CLINICAL PATHOLOGY

ST
1 PRACTICALS
BY DEADPOOL
DISCLAIMER
• THIS IS NOT A SUBSTITUTE FOR READING YOUR
MANUALS. #BASABASADIN
• THIS IS DESIGNED TO MAKE YOU FAMILIAR WITH
THE THINGS THAT MIGHT BE DISPLAYED DURING
THE EXAM. IT IS UP TO YOU TO RECALL CONCEPTS
IMPORTANT TO THOSE DIAGNOSTIC TESTS
#REVIEWTOHINDILECTURE
• YOU MAY SHARE THIS REVIEWER WITH ANY UERM
MEDICINE STUDENT. THE CREATOR OF THIS
REVIEWER IS NOT LIABLE FOR YOUR TEST RESULTS
#ARALARALDIN
• IF YOU IMPROVE THIS REVIEWER, DON’T FORGET
TO SHARE IT. #SHARINGISCARING
ACKNOWLEDGEMENTS
• ATE MHEL FROM PATHO DEP
• EVEZ CARA, BRIAN DAVID, AND MJ NG FOR THE PICS
• www.hawaii.edu/medtech/MEDT251/Seds_files/Seds.ppt
APPROACH TO CLIN PATH PRACS
• KNOW THE FOLLOWING REGARDING EACH
DIAGNOSTIC TEST
• TEST INDICATION
• CHEMICAL PRINCIPLES INVOLVED (IF APPLICABLE)
• REFERENCE VALUES
• INTERPRETATION OF RESULTS
• REAGENTS, MATERIALS, AND EQUIPMENT USED
PHLEBOTOMY & BLOOD COLLECTION

• REMEMBER: YELLOW-RED-BLUE-PURPLE
PERIPHERAL BLOOD SMEAR

Wright stain soln – 5 mins then Buffer 5mins then rinse

Let it dry and read in Oil immersion look for the cells total of 100cells
PERIPHERAL BLOOD SMEAR

• POSSIBLE PRAX SETUP

HEMATOCRIT
HEMATOCRIT

• POSSIBLE PRAX SETUP

ESR

Put coagulated blood up to 10mark then read after 1

hr. result mm/hr
ESR

• POSSIBLE PRAX SETUP

WBC DIFF COUNT
WBC DIFF COUNT

• POSSIBLE PRAX SETUP

BLEEDING TIME
BLEEDING TIME - DUKE METHOD

• POSSIBLE PRAX SETUP

BLOOD TYPING

REMEMBER:
ANTI-A : BLUE
ANTI-B : YELLOW
ANTI-D : CLEAR
BLOOD TYPING

• POSSIBLE PRAX SETUP

REVERSE TYPING
A B

2 drops of serum in test tube A & B then

add 1 drop of washed RBC A in test tube A
and washed RBC B in test tube B then
centrifuge for 1 min… interpret result

REMEMBER: UNKNOWN SERA, KNOWN RBC

RESULTS:
• CLUMPING IN TEST TUBE A: ANTI-A
• CLUMPING IN TEST TUBE B: ANTI-B
REVERSE TYPING

• POSSIBLE PRAX SET-UP; TAKE NOTE OF TUBE A & B

COAGULATION TIME

1 2 3

Test tube 1,2,3

COAGULATION TIME

• POSSIBLE PRAX SETUP

URINALYSIS
1 2

Put urine in 1 test

tube while water in
2 test tube to act as
a balancer
centrifuge for 5
mins then decant
then read in
microscope only
LPO & HPO

refractometer
URINALYSIS
• TESTS REFERENCED IN THE PRECEDING SLIDE
• DIPSTICK
• SPECIFIC GRAVITY USING REFRACTOMETER
• MICROSCOPIC URINE ANALYSIS
URINALYSIS

• POSSIBLE PRAX SETUP

URINE MICROSCOPY R
B
C
wbc
Uric acid crystals

WBC Hyaline cast

Rbc cast
WBC cast Calcium oxalate
URINE MICROSCOPY
URINE MICROSCOPY

• CALCIUM OXALATE CRYSTALS

URINE MICROSCOPY
URINE MICROSCOPY
URINE MICROSCOPY
URINE MICROSCOPY
URINE MICROSCOPY
• RBCs IN URINE
• POSSIBLE PRAX
SETUP
TEST FOR URINE PROTEIN

5ml of centrifuge urine

gently boil the upper portion
if cloudiness appear add 2
drops of glacial acetic acid
then report result
TEST FOR URINE PROTEIN
KETONE TEST
TEST FOR URINE SUGAR
8 drops of urine + 5ml
of Benedict’s reagent
Heat to gentle boiling
w/ intermittent
shaking for 5 mins
then report result

(-) (+/-) +3 +4
TEST FOR URINE SUGAR
TEST FOR URINE BILIRUBIN

• TAKE NOTE OF THE

GREEN PRECIPITATE
(HARD TO SEE)
ADDENDUM
• THE FOLLOWING SLIDES WERE LIFTED DIRECTLY
FROM:
www.hawaii.edu/medtech/MEDT251/Seds_files/Seds.ppt
Urinary Sediments
• Formed elements: epithelia, red cells, white cells
• Crystals
• Mucus
• Renal casts
• Microorganisms
• Sternheimer-Malbin stain
Microscopic UA
• Correlate with cloudiness and other findings
• Quality control
• Consistent volume
• Centrifugation
• Well mixed fresh specimen
• Microscopy (wet mount, use low light)
• Sternheimer-Malbin stain
Epithelia
• Squamous epithelia
• Large flat cell with central oval nucleus
• Transitional (bladder) epithelia
• Spindle shaped with large oval nucleus
• Maybe in sheet
• Renal tubular epithelia
• Small cell with large oval nucleus
• Most clinically significant
Squamous Epithelia
Transitional Epithelia
Renal Tubular Epithelia
Leukocytes
• Pus, or pyuria
• May indicate urinary tract infection UTI if more than
10/HPF
• Glitter cells in dilute alkaline urine
Pyuria Bacteriuria
Erythrocytes

• Hematuria may indicate renal damage

• Menstrual contamination
• May be crenated or ghost cells
Hematuria
Renal Casts
• Cylindruria
• Renal stasis
• Acidic pH
• Proteinuria
• Concentrated urine
• Tamm-Horsfall mucoprotein matrix
Renal Casts
• Hyaline
• Least significant
• Not refractile
• Coarse and fine granular
• Cellular
• Classified by cells in the cast
• Waxy
• End stage renal disease
Hyaline Cast
How many casts do you see?
Fine Granular Casts
Coarse Granular Cast
RBC Casts
WBC Casts
Epithelial Casts

Fatty Cast
Broad Cast

Waxy Casts
Mucus
• Usually of no clinical significance
Common Crystals in Acid pH
• Amorphous urate
• Orange powder
• May clear with warming or saline
• Uric acid
• Brown lemon shaped or star shaped
• Birefringent with polarized light
• Calcium oxalate
• Envelope
Amorphous Urate
Uric Acid
Uric Acid
Polarized
Calcium Oxalate
Common Crystals in Alkaline pH
• Amorphous phosphate
• White powder
• May clear with saline
• Triple phosphate
• Coffin lid
• Ammonium biurate
• Thorn apple
• Calcium carbonate
• Effervesce with SSA
Amorphous Phosphate
Triple Phosphate
Ammonium Biurate
Calcium Carbonate
GOODLUCK!

END OF REVIEWER