Microscopic Examination Flashcards
Sediments in urine with these clinical significance:
1. renal disease
2. lower urinary tract disease
3. toxic reactions due to drugs
4. physiologic causses
RBCs
salicylates and anticoagulant therapy produces what sediments in urine
RBCs
what are the 4 rbc morphology that can be found in urine
- normal
- crenated
- ghost
- dysmorphic
RBCs with ___ cells/hpf is considered abnormal.
> 3 cells/hpf
Erythrocytes are found in ___ cells/hpf in normal urine
0-2 cells/hpf
toxic drugs such as sulfonamides, methanamine can produce what sediment in urine?
RBCs
RBC morphology where rbc is lysed and only cell membrane is left.
Ghost RBCs
RBC morphology that can be found in hyposthenuria (low specific gravity)
ghost rbcs
RBC morph where rbc shrinks, found in hypersthenuria
crenated rbcs
7 um in diameter of RBCs is considered what rbc morphology
normal duh
dysmorphic rbcs in urine is ___ in origin
glomerular
doughnut shaped rbc with 1 or more membrane blebs
G1 cell
May be more specific than dysmorphic cells for
diagnosing glomerular hematuria (Dinda, 1997)
G1 cell
what are 2/3 sources of rbc identification errors
- yeast
- oil droplets
- air bubbles
what stain or chemical is used to differentiate RBCs errors such as yeast or oil droplets, and wbc
acetic acid
sediment characteristic:
exhibit greater variation in size and are highly refractile
oil droplets and air bubbles
___ leukocytes/hpf are seen in normal urine
<5
increase in urinary WBCs (principally neutrophils)
Pyuria
Chlamydia trachomatis, staphylococci, and coliforms are causative agents
Pyuria
correlated with
- Leukocyte esterase
- Nitrite
- Specific Gravity
- pH
WBCs
what is the significance of NITRITE screening test?
Bacteria/WBCs
What is the significance of the screening test for PROTEINS?
casts/cells
significance of screening test for GLUCOSE
yeast
Provided evidence that chamber counts on centrifuged urine sediments are more reliable in predicting renal functional abnormalities than coventional method using cells per HPF
Kesson (1978)
Normal value of these parameters in quantitative count.
neutrophils? 5 to __/uL
RBCs? 3 to __ /uL
casts? 1 to __/ul
neutrophils = 5 to 30/uL
RBCs = 3 to 20/uL
casts = 1 to 2/uL
When was Addis count developed
1926
Standard amount of specimen centrifuged is ___ mL.
10 to 15 mL
If not possible to obtain 12 mL specimen…
- specimen volume noted on report
- for correction, results are multiplied by 2
How many minutes do we centrifuge the specimen?
5 minutes @ 400 RCF (Relative centrifugal force) because it produces least chance of damage to elements
Used when quantitating the number of elements per mL
Concentration factor
What are the sediment volumes frequently used
0.5 and 1.0mL
Reporting of CASTS in routine microscopic examination
per 10 LPFs
reporting of RBCs and WBCs in routine microscopic examination
per 10 HPFs
This stain is used for methylene blue and eosin y, for eosinophil granules
Hansel stain
stains structures containing iron
Prussian blue stain
identifies WBCs, epithelial cells, and casts
Sternheimer-Malbin
Toluidine blue stain is for
enhancement of nuclear detail
This is used for detection of malignancies of the lower urinary tract
Cytodiagnostic urine testing
stain used in cytodiagnostic urine testing
Papanicolaou stain
part of illumination system of the microscope which contains a number of leaves that the operator may open or close to increase the amount of light illuminating the object
iris diaphragm
part of illumination system of the microscope which gathers the light coming from the light source and to concentrate that light in a collection of parallel beams into the specimen
condenser
most common and simplest condenser
Abbe condenser
most common filter used
blue
since it absorbs some of the yellow to red light from illumination bulbs
usual thickness of cover glass
0.17 mm
filters are used for
enhanced contrast and color correction
this is a technique used to optimize light quality and sharpness by aligning and adjusting each component of the optical system.
performed whenever an objective is changed.
Kohler Illumination
image in the microscope is upside down and reversed, what is this called?
virtual image
most common type of microscope wherein object appear dark against a light background
Bright-field microscopy
Enhances visualization of elements with low refractive indices, such as hyaline casts, mixed cellular casts, mucus threads, and Trichomonas
eliminates the need to fix or stain living cells
Phase contrast microscopy
calculated as the speed with which light travels in air divided by the speed with which light travels through the substance
refractive index
aids in identification of birefringent elements: cholesterol on OFB, fatty casts, and crystals
Polarizing microscope
Allows visualization of naturally fluorescent substances or those that have been stained with a fluorochrome or fluorophore to produce an image
Fluoroscence microscopy
property by which atoms absorb light at a particular wavelength and emit light of a longer wavelength
Fluorescence
Fluorescent compound with green emission at 517nm
FITC
Fluorescein Isothiocyanate
Fluorescent compound that is red emission at 580nm
TRITC
Tetramethylrhodamine Isothiocyanate
enhances visualization of elements with low refractive indices such as hyaline casts, mixed cellular casts, mucous threads, and trichomonas
phase-con mic
aids in ID of Treponoma pallidum
Dark-field microscopy
produces a three dimensional microscopy image and layer by layer imaging of a specimen
interference-contrast
