Urine FEME, also known as Urine Formed Elements with Microscopic Examination, consists of mainly two components. One component involves using reagent strips on patient's urine sample, while the other component involves microscopic examination of the urine.
The reagent strips contains nine separate reagent areas that contain different chemicals for the determination of a particular analyate. It also contains a non-reactive reagent pad which is used to determine the colour of the urine specimen. The automated machine used in the clinical laboratory is called the Clinitek Atlas analyzer. The machines contains the reagent strips mentioned above, and would be able to test several components in a urine specimen. The 12 components to be tested are pH, colour of urine, clarity, protein, occult blood, leukocytes, nitrite, glucose, ketone, bilirubin, urobilinogen and specific gravity. When a patient's urine sample reacts with the reagent pad, there would be a colour change on the respective reagent pad. A manual test can be carried out a spearate manual test reagent strip. The results can be read using a colour chart supplied by the manufacturer which indicate the presence or absence of some analytes, pH of urine or the level of analytes present in the urine specimen. These results may provide information regarding the patient's kidney function, urinary tract infections, carbohydrate metabolism and liver function
Firstly, 5ml of a patient's urine sample is poured into a clear plastic tube and labelled with the patient's particulars and barcode label. The tuve is then loaded onto a tube rack and loaded onto the analyzer. The machine would take up a small volume of the urine specimen and aliquot it onto the 10 reagent pads on the reagent strips. After which, the machine would detect the colour change on the test strip and the test results would be recorded.
The test results might give us some information of a patient's health status. For example, a presence of leukocytes could indicate a possible urinary tract infection. Presence of ketones could indicate a possible carbohydrate metabolic disorder or due to fasting. Presence of casts or blood in the urine could indicate a possible loss of kidney function.
The microscopic examination of the urine specimen involves charging a small volume of urine to a Kova microscopic slide. The slide is then examined using a light microscope and observed for the presence of RBC, WBC, epithelial cells, casts or crystals present in the urine. The results of microscopic examination should be cross-referenced to the results from the reagent strips, such as the presence of RBCs and WBCs. The results of the two different components should tally.