Microscopic Urine Final

7/25/2019 Microscopic Urine Final

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Nama : Tahono

Alamat : Jl. Yustisia No.12 - Perum UNS JatenKaranganyar Surakarta.

Jabatan :

1. Sta Penga!ar "agian Patologi

Klinik #KUNS$%S&' 2. KPS PP&S-1

Patologi Klinik #KUNS

Pen(i(ikan :

1. &okter Umum ) #KUNS Tahun 1*+*

2. &okter S,esialis Patologi Klinik )

#KU' Tahun 1** /. Konsultan Patologi

Klinik ) Tahun 1**0

rganisasi Proesi :

CURRICULUM VITAE

1. &

2. P&S PATK3N

/. P4T&

5. P6T%

7. 4KK


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TAHONOSMF/Bagian Patologi Klinik

FKUNS / RSDM Surakarta

MicroscopicAnalysis of Urine

Workshop, surakarta april !"!


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PROS#DUR# P#M#R$KSAAN

"% Sa&p'l urin (iho&og'nkan

% Pin(ahkan k' (ala& ta)ung s'ntri*ug' "!&l%

+% S'ntri*ug' Rotor sing-out k'.'patanr'lati* r'n(ah "!! - !!! rp& / &'nit%

TAHAP $ 0 ol'nsa o)1'kti* "!2 / lapang pan(ang l'&ah34P45 / lo po'r 6'l( 34PF5oi('nti6kasi )'n(a )'sar silin('r (ankristal

TAHAP $$ 0

ol'nsa o)1'kti* 7!2 / lapang pan(ang kuat34PK5 atau high po'r 6'l( 3HPF5oi('nti6kasi 8 k'.il 'ritrosit, l'kosit, 'pit'l,ragi, )akt'ri, Tri.ho&onas, sp'r&a%


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M$KROSKOP$S

"% S'l 0 #ritrosit, 4'ukosit, 'pit'l

% Kristal

+% Silin('r

7% Mikroorganis&'

% Sp'r&ato9oon

:% 4ain


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S'(i&'nt Stain ;hara.t'risti.s


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Epithel Casts

Individual Leukocytes

Leukocyte Casts

Individual Erythrocytes

Erythrocyte Casts

Individual Epithel

Signi6.an.' o* ;'llular ;asts

Bacterial Casts

Individual Bacterial


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o H'&aturia &ak < &ik%o H'&aturia &ikroskopik

= 'ritrosit/4PK% n'*ropati (ia)'tik,

hip'rt'nsi, (an gin>alpolikistik%

P'rsist'n < )'rulang

H'&aturia p'rsist'n p'r(arahan glo&'rulusgin>al%

#ritrosit (is&or6k 0oukuran h't'rog'n,hipokro&ik, t'r(istorsi , s'ringta&pak gu&palan k'.il ti(ak)'raturan t'rs')ar (i&'&)ran s'l%ot'r(istorsi saat &'laluistruktur glo&'rulus 1ang

a)nor&al%o 'n akit lo&'rular

#ritrosit


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lekosit


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;R#NAT#D RB;


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o )ulat, )'rinti, granul'r,ukuran ", ? kali

'ritrosit%o Biasan1a n'utro6l /

PMN%o l'ukosituria / piuria $SK

)agian atas /)aah,

sistitis, pi'lon'*ritis,glo&'rulon'*ritis akut.febris, dehidrasi, stress

o konta&inan @agina, in*'ksi s'r@iks, &'atus ur'tra'kst'rna pria%

o l'uk'&ia k'.'patan 'kskr'si l'ukosit &'ningkat okp'ru)ahan p'r&'a)ilitas &'&)ran glo&'rulus /p'ru)ahan&otilitas l'ukosit%

o B r'n(ah, l'ukosit (ala& )'ntuk s'l litt'r &'rupakanl'kosit PMN 1ang &'nun>ukkan g'rakan Bron )utiran (ala&

sitoplas&a%o H alkali l'ukosit .'n('run )'rk'lo& ok%

4'ukosit


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o )ulat /o@al, = (ari l'ukosit,o inti )ulat /o@al )'sar,

)'rgranulao

M'ningkat 0 Sin(ro& n'*rotik ('g'n'rasi saluran k'&ih, >u&lah s'l tu)ulus C "+ /

4PK p'n1akit gin>al akti@ nefritis, nekrosis tubulerakut, infeksi virus pada ginjal,

penolakan transplnatasi ginjal,

keracunan salisilat.

S'l 'pit'l tu)ulus


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o S'l 'pit'l tu)ulus t'risi

t't'san l'&ak 1ang )'ra(a(ala& lu&'n tu)ulus3lipoprot'in 1ang &'n'&)usglo&'rulus5,

o Indikator (is*ungsi

glo&'rulus ('ngan k')o.oranplas&a k' (ala& urin (ank'&atian s'l 'pit'l tu)ulus%

o sin(ro& n'*rotik, DM lan>ut,k'rusakan s'l 'pit'l tu)ulus k'ra.unan 'til'n glikol, air

raksa%o oval fat bodies &akro*ag

atau hisiosit%o $n*'ksi @irus S'l 'pit'l

tu)ulus &'&)'sar ('ngan

&ultinukl'us 3multinucleatediant cells ;M HS%

o@al *at )o(i's / r'nal tu)ular *at / r'nal tu)ular *at)o(i's%


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S'l 'pit'ltransisionalo Asal 0 p'l@is gin>al, ur't'r,

vesica urinaria, ur'trao l')ih )'sar (ari 'pit'l

tu)ulus < l')ih k'.il (ari'pit'l skua&osa%

o )'ntuk )ulat atau o@al olan%

o s'l 'pit'l t'r)'sar (i urin

nor&al%o tipis, (atar, (an inti )ulat k'.il%o s')agai s'l tunggal / ukuran

)'r@ariasi%o >u&lah l')ih r'n(ah (an

)'rasal (ari p'r&ukaan kulit /luar ur'tra

o Signi6kansi uta&a in(ikatorkonta&inasi%

S'l 'pit'l skua&osa


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squamous, caudate transitional,

and !E cells

#pit'l Transisional 0sph'ri.al, pol1h'(ral,

.au(at'

Transisional sph'ri.al


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Silin('r

o &assa prot'in )'r)'ntuk silin(ris < t'r)'ntuk (i

tu)ulus (istal gin>alo Silin('r ga&)aran &or*ologik (an

ko&posisin1a%o Faktor 1ang &'n(ukung la>u aliran urin 1ang

r'n(ah, kons'ntrasi gara& tinggi, @olu&' urin'1ang r'n(ah, < pH asa& ('naturasi (anpr'.ipitasi prot'in, t'ruta&a &ukoprot'in Ta&&-Hors*all%

o Mukoprot'in Ta&&-Hors*all &atriks prot'in1ang l'ngk't , t'r(iri glikoprot'in (ari s'l 'pit'lgin>al%

o Konstitu'n s'lular 'ritrosit, l'ukosit, (an s'l'pit'l tu)ulus,

o konstitu'n s'lular &'ngala&i (isint'grasi


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Silin('r hialin o t'r(iri (ari THM,ho&og'n, t'kstur halus,

>'rnih, sisi-sisin1aparall'l, (an u>ung-u>ungn1a &'&)ulat%

oT'r)'ntuk (i saluranp'ngu&pul%

o M'ningkat prot'inuriagin>al / p'n1akitglo&'rular, pr' r'nalo@'rEo prot'inuria

MMo Silin('r prot'in

pan>ang, 'kor tipist'r)'ntuk (i

p'rsi&pangan l'ngkungH'nl's (an tu)ulus


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Silin('r 'ritrosito )'rsi*at granul'r (an

&'ngan(ung

h'&oglo)in (arik'rusakan 'ritrosit%

o silin('r 'ritrosit 3G5 al )'rat al%

o $n(ikator k'parahanp'n1akit < (ilatasi n'*ron t'rlihat pa(a tahap akhirp'n1akit gin>al kronis%

Telescoped urinary s'(i&'nt a(alah salah satu

'ritrosit, l'ukosit, o@al *at )o(i's, < s'gala >'nis silin('r1ang (it'&ukan kurang l')ih sa&a-sa&a )'rli&pah%

T'r(apat 0 "5 lupus n'*ritis 5 hip'rt'nsi ganas +5 (ia)'t'sglo&'rulos.l'rosis, (an 75 glo&'rulon'*ritis progr'si*.'pat%

Pa(a tahap akhir p'n1akit gin>al s'(i&'n kurang n'*ron 1ang &asih t'rsisa &'nghasilkan urin 'n.'r%


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Ragi

o konta&inan / in*'ksi >a&urs'>ati%

o ragi &'&iliki

k'.'n('rungan )'rtunas%o Paling s'ring ;an(i(a

(apat &'ngin@asi kan(ungk'&ih, ur'tra, atau @agina%

Tri.ho&onas @aginalis

o Ukuran )'r@ariasi "- kali(ia&'t'r l'ukosit%

o $('nti6kasi Eag'lla (anp'rg'rakann1a 1ang ti(ak&'n'ntu%


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Bakt'ri

Bakt'ri

)'rpot'nsi)'rk'&)ang )iak (i urin'pa(a suhu ka&arBan1akn1a &ikro)a Eoranor&al @agina /&'atus

ur'tra 'kst'rnalkonta&inan (ala&a(ah p'ngu&pul,konta&inasi tin>a, (ala&

urin' 1ang (i)iarkanla&a%in*'ksi (i saluran k'&ih%


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Parasit (i urin

TrichurisYeastspseudohyph

ae

Microlaria


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Kristal

o S'ring kristal .al.iu& oallat', tripl' phosphat',

asa& urat%o Nilai klinik >u&lah )'rl')ih < pr'(isposisi in*'ksio Batu (i saluran k'&ih &'ni&)ulkan >'>as

*rag&'n s'l 'pit'l t'rk'lupas%o P'&)'ntukan )atu (apat (is'rtai kristaluria,

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Microscopic Urine Final