Clinical Microscopy Quick Notes Review

Comprehensive vocabulary flashcards covering urinalysis, fecal analysis, semen analysis, CSF, and other body fluid diagnostics based on the Clinical Microscopy quick notes.

Normal stool pH

pH 7 to 8

Stool pH in CHO (carbohydrate) disorders

pH 5.5 or less

Glitter Cells

Neutrophils seen in hypotonic urine that stain light blue with Sternheimer-Malbin stain, rather than the usual violet color.

Prussian blue stain

The stain used for iron to confirm the presence of yellow-brown hemosiderin granules in renal tubular epithelial (RTE) cells, casts, or urine sediment.

Prealbumin (transthyretin)

The second most prevalent protein found in Cerebrospinal Fluid (CSF).

Meconium

The first bowel movement of a newborn, formed in the intestine from fetal intestinal secretions and swallowed amniotic fluid; it is a dark green, mucus-like material.

Apt test (Fetal blood result)

Produces a pink solution.

Apt test (Maternal blood result)

Produces a yellow-brown supernatant.

Florence test

A test for choline using Iodine and KI, which results in dark brown rhombic crystals.

Barbiero's test

A test for spermine using Picric acid and TCA, which results in yellow leaf-shaped crystals or needles.

Blondheim's test

A test to differentiate hemoglobin from myoglobin where ammonium sulfate is used to precipitate hemoglobin.

Total renal BLOOD flow

$$1200\,mL/min$$

Total renal PLASMA flow

$$600\text{ to }700\,mL/min$$

Acute Tubular Necrosis (ATN) casts

Granular, dirty, brown casts representing hemoglobin degradation products such as methemoglobin.

Melena

Black, tarry stool associated with gastrointestinal hemorrhage.

Bulky/Frothy stool

Often associated with pancreatic disorders or bile-duct obstruction.

Ribbon-like stool

Associated with intestinal constriction.

Azoospermia

The absence of sperm in a semen sample.

Oligospermia

A low sperm count.

Sertoli cells

Cells that are part of the germinal epithelium of the seminiferous tubules which give rise to spermatozoa.

Leydig cells

Cells of the testicles responsible for producing testosterone.

Acrosomal cap

The tip of a spermatozoa head containing enzymes necessary for entry into an ovum.

Protein Error of Indicators

A color-change phenomenon occurring because proteins act as hydrogen ion acceptors at a constant pH.

Asparagus urine odor

A urine odor produced by everyone after ingestion, though only genetically predisposed individuals can smell it.

Methionine malabsorption urine odor

Characterized by a cabbage odor.

Ethylene glycol poisoning crystal

Monohydrate calcium oxalate (CaOx), which appears as oval or dumbbell shapes.

Triple Phosphate appearance

Described as having a coffin-lid appearance or a feathery appearance as they disintegrate.

Makler counting chamber

A method for counting undiluted seminal fluid; sperms are immobilized by heating before charging.

CASA (Computer-Assisted Semen Analysis)

Provides objective determination of both sperm velocity and trajectory (direction of motion).

Osmotic Diarrhea

Increased retention of water and solutes in the large intestine associated with malabsorption and maldigestion.

Secretory Diarrhea

Increased secretion of water and electrolytes into the large intestine caused by bacterial endotoxins.

Renal threshold for glucose

$$160\text{ to }180\,mg/dL$$

Sternheimer-Malbin stain components

Crystal violet and Safranin.

Acute Glomerulonephritis urinary findings

Moderate hematuria and RBC casts.

Pyelonephritis urinary findings

Pyuria with bacterial and WBC casts.

Nephrotic Syndrome proteinuria

Heavy proteinuria characterized by levels greater than $4\,g/day$.

Limulus lysate test

Used to detect Gram negative bacterial endotoxin.

Gout crystal

Uric acid or monosodium urate.

Pseudogout crystal

Calcium pyrophosphate.

Best test for fetoplacental unit status

Serum free estriol.

Varicocele

The most common cause of male infertility.

Stain of choice for sperm morphology

Pap’s stain.

Stain for sperm viability

Eosin (modified Bloom's/eosin-nigrosin).

Zollinger-Ellison Syndrome indicator

Greatly increased serum gastrin levels.

Serum osmolarity

$$275\text{ to }300\,mOsm$$

Urine volume average (24 hours)

$$1200\text{ to }1500\,mL$$

Refractometer adjustment for Protein

$1\,g/dL$ of protein raises urine specific gravity by $0.003$.

Refractometer adjustment for Glucose

$1\,g/dL$ of glucose raises urine specific gravity by $0.004$.

Significant AER (Albumin Excretion Rate)

$20\text{ to }200\,\mu g/min$ or $30\text{ to }300\,mg\text{ albumin}/24\text{ hours}$.

Ketone body composition

$78\%$ beta-hydroxybutyric acid (BHA), $20\%$ acetoacetic acid (AAA), and $2\%$ Acetone.

CSF production and reabsorption

Approximately $20\,mL$ is produced every hour in the choroid plexuses and reabsorbed by the arachnoid villi.

CSF Glucose ratio

Approximately $60\text{ to }70\%$ that of plasma glucose.

Normal CSF protein range

$$15\text{ to }45\,mg/dL$$

Semen Liquefaction time

Within $30\text{ to }60\text{ minutes}$.

Semen Fructose requirement

$\geq 13\,\mu mol\text{ per ejaculate}$; specimens should be tested within $2\text{ hours}$ or frozen.

Synovial fluid string test

Normal fluid is able to form a $4\text{ to }6\,cm\text{ string}$.

Exudate indicators (Pleural fluid)

Fluid cholesterol $> 60\,mg/dL$, ratio to serum cholesterol $> 0.3$, or fluid to serum total bilirubin ratio $\geq 0.6$.

CA 125 antigen sources

Ovaries, fallopian tubes, or endometrium.

Polyuria definition

Urine output greater than $2.5\,L/day$ in adults.

Oliguria definition

Urine output less than $400\,mL/day$ in adults.

Clinitest tablet contents

Copper sulfate, sodium carbonate, sodium citrate, and sodium hydroxide.

Acetest tablet contents

Sodium nitroprusside, glycine, disodium phosphate, and lactose.

Bence Jones protein temperature properties

Coagulates between $40^{\circ}C\text{ and }60^{\circ}C$ and dissolves at $100^{\circ}C$.

Telescoped sediment

Urinary sediment containing elements of both glomerulonephritis and nephrotic syndrome.

Reflectance photometry

The principle used by automated reagent strip readers.

Saccomano’s fixative

The preservative of choice for urine cytology studies.

Urobilinogen collection time

Afternoon sample ($2\text{ to }4\,pm$).

Amorphous urates appearance

Yellow brown-granules microscopically, producing a pink 'brick dust' sediment due to uroerythrin.

Psammoma bodies

Collagen-like material with concentric striations seen in ovarian and thyroid carcinomas.

Diagnex tubeless test

A noninvasive test used to determine gastric acidity.