Medical Technology (MTLE)

Urinalysis and Body Fluids Reviewer for MTLE Philippines 2026

LisensyaPrep Team•May 1, 2026•11 min read

Filipino female medical technologist in white coat examining a specimen tube for MTLE urinalysis body fluids reviewer Philippines 2026

Urinalysis is one of the oldest and most informative laboratory tests in clinical medicine. A complete urinalysis has three components: physical examination, chemical examination using the dipstick, and microscopic examination of the urine sediment. The MTLE tests all three components in detail, plus analysis of other body fluids including cerebrospinal fluid, pleural fluid, and synovial fluid.

Physical Examination of Urine

Color

Normal urine is pale yellow to amber, the color coming from the pigment urochrome. The intensity of color varies with concentration.

Color	Possible Cause

|-------|---------------|

Colorless	Very dilute urine, diabetes insipidus
Dark yellow to amber	Concentrated urine, dehydration
Orange	Bilirubin, urobilin, rifampicin
Red to red-brown	Hematuria, hemoglobinuria, myoglobinuria, beets
Brown to black	Melanin, methemoglobin, alkaptonuria
Green to blue-green	Biliverdin, Pseudomonas UTI, methylene blue
Cloudy white (milky)	Pyuria, chyluria, phosphaturia

Clarity (Turbidity)

Normal fresh urine is clear. Turbidity can result from cells, casts, bacteria, crystals, mucus, or lipids.

Specific Gravity

Specific gravity measures urine concentration by comparing its density to water. Normal range is 1.001 to 1.035.

Isosthenuria: Fixed specific gravity at 1.010, the same as plasma ultrafiltrate. Indicates loss of renal concentrating ability. Seen in chronic renal failure.

Hyposthenuria: Specific gravity below 1.010. Seen in diabetes insipidus, excessive fluid intake.

Hypersthenuria: Specific gravity above 1.020. Seen in dehydration, diabetes mellitus (glucose adds to SG), syndrome of inappropriate ADH.

Chemical Examination: The Dipstick

Urine dipstick parameters and clinical significance

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Microscopic Examination of Urine Sediment

The microscopic examination identifies formed elements in urine. It is the most technically demanding and most information-rich part of the urinalysis.

Cells

Red Blood Cells: Normal is 0 to 2 per high power field (HPF). More than 3 RBCs per HPF is hematuria. Dysmorphic RBCs (acanthocytes, fragmented forms) indicate glomerular origin. Isomorphic RBCs indicate lower urinary tract bleeding.

White Blood Cells: Normal is 0 to 5 per HPF. More than 5 WBCs per HPF is pyuria, indicating urinary tract infection or interstitial nephritis. Clumps of WBCs suggest infection.

Epithelial Cells: Squamous epithelial cells from the lower urethra are normal and indicate specimen contamination. Transitional epithelial cells from the bladder and ureters are occasionally seen. Renal tubular epithelial cells (RTECs) are abnormal and indicate tubular damage from toxins, ischemia, or viral infection.

Casts

Casts are cylindrical structures formed in the renal tubules. They are named for what is incorporated within their protein matrix.

Hyaline casts: Made of Tamm-Horsfall protein alone. Can be seen in normal urine after exercise or dehydration. Low clinical significance.

RBC casts: Contain red blood cells. Pathognomonic of glomerulonephritis. The most significant finding in urinalysis for renal disease.

WBC casts: Contain white blood cells. Indicate pyelonephritis or interstitial nephritis.

Granular casts: Contain cellular debris. Indicate renal tubular damage. Fine granular casts are less significant than coarse granular casts.

Waxy casts: Broad, waxy appearance. Indicate severe chronic renal disease and stasis of urine flow.

Fatty casts: Contain lipids. Seen in nephrotic syndrome. Associated with oval fat bodies and free fat droplets.

Bacterial casts: Indicate bacterial infection within the tubules.

Cerebrospinal Fluid (CSF) Analysis

CSF analysis is tested in the MTLE body fluids section. Knowing the normal values and what abnormal findings indicate is essential.

Parameter	Normal CSF	Bacterial Meningitis	Viral Meningitis	TB Meningitis

|-----------|-----------|---------------------|-----------------|--------------|

Appearance	Clear, colorless	Turbid, cloudy	Clear	Clear to cloudy
WBC count	0 to 5 cells/uL	>1000, mostly PMNs	10 to 500, mostly lymphocytes	100 to 500, lymphocytes
Protein	15 to 45 mg/dL	Markedly elevated	Normal to slightly elevated	Elevated
Glucose	60 to 80% of blood glucose	Very low (<40 mg/dL)	Normal	Low
Gram stain	Negative	Often positive	Negative	Negative (AFB stain needed)

Xanthochromia: Yellow discoloration of CSF supernatant. Indicates subarachnoid hemorrhage that occurred more than 2 hours before lumbar puncture. Differentiates true bleeding from traumatic tap.

Other Body Fluids

Pleural Fluid (Thoracentesis)

Transudate vs Exudate is the critical distinction in pleural fluid analysis.

Transudate: Results from imbalance in hydrostatic and oncotic pressures. Causes: heart failure, cirrhosis, nephrotic syndrome. Low protein, low LDH, low specific gravity.

Exudate: Results from inflammation, infection, or malignancy. High protein (more than 3 g/dL), high LDH. Causes: pneumonia, tuberculosis, malignancy, pulmonary embolism.

Light's Criteria is used to classify pleural fluid. Exudate if any of: pleural fluid protein to serum protein ratio more than 0.5, pleural LDH to serum LDH ratio more than 0.6, pleural LDH more than two-thirds the upper normal limit for serum LDH.

Synovial Fluid

Normal synovial fluid is clear, viscous, and straw-colored. In inflammatory conditions it becomes turbid with decreased viscosity. In septic arthritis it can become frankly purulent with very high WBC counts.

The string test assesses viscosity. Normal synovial fluid forms a string of 4 to 6 cm when dropped from a syringe. Inflammatory fluid has reduced viscosity and does not string well.

Practice What You Just Learned

Urinalysis questions in the MTLE present clinical scenarios and ask you to interpret physical, chemical, and microscopic findings. Practice those scenarios at LisensyaPrep now. No account needed.

Practice MTLE Urinalysis Questions at LisensyaPrep