Macroscopic Information and Courses from MediaLab, Inc.
These are the MediaLab courses that cover Macroscopic and links to relevant pages within the course.
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| Macroscopic abnormalities may include which of the following? | View Page |
| More on Undiluted Specimens In an undiluted specimen, count and differentiate red cells and white cells at the same time. You can count red cells on a hand counter and use the differential counter for white cells.
If you cannot differentiate white cells from red cells in the undiluted specimen, a plain capillary tube may be filled with crystal violet acetic acid diluent which is subsequently expelled from the tube. A very thin coating of the diluent will remain on the inside of the tube. CSF is drawn halfway up into the tube, which is then rocked back and forth to mix. The hemacytometer is then filled with the fluid containing stained white blood cells and lysed red cells.
If cells are numerous and overlapping and it is necessary to focus through several planes in order to see all of the cells, a dilution must be made.
When macroscopic appearance is turbid, milky or bloody, a significant dilution is usually necessary. | View Page |
| Table of Conditions The following table lists the various cell types and macroscopic descriptions of CSF, and the patient conditions that could cause those properties to be present in the patient's CSF: Predominant Cell Appearance Conditions lymphs variable; clear - turbid viral meningitis tubercular meningitis multiple sclerosis drug abuse lymphoma leukemia Guillain-Barré syndrome chronic alcoholism neutrophils variable; clear - turbid bacterial meningitis mycotic meningitis early tuberculosis hemorrhage cerebral abscess tumors monocytes variable chronic bacterial meningitis partial treatment of meningitis tumors macrophages clear - turbid or clear - xanthochromic bloody tuberculosis fungal meningitis following hemorrhage blood contamination eosinophils variable parasitic meningitis fungal meningitis allergic reaction medications shunts dyes tumor cells variable metastatic carcinoma blast cells variable leukemia lymphoma normal to increased lymphs clear - xanthochromic benign tumor spinal cord brain ependymal or orchoid cells (often clumped) variable; may be xanthochromic bloody trauma spinal tap Adapted from Saunders Manual of Clinical Laboratory Science. Craig A. Lehrmann, Ed. WB Saunders, 1998. | View Page |
| Reasons for Performing Confirmatory or Secondary Macroscopic Urine Tests Urine reagent strips are normally adequate for urine screening, but occasionally, it may be necessary to perform a secondary procedure to ensure the accuracy of the test result. Confirmatory or secondary procedures are usually performed for one or more of these reasons: To confirm a result that has been obtained on the reagent strip. To obtain a result from a highly pigmented urine that masks the result on the reagent strip. To test for a specific analyte (or analytes) that are not included in the specificity of the reagent strip test. For example, the glucose reagent strip test is specific for glucose, but you want to test for other reducing substances. | View Page |
| Macroscopic Smear Appearance Before choosing a field for microscopic examination, it is important to look at the smear macroscopically.This slide shows an example of a good smear.Note that the smear is easily visible in ordinary light. | View Page |
| How to Choose a Microscopic Field This topic shows examples of fields appropriate for microscopic examination.Before examining the patient's smear under the microscope, it is important to evaluate the control slides and the macroscopic appearance of the patient's slide. | View Page |
| Macroscopic Appearance The macroscopic appearance of correctly stained control slides. | View Page |
| True Rouleaux Another example of rouleaux is seen in this slide taken from a patient with multiple myeloma. Frequently, the darkly stained macroscopic appearance of the slide will be a clue to the presence of rouleaux on the smear. Increased globulins in the plasma oftne cause the background of the stained smear to be somewhat bluer than the other slides stained at the same time. | View Page |
| A specimen was collected three hours before it was brought to the laboratory for examination. What course of action should be taken? | View Page |
| Summary of macroscopic evaluation In summary, the macroscopic examination of semen can provide important information. Changes in semen liquefaction parameters, viscosity, volume, pH may provide clues to the clinician about causes of infertility or abnormalities of the reproductive tract. | View Page |
| Microscopic Examination The microscopic examination was traditionally performed on all urine specimens after macroscopic exam, specific gravity and chemical tests were completed. Today, many laboratories perform a urine microscopic only if preliminary evaluation indicates the need for microscopic examination. Such laboratories must have criteria determining the specimens on which a urine microscopic will be determined.
The microscopic exam is often important in detecting and evaluating renal and urinary tract disorders as well as other systemic diseases. | View Page |
| Bilirubin Crystals Bilirubin crystals are seen in the urine when the serum bilirubin level is increased. The macroscopic appearance of urine with bilirubin crystals is orange to almost black in color. The crystals themselves appear as gold orange needle-like forms, or as amorphous material. | View Page |
| Correlation of Results Once the microscopic examination is completed, it is important to decide whether the results are normal or abnormal. Correlation involves comparing the microscopic findings with the macroscopic findings. If the results are consistent with each other, the urinalysis may be reported. If a discrepancy exists, the microscopic results cannot be reported. The findings that do not correlate must be repeated. The following table illustrates results which may be found together in a urinalysis. Microscopic Macroscopic Casts (may be accompanied by mucous) Possible positive protein reaction White Blood Cells (bacteria may accompany WBCs in microscopic) Possible positive protein reaction Possible alkaline pH (fresh) Possible cloudy urine Red Blood Cells Possible positive blood reaction Possible positive protein reaction Possible negative blood reaction (if only a few RBCs are seen) Possible cloudy urine Possible red or brown urine Bacteria (may be accompanied by WBCs) Possible alkaline pH (fresh) Possible positive protein reaction Possible cloudy urine Possible positive nitrite reaction Yeast (may be accompanied by WBCs) Possible glucose Possible cloudy urine Crystals Should suggest approximate pH Possible cloudy urine Possible high sp. gravity Trichomonas Possible cloudy urine due to increased WBCs and mucous Report the microscopic findings if they correlate with the macroscopic. Report common crystals if requested or when an unusual number of one type is present. Do not report abnormal crystals unless confirmed by further tests and pathologist. Do not report sperm. | View Page |
| Urinalysis Reports Study the following five urinalysis reports. There will be a short discussion following each report correlating the macroscopic findings with the microscopic findings. | View Page |