Urines and Smears Alan Cheng UNC Medicine Upper Level Conference 7/15/09

Urines and Smears

Alan ChengUNC Medicine Upper Level Conference

7/15/09

Epithelial cell

Transitional cellAbove, clue cell. Below, normal.

http://www.medicine.uiowa.edu/cme/clia/modules.asp?testID=20

Normal RBC’s

Crenated RBC’s from elevatedSG or PH.

Normal RBC’s

Dysmorphic RBC’s (mickey mouse)http://www.medicine.uiowa.edu/cme/clia/modules.asp?testID=20http://www.agora.crosemont.qc.ca/urinesediments/Imdoceng/d13d001.htm

Mixed bacteria

trichomonad

B – yeast, C - RBC

http://www.medicine.uiowa.edu/cme/clia/modules.asp?testID=20

http://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

RBC casts

WBC cast

http://www.meddean.luc.edu/lumen/MedEd/MEDICINE/PULMONAR/Renal/Atlas/urineatlas_f.htm

http://meded.ucsd.edu/isp/1994/im-quiz/urine.htm

Uric acid crystals

Calcium oxalate

Triple phosphate or Struvite

Cysteine stones

Calcium oxalate

sperm

http://meded.ucsd.edu/isp/1994/im-quiz/urine.htm

cotton

Triple phosphate

Uric acid

http://www.meddean.luc.edu/lumen/MedEd/MEDICINE/PULMONAR/Renal/Atlas/urineatlas_f.htm

A = renal tubular cellB = WBC

A = renal tubular cellB = oval fat body

oval fat body

http://meded.ucsd.edu/isp/1994/im-quiz/urine.htmhttp://www.meddean.luc.edu/lumen/MedEd/MEDICINE/PULMONAR/Renal/Atlas/urineatlas_f.htm

Now on to heme…

Normal smear

Plasma cell

lymphocyte

neutrophilMonocyte

Basophil Neutrophil and eosinophil

http://www.healthsystem.virginia.edu/internet/hematology/hessidb/normal-hematopoietic-cells.cfm

reticulocyte

http://www.healthsystem.virginia.edu/internet/hematology/hessidb/normal-hematopoietic-cells.cfm

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

Howell Jolly bodiesBasophilic Stippling

Nucleated RBCPappenheimer bodies

http://www.healthsystem.virginia.edu/internet/hematology/hessidb/normal-hematopoietic-cells.cfm

Malaria

Auer Rods, AML M3

http://www.healthsystem.virginia.edu/internet/hematology/hessidb/normal-hematopoietic-cells.cfm

Heinz body

Rouleaux (stack of coins)http://www.healthsystem.virginia.edu/internet/hematology/hessidb/normal-hematopoietic-cells.cfm

elliptocyte

spherocyte

http://www.healthsystem.virginia.edu/internet/hematology/hessidb/normal-hematopoietic-cells.cfm

schistocyte

Teardrop cell

Sickle cellshttp://www.healthsystem.virginia.edu/internet/hematology/hessidb/normal-hematopoietic-cells.cfm

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

normal

macrocytosis

Microcytic, hypochromic

http://www.healthsystem.virginia.edu/internet/hematology/hessidb/normal-hematopoietic-cells.cfm

• Thanks