TU Room is one of the “stations” that I’ve been to during week 4. (Please don’t ask me what does TU stand for and why is it call TU room, because nobody in my lab knows it) The tests that are done in the TU room include paediatric bilirubin on bilirubinometer, osmolality of serum or urine, CSF/urine FEME*, pH of urine and body fluid on pH meter, specific gravity of urine and body fluid on refractometer and urine phase contrast microscopy.

*FEME it’s like a package which includes cell count, specific gravity and total protein.

I am going to focus on urine phase contrast out of the above tests mentioned. This is the procedure of how urine phase contrast is done.

1. Mix the fresh urine sample well.
   
2. Pour 10ml of the urine into a labeled 10ml centrifuge tube. (make sure the names are correct when labeling)
   
3. Centrifuge at 2000rpm for 10minutes.
   
4. Pipette off the urine’s supernant leaving 0.5ml of urine in the centrifuge tube. (this is to concentrate the “particles” in the urine)
   
5. Vortex the 0.5ml of urine and sediment for 10 seconds.
   
6. Fill one compartment of the Med-Fuchs Rosenthal counter chamber with the vortex urine sample and set the microscope for phase contrast.
   
7. Under x10 locate the grids.
   
8. Under x20, (using phase 1), examine the urine sediments to detect presence of casts, epithelial cells and heavy microorganism.
   
9. Under x40, (using phase 2), count the number of dysmorphic and isomorphic red blood cell and also count the white blood cells if presence. Usually count 4 squares out of the 16 small squares and choose another 4 squares to count then take the average.
   

Granular Cast and WBC
http://www.udel.edu/medtech/mclane/Q1MM.html

The picture at the top shows isomorphic RBC and some WBC. As you can see, the shape of the RBC is still intact and you can still see the biconcave shape of the RBC. the picture at the bottom shows dysmorphic RBC and some have already ruptured.
http://www.avis.ne.jp/~naganoamt/kenkiyu/ippan

Presence of amorphous urate indicates acidic urine and there might be presence of uric acid to confirm that it is amorphous urate and it also has a coarse appearance. It is soluble in alkali, so by adding NaOH to the urine, it will solublize the amorphous urate, changing the urine clear. Therefore we can use this method to confirm that its amorphous urate.

On another hand, presence of amorphous phosphate indicates alkaline urine and it appears to be very fine granules. Presence of amorphous phosphate is soluble in diluted HCl and therefore dilute HCl can be added to confirm the presences of amorphous phosphate, which will also clear the urine.