microscopic Flashcards by Ruth Joy De Guzman

significance of color

blood

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significance of clarity

hematuria vs hemoglobinuria/myoglobinuria

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significance of blood

rbcs/ rbc cast

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significance of protein

cast/cells

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significance of nitrite

bacteria
wbc

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significance of leukocyte esterase

wbc/wbc cast/ bacteria

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significance of glucose

yeast

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chemical correlation of rbc

+ blood
+ protein

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chemical correlation of wbc

+ protein
+ leukocyte esterase
+ nitrite

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chemical correlation of casts

+ protein

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chemical correlation of bacteria

increase ph
+ nitrite
+ leukocyte

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chemical correlation of crystals

ph
bilirubin

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Delineates structure
and contrasting
colors of the nucleus
and cytoplasm

Sternheimer-
Malbin

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Enhances nuclear
detail

Toluidine blue

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Lyses RBCs and
enhances nuclei of
WBCs

2% acetic acid

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Stains triglycerides
and neutral fats
orange-red

Lipid Stains: Oil
Red O and
Sudan III

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Identifies WBCs,
epithelial cells, and
casts

Sternheimer-
Malbin

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Distinguishes RBCs
from WBCs, yeast,
oil droplets, and
crystals

2% acetic acid

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Methylene blue and
eosin Y stains
eosinophilic granules

Hansel stain

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Stains structures
containing iron

Prussian blue
stain

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Identifies free fat droplets
and lipid-containing cells
and casts

Lipid Stains: Oil
Red O and
Sudan III

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Differentiates gram-
positive and gram-
negative bacteria

eosinophils

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Identifies yellow-brown
granules of hemosiderin in
cells and casts

prussian blue

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Very uniform color;
slightly darker than
mucous threads

hyaline cast

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Darker than hyaline casts, but of a pale even color; distinct broken ends

waxy cast

Used for routine urinalysis

bright field microscopy

Aids in identification of cholesterol in oval fat bodies, fatty casts, and crystals

polarizing microscopy

Enhances visualization of elements with low refractive indices, such as hyaline casts, mixed cellular casts, mucous threads, and Trichomonas

Phase-contrast microscopy

Aids in identification of Treponema pallidum

Dark-field microscopy

Allows visualization of naturally fluorescent microorganisms or those stained by a fluorescent dye

Fluorescence microscopy

Produces a three-dimensional microscopy-image and layer-by-layer imaging of a specimen

Interference- contrast

RBC sources of ident error

* Yeast cells * Oil droplets / airbubbles

Reporting of rbc

Average number per 10 hpfs

Complete urinalysis correlation of rbc

* Color * Reagent strip blood reaction

Sources of Identification error of wbc

Renal tubular epithelial cells

Complete urinalysis correlation of wbc

* Leukocyte esterase * Nitrite * Specific gravity * pH

Largest cells in the sediment with abundant, irregular cytoplasm and prominent nuclei

(Squamous epithelial cels

Complete urinalysis correlation of wbc

clarity

Sources of Identification error of wbc

folded cells may resemble cast

Spherical, polyhedral, or caudate with centrally located nucleus

(Transitional/Urothelial epithelial cell

Sources of Identification for wbc

Spherical forms resemble RTE cells

Complete urinalysis correlation of wbc

* Clarity; * blood, if malignancy-associated

Rectangular, columnar, round, oval or, cuboidal with an eccentric nucleus possibly bilirubin-stained or hemosiderin-laden

Epithelial Cells (Renal Tubular)

Highly refractile RTE cells

Oval Fat Bodies

Identification error of bacteria

Amorphous phosphates and urates

(Composition and Formation of cast

Tamm-Horsfall protein albumin, immunoglobulin protein gel tapered end

Sources of Identification error of hyaline cast

Mucus, fibers, hair, increased lighting

*Organic & iatrogenic compounds ppts in

acidic ph

*inorganic salts ppts in

neutral and alkaline soln

ppts in acidic and neutral

calcium oxalate

Yellow-brown (rhombic/4- sided/rosette)

uric acid

solubility of uric acid

Alkali Soluble

Brick dust or yellow brown granules

amorphous urates

solubility of amorphous urates

Alkali and heat

Colorless (envelopes, oval, dumbbell, octahedral)

calcium oxalate

solubility of calcium oxalate

Dilute HCl

Normal Crystal Seen in Acidic Urine

uric acid amorphous urates calcium oxalate

White–colorless (granular/white ppt)

Amorphous phosphates

Colorless (flat rectangular plates/thin prisms often in rosette formations)

Calcium phosphate

Normal Crystal Seen in Neutral/Alkaline Urine

Amorphous phosphates Calcium phosphate

Colorless (prism shape “coffin lids”)

Triple phosphate

Yellow-brown (spicule-covered spheres “thorny apples”)

Ammonium biurate

Colorless (dumbbells/spheric al)

Calcium carbonate

solubility of calcium carbonate

Gas from acetic acid

solubility of ammonium biurate

Acetic acid with heat

Normal Crystal Seen in Alkaline Urine

Triple phosphate Ammonium biurate Calcium carbonate

Abnormal Crystals seen in Acid Urine

Cystine Cholesterol Bilirubin Radiographic dye

* Colorless * Hexagonal plates

Cystine

Colorless notched plates

cholesterol

Confirmation test for cystine

 cyanide- nitroprusside test

Seen in refrigerated specimen

Cholesterol

disease in cholesterol

Nephrotic syndrome

Yellow * clumped needles or granules

Bilirubin

present in hepatic disorder

bilirubin

Colorless * Cholesterol crystal like

Radiographic dye

Markedly high specific gravity when measured by refractometer

Radiographic dye

Abnormal Crystals seen in Acid/Neutral Urine

Leucine Tyrosine Sulfonamides Ampicillin

Spheres (concentric circles and radial striations)

leucine

Fine needle (clump or rosette form)

Tyrosine

* Crystals Associated With Liver Disorders

leucine

seen in conjunction with leucine crystals in specimens with positive chemical test results for bilirubin

tyrosine

Needles, rhombics, whetstones, sheaves of wheat, and rosettes

Sulfonamides

needles (form bundles following refrigeration

Ampicillin

Seen in inadequate patient hydration

Sulfonamides

Contaminants from improper collection

Urinary Sediment Artifacts

starch granule oil droplets air bubbles pollen grains hair and fibers from clothing and diapers fecal artifacts

* Resemble fat droplets when polarized * Dimpled center

Starch Granule

highly refractile and may resemble RBCs

oil droplets air bubbles

* spheres with a cell wall and occasional concentric circles

Pollen grains

mistaken for casts * usually much longer and more refractile

Hair and fibers from clothing and diapers

presence of a fistula between the intestinal and urinary tracts * appear as plant and meat fibers or as brown amorphous material

fecal artifcact