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Urines and Smears Alan Cheng UNC Medicine Upper Level Conference 7/15/09
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Epithelial cell Transitional cell Above, clue cell. Below, normal. http://www.medicine.uiowa.edu/cme/clia/modules.asp?testID=20
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Normal RBC’s Crenated RBC’s from elevated SG or PH. Normal RBC’s Dysmorphic RBC’s (mickey mouse) http://www.medicine.uiowa.edu/cme/clia/modules.asp?testID=20 http://www.agora.crosemont.qc.ca/urinesediments/Imdoceng/d13d001.htm
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Mixed bacteria trichomonad B – yeast, C - RBC http://www.medicine.uiowa.edu/cme/clia/modules.asp?testID=20
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http://www.med.illinois.edu/internalMed/residency/edmod/mod1/casts.htmhttp://www.med.illinois.edu/internalMed/residency/edmod/mod1/casts.htm; http://www.agora.crosemont.qc.ca/urinesediments/Imdoceng/d19d002.htm Hyaline casts WBC cast RBC cast Granular cast vs WBC cast
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RBC casts WBC cast http://www.meddean.luc.edu/lumen/MedEd/MEDICINE/PULMONAR/Renal/Atlas/urineatlas_f.htm
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http://meded.ucsd.edu/isp/1994/im-quiz/urine.htm Uric acid crystals Calcium oxalate Triple phosphate or Struvite Cysteine stones Calcium oxalate
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sperm http://meded.ucsd.edu/isp/1994/im-quiz/urine.htm cotton
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Triple phosphate Uric acid http://www.meddean.luc.edu/lumen/MedEd/MEDICINE/PULMONAR/Renal/Atlas/urineatlas_f.htm
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A = renal tubular cell B = WBC A = renal tubular cell B = oval fat body oval fat body http://meded.ucsd.edu/isp/1994/im-quiz/urine.htm http://www.meddean.luc.edu/lumen/MedEd/MEDICINE/PULMONAR/Renal/Atlas/ur ineatlas_f.htm
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Now on to heme…
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Normal smear Plasma cell lymphocyte
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neutrophil Monocyte BasophilNeutrophil and eosinophil http://www.healthsystem.virginia.edu/internet/hematology/hessidb/normal-hematopoietic-cells.cfm
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reticulocyte http://www.healthsystem.virginia.edu/internet/hematology/hessidb/normal-hematopoietic-cells.cfm
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Acanthocyte (spur cell) -Liver disease -Asplenia Echinocyte (burr cell) -(Liver or) Renal disease http://www.healthsystem.virginia.edu/internet/hematology/hessidb/normal-hematopoietic-cells.cfm
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Howell Jolly bodies Basophilic Stippling Nucleated RBC Pappenheimer bodies http://www.healthsystem.virginia.edu/internet/hematology/hessidb/normal-hematopoietic-cells.cfm
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Malaria Auer Rods, AML M3 http://www.healthsystem.virginia.edu/internet/hematology/hessidb/normal-hematopoietic-cells.cfm
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Heinz body Rouleaux (stack of coins) http://www.healthsystem.virginia.edu/internet/hematology/hessidb/normal-hematopoietic-cells.cfm
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elliptocyte spherocyte http://www.healthsystem.virginia.edu/internet/hematology/hessidb/normal-hematopoietic-cells.cfm
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schistocyte Teardrop cell Sickle cells http://www.healthsystem.virginia.edu/internet/hematology/hessidb/normal-hematopoietic-cells.cfm
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Target cell – increase in membrane:volume ratio -Asplenia - Thalassemia - Hemoglobinopathies - Liver disease - Iron deficiency http://www.healthsystem.virginia.edu/internet/hematology/hessidb/normal-hematopoietic-cells.cfm
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normal macrocytosis Microcytic, hypochromic http://www.healthsystem.virginia.edu/internet/hematology/hessidb/normal-hematopoietic-cells.cfm
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Thanks
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