Clinical Microscopy 2

Major inorganic solute

Chloride

Major organic solute

Urea

Second major organic

Creatine

2nd major inorganic

Sodium

Normal daily urine output

1200-1500 ml

Modulation contrast(hoffman), different interference contrast (nomarski)

Interference contrast microscopy

Automated reagent strip reader

Reflectance photometry

Normal value:
0 - 500,000 RBC,
0- 1.8 M WBC & EC
0 - 5000 hyaline cast

Addis count

12 hour specimen, used a hemocytometer to count

Addis count

Oil red O and sudan III

Lipid stains

Color of lipid stained

Orange to red

Enhances visualization of elements with low refractive indices

Phase contrast microscopy

Produce a three dimensional microscopy image

Interference microscope

Irregular cytoplasm and a prominent nucleus about the size of RBC

Squamous cells

Clue cell

Vaginal infection

Clue cell

Gardnerella vaginalis

Most clinically significant of the epithelial cells

RTE

Increase amount of RTE

Necrosis of renal tubules

Determination of microalbumin

Micral test

Principle of micral test

Enzyme immunoassay

Gastric tube that introduced through mouth

Rehfuss

More specific for neural tube

Acetylcholinesterase (AChe)

Gastric tube that inserted through nose

Levine

Increased level of alpha fetoprotein in both maternal circulation and amniotic fluid

Neural tube defect

Most common cause of male infertility

Varicocele

An oval shaped head ( 5micron, 3 micron wide) and flagellar tail (45micron)

Normal sperm

Half of the head and 2/3 of the sperm nucleus

Acrosomal cap

Thickest part of the of the tail because it is surrounded by a mitochondrial sheath that produces the energy required bt the tail for motility

Midpiece

Sperm droplet with threads longer than 2 cm

Highly viscous

Amount of specimen for sperm motility

10ul (22x 22mm coverslip)

Sperm motility grading:
No movement

0

Sperm motility grading:
No forward progression

1

Sperm motility grading:
Slow forward progresion, noticeable lateral movement

2

Slower speed, some lateral movement

3

Rapid, straight line motility

4

Sperm concentration, The most common used dilution prepared using ____

1:20 , positive displacement pipette

The traditional diluting fluid for sperm concentration

Sodium bicarbonate and Formalin

In sperm concentration that can give good result

Saline and distilled water

Low sperm concentration indicate

Low fructose level

Test for fructose

Resorcinol test

Color of resorcinol test when presence of fructose

Orange

< Decreased neutral alpha glucosidase

Disorder of the epididymis

Chain of custody

Step by step doocumatation of handling and testing of legal specimes

Drug testing, COC

30 to 40 mL urine
32.5 to 37.7 °C temp

Routine analysis

10 to 15 mL urine, ave.12mL

Glucose reabsorption

Proximal convoluted tubules

Passive reabsorption of water takes place in all parts of the nephron EXCEPT

Ascending loop of Henle

Print blurred through urine

Cloudy

Calibration of refractometer, 5 % NaCl

1.022+/-0.001

Calibration of refractometer, 9% sucrose

1.034+/-0.001

Cabbage odor urine

Methionine malabsorption

Significant value of AER Albumin excretion rate

20 to 200 ug/min

Principle of Micral test

EIA

11th pad in the reagent strip

Vitamin C, ascorbic acid

Differentiates hemoglobin from myoglobin

Blondheims test
Ammoniun sulfate ppt. Hemoglobin

Normarski microscope

Interference contast microscope

RBCs in hypotonic urine

Ghost cells

WBCs in hypotonic urine

Glitter cells

Lipid-containing RTE cells

Oval fat bodies, lipiduria-nephrotic syndrome

RTE cells with nonlipid-containing vacuoles

Bubble cells, acute tubular necrosis

Casts

Formed in DCT & CT

Lemon-shaped crystal

Uric Acid

Ethylene glycol poisoning

Monohydrate calcium oxalate

Ampicillin crystals

Colorless needles

Sulfonamide

Yellow-brown,occasinally colorless Sheaves of wheat , rosettes, needles confirmed by the Diazo reaction

Flat, rectangular plates or prisms

Calcium phosphate, apatite

Apatite

Calcium phosphate

Weddelite

Dihydrate calcium oxalate
Envelope, pyramidal

Whewellite

Monohydrate calcium oxalate
Oval, dumbbell

Struvite

Triple phosphate
Magnesium ammonium phosphate

Renal calculi my form in the

Calyces & pelvis of the kidney, uterus & bladder

Calculi: yellow to brownish red, mod.hard

Uric acid & urate stones

Calculi: pale & friable

Phosphates stones

Calculi: very hard, dark color, rough surface

Calcium oxalate stones

Calculi: yellow-brown resembling an old soap, somewhat greasy

Cystine stones

CTAB, cetyltrimethyl ammonium bromide

Mucopolysaccharides, Pos.white turbidity

Crystal seen in Fanconi's syndrome

Cystine

Dilution of cloudy CSF

1:200

Red, brown seminal fluid

Blood

Size of acromosal cap

1/2 of the head & covers 2/3 of the nucleus

Most common cause of male infertility

Varicocele, hardening of the veins that drains the testes

Test for seminal fluid fructose

Analyzed within 2 hours of frozen

Synovial fluid

Clear & pale yellow, does not clot
Normal value <3.5mL

Gout

Monosodium urate, uric acid
Yellow(-) birefringence under a comprensated polarizing light

Pseudogout

Calcium pyrophosphate
Blue(+) birefringence under a compasated polarizing light

Calcified cartilage degeneration

Osteoatthritis

Calcium phosphate
No birefringence

Normal apperance of pleural, peritoneal & paricardial fluid

Clear & pale yellow

Psammoma bodies

Concentric striations of collagen-like materials, benign conditions
- Ovarian & thyroid carcinoma

Dark green amniotic fluid

Meconium

Dark red brown amniotic fluid

Fetal death

Inserted through the mouth

Rehfuss tube

Tubeless test for gastric acidity

Diagnex, urine sp.azure blue

Positive result with guaiac

Blue

Creola bodies

Cluster of columnar cells, bronchial asthma

Normal stool pH

PH 7 to 8

Number of fecal leukocytes indicative of an invasive condition

/- 3 neutrophils/hpf

Blue quadrant

Health

Red quadrant

Fire

White quadrant

Specific hazard

Yellow quadrant

Reactivity