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Clinical Microscopy

RMT in the making! What your body fluids reveal about your health. Microscopy tells the story!

1. Urinalysis ๐Ÿงช

Physical Examination

  • Color: Pale yellow to amber (normal). Red = blood, Orange = bilirubin
  • Clarity: Clear to slightly hazy. Turbid = cells, bacteria, crystals
  • Specific Gravity: 1.003-1.030 (kidney concentrating ability)

Chemical Examination (Dipstick)

  • pH: 4.5-8.0 (avg 6.0)
  • Protein: Negative (positive = kidney disease)
  • Glucose: Negative (positive = diabetes)
  • Ketones: Negative (positive = DKA, starvation)
  • Blood: Negative (positive = hematuria)
  • Leukocyte Esterase: Positive = WBCs (UTI)
  • Nitrite: Positive = Gram-negative bacteria (UTI)

Microscopic Examination

  • RBC: 0-2/HPF (elevated = glomerulonephritis, stones)
  • WBC: 0-5/HPF (elevated = UTI)
  • Bacteria: Usually indicates infection
  • Casts: Formed in tubules (RBC casts = glomerulonephritis)
  • Crystals: Uric acid, calcium oxalate, triple phosphate

2. Stool Examination (Fecalysis) ๐Ÿ’ฉ

Physical Examination

  • Color: Brown (normal). Black = upper GI bleed, Red = lower GI bleed
  • Consistency: Formed (normal). Watery = diarrhea
  • Mucus: Present in inflammation, infection

Common Parasites

  • Ascaris lumbricoides: Largest roundworm, fertilized eggs
  • Trichuris trichiura: Whipworm, barrel-shaped eggs
  • Hookworm: Ancylostoma/Necator, thin-shelled eggs
  • Entamoeba histolytica: Trophozoites with ingested RBCs
  • Giardia lamblia: Falling leaf motility, face appearance

Occult Blood Test (FOBT)

Detects hidden blood in stool. Used for colorectal cancer screening.

Guaiac test: Color change with blood + developer

3. Other Body Fluids ๐Ÿ’ง

CSF (Cerebrospinal Fluid)

  • Normally: Clear, colorless, <5 WBC/ฮผL
  • Bacterial meningitis: Cloudy, โ†‘WBC (neutrophils), โ†“glucose
  • Viral meningitis: Clear, โ†‘WBC (lymphocytes), normal glucose

Seminal Fluid Analysis

  • Volume: 2-5 mL
  • Count: >15 million/mL (WHO 2010)
  • Motility: >40% progressive
  • Morphology: >4% normal forms

๐Ÿ’ก Board Exam Tips - Clinical Microscopy

  • โœ“ RBC casts = Glomerulonephritis (pathognomonic)
  • โœ“ Leukocyte esterase + Nitrite positive = UTI (Gram-negative)
  • โœ“ E. histolytica trophozoites with ingested RBCs = Invasive amebiasis