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242 Manual of basic techniques for a health laboratory Fig. 7.10 Leukocytes a: Intact cells; b: degenerated cells; c: pus. Fig. 7.11 Ureteral and renal pelvic cells Note: Erythrocytes may be found in the urine of women if the specimen has been taken during the menstrual period. Leukocytes (Fig. 7.10) Leukocytes found in urine may be: (a) intact: clear granular discs, 10–15mm (the nuclei may be visible); (b) degenerated: distorted shape, shrunken, less granular; (c) pus: clumps of numerous degenerated cells. The presence of many leukocytes, especially in clumps, indicates a urinary tract infection. How to express the quantity of erythrocytes and leukocytes found in urine deposits Place one drop of urine deposit on a slide and cover with a coverslip. Using the ¥ 40 objective, examine the deposit and count the number of erythrocytes and leukocytes per microscope field. Report the results as described in Tables 7.3 and 7.4. Ureteral and renal pelvic cells (Fig. 7.11) Medium-sized oval cells with a distinct nucleus. If many cells are present together with leukocytes and filaments, they may be from the ureter. If a few are present, with no leukocytes, they may be cells from the renal pelvis. Table 7.3 Reporting the results of microscopic examination of urine for erythrocytes Number of erythrocytes per microscope field Result 0–10 few erythrocytes (normal) 10–30 moderate number of erythrocytes > 30 many erythrocytes
7. Examination of urine 243 Table 7.4 Reporting the results of microscopic examination of urine for leukocytes Number of leukocytes per microscope field Result 0–10 few leukocytes (normal) 10–20 moderate number of leukocytes 20–30 many leukocytes 20–30 (degenerated) in clumps many leukocytes seen in clumps > 30 (degenerated) in clumps full field Fig. 7.12 Renal cells Fig. 7.13 Hyaline casts Renal cells (Fig. 7.12) Renal cells are smaller than renal pelvic cells (the size of 1–2 leukocytes) and are very granular. The nucleus is shiny and clearly visible. Renal cells are almost always present with protein in the urine. Casts Casts are cylindrical in shape and long, crossing almost the whole field when examined under the ¥ 40 objective. Hyaline casts are transparent and slightly shiny; the ends are rounded or tapered (Fig. 7.13). They may be found in healthy persons after strenuous muscular effort and have no diagnostic significance. Granular casts are rather short casts filled with large granules, pale yellow in colour, with rounded ends (Fig. 7.14). The granules come from degenerated epithelial cells from the tubules of the kidney and have no diagnostic significance. Fine granular casts (Fig. 7.15) have smaller granules that do not fill the cast (a). Do not confuse with hyaline casts, partly covered by amorphous phosphate crystals (b). Blood casts are filled with more or less degenerated erythrocytes, brownish in colour (Fig. 7.16). They are found in acute kidney Fig. 7.14 Granular casts disease. Pus casts (Fig. 7.17) are completely filled with leukocytes (a). Do not confuse with hyaline casts, which may contain a few leukocytes (b). Pus casts are found in patients suffering from kidney infection. Epithelial casts are filled with pale yellow epithelial cells (Fig. 7.18). (To make the cells more distinct, add a drop of 10% acetic acid (reagent no. 2) to the deposit.) Epithelial casts have no diagnostic significance. Fatty casts are very shiny yellowish casts; the edges are indented and distinct and the ends are rounded (Fig. 7.19). They are soluble in ether but not in acetic acid. Fatty casts are found in patients with severe kidney disease.
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M A N U A L O F B A S I C TECHNIQUE
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Contents i Manual of basic techniqu
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Contents iii Contents Preface x 1.
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Contents v 4.2.1 Collection of spec
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Contents vii PART III 231 7. Examin
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Contents ix 10.1.3 Method 322 10.1.
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1. Introduction 1 1. Introduction 1
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1. Introduction 3 The following sec
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1. Introduction 5 Table 1.4 SI deri
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1. Introduction 7 Table 1.5 (cont.)
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2. Setting up a peripheral health l
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3. General laboratory procedures 53
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4. Parasitology 103 Part II
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4. Parasitology 105 4.Parasitology
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4. Parasitology 107 4.2 Examination
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4. Parasitology 109 colourless, red
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4. Parasitology 111 Table 4.3 Patho
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4. Parasitology 113 Fig. 4.13 Invas
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4. Parasitology 115 Motility: eithe
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4. Parasitology 117 Rapid Field sta
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4. Parasitology 119 Fig. 4.24 Featu
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4. Parasitology 121 Identification
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4. Parasitology 123 Measurement Acc
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4. Parasitology 125 Shape: round or
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4. Parasitology 127 ● ● ● The
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4. Parasitology 129 Fig. 4.39 Terms
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4. Parasitology 131
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4. Parasitology 133 Fig. 4.42 Ancyl
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4. Parasitology 135 Dipylidium cani
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4. Parasitology 137 Fig. 4.59 Trans
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4. Parasitology 139 Fig. 4.66 Heter
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4. Parasitology 141 Shell: smooth,
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4. Parasitology 143 Fig. 4.79 Filli
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4. Parasitology 145 These granules
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4. Parasitology 147 Fig. 4.92 Adult
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4. Parasitology 149 Fig. 4.97 Featu
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4. Parasitology 151 Fig. 4.101 Schi
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4. Parasitology 153 Method Preparat
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4. Parasitology 155 2. Using the sp
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4. Parasitology 157 differentiated
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4. Parasitology 159 5. Add to the t
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4. Parasitology 161 Method Collecti
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4. Parasitology 163 Procedure for o
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4. Parasitology 165 Table 4.8 Chara
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4. Parasitology 167 Method 1. Colle
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4. Parasitology 169 7. Remove the s
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4. Parasitology 171 Cephalic space
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4. Parasitology 173 Table 4.10 Geog
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4. Parasitology 175 Fig. 4.132 Coll
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4. Parasitology 177 1. Allow the th
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4. Parasitology 179 Table 4.11 Comp
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4. Parasitology 181 Table 4.12 (con
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4. Parasitology 183 African trypano
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4. Parasitology 185 Fig. 4.144 Twis
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4. Parasitology 187 Fig. 4.150 Usin
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4. Parasitology 189 The above mater
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292 Manual of basic techniques for
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10. Blood chemistry 10.1 Estimation
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11. Immunological and serological t
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370 Index BI, see Bacteriological i
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372 Index Dark-field microscopy 64,
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374 Index Formaldehyde-ether sedime
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376 Index Labelling (continued) spe
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378 Index Open two-pan balances 67-
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380 Index Reference ranges (continu
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382 Index Strongyloides stercoralis
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384 Index Venous blood collection 2
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This manual provides a practical gu
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