Slides Exam

Introduction to Medical Technology

By
Dr. Nabil El Aila
Assistant Professor of Microbiology
Medical Technology Department
Al -Aqsa University
 Normal Red cell morphology
MCV = 80 - 100 fL
MCH= 31-36 pg
MCHC= 31 to 36 g/dL
(Normocytic Normochromic)
Dr. Nabil El Aila Intro. Med. Technology
 Severe hypochromia and microcytosis
MCV < 80 fL
MCH <31 pg
MCHC <31 g/dL
Found in: iron deficiency anemia
Dr. Nabil El Aila Intro. Med. Technology
 Macrocytic Hyperchromic
MCV > 80 fL
MCH >31 pg
MCHC >31 g/dL
Found in: Pernicious anemia
Dr. Nabil El Aila Intro. Med. Technology
 Anisocytosis
Variation in RBCs size, High RDW

Dr. Nabil El Aila Intro. Med. Technology

 • Variations in red cell size (anisocytosis) and
shape (poikilocytosis)
• This patient has myelofibrosis.

Dr. Nabil El Aila Intro. Med. Technology

 • Reticulocytes
• constitute about 1% of the total number of
circulating erythrocytes

Dr. Nabil El Aila Intro. Med. Technology

 Polychromasia
Found in:
reticulocytosis – for example bleeding,
haemolysis
Dr. Nabil El Aila Intro. Med. Technology
 Target Cells
Found in:
Thalassaemia

Dr. Nabil El Aila Intro. Med. Technology

 Acanthocytosis
Found in:
Liver disease

Dr. Nabil El Aila Intro. Med. Technology

 Sickle Cell
Found in:
Sickle cell anemia

Dr. Nabil El Aila Intro. Med. Technology

 Schistocyte
Found in:
Disseminated Intravascular Coagulation

Dr. Nabil El Aila Intro. Med. Technology

 Tear drop Cell
Found in:
Megaloblastic anaemia

Dr. Nabil El Aila Intro. Med. Technology

 Spherocyte
Found in:
Hereditary spherocytosis

Dr. Nabil El Aila Intro. Med. Technology

 Elliptocyte
Found in:
Hereditary elliptocytosis

Dr. Nabil El Aila Intro. Med. Technology

 Stomatocyte
Found in:
Alcoholic liver disease

Dr. Nabil El Aila Intro. Med. Technology

 Cigar Cells
Found in:
Iron deficiency

Dr. Nabil El Aila Intro. Med. Technology

 Echinocytes (Burr cell)
Found in:
Uraemia

Dr. Nabil El Aila Intro. Med. Technology

 Red cell-agglutination
Found in:
Cold agglutinins

Dr. Nabil El Aila Intro. Med. Technology

 Rouleaux Formation
Found in:
Hyperfibrinogenaemia

Dr. Nabil El Aila Intro. Med. Technology

 RBC Inclusions (Basophiling stippling)
Found in:
Thalassaemia

Dr. Nabil El Aila Intro. Med. Technology

 Howell-Jolly Bodies
Found in:
Haemolytic anaemias

Dr. Nabil El Aila Intro. Med. Technology

 Cabot Ring
Found in:
pernicious anemia

Dr. Nabil El Aila Intro. Med. Technology

 Pappenheimer bodies
Found in:
sideroblastic anemia

Dr. Nabil El Aila Intro. Med. Technology

 Red cells containing
Plasmodium falciparum
ring forms.

Dr. Nabil El Aila Intro. Med. Technology

 A red cell containing
a trophozoite of
Plasmodium vivax.

Dr. Nabil El Aila Intro. Med. Technology

  Band/Stab neutrophil
 0-3% in circulation
 Increased in bacterial infection

Dr. Nabil El Aila Intro. Med. Technology

 • SEGMENTED NEUTROPHIL
• 60-70% in circulation
• Increased in bacterial infection

Dr. Nabil El Aila Intro. Med. Technology

 • Eosinophil
• 2-4% in circulation
• Increased in allergy, parasites

Dr. Nabil El Aila Intro. Med. Technology

 • BASOPHIL
• <1% in circulation
• Increased in allergy, Chronic myelogenous
leukemia
Dr. Nabil El Aila Intro. Med. Technology
 • Lymphocytes:
• 20 - 25% in circulation
• Increased in viral infection

Dr. Nabil El Aila Intro. Med. Technology

 • Monocytes
• 3-8% in circulation
• Increased in Monocytosis infection (Tuberculosis,
Brucellosis, Malaria, Rocky Mountain spotted fever)
Dr. Nabil El Aila Intro. Med. Technology
 • Platelets
• In a healthy individual, a normal platelet count
ranges from 150,000 and 450,000 per mm³
• Increased Platelets count (thrombocytosis) in
Myeloproliferative disease

Dr. Nabil El Aila Intro. Med. Technology

 • Red Blood cells in urine analysis
• Normal .. .. 0 -2 cells/HPF
• Increased erythrocyte in Renal diseases

Dr. Nabil El Aila Intro. Med. Technology

 • White Blood cells in urine analysis
• Normal .. .. 0 -5 cells/HPF
• Increased WBCs in Bacterial Infection, including
pyelonephritis, cystitis, prostatitis and urthritis
Dr. Nabil El Aila Intro. Med. Technology
 • Squamous epithelial cells
• Increased numbers may be seen in female urine (not
midstream urine) and Vaginal discharge
contamination

Dr. Nabil El Aila Intro. Med. Technology

 • Transitional epithelial cells
• In a person with an active inflammation
• injuries can cause an increase in transitional
epithelial cells.
Dr. Nabil El Aila Intro. Med. Technology
 • Renal tubular epithelial cells
• increased numbers indicates tubular necrosis
and is particularly important in renal graft
rejection
Dr. Nabil El Aila Intro. Med. Technology
 • Hyaline casts
• 0-2 hyaline casts per low power field
• Increased in Nephritis and Malignant
hypertension
Dr. Nabil El Aila Intro. Med. Technology
 • Granular casts
• Increased in acute tubular necrosis

Dr. Nabil El Aila Intro. Med. Technology

 • Waxy casts
• Increased in Chronic renal disease and ubular
inflammation and degeneration

Dr. Nabil El Aila Intro. Med. Technology

 • Broad Casts
• Indicate tubular dilatation and/or stasis in the
distal collecting duct

Dr. Nabil El Aila Intro. Med. Technology

 • Fatty casts
• Increased in Nephrotic syndrome

Dr. Nabil El Aila Intro. Med. Technology

 Red cell casts
Increased in Acute glomerulonephritis

Dr. Nabil El Aila Intro. Med. Technology

 White blood cell casts
Indicative of inflammation or infection

Dr. Nabil El Aila Intro. Med. Technology

 • Renal tubular epithelial casts
Reflect tubular damage, e.g. acute tubular
necrosis, acute allograft rejection,

Dr. Nabil El Aila Intro. Med. Technology

 • Uric acid crystals
• Uric acid crystals are seen in normal urine.
They may also be associated with kidney stone
formation
Dr. Nabil El Aila Intro. Med. Technology
 Amorphus urates crystals

Dr. Nabil El Aila Intro. Med. Technology

 Sodium urates crystals

Dr. Nabil El Aila Intro. Med. Technology

 • Calcium oxalate crystals
• Calcium oxalae crystals are associated with
diets high in oxalic acid

Dr. Nabil El Aila Intro. Med. Technology

 Triple phosphate crystals

Dr. Nabil El Aila Intro. Med. Technology

 Amorphus phosphate crystals

Dr. Nabil El Aila Intro. Med. Technology

 Calcium phosphate crystals

Dr. Nabil El Aila Intro. Med. Technology

 Ammonium biurate crystals

Dr. Nabil El Aila Intro. Med. Technology

 Calcium carbonate crystals

Dr. Nabil El Aila Intro. Med. Technology

 • Cystine crystals are found in the inherited condition,
cystinuria.
• Cystine crystals are the most frequent cause of kidney
stones in children.

Dr. Nabil El Aila Intro. Med. Technology

 • Cholesterol crystals are usually associated
with Nephrotic Syndrome.

Dr. Nabil El Aila Intro. Med. Technology

 • Leucine crystals may be seen in liver disorders
in which amino acid metabolism is impaired.

Dr. Nabil El Aila Intro. Med. Technology

 • Tyrosine crystals may be seen in tyrosinemia
and in certain liver disorders in which amino
acid metabolism is impaired.

Dr. Nabil El Aila Intro. Med. Technology

 Bilirubin crystals are seen in several hepatic
disorders

Dr. Nabil El Aila Intro. Med. Technology

 • Sulfonamide crystals may appear in the urine
following antibiotic therapy with sulfonamides.

Dr. Nabil El Aila Intro. Med. Technology

 Bacteria under microscopic examination of urine

Dr. Nabil El Aila Intro. Med. Technology

 Yeast cells usually candida albicans
under microscopic examination of urine

Dr. Nabil El Aila Intro. Med. Technology

 Trichomonas vaginalis
under microscopic examination of urine

Dr. Nabil El Aila Intro. Med. Technology

 Schistosoma haematobium
under microscopic examination of urine

Dr. Nabil El Aila Intro. Med. Technology

 Spermatozoa
under microscopic examination of urine
 Mucus
under microscopic examination of urine
 starch granule
under microscopic examination of urine

Dr. Nabil El Aila Intro. Med. Technology

 fibers
under microscopic examination of urine

Dr. Nabil El Aila Intro. Med. Technology

 Fat droplets
under microscopic examination of urine

Dr. Nabil El Aila Intro. Med. Technology