1 / 55

CLLS 3231 URINALYSIS AND BODY FLUIDS

CLLS 3231 URINALYSIS AND BODY FLUIDS. MICROSCOPIC EXAMINATION Formed Elements: Cellular, Casts, Bacteria and Yeast. Standardization of Specimen Preparation. Commercial Systems Specimen volume Centrifugation Sediment Concentration Volume of Sediment Viewed. Methods to Increase Contrast.

irma
Download Presentation

CLLS 3231 URINALYSIS AND BODY FLUIDS

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. CLLS 3231URINALYSIS AND BODY FLUIDS MICROSCOPIC EXAMINATION Formed Elements: Cellular, Casts, Bacteria and Yeast

  2. Standardization of Specimen Preparation • Commercial Systems • Specimen volume • Centrifugation • Sediment Concentration • Volume of Sediment Viewed

  3. Methods to Increase Contrast • Staining Techniques • Supravital Stains • Fat or Lipid Stains • Acetic Acid • Gram Stain • Hansel’s Stain

  4. Microsocpic Techniques • Examine within 2 hours of collection • Correlation with physical and chemical results • FIRST • Scan using low (10X) power and report LPF for certain elements • SECOND • Scan high (40X) power and report as indicated

  5. Formed Elements: RBCs • Appearance • hypertonic • hypotonic • Differentiate from yeast, oil, etc.. • Correlate with physical examination

  6. Formed Elements: RBCs • Correlate with chemical examination • False Positive Chemical • False Negative Chemical • Clinical Significance - Handout

  7. RBC’s Cont...

  8. RBC’s

  9. Formed Elements: WBC’s • Appearance • Correlation with Physical Examination • Correlation with Chemical Examination

  10. Formed Elements: WBC’s • Look-alikes: • Eosinophiluria • Lymphocytes • Monocytes and Macrophages

  11. WBC’s

  12. WBC’s Cont...

  13. Macrophage

  14. Formed Elements: Epithelial Cells • Presence: • Squamous Epithelial Cells • Most Common • Largest

  15. Squamous Epithelial Cells • Specimen Contamination • Low Power magnification

  16. Squamous Epithelal Cells

  17. Transitional (urothelial) Epithelial Cells • Location: • Description • UTI

  18. Transitional Epis.

  19. Renal Tubular Epithelial Cells • Each renal tubule is lined with a single layer of a characteristically different epithelium • Convoluted Renal Tubule • Proximal convoluted tubular cells • Distal convoluted tubular cells • Collecting Duct Cells

  20. Renal with Squamous Epis

  21. Convoluted Renal Tubular Cells • Description • Differentiation • Clinical Significance • Oval Fat Bodies

  22. Renals Continued...

  23. Collecting Duct Epithelial Cells • Description • Clinical Significance • Fragments

  24. Comparison of Epithelial Cells from the Urinary Tract EPITHELIAL CELL TYPE SIZE (DIAMETER) SHAPE NUCLEUS Squamous 40 - 60m Thin, flagstone shape, with distinct edges. Large amount of cytoplasm with fine granulation that increases with age. Small (approx. 8 m), centrally located, can be anucleated. Transitional (urothelial) 20 - 40m Variable, depending on cell layer. Superficial layer: large, round or pear shape; Intermediate layer: smaller and rounder; Deep basal layer: small and can be elongated or columnar-like. Cell edges are distinct and appear “firm”. Small (8 - 14m), centrally located, oval to round with variable density in the chromatin pattern Renal Tubular Epithelial Cells Collecting duct cells 12 - 20m Variable. Polygonal or cuboidal from small ducts; columnar from larger ducts. Relatively smooth cytoplasm Large, moderately dense, round nucleus that takes up approx. 2/3’s cytoplasm. Columnar cells the nucleus is usually slightly eccentric. Distal Convoluted tubular cells 14 - 25m Oval to round with grainy cytoplasm. Small, round, dense nucleus; centered or slightly eccentric. Proximal convoluted tubular cells 20 - 60m Oblong or cigar-shaped. These cells have a large amount of grainy cytoplasm. Cell edges are not sharply defined. They can resemble casts. Small, round, dense nucleus; eccentric; can be multinucleated.

  25. CASTS • Formation and General Characteristics • Formed in distal and collecting tubules • Accounts for shape: • Tamm-Horsfall protein: • Enhanced Cast Formation

  26. Renal Cast Formation

  27. Classification of Casts • Classified microscopically based on composition of matrix and the type of substances or cells enmeshed in them. • Homogenous: hyaline, waxy • Cellular Inclusion: RBC, WBC, RTE, Mixed cells, Bacteria • Other inclusions: granular, fat globules (cholesterol or triglycerides), hemosiderin granules, crystals • Pigmented: bilirubin, hemoglobin, myoglobin • Size: broad

  28. Homogenous Casts • Hyaline Cast • Waxy Cast

  29. Hyaline Cont...

  30. Hyaline

  31. Waxy Casts Cont...

  32. Waxy Casts

  33. Cellular Casts • RBC Cast • WBC Cast

  34. RBC Cast

  35. RBC Cast Cont...

  36. WBC Cast

  37. WBC Cast Cont...

  38. Cellular Casts Continued • RTE Cast • Mixed Cell Cast • Bacterial Cast

  39. Renal Cast

  40. Other inclusions • Granular Cast • Fatty Cast • Hemosiderin and Crystal Casts

  41. Granular Casts

  42. Granular Casts Cont...

  43. Fatty Cast

  44. Pigmented and Broad Casts • Hyaline matrix with pigment incorporated • hemoglobin • myoglobin • bilirubin • Broad Cast - dilated convoluted tubule or in collecting ducts

  45. Bacteria

  46. Yeast

  47. Yeast Cont...

  48. Oval Fat Bodies

More Related