6th week of SIP

Hi everyone! For the last 2weeks, I was attached to the Urinalysis/Routine section. Well, it was interesting to look at the different colour of urine specimen. Do you know that urine are not always colourless yellow?Some are bloody yellow, and some are dark yellow and are very turbid. Yucks. Haha, but as the 2nd weeks pass by, it became normal thing. In this section, I get to observe and practice on the different test done on urine sample. Some of the tests done at the lab are Urine FEME (Full Examination/Microscopic Examination), Blood Ketone Test, Urine Pregnancy Test, Feccal Occult Blood Test, Ove, Amoeba and Cyst Test and etc..


Topic: Urine FEME (Full Examination/Microscopic Examination)

Urine FEME are microscopic examination of urine sediment. It is one of the common test done in the lab. Everyday, there will be lots of requests for this test. Urine specimen is examined unstained and used to access for sediments such as red blood cells, epithelial cells, white blood cells, casts, crystals, microoragnisms, blastoconidia, parasites and spermatoza. Random urine sample received from the processing section are mixed well by inverting the container about 5-8times. The urine is then transfered to the notch on the KOVA Glasstic Slide Chamber with a plastic pipette. The urine(about 6.6ul) will be drawn into the chamber by the caillary action. According to the SOP, to examine and quantitate casts and epithelial cells, use low power magnification which is 10X objective. While to quantitate all the other cells, use high power magnification which is 40X objective. Usually the MedTech would view the grid using the 20X objective to evaluate whether it is a low cell count or high cell count. They would then proceed to count either 10 small grids within different quadrant if it is a high cell count or count 4 complete quadrants of the grids if it is a low cell count. Cells/ul are calculated by multiplying the average cells obtained per grid by 90.




KOVA Glasstic Slide Chamber

Picture taken from:
http://www.cardinal.com/mps/catalog/ASP/U3050-11.asp?cat=Laboratory




This is how the grid would look like.
If it is a low cell count (few cells), only the four quadrants are count.





If it is a high count, 10 smaller grids are counted.


All urine sample which request for Urine FEME will be run in the Clinitek Atlas Analyser. It is a fully automated reflectance spectrophotometer which uses Clinitek Atlas Reagent Paks for testing glucose, bilirubin, ketone, occult blood, pH, protein, urobilinogen, nitrite, leukocytes, and the colour of the specimen. The analyser also helps to determine the specimen's specific gravity using the refractive index method and the clarity by measuring the transmission and scattering of light that passes through the specimen. Basically, the Clinitek Atlas Analyser acts as an automated dipstick. However, if the analyser is down, the manual dipstick test have to be done. Last week, I experience a situation in which the analyser was faulty and we had to the the manual dipstick method. It was hectic as there were so many urine samples and we had to read the result one by one and record it down before entering it into the LIS. Fortunately, the engineer came to the rescue and fixed the analyser.



Clinitek Atlas
Picture taken from :
http://diagnostics.siemens.com/webapp/wcs/stores/servlet/ProductDisplay~q_catalogId~e_-111~a_catTree~e_100001,1015867~a_langId~e_-111~a_productId~e_172988~a_storeId~e_10001.htm



Topic 2: Urine/Serum hcG Pregnancy Test




hcG combo pack

Urine pregnacy test is one of the common and simple test. It only takes 5 miunutes. The test uses the TestPack hCG Combo which is a rapid immunoassay for qualitative detection of Human Chronic Gonadotropin (hcG) in serum and urine for early detection. hcG is a glycoprotein hormone that is produced by the blastocyst. The specimen used in this test is a random urine specimen collected in a clean and dry container. It will be best if collection is done on first morning specimen as it contains the highest amount of hcG. Urine sample is sent to the Urinalysis section. Urine is drawn to the line marked in the transfer pipette. The entire content in the pipette is drop into the sample well on the reaction disc. Sample is allow to react with the test kit.

In the test procedure, urine or serum is added to the sample well of the reaction disc with the aid of the transfer pipette and is allowed to migrate through the membrane. The urine or serum will pass through the membrane and thereby mobilizing the anti-hcG monoclonal antibody-colloid. The antibody-colloid complex migrates through the membrane and is captured by the immobilized anti-hcG polyclonal antibodies in the result window, providing a visual indication of the presence of hcG. Since the test only takes 5 minutes, reading should be after the 5 minutes.Any result that appears after 5 minutes are to be ignored. If hcG is present in the urine or serum at levels of 25mlu/ml or greater, a plus sign (+) will appear in result window. If no hcG is detected, a minus(-) will appear. Thus. providing an easy intepretion of result for patient's sample.

Pre-menopausal females generally contain < 5mlu/ml hcG while healthy males and post menopausal females generally contain < 10 mlu/ml. In pregnant women the hcG level rises within 9-12days after ovulation and the urine hcG reaches level of up to 1500mlu/ml 8-10 weeks after last menstrual period.

Thank You for reading!

Peace,
Dyana