Clinical Microscopy
"RMT in the making! What your body fluids reveal about your health. Microscopy tells the story!"
1. Urinalysis 🧪
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) 💩
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 💧
CSF (Cerebrospinal Fluid)
- Normally: Clear, colorless, <5 WBC/μL
- Bacterial meningitis: Cloudy, ↑WBC (neutrophils), ↓glucose
- Viral meningitis: Clear, ↑WBC (lymphocytes), normal glucose
Seminal Fluid Analysis
- Volume: 2-5 mL
- Count: >15 million/mL (WHO 2010)
- Motility: >40% progressive
- Morphology: >4% normal forms
💡 Board Exam Tips - Clinical Microscopy
- ✓ RBC casts = Glomerulonephritis (pathognomonic)
- ✓ Leukocyte esterase + Nitrite positive = UTI (Gram-negative)
- ✓ E. histolytica trophozoites with ingested RBCs = Invasive amebiasis
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