ of digested fluid-like material that enters the intestinal tract a day, and oral fluid, saliva, gastric secretion, pancreatic juice and bile add to the formation of feces.
8 to 10L
The ________ (3) of
the stool should be noted.
quantity
form consistency
color
Large amounts of mushy,
frothy, foul smelling stool are characteristic of?
steatorrhea
Feces have a characteristic odor that varies with the _____ and _____ of the stool.
diet and pH
The first indication of gastrointestinal disturbances can often be provided by changes in the ______ and ______of the normal stool.
brown color and formed consistency
The brown color or normal feces is probably due to _______, a bile pigment derivative.
stercobilin (urobilin)
What Color of Stool will be caused by the ff?
Upper gastrointestinal bleeding
Iron Therapy
Charcoal
Bismuths (Antacids)
Black
What Color of Stool will be caused by the ff?
Lower Gastrointestinal Bleeding
Beets and food coloring
Rifampin
Red
What Color of Stool will be caused by the ff?
Bile-duct obstruction
Barium sulfate
Pale, Yellow, White, Gray
What Color of Stool will be caused by the ff?
Biliverdin/Oral Antibiotics Green vegetables
Green
What Color of Stool will be caused by the ff?
Bile-duct obstruction
Pancreatic disorders
Bulky/Frothy
What Color of Stool will be caused by the ff?
Intestinal constriction
Ribbon-like
What Color of Stool will be caused by the ff?
Colitis
Dysentery
Malignancy
Constipation
Mucus/Blood streaked mucus
STOOL CONSISTENCY (5)
FORMED
SEMI-FORMED
SOFT
WATERY
MUCOID
The most frequently performed fecal analysis is chemical screening for the detection of ________.
occult (hidden) blood
Bleeding in the upper GI tract may produce a ______, ______ stool.
black, tarry
Bleeding in the lower GI tract
may result in an overtly ______ stool.
bloody
_______ testing is also controversial owing to many false-positive and false-negative results.
Occult blood
**Patients must be on a ______ diet for ______ prior to the test to avoid false positive
reaction. Salmons, sardines, and mutton also
produce positive blood test.
meat-free; 4 days;
What foods can cause positive result in occult blood testing?
Salmons, sardines, and mutton
What are the tests for testing of occult blood?
Benzidine Test
Guaiac Test
Procedure for Benzidine Test:
- Take a piece of stool about a size of a pea and place on the spot plate
- Add few drops of unsaturated solution of benzidine in glacial acetic acid and mix with feces
using an applicator - Add a few drops of 3% hydrogen peroxide is produced
Positive Result of Benzidine Test
A blue to green color is produced
Procedure of Guaiac Test
- Take a piece of feces the size of a pea and
place on a spot plate - Add 2 drops of glacial acetic acid and mix with
the feces, using an application stick - Add a few drops of the Guaiac reagent. Mix.
Positive result of Guaiac Test
A blue to green color is produced
Increased destruction of red blood cells, as in hemolytic anemia, increases the amount
of _______ excreted.
urobilinogen
Liver disease, in general, reduces the flow of ______ to the intestine and thereby decreases the fecal excretion of urobilinogen.
bilirubin
In addition, complete ______ of the bile duct reduces urobilinogen to very low levels.
obstruction
DETECTION OF FECAL UROBILIN: This test investigates ______ and _____ conditions.
hemolytic diseases and
hepatic obstructive
is an estimation of the total excretion of bile pigments, which are breakdown products of hemoglobin.
Determination of stool urobilinogen
Reference Values or Stool Urobilin in adult? in newborns-6months
50-300 mg/24hourss or 100-400 Erlich units/100g
Newborns - 6 months: Negative
Principle of Schmidt’s Test
Hydrobilirubin unites with mercury compounds to form a red hydrobilirubin -mercury
Procedure of Schmidt’s Test
- Place a few grams of fresh feces in a mortar
and add an equal quantity of 10% mercuric
chloride solution. - Mix well with pestle
- Transfer to a shallow evaporating dish and
allow to stand 6-24 hours
Positive result of Schmidt’s Test: Urobilin which is normally
present will give a _____ color
Bile which is not normally present in feces will
give a _____ color
red; green
Positive result of Schmidt’s Test: Urobilin which is normally
present will give a _____ color
Bile which is not normally present in feces will
give a _____ color
red; green
Microscopic screening of fecal smears is performed to detect the presence of_____ associated with microbial
diarrhea and undigested muscle fibers and
fats associated with steatorrhea.
leukocytes
Fecal leukocytes primarily _______, are seen in the feces in conditions that affect the
intestinal mucosa, such as _____ and _____.
neutrophils; ulcerative colitis
and bacterial dysentery
______ can be helpful in the diagnosis and monitoring of
patients with pancreatic insufficiency, such
as in cases of cystic fibrosis.
Undigested striated muscle fibers
Procedure of Direct Fecal Smear Method
- Emulsify a minute amount of the most suspicious portion of the stool with an applicator
stick and NSS solution. - Place a cover slip
- Examine the preparation under the microscope
Direct Fecal Smear Method: *This method permits the examination of motile stages of fresh stools. In the case of cyst,
the addition of a drop dilute ______ solution will help in bringing about details in these structure.
Lugol’s
