Specimens collection part 2

Specimens collection (2)Specimens collection (2)

Urine SpecimenUrine Specimen
 Random
 Clean
 Female ? Menses (make note)
 Tested for:
 Specific gravity
 pH
 Albumin
 Glucose
 Microscopic exam
 Random
 Clean
 Female ? Menses (make note)
 Tested for:
 Specific gravity
 pH
 Albumin
 Glucose
 Microscopic exam

Precautions for urine analysisPrecautions for urine analysis
 The ideal situation is when the specimen is analyzed shortly
after collection (within 1h)
 If examination can not be done directly after collection the
sample must be refrigerated within 1 hour of collection.
 If the specimen is not refrigerated within 1 hour of
collection, the following changes in composition may
occur:
 Increased pH from the breakdown of urea to ammonia by
urease-producing bacteria)
 Decreased glucose from glycolysis and bacterial utilization
 Decreased ketones because of volatilization
 Decreased bilirubin from exposure to light
 The ideal situation is when the specimen is analyzed shortly
after collection (within 1h)
 If examination can not be done directly after collection the
sample must be refrigerated within 1 hour of collection.
 If the specimen is not refrigerated within 1 hour of
collection, the following changes in composition may
occur:
 Increased pH from the breakdown of urea to ammonia by
urease-producing bacteria)
 Decreased glucose from glycolysis and bacterial utilization
 Decreased ketones because of volatilization
 Decreased bilirubin from exposure to light

 Decreased urobilinogen as a result of its
oxidation to urobilin
 Increased bacteria from bacterial reproduction
 Increased nitrite from bacterial reduction of
nitrate
 precipitation of amorphous urate
 Changes in color caused by oxidation or
reduction of metabolites
 Increased turbidity caused by bacterial growth
and precipitation of amorphous material
 Disintegration of red blood cells (RBCs) and
casts, particularly in dilute alkaline urine
 Decreased urobilinogen as a result of its
oxidation to urobilin
 Increased bacteria from bacterial reproduction
 Increased nitrite from bacterial reduction of
nitrate
 precipitation of amorphous urate
 Changes in color caused by oxidation or
reduction of metabolites
 Increased turbidity caused by bacterial growth
and precipitation of amorphous material
 Disintegration of red blood cells (RBCs) and
casts, particularly in dilute alkaline urine

 Generally specimens that could lead to false
interpretation should be rejected such as:
 The sample must be sufficient quantity { The
widely accepted urine volume is about 12
ml}
 Specimens that is contaminated from a
woman's menstrual period.
 Not getting urine sample to lab in 2 hour.
 urine sample that is taken in dirty container
 Specimens that is contaminated with feaces
 Generally specimens that could lead to false
interpretation should be rejected such as:
 The sample must be sufficient quantity { The
widely accepted urine volume is about 12
ml}
 Specimens that is contaminated from a
woman's menstrual period.
 Not getting urine sample to lab in 2 hour.
 urine sample that is taken in dirty container
 Specimens that is contaminated with feaces

Characteristics of UrineCharacteristics of Urine
1. APPEARANCE
 NORMAL URINE- CLEAR
 Cloudy- Precipitation of amorphous
phosphates in alkaline urine / amorphous
urates in acid urine.
 Turbid- Leucocytes , epithelial cells,
bacteria
 Hazy- Mucous
 Smoky- RBC
 Milky- Fat, Chyle
1. APPEARANCE
 NORMAL URINE- CLEAR
 Cloudy- Precipitation of amorphous
phosphates in alkaline urine / amorphous
urates in acid urine.
 Turbid- Leucocytes , epithelial cells,
bacteria
 Hazy- Mucous
 Smoky- RBC
 Milky- Fat, Chyle

 The turbidity of the urine sample is gauged
subjectively and reported.
 Normally, fresh urine is clear to very slightly
cloudy.
 Procedure:
 Observe the clarity of a fresh urine sample by visually
examining a well-mixed specimen in front of a light source.
 Common terms used to report appearance include the
following:
 Clear, hazy, slightly cloudy, cloudy, turbid,
and milky.
 The turbidity of the urine sample is gauged
subjectively and reported.
 Normally, fresh urine is clear to very slightly
cloudy.
 Procedure:
 Observe the clarity of a fresh urine sample by visually
examining a well-mixed specimen in front of a light source.
 Common terms used to report appearance include the
following:
 Clear, hazy, slightly cloudy, cloudy, turbid,
and milky.

Infected (turbid) Urine. Note the turbidInfected (turbid) Urine. Note the turbid
appearance. In most cases the urine will haveappearance. In most cases the urine will have
a disagreeable odor.a disagreeable odor.

UrineUrine--GrossGross HematuriaHematuria. Note the dark. Note the dark
red or "port wine" appearance.red or "port wine" appearance.

UrineUrine--IctericIcteric. Note the brownish. Note the brownish
color and the foamy appearancecolor and the foamy appearance

2. Urine Color :Urine Color :
 The color of the urine sample is assessed
and reported as red, brown, yellow, etc,
 Note: Normal urine color darkens on
standing because of the oxidation of
urobilinogen to urobilin.This decomposition
process starts about 30 minutes after voiding
2. Urine Color :Urine Color :
 The color of the urine sample is assessed
and reported as red, brown, yellow, etc,
 Note: Normal urine color darkens on
standing because of the oxidation of
urobilinogen to urobilin.This decomposition
process starts about 30 minutes after voiding

Urine Specimen Collection :Urine Specimen Collection :
1. Random Specimens
 Clean-not sterile
 Ordered for
 Urinalysis testing
 Measurement of specific gravity
 pH
 Glucose levels
1. Random Specimens
 Clean-not sterile
 Ordered for
 Urinalysis testing
 Measurement of specific gravity
 pH
 Glucose levels

UrineUrine specimenspecimen collection cont,collection cont,
2. Midstream Specimen
 Clean voided
 C & S
 30-60 mls urine
3. Sterile Specimen
 Indwelling catheter
 Drainage bag
2. Midstream Specimen
 Clean voided
 C & S
 30-60 mls urine
3. Sterile Specimen
 Indwelling catheter
 Drainage bag

Urine collection cont,Urine collection cont,
4. Timed urine specimens
 2-72 hr intervals (24hr most common)
 Begin after urinating
 Note start time on container & requisition
 Collect all urine in timed period
Post Reminder Signs
4. Timed urine specimens
 2-72 hr intervals (24hr most common)
 Begin after urinating
 Note start time on container & requisition
 Collect all urine in timed period
Post Reminder Signs

Common Urine Lab TestsCommon Urine Lab Tests
 Routine Urinalysis
◦ Examine within 2hrs
◦ 1st voided specimen in AM
◦ Reagent strip
 Specific Gravity
◦ Concentration
◦ 1.010 - 1.025
 Urine glucose
◦ Diabetics
◦ Reagent strips
◦ Double void
 Routine Urinalysis
◦ Examine within 2hrs
◦ 1st voided specimen in AM
◦ Reagent strip
 Specific Gravity
◦ Concentration
◦ 1.010 - 1.025
 Urine glucose
◦ Diabetics
◦ Reagent strips
◦ Double void

Measuring chemical properties ofMeasuring chemical properties of
urine=Urinalysisurine=Urinalysis
 Glucose
 Ketones
 Protein
 Blood- hematuria
 pH
 Specific gravity
 Microscopic examination
 Glucose
 Ketones
 Protein
 Blood- hematuria
 pH
 Specific gravity
 Microscopic examination

Chemical examination :Chemical examination :
Proteins in urine
 Normal- upto 150 mg/24 hours or 10mg/100ml in
 single sample.
 Methods-
 Heat and acetic acid test-The test is based
on the
 principle of heat coagulation and precipitation of
proteins by acetic acid.
 Sulphosalicylic acid test- Sulphosalicylic
acid : neutralizes protein cation, resulting in
precipitation of
Proteins in urine
 Normal- upto 150 mg/24 hours or 10mg/100ml in
 single sample.
 Methods-
 Heat and acetic acid test-The test is based
on the
 principle of heat coagulation and precipitation of
proteins by acetic acid.
 Sulphosalicylic acid test- Sulphosalicylic
acid : neutralizes protein cation, resulting in
precipitation of

 Proteins in urine
Heat and Acetic Acid Method
 Procedure :
 Take a long test tube and fill ¾ the tube with clear urine.
 Boil the upper portion over a flame, the lower portion
serves as the control.
If proteins, phosphates or carbonates are present in the
urine a turbidity develops.
 Add 1-3 drops of 10% glacial acetic acid.
 Any turbidity due to phosphate precipitation will clear or if it
is due to carbonates they disappear with effervescence.
 If it persists, it is due to albumin.
 Proteins in urine
Heat and Acetic Acid Method
 Procedure :
 Take a long test tube and fill ¾ the tube with clear urine.
 Boil the upper portion over a flame, the lower portion
serves as the control.
If proteins, phosphates or carbonates are present in the
urine a turbidity develops.
 Add 1-3 drops of 10% glacial acetic acid.
 Any turbidity due to phosphate precipitation will clear or if it
is due to carbonates they disappear with effervescence.
 If it persists, it is due to albumin.

 Interpretation
 Negative – No turbidity or cloudiness.
 Trace – Cloudiness visible against a black
 background ( 5 mg / dl).
 1+ - Definite cloudiness without flocculation and
 granularity
 ( 10 – 30 mg / dl ).
 2+ - Heavy and granular cloudiness without
 flocculation.
 ( 40 – 100 mg / dl).
 3+ - Dense opaque cloud with marked flocculation
 ( 200 – 500 mg / dl) .
 4+ - Thick cloudiness with precipitation
 Interpretation
 Negative – No turbidity or cloudiness.
 Trace – Cloudiness visible against a black
 background ( 5 mg / dl).
 1+ - Definite cloudiness without flocculation and
 granularity
 ( 10 – 30 mg / dl ).
 2+ - Heavy and granular cloudiness without
 flocculation.
 ( 40 – 100 mg / dl).
 3+ - Dense opaque cloud with marked flocculation
 ( 200 – 500 mg / dl) .
 4+ - Thick cloudiness with precipitation

 Sulphosalicylic acid test
 If urine is alkaline, it should be acidified.
 Procedure:
 2ml of acidic urine taken in test tube.
 Add an equal volume of 20%
Sulphosalicylic acid.
 Mix thoroughly, allow it to stand for 10
minutes and estimate the amount of
turbidity.
 Absence of cloudiness- Absence of
protein.
 Sulphosalicylic acid test
 If urine is alkaline, it should be acidified.
 Procedure:
 2ml of acidic urine taken in test tube.
 Add an equal volume of 20%
Sulphosalicylic acid.
 Mix thoroughly, allow it to stand for 10
minutes and estimate the amount of
turbidity.
 Absence of cloudiness- Absence of
protein.

 If turbidity persists after boiling- Positive
for protein.
 Negative : No cloudiness
 Trace: Barely visible cloudiness.
 1+ : definite cloud without granular
flocculation
 2+ : heavy and granular cloud without granular
 flocculation
 3+ : dense cloud with marked flocculation.
 4+ : Cloudiness with precipitation
 If turbidity persists after boiling- Positive
for protein.
 Negative : No cloudiness
 Trace: Barely visible cloudiness.
 1+ : definite cloud without granular
flocculation
 2+ : heavy and granular cloud without granular
 flocculation
 3+ : dense cloud with marked flocculation.
 4+ : Cloudiness with precipitation

UrineUrine--ProteinuriaProteinuria--SulfasalicylicSulfasalicylic AcidAcid
Test from left to right negative toTest from left to right negative to 44++
(negative,(negative, 11+,+, 22+,+, 33+,+, 44+)+)

 Dipstick test:
 Principle
 This test is based on the "protein error of
indicator dyes (tetrabromphenol blue)".
 Basically, the test is dependent on the
ability of amino groups in proteins to bind
to and alter the color of acid-base
indicators, even though the pH is
unchanged.
 Dipstick test:
 Principle
 This test is based on the "protein error of
indicator dyes (tetrabromphenol blue)".
 Basically, the test is dependent on the
ability of amino groups in proteins to bind
to and alter the color of acid-base
indicators, even though the pH is
unchanged.

 False positive reactions
 False positives occur rarely in highly alkaline urine
samples
 Contact time: Leaching of the citrate buffer
occurs if the urine remains in contact with the
pad for a long time.
 Urine of high specific gravity may cause higher
than normal readings
 False negative reactions
 Bence- Jones proteinuria
 Very dilute urine may give a falsely low protein
value.
 False positives occur rarely in highly alkaline urine
samples
 Contact time: Leaching of the citrate buffer
occurs if the urine remains in contact with the
pad for a long time.
 Urine of high specific gravity may cause higher
than normal readings
 Bence- Jones proteinuria
 Very dilute urine may give a falsely low protein
value.

 SUGARS IN URINE
 This is a non-specific test useful for
semiquantitation of marked glucosuria.
Benedict’s qualitative test
 Principle- Aldehyde group of reducing sugar reduces
Cupric ions in Benedict’s reagent to cuprous oxide.
 Detects all sugars except sucrose.
 The final color of the solution depends on how
much of this precipitate was formed, and therefore
the color gives an indication of how much reducing
sugar was present.
 Increasing amounts of reducing sugar
 Green yellow orange red
 SUGARS IN URINE
 This is a non-specific test useful for
semiquantitation of marked glucosuria.
Benedict’s qualitative test
 Principle- Aldehyde group of reducing sugar reduces
Cupric ions in Benedict’s reagent to cuprous oxide.
 Detects all sugars except sucrose.
 The final color of the solution depends on how
much of this precipitate was formed, and therefore
the color gives an indication of how much reducing
sugar was present.
 Increasing amounts of reducing sugar
 Green yellow orange red

 Procedure
 Take 5ml of Benedict’s reagent
 Boil for 3 – 5 minutes
 Add 0.5ml (8 drops)of urine.
 Boil for 2 minutes.
 Cool and note the color.
 Procedure
 Take 5ml of Benedict’s reagent
 Boil for 3 – 5 minutes
 Add 0.5ml (8 drops)of urine.
 Boil for 2 minutes.
 Cool and note the color.

 Recording results
 The color varies from blue through green –
yelloworange-
 brick red.
 Negative No change in color.
 Trace Greenish blue
 1+ Greenish yellow (0.5% sugar)
 2+ Yellow (1% sugar)
 3+ Orange precipitate (1.5% sugar)
 4+ Brick red precipitate (2% sugar)
 Recording results
 The color varies from blue through green –
yelloworange-
 brick red.
 Negative No change in color.
 Trace Greenish blue
 1+ Greenish yellow (0.5% sugar)
 2+ Yellow (1% sugar)
 3+ Orange precipitate (1.5% sugar)
 4+ Brick red precipitate (2% sugar)

COLORIMETRIC REAGENT STRIPCOLORIMETRIC REAGENT STRIP
TESTTEST
 Principle: this test is based on a double
sequential enzyme reaction.
 One enzyme, glucose oxidase, catalyzes the
formation of gluconic acid and hydrogen
peroxide from the oxidation of glucose.
 A second enzyme, peroxides catalyzes the
reaction of hydrogen peroxide with
potassium iodide chromogen to oxidize the
chromogen to colors ranging from green to
brown.
 Principle: this test is based on a double
sequential enzyme reaction.
 One enzyme, glucose oxidase, catalyzes the
formation of gluconic acid and hydrogen
peroxide from the oxidation of glucose.
 A second enzyme, peroxides catalyzes the
reaction of hydrogen peroxide with
potassium iodide chromogen to oxidize the
chromogen to colors ranging from green to
brown.

◦ The presence of bacterial peroxidases (e.g. cystitis), will produce
false positive reactions.
◦ Drugs: Nalidixic acid, cephalosporins, Chloramphenicol, Isoniazid and
penicillin
◦ Stress, excitement,testing after a heavy meal, and testing soon
after the administration of intravenous glucose may all cause
false-positive results, most frequently trace reactions.
◦ High concentrations of ascorbic acid (>25 mg/dl) inhibit the
reaction.
◦ Drugs: salicylates, tetracyclines.
◦ High pH inhibit the reaction
◦ If urine is left to sit at room temperature for an extended
period, owing to the rapid glycolysis of glucose.
◦ The presence of bacterial peroxidases (e.g. cystitis), will produce
false positive reactions.
◦ Drugs: Nalidixic acid, cephalosporins, Chloramphenicol, Isoniazid and
penicillin
◦ Stress, excitement,testing after a heavy meal, and testing soon
after the administration of intravenous glucose may all cause
false-positive results, most frequently trace reactions.
◦ High concentrations of ascorbic acid (>25 mg/dl) inhibit the
reaction.
◦ Drugs: salicylates, tetracyclines.
◦ High pH inhibit the reaction
◦ If urine is left to sit at room temperature for an extended
period, owing to the rapid glycolysis of glucose.

 KETONES IN URINE (ketonuria):
 TYPES : Acetone, diacetic acid
(acetoacetic acid), betahydroxybutyric
acid.
 KETONES IN URINE (ketonuria):
 TYPES : Acetone, diacetic acid
(acetoacetic acid), betahydroxybutyric
acid.

 Chemical strip testing
 Principle
 This test is based on the development of colors
ranging from buff-pink, for a negative reading, to
purple when acetoacetic acid reacts with
nitroprusside.
Urine testing only detects acetoacetic acid, not the
other ketones, acetone or beta-hydroxybuteric acid.
 Interfering Factors
 False-positive results caused by drugs such as
Levodopa , Insulin , Penicillamine, depakene
 False-negative results occur if urine stands too long,
owing to loss of ketones into the air.
 Chemical strip testing
 Principle
 This test is based on the development of colors
ranging from buff-pink, for a negative reading, to
purple when acetoacetic acid reacts with
nitroprusside.
Urine testing only detects acetoacetic acid, not the
other ketones, acetone or beta-hydroxybuteric acid.
 False-positive results caused by drugs such as
Levodopa , Insulin , Penicillamine, depakene
 False-negative results occur if urine stands too long,
owing to loss of ketones into the air.

 UrineUrine BilirubinBilirubin :
 Bilirubin is the yellow breakdown product of normal heme
catabolism.
 Procedure:
1- Chemical strip testing
Principle
 This test is based on the coupling of bilirubin with diazotized
dichloroanaline in a strongly acid medium.The color ranges
through various shades of tan.
 The test is sensitive to 0.2-0.4 mg/dL of conjugated bilirubin.
 Note: Examine the urine within 1 hour of collection because
urine bilirubin is unstable, especially when exposed to light.
 Note: If the urine is yellow-green to brown, shake the urine. If
yellow-green foam develops, bilirubin is probably present.
 UrineUrine BilirubinBilirubin :
 Bilirubin is the yellow breakdown product of normal heme
catabolism.
 Procedure:
1- Chemical strip testing
Principle
 This test is based on the coupling of bilirubin with diazotized
dichloroanaline in a strongly acid medium.The color ranges
through various shades of tan.
 The test is sensitive to 0.2-0.4 mg/dL of conjugated bilirubin.
 Note: Examine the urine within 1 hour of collection because
urine bilirubin is unstable, especially when exposed to light.
 Note: If the urine is yellow-green to brown, shake the urine. If
yellow-green foam develops, bilirubin is probably present.

 High concentrations of ascorbic acid or
nitrate cause decreased sensitivity.
 Aged urine samples: Conjugated bilirubin
hydrolyzes to unconjugated bilirubin if left at
room temperature resulting in false negative
reactions.
 Exposure to UV light: UV light converts
bilirubin to biliverdin, resulting in false
negative reactions.
 High concentrations of ascorbic acid or
nitrate cause decreased sensitivity.
 Aged urine samples: Conjugated bilirubin
hydrolyzes to unconjugated bilirubin if left at
room temperature resulting in false negative
reactions.
 Exposure to UV light: UV light converts
bilirubin to biliverdin, resulting in false
negative reactions.

2- Iodine test
 Add equal amount of iodine to the urine and
drop iodine carefully on the tube wall
 Green colored ring developed gradually
between iodine and urine
 Normal:
 Normally, a tiny amount of bilirubin is
excreted in the urine, accounting for the
light yellow color.
 Note: urine bilirubin is reported a follow
negative, +, ++, +++
2- Iodine test
 Add equal amount of iodine to the urine and
drop iodine carefully on the tube wall
 Green colored ring developed gradually
between iodine and urine
 Normal:
 Normally, a tiny amount of bilirubin is
excreted in the urine, accounting for the
light yellow color.
 Note: urine bilirubin is reported a follow
negative, +, ++, +++

Stool SpecimenStool Specimen
Analysis of fecal material can detect
pathological conditions ie: tumors,
hemorrhage, infection
 Tests
◦ Occult Blood
◦ Pus
◦ Ova & Parasites
Analysis of fecal material can detect
pathological conditions ie: tumors,
hemorrhage, infection
 Tests
◦ Occult Blood
◦ Pus
◦ Ova & Parasites

 Laboratory analysis includes macroscopic,
microscopic examination, chemical tests, and
microbiologic tests.
 The stool will be checked for color,
consistency, weight (volume), shape, odor,
and the presence of mucus and parasites
stages.
 The stool may be examined for hidden
(occult) blood, fat, bile, white blood cells,
and sugars called reducing substances.
 The pH of the stool also may be measured.
 Laboratory analysis includes macroscopic,
microscopic examination, chemical tests, and
microbiologic tests.
 The stool will be checked for color,
consistency, weight (volume), shape, odor,
and the presence of mucus and parasites
stages.
 The stool may be examined for hidden
(occult) blood, fat, bile, white blood cells,
and sugars called reducing substances.
 The pH of the stool also may be measured.

Collection of Fecal SpecimenCollection of Fecal Specimen
• Random specimen: suitable for
qualitative testing for microscopic
examination.
• Timed specimen: for quantitative fecal
testing such as fecal fat testing,
• Random specimen: suitable for
qualitative testing for microscopic
examination.
• Timed specimen: for quantitative fecal
testing such as fecal fat testing,

Universal precautions :Universal precautions :
 Pt. is asked to pass stool in a clean container.
 Stool should be collected in a sterilized, wide
mouthed container.
 Loose/last/portion containing mucus, blood
etc is to be collected in a wide mouthed
bottle.
 >2gm is required.
 Freshly passed stool samples avoid specimens
from a bed pan
 Pt. is asked to pass stool in a clean container.
 Stool should be collected in a sterilized, wide
mouthed container.
 Loose/last/portion containing mucus, blood
etc is to be collected in a wide mouthed
bottle.
 >2gm is required.
 Freshly passed stool samples avoid specimens
from a bed pan

• The stool specimen must be enough for
satisfactory examination of fresh feces
uncontaminated by urine, dirt, water or other
body secretion such as menstrual blood.
• If the sample is too small or contaminated
with urine, it should not be accepted. Ask the
patient to pass another specimen.
 The container with the specimen should be clearly
labeled with the following:
o Patient’s name or number.
o Date and time of collection.
• The stool specimen must be enough for
satisfactory examination of fresh feces
uncontaminated by urine, dirt, water or other
body secretion such as menstrual blood.
• If the sample is too small or contaminated
with urine, it should not be accepted. Ask the
patient to pass another specimen.
 The container with the specimen should be clearly
labeled with the following:
o Patient’s name or number.
o Date and time of collection.

 Liquid stool to be examined within ½ hour
 Solid stool to be examined within 1 hour.
 If delayed store in a refrigerator.
 Samples and forms from patient with a
confirmed or suspected diagnosis of certain
infectious diseases such as AIDS or hepatitis
should be clearly labeled with “Biohazard”
 Formalin is the best preservative. It kills the
bacteria but preserves the protozoa and
helminthes.
 For culture no preservatives to be used
 Liquid stool to be examined within ½ hour
 Solid stool to be examined within 1 hour.
 If delayed store in a refrigerator.
 Samples and forms from patient with a
confirmed or suspected diagnosis of certain
infectious diseases such as AIDS or hepatitis
should be clearly labeled with “Biohazard”
 Formalin is the best preservative. It kills the
bacteria but preserves the protozoa and
helminthes.
 For culture no preservatives to be used

Fecal CharacteristicsFecal Characteristics
 Color
 Odor
 Consistency
 Frequency
 Amount
 Shape
 Constituents
 Color
 Odor
 Consistency
 Frequency
 Amount
 Shape
 Constituents

Macroscopic ExaminationMacroscopic Examination
•Brown is normal color, results from the intestinal
oxidation of stercobilinogen to urobilin.
•Bright red to dark red to black stools occur when
iron taken or when there is intestinal hemorrhage.
•Pale yellow stools indicate the biliary obstruction,
•White stools occur when there is obstructive
jaundice.
•Green stool may observed in patient taking oral
antibiotic, because of oxidation of bilirubin to
biliverdin.
•Brown is normal color, results from the intestinal
oxidation of stercobilinogen to urobilin.
•Bright red to dark red to black stools occur when
iron taken or when there is intestinal hemorrhage.
•Pale yellow stools indicate the biliary obstruction,
•White stools occur when there is obstructive
jaundice.
•Green stool may observed in patient taking oral
antibiotic, because of oxidation of bilirubin to
biliverdin.

2.2. degree of moisture, will be
a guide as to whether the trophozoite
stage or the cyst stage of protozoa is
likely to present.
 Formed
 Soft
 Loose
 Watery
Macroscopic Examination cont,Macroscopic Examination cont,
2.2. degree of moisture, will be
a guide as to whether the trophozoite
stage or the cyst stage of protozoa is
likely to present.
 Formed
 Soft
 Loose
 Watery

• mucus , and blood .
•The presence of mucus coated stool is indicative for
intestinal inflammation or irritation.
•The feces may have adult helminthes or segments
present such as Ascaris lumbricoides, Entrobius
vermicularis, or Taenia spp. gravid segment, these can be
seen by naked eye.
•And frequently motile for several days and may migrate
to the top of the container.
Macroscopic Examination cont,Macroscopic Examination cont,
• mucus , and blood .
•The presence of mucus coated stool is indicative for
intestinal inflammation or irritation.
•The feces may have adult helminthes or segments
present such as Ascaris lumbricoides, Entrobius
vermicularis, or Taenia spp. gravid segment, these can be
seen by naked eye.
•And frequently motile for several days and may migrate
to the top of the container.

Techniques of Stool ExaminationTechniques of Stool Examination
1-Direct wet mount.
 Unstained- stained Wet Mounts.
2-Concentration Techniques:
 Flotation technique
 Sedimentation technique
3-Permanent Stained Smears.
1-Direct wet mount.
 Unstained- stained Wet Mounts.
2-Concentration Techniques:
 Flotation technique
 Sedimentation technique
3-Permanent Stained Smears.

Direct Wet mountDirect Wet mount
Materials:
• Microscope slides
• Cover glass
• Sodium chloride
• Wooden stick
• Fresh stool

Procedures:
1-Use cleaned microscope
slides
2-Place a drop of saline
3-Take a small amount of stool
with a wooden stick

4-Mix stool with saline
5-Place cover glass
Avoid air bubbles
5-Place cover glass
Avoid air bubbles
6-Examination ,Use 10x and 40x
objective
Mistake:
Too much stool

Specimens collection part 2

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Specimens collection part 2