find out Total RBC Count of your's own blood Find out abnormal constituents of urine sample 2nd
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I have all the information needed. Here is the comprehensive answer to both parts:
Part 1: Total RBC Count (Manual Method — Haemocytometer/Neubauer Chamber)
Note: As an AI, I don't have blood of my own. This question is a standard practical exercise in haematology. The answer below covers the complete methodology and normal values.
Principle
RBCs are counted manually using an improved Neubauer haemocytometer — a thick glass slide with a ruled platform of known area (3 mm × 3 mm grid) and precisely controlled chamber depth of 0.1 mm under the coverslip.
Procedure
| Step | Details |
|---|---|
| Dilution | Blood is diluted 1:200 (sometimes 1:100 or 1:500) in Hayem's fluid (or isotonic saline). This lyses WBCs and preserves RBCs |
| Loading | The diluted sample is loaded into the counting chamber using a Pasteur pipette |
| Settling | Cells are allowed to settle for 2–3 minutes |
| Counting area | 5 small squares in the central large square are counted (the 4 corner + 1 middle small squares of the central 1 mm²) under high-power objective (40×) |
| Cell distribution | Verify uniform distribution under low power (10×) first |
Calculation Formula
$$\text{RBC Count} = \frac{N \times D \times 10}{A}$$
Where:
- N = Total cells counted in 5 small squares
- D = Dilution factor (200)
- 10 = Depth correction factor (chamber depth = 0.1 mm, so multiply by 1/0.1 = 10)
- A = Area counted (5 small squares = 5 × 1/25 mm² = 0.2 mm²)
Simplified: RBC/mm³ = Cells counted in 5 small squares × 10,000 (for 1:200 dilution)
Normal Reference Values
| Parameter | Female | Male |
|---|---|---|
| RBC Count | 4.0–5.4 × 10⁶/μL (4.0–5.4 × 10¹²/L) | 4.5–6.0 × 10⁶/μL (4.5–6.0 × 10¹²/L) |
| Hemoglobin | 12–16 g/dL | 13.5–17.5 g/dL |
| Hematocrit | 36–48% | 40–52% |
| MCV | 81–99 fL | 81–99 fL |
— Goldman-Cecil Medicine, Table 144-2; Henry's Clinical Diagnosis, p. 629
Sources of Error
- Incomplete mixing before dilution
- Uneven cell distribution in chamber
- Touching ruled surfaces (causes scratching)
- Cold agglutinins (cause spuriously decreased RBC count due to clumping)
- High WBC count → may spuriously increase RBC count in anemic patients
Part 2: Abnormal Constituents of Urine (Sample 2 — Routine Urine Examination)
Routine urine examination (urinalysis) screens for both chemical and microscopic abnormal constituents. Normal urine contains water, urea, creatinine, uric acid, electrolytes, and trace proteins only.
A. Physical/Chemical Abnormalities (Dipstick / Reagent Strip)
| Constituent | Normal | Abnormal Finding | Clinical Significance |
|---|---|---|---|
| Glucose (Glycosuria) | Absent | Present | Diabetes mellitus, renal glycosuria, Fanconi syndrome |
| Protein (Proteinuria) | Trace or absent (<150 mg/day) | >150 mg/day (dipstick ≥1+) | Glomerulonephritis, nephrotic syndrome, UTI, myeloma (Bence Jones) |
| Ketones (Ketonuria) | Absent | Present | Diabetic ketoacidosis, starvation, vomiting, alcoholism |
| Bilirubin (Bilirubinuria) | Absent | Present (conjugated) | Obstructive jaundice, hepatocellular disease |
| Urobilinogen | Trace (up to 1 EU/dL) | Increased | Haemolysis, liver disease; Absent in complete biliary obstruction |
| Blood/Haemoglobin | Absent | Present | Haematuria (RBCs), haemoglobinuria (free Hb), myoglobinuria |
| Nitrites | Absent | Present | Gram-negative bacterial UTI |
| Leukocyte esterase | Absent | Present | Pyuria, UTI |
| pH | 4.5–7.8 | <4.5 or >7.8 | Acidosis, alkalosis, UTI (alkaline) |
| Specific gravity | 1.003–1.030 | Fixed at 1.010 (isosthenuria) | CKD; very low → diabetes insipidus |
B. Microscopic Abnormalities (Urine Sediment)
Cells
| Cell Type | Normal | Abnormal (>normal) | Significance |
|---|---|---|---|
| RBCs (Erythrocytes) | 0–2/hpf | >3/hpf | Glomerulonephritis, calculus, tumour, UTI, renal vein thrombosis, trauma |
| WBCs (Leucocytes) | 0–4/hpf | >5/hpf (pyuria) | UTI, pyelonephritis, interstitial nephritis |
| Epithelial cells | Few (squamous) | Renal tubular cells | ATN, nephrotic syndrome, heavy metal toxicity |
| Dysmorphic RBCs | Absent | Present (>20%) | Glomerular bleeding (glomerulonephritis) |
Casts
| Cast | Significance |
|---|---|
| Hyaline casts | Normal in small numbers; increased in dehydration, fever |
| RBC casts | Pathognomonic of glomerulonephritis or vasculitis |
| WBC casts | Pyelonephritis, interstitial nephritis |
| Granular casts | ATN, glomerulonephritis (non-specific) |
| Waxy/Broad casts | Advanced CKD (renal failure) |
| Fatty casts | Nephrotic syndrome |
| Epithelial cell casts | ATN, heavy metal toxicity |
Crystals (Abnormal)
| Crystal | Significance |
|---|---|
| Calcium oxalate | Hyperoxaluria, ethylene glycol poisoning |
| Uric acid | Gout, high cell turnover |
| Cystine | Cystinuria (rare, genetic) |
| Triple phosphate (struvite) | UTI with urease-positive organisms |
| Tyrosine/leucine | Severe liver disease |
Other Abnormal Constituents
- Bacteria — UTI (significant if >10⁵ organisms/mL)
- Yeast (Candida) — Candidiasis, diabetes mellitus
- Parasites — Trichomonas vaginalis, Schistosoma haematobium ova
- Fat droplets / lipiduria — Nephrotic syndrome
Colour Abnormalities as Clues
| Urine Colour | Cause |
|---|---|
| Dark yellow/amber | Concentrated urine, dehydration, urobilinogen |
| Red/pink | Haematuria, haemoglobinuria, myoglobinuria, drugs (rifampicin), beets |
| Orange | Bilirubin, bile salts, pyridium |
| Brown/black | Melanin (melanoma), homogentisic acid (alkaptonuria), severe haemolysis |
| Green/blue | Pseudomonas UTI, biliverdin, methylene blue |
| Cloudy | Pyuria, bacteriuria, phosphaturia |
| Frothy | Proteinuria (nephrotic syndrome) |
| Fruity/sweet odour | Ketones (DKA) |
— Brenner and Rector's The Kidney; Henry's Clinical Diagnosis and Management by Laboratory Methods; Barash's Clinical Anesthesia
Summary for the Practical Report:
- RBC Count (your own sample): Record the actual count obtained from the Neubauer chamber. Compare with normal range: Male: 4.5–6.0 × 10⁶/μL | Female: 4.0–5.4 × 10⁶/μL
- Urine Sample 2 abnormal constituents: Report whichever of the above are detected on dipstick and microscopy — document presence/absence of protein, glucose, ketones, blood, nitrites, and any cells/casts/crystals seen on microscopy.
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