PENUNTUN PRAKTIKUM PATOLOGI KLINIK

FAKULTAS KEDOKTERAN UNIVERSITAS SRIWIJAYA

BLOK 13
SISTEM DIGESTIF
NAMA
NIM
SEMESTER

: ........................................
: ........................................
: ........................................

BAGIAN PATOLOGI KLINIK

FAKULTAS KEDOKTERAN UNSRI
PALEMBANG
2012
PEMERIKSAAN TINJA

Tinja yang dipakai untuk pemeriksaan sebaiknya berasal dari defekasi

spontan, jika pemeriksaan sangat diperlukan boleh juga sampel diambil langsung
dari rektum. Untuk pemeriksaan dipakai tinja sewaktu. Tinja hendaknya diperiksa
dalam keadaan segar, bila dibiarkan terlalu lama unsur-unsur dalam tinja akan
rusak. Untuk mengirim tinja sebaiknya menggunakan wadah dari kaca atau
plastik, wadah harus bermulut lebar. Pemeriksaan yang penting dalam tinja ialah
pemeriksaan terhadap parasit dan telur cacing, serta pemeriksaan darah samar.
Pada pemeriksaan tinja pilihlah bagian tinja yang memberi kemungkinan
sebesar-besarnya untuk mendapatkan kelainan, umpamanya bagian yang
bercampur darah atau lendir. Karena unsur-unsur patologik biasanya tidak
terdapat merata, maka hasil pemeriksaan mikroskopi tidak dapat dinilai derajat
kepositifannya dengan tepat, cukup dinilai secara semikuantitatif saja.
MAKROSKOPIS
1. Warna
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
.....................................
2. Bau
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
.....................................
3. Konsistensi
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
.....................................
4. Lendir
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
.....................................
5. Darah
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................

................................................................................................................................
.....................................
6. Parasit
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
.....................................
MIKROSKOPIS
1. Sel epitel
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
.....................................
2. Makrofag
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
.....................................
3. Leukosit
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
.....................................
4. Eritrosit
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
.....................................
5. Kristal-kristal
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
.....................................
6. Sisa makanan

................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
.....................................
7. Sel ragi
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
.....................................
8. Telur dan larva cacing
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
.....................................
DARAH SAMAR
Tes terhadap darah samar penting sekali untuk mengetahui adanya perdarahan
minimal yang tidak dapat dinyatakan secara makroskopis atau mikroskopis.
A. Cara dengan Benzidine Basa atau Benzidine Dihidrochlorida
1. Buatlah emulsi tinja dengan air atau dengan larutan garam kira-kira 10 ml
dan panasilah hingga mendidih.
2. Saringlah emulsi yang masih panas itu dan biarkan filtrat sampai menjadi
dingin kembali
3. Ke dalam tabung reaksi lain dimasukkan benzidine basa sebanyak
sepucuk pisau.
4. Tambahlah 3 ml asam asetat glasial, kocoklah sampai benzidine itu larut
dengan meninggalkan beberapa kristal.
5. Bubuhilah 2 ml filtrat emulsi tinja, campur.
6. Berilah 1 ml larutan hidrogen peroxida 3%, campur.
7. Hasil dibaca dalam waktu 5 menit (jangan lebih lama).
Hasil:
Negatif (-)
Tidak ada perubahan warna atau warna samar-samar
hijau
Positif 1 (+) Hijau
Positif 2 (+ Biru bercampur hijau
+)
Positif 3 (+ Biru
++)
Positif 4 (+ Biru tua
+++)
*pemakaian benzidine dihidrochlorida akan membuat tes menjadi kurang
peka sehingga hasil positif palsu dapat dikurangi

B. Cara dengan Guajac

1. Buatlah emulsi tinja sebanyak 5 ml dalam tabung reaksi dan tambahkanlah
1 ml asam asetat glasial, campur.
2. Dalam tabung reaksi lain dimasukkan sepucuk pisau serbuk guajac dan 2
ml alkohol 955, campur.
3. Tuanglah dengan hati-hati isi tabung kedua ke dalam tabung yang berisi
emulsi tinja sehingga kedua jenis campuran tetap sebagai lapisan terpisah
4. Hasil positif dapat dilihat dari warna biru yang terjadi pada batas kedua
lapisan itu. Derajat kepositifan dinilai dari warna itu.
C. Cara dengan Tes Carik Celup
1. Celupkan seluruh permukaan reagen carik celup dengan sampel tinja dan
tarik dengan segera
2. Ketukkan carik pada bibir wadah untuk mengurangi tinja yang berlebihan
3. Pegang carik secara horizontal dan bandingkan dengan kertas warna yang
terdapat pada label tabung dan catatlah hasilnya dengan waktu seperti
yang tertera pada label tabung
Hasil:
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
.....................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................................................
.....................................
UROBILIN
1. Taruhlah bebrapa gram tinja dalam sebuah mortir dan campurlah dengan
larutan mercurichlorida 10% yang volumenya kira-kira sama banyak
dengan tinja itu.
2. Campurlah baik-baik dengan memakai alu
3. Tuanglah bahan tersebut ke dalam cawan datar agar lebih mudah
menguap dan biarkan selama 6-24 jam
4. Adanya urobilin ditunjukkan dengan timbulnya warna merah
Catatan: dalam tinja normal selalu ada urobilin, jumlah urobilin akan
berkurang pada ikterus obstruktif. Jika obstruksi itu total, hasil menjadi
negatif.