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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