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xi
1-1. Common safety symbols. 5
1-2. NFPA symbol. 7
2-1. Male urinary tract—lateral view. 12
2-2. Female urinary tract—lateral view. 12
2-3. The urinary system. 13
2-4. Structures of the urinary tract. 14
2-5. The kidney. 14
2-6. The sectioned left kidney. 15
2-7. The nephron. 16
2-8. Different sections of the tubule and reabsorption
of sodium and water. 17
2-9. Renal arterial and venous blood flow through the
kidney. 17
2-10. The renal pyramid with corresponding blood
vessels. 18
2-11. Bowman capsule, the glomerular tuft, and the
juxtaglomerular apparatus. 18
2-12. The glomerulus (renal corpuscle) and the
filtration barrier of the glomerulus. 18
2-13. Formation of urine via filtration, reabsorption,
secretion, and hormonal effects. 19
2-14. Filtration and tubular processing of the
glomerular ultrafiltrate. 19
2-15. The countercurrent mechanism and antidiuretic
hormone in urine concentration. 20
2-16. The renin–angiotensin–aldosterone cycle and
hypertension. 21
2-17. Renal cell becoming an oval fat body. 22
3-1. Cloth fibers (160�). 26
3-2. Urine specimens of varying color. 29
3-3. Schematic diagram of the Total Solids
refractometer. 32
3-4. Schematic representation of the refractometer
scales of measurement. 32
3-5. Specific gravity color chart. 33
4-1. Illustration of Multistix 10 SG. 36
4-2. pH color chart. 37
4-3. Protein color chart. 38
4-4. Glucose color chart. 40
4-5. Clinitest color chart. 41
4-6. Ketone color chart. 42
4-7. Acetest color chart. 43
4-8. Blood color chart. 44
4-9. Bilirubin color chart. 47
4-10. Ictotest color reactions. (A) negative, (B)
moderate, and (C) large. 47
4-11. Urobilinogen color chart. 48
4-12. Nitrite color chart. 50
4-13. Leukocyte esterase color chart. 50
5-1. Amorphous phosphates and hyaline cylindroid
(200�). 57
5-2. Red blood cells. The field also contains a white
cell and several “ghost” cells (400�). 58
5-3. RBCs and WBCs (A). Charging the focus causes the
red cells to appear as black circles (B) (400�). 58
5-4. White blood cells in a hypotonic urine
(800�). 59
5-5. White cell clumps (200�). 60
5-6. Numerous white cells (400�). 60
5-7. Transitional cell (A), Renal epithelial cells (B) and
WBCs (C) (800�). 61
5-8. Transitional epithelial cells (500�). 61
5-9. Transitional epithelial cell, several squamous
epithelial cells, and white cells (200�). 62
5-10. Squamous epithelial cells (160�). 62
5-11. Crystals frequently found in acidic urine. 64
5-12. Other crystals found in acidic urine. 65
5-13. Uric acid crystals. (500�). 66
5-14. Uric acid crystals in rosette formation (500�). 66
5-15. Six-sided uric acid crystal (400�). 66
5-16. Polarized uric acid crystal (400�). 67
5-17. Calcium oxalate crystals (400�). 67
5-18. Calcium oxalate crystals (500�). 67
5-19. Amorphous urates (200�). 69
5-20. Hippuric acid crystal (400�). 69
5-21. Sodium urate crystals (400�). 69
5-22. Cystine crystal (1000�). 70
5-23. Cystine crystals. Several have laminated
surfaces (160�). 70
5-24. Leucine spheroid (400�). 70
5-25. Tyrosine crystals (160�). 71
5-26. Tyrosine crystals (1000�). 71
5-27. Cholesterol crystal with typical notched
edges (250�). 71
5-28. Sulfonamide crystals, yeast, and WBCs
(400�). 72
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xii List of Figures
5-29. X-ray dye crystals (Hypaque) (160�). 72
5-30. X-ray dye crystals (Renografin) (400�). 72
5-31. X-ray dye crystals (Hypaque) (160�). 73
5-32. Polarized x-ray dye crystals (160�). 73
5-33. Bilirubin crystals (500�). 74
5-34. Crystals found in alkaline urine. 75
5-35. Triple phosphate crystals (200�). 75
5-36. Amorphous phosphates (400�). 76
5-37. Calcium carbonate crystals (400�). 76
5-38. Calcium phosphate crystals (400�). 76
5-39. Calcium phosphate plate or phosphate
sheath (200�). 77
5-40. Ammonium biurate crystals (500�). 77
5-41. Ammonium biurate crystals without
spicules (500�). 77
5-42. Sequence of urinary cast degeneration. 78
5-43. Hyaline cast and red blood cells (400�). 79
5-44. Red cell cast and RBCs (400�). 80
5-45. White cell cast and WBCs (500�). 81
5-46. Finely granular casts (500�). 81
5-47. Broad coarsely granular cast (200�). 81
5-48. Epithelial cell cast (200�). 82
5-49. Waxy cast and WBCs (200�). 82
5-50. Waxy cast, WBCs, and bacteria (400�). 82
5-51. Fatty cast (400�). 83
5-52. Bacteria (rods, cocci, and chains) (500�). 84
5-53. Yeast cells (1000�). 84
5-54. Cylindroid (400�). 84
5-55. Spermatozoa (500�). 85
5-56. Mucous threads. Viewed with an 80A
filter (100�). 85
5-57. Oval fat body and a fiber (500�). 86
5-58. Fat droplets (500�). 86
5-59. Polarized anisotropic fat droplets (160�). 87
5-60. Starch crystal (500�). 88
5-61. Polarized starch crystals (400�). 88
5-62. Cloth fibers (160�). 88
5-63. Fibers (200�). 89
5-64. Fiber (400�). 89
5-65. Oil droplet. Field also contains WBCs and
squamous epithelial cells (400�). 90
5-66. Hair and a coarsely granular cast. Viewed with an
80A filter (400�). 90
5-67. Glass fragments (400�). 91
5-68. Air bubble and amorphous urates (160�). 91
5-69. Talcum powder particles (160�). 91
5-70. Fecal contamination. Field also contains triple
phosphate crystals (100�). 92
5-71. Trichomonas vaginalis (1000�). 92
5-72. Enterobius vermicularis ovum and
WBCs (500�). 93
5-73. Head of the Enterobius vermicularis adult female
worm (100�). 93
5-74. Schistosoma haematobium ovum. 94
5-75. Image for Case Study 5-1. 95
5-76. Image for Case Study 5-2. 96
5-77. Image for Case Study 5-2. 96
5-78. Image for Case Study 5-3. 96
5-79. Image for Case Study 5-4. 97
5-80. Image for Case Study 5-4. 97
5-81. Image for Case Study 5-5. 97
6-1. Hypotonic urine containing an RBC, several
WBCs, two renal epithelial cells, and a
transitional epithelial cell (500�). 100
6-2. Renal epithelial cells, WBCs, RBCs, and bacteria
(500�). 100
6-3. Many RBCs and a squamous epithelial cell
(160�). 101
6-4. SM-stained RBCs, some crenated (400�). 101
6-5. SM-stained RBCs, some crenated, under phase
contrast microscopy (400�). 102
6-6. WBCs, a few RBCs, and bacteria (500�). 102
6-7. SM-stained WBCs and bacteria under phase
contrast microscopy (400�). 103
6-8. Large clump of WBCs and many squamous
epithelial cells (400�). 103
6-9. SM-stained RBCs, WBCs, and squamous
epithelial cells (400�). 104
6-10. Distorted WBCs (400�). 104
6-11. Clump of WBCs, stained by bilirubin
(200�). 105
6-12. WBCs and squamous epithelial cells
(400�). 105
6-13. Renal epithelial cells (500�). 106
6-14. Sheet of squamous epithelial cells (160�). 106
6-15. Numerous WBCs and few transitional cells.
(200�). 107
6-16. SM-stained WBCs and transitional epithelial
cells (200�). 107
6-17. Squamous epithelial cells. 108
6-18. WBCs and bacteria. 108
6-19. SM-stained WBCs and bacteria (400�). 109
6-20. SM-stained WBCs, and bacteria, under phase
contrast microscopy (400�). 109
6-21. Amorphous urates (100�). 110
6-22. Amorphous urates (100�). 110
6-23. Uric acid crystals, diamond or rhombic form
(400�). 111
6-24. Uric acid crystals in the urine of a patient with a
kidney stone (400�). 111
6-25. WBC cast and uric acid crystals (400�). 112
6-26. Uric acid crystals in rosette formation
(400�). 112
6-27. Uric acid crystals, atypical form (400�). 113
6-28. Uric acid crystals, layered formation
(500�). 113
6-29. Uric acid crystals, thick rosette formation
(200�). 114
6-30. Uric acid, thick rosette formation under higher
power (500�). 114
6-31. Uric acid and calcium oxalate crystals
(500�). 115
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6-32. Uric acid crystals under polarized light
(400�). 115
6-33. Uric acid under polarized light (400�). 116
6-34. Uric acid crystals (100�). 116
6-35. Uric acid crystals under polarized light
(100�). 117
6-36. Uric acid crystals in pseudocast formation
(400�). 117
6-37. Uric acid, barrel shape, and yeast in the
background (200�). 118
6-38. Sodium urate crystals (400�). 118
6-39. Sodium urates and a WBC (400�). 118
6-40. Sodium urate crystals (400�). 119
6-41. Uric acid, needle shape under polarized light with
red compensator (400�). 119
6-42. Calcium oxalate crystals (200�). 120
6-43. Calcium oxalate crystals (160�). 120
6-44. Calcium oxalates, amorphous urates, and a piece
of debris (200�). 121
6-45. Calcium oxalate crystals clustered around a piece
of debris (100�). 121
6-46. Calcium oxalates and amorphous urates
(100�). 122
6-47. Hippuric acid crystals (400�). 122
6-48. Cystine crystals (160�). 122
6-49. Cystine crystal with unequal sides (1000�). 123
6-50. Cystine crystals (160�). 123
6-51. Cystine crystal with layered or laminated surface
(1000�). 124
6-52. Cystine crystals and a squamous epithelial cell
(400�). 124
6-53. Leucine crystals. 125
6-54. Leucine crystals under interference contrast
microscopy. 125
6-55. Tyrosine crystals (160�). 125
6-56. Tyrosine crystals (1000�). 126
6-57. Tyrosine crystals (1000�). 126
6-58. Tyrosine crystals under polarized light. 127
6-59. Tyrosine crystals (1000�). 127
6-60. Cholesterol crystals from “kidney fluid”
(200�). 128
6-61. Same specimen as the previous figure under
polarized light. 128
6-62. X-ray dye crystals (160�). 129
6-63. X-ray dye crystals (400�). 129
6-64. X-ray dye crystals under polarized light
(160). 130
6-65. Bilirubin crystals and bilirubin-stained WBC and
granular cast (500�). 130
6-66. Bilirubin crystals and bilirubin-stained sediment
(500�). 131
6-67. Bilirubin crystals. 131
6-68. Sulfonamide crystals (400�). 132
6-69. Sulfonamide crystals under polarized light with
red compensator. 132
6-70. Triple phosphate crystals (200�). 133
6-71. Triple phosphate crystals and amorphous
phosphates (200�). 133
6-72. Triple phosphate crystals (400�). 134
6-73. Triple phosphate crystals (500�). 134
6-74. Triple phosphates crystal and amorphous
phosphates (200�). 135
6-75. Triple phosphate crystals under polarized
light. 135
6-76. Triple phosphates crystal and amorphous
phosphates (200�). 136
6-77. Triple phosphates crystal and amorphous
phosphates (200�). 136
6-78. Triple phosphates crystal and mucus (400�). 137
6-79. Triple phosphate crystal (400�). 137
6-80. Triple phosphate crystals under polarized light
with red compensator (200�). 138
6-81. Calcium phosphate crystals (400�). 138
6-82. Calcium phosphate plates and amorphous
phosphates (200�). 139
6-83. Calcium phosphate plate (or phosphate sheath)
and amorphous phosphates (200�). 139
6-84. Ammonium biurate crystals (200�). 140
6-85. Ammonium biurate crystals (200�). 140
6-86. Ammonium biurate crystals (500�). 141
6-87. Ammonium biurate crystals (500�). 141
6-88. Ammonium biurate crystals (500�). 142
6-89. Ammonium biurate crystal and a squamous
epithelial cell (500�). 142
6-90. Ammonium biurate crystals (500�). 143
6-91. Ammonium biurate crystals. Spheroid form
without spicules (400�). 143
6-92. Ammonium biurate crystals (500�). 144
6-93. Hyaline cast, WBCs, RBCs, and bacteria
(500�). 144
6-94. Hyaline casts (200�). 145
6-95. Hyaline cast that is bent back upon itself and
many RBCs (400�). 145
6-96. Hyaline casts and many RBCs (100�). 146
6-97. Hyaline casts (400�). 146
6-98. Hyaline casts using phase contrast
microscopy. 147
6-99. Many hyaline casts and WBC casts, and rare RBC
(200�). 147
6-100. Hyaline, WBCs, RBCs, and epithelial cells
(200�). 148
6-101. Hyaline cast with a few granular inclusions
(500�). 148
6-102. Convoluted red blood cell cast (500�). 149
6-103. Red blood cell cast and many RBCs (500�). 149
6-104. Red blood cell cast (500�). 150
6-105. Red blood cell cast (200�). 150
6-106. Red blood cell cast and amorphous urates
(500�). 151
6-107. White blood cell cast, WBCs, squamous epithelial
cells, and mucus (400�). 151
6-108. White blood cell cast (500�). 152
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xiv List of Figures
6-109. SM-stained WBC cast (400�). 152
6-110. White blood cell cast (400�). 153
6-111. Bilirubin-stained casts, fibers, and sediment
(200�). 153
6-112. Mixed cell cast, WBCs, and RBCs (500�). 154
6-113. Bilirubin-stained WBC cast (500�). 154
6-114. Many WBC casts and many WBCs (200�). 155
6-115. SM-stained mixed cellular cast including renal
tubular epithelial cells (400�). 155
6-116. Epithelial cell cast (500�). 156
6-117. Mixed cast. This cast is half hyaline and half
granular (400�). 156
6-118. Mixed cast, yeast, and a WBC (500�). 157
6-119. Mixed cast (500�). 157
6-120. Many casts, WBCs, RBCs, and amorphous
sediment (200�). 158
6-121. Broad mixed granular and RBC cast, and a broad
granular cast (500�). 158
6-122. SM-stained hyaline cast, granular cast, mixed
cellular cast, and partially degenerated RTE cells
(200�). 159
6-123. Broad granular cast (400�). 159
6-124. Fine granular cast, WBCs, and RBCs (500�). 160
6-125. Fine granular casts and WBCs (500�). 160
6-126. SM-stained granular cast (200�). 161
6-127. Fine granular casts and WBCs (400�). 161
6-128. Coarse granular cast (500�). 162
6-129. Coarse granular cast (400�). 162
6-130. Coarse granular cast, calcium phosphate plate,
and amorphous phosphates (200�). 163
6-131. Broad and narrow coarse granular casts
(200�). 163
6-132. Coarse granular cast (400�). 164
6-133. Bilirubin-stained granular cast (500�). 164
6-134. Fine granular cast (400�). 165
6-135. Fine granular cast, WBCs, and bacteria
(400�). 165
6-136. Waxy cast and amorphous urates (500�). 166
6-137. Bilirubin-stained waxy cast, granular cast,
WBCs, and amorphous sediment (500�). 166
6-138. Long waxy cast, WBCs, and an epithelial cell
(200�). 167
6-139. Fine granular cast becoming a waxy cast
(500�). 167
6-140. Convoluted waxy cast. This field also contains
WBCs, rare RBC, and bacteria (500�). 168
6-141. Convoluted waxy cast (500�). 168
6-142. SM-stained waxy cast (100�). 169
6-143. SM-stained waxy cast using phase contrast
microscopy (100�). 169
6-144. SM-stained waxy-granular cast (200�). 170
6-145. Granular cylindroid (500�). 170
6-146. Hyaline cylindroid (160�). 171
6-147. Fine granular cast and yeast (400�). 171
6-148. Bacteria. This field contains rods, cocci, and
chains (500�). 172
6-149. Yeast, WBCs, rare RBC, and bacteria
(500�). 172
6-150. Yeast (1000�). 173
6-151. SM-stained yeast with pseudohyphae and
WBCs (200�). 173
6-152. Yeast under phase contrast microscopy
(400�). 174
6-153. Pinworm ovum and WBCs (100�). 174
6-154. Enterobius vermicularis or pinworm ovum
(400�). 175
6-155. Tail of the adult female pinworm (40�). 175
6-156. Pinworm ovum and WBCs (500�). 176
6-157. Schistosoma haematobium ovum under interference
contrast microscopy. 176
6-158. Trichomonas vaginalis with mixed cellular
background viewed under phase contrast
microscopy. 177
6-159. Sperm and epithelial cells (500�). 177
6-160. SM-stained sperm. 177
6-161. Mucus. 178
6-162. Mucus containing WBCs and RBCs
(200�). 178
6-163. Fat droplets and epithelial cells (160�). 179
6-164. Oval fat body, granular cast, and amorphous
urates (500�). 179
6-165. Oval fat body (400�). 180
6-166. Oval fat body (500�). 180
6-167. Oval fat bodies and WBCs (500�). 181
6-168. Oval fat body (400�). 181
6-169. Oval fat body (400�). 182
6-170. Oval fat body (400�). 182
6-171. Sudan III stained fat droplets. 183
6-172. Starch granules (200�). 183
6-173. Starch crystals (500�). 184
6-174. Starch granules. 184
6-175. Starch crystals under polarized light
demonstrating the typical “Maltese-cross”
formation (400�). 185
6-176. Talcum powder particles and a few squamous
epithelial cells (160�). 185
6-177. Debris from a diaper (400�). 186
6-178. A. Fine granular cast and WBCs. B. Fiber
(200�). 186–187
6-179. Fiber (400�). 187
6-180. Fiber (400�). 188
6-181. Fiber (400�). 188
6-182. Debris from a diaper (200�). 188
6-183. Fibers (400�). 189
6-184. Fibers (400�). 189
6-185. Fiber (400�). 190
6-186. Fibers (500�). 190
6-187. Fiber, calcium oxalate crystals, and amorphous
urates (400�). 191
6-188. Fiber, calcium oxalate crystals, and
amorphous urates, but on a different focal
plane (400�). 191
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6-189. Air bubbles, phosphate plate, and amorphous
phosphates (200�). 192
6-190. Coverslip defects. 192
7-1. The normal metabolic pathway of phenylalanine
and tyrosine. 203
7-2. Increased formation of phenylalanine
metabolites. 204
7-3. Biosynthesis of heme. 210
7-4. RBC cast: urine sediment; 400�. 213
7-5. Broad finely granular cast becoming waxy cast
with mixed cellular background. 214
7-6. Fatty casts, urine sediment; 400�. 214
7-7. Fatty casts; POL; urine sediment; 400�. 214
7-8. Granular casts, urine sediment. SM stain;
200�. 214
7-9. WBC cast, urine sediment. SM stain; 400�. 215
7-10. Direct Gram stain of urine showing gram-
negative rod bacteria and three WBCs
(neutrophils); 1000�. 215
7-11. Cystine crystal. Urine sediment, SM stain;
200�. 215
7-12. Cystine crystal. Urine sediment; 200�. 216
7-13. Cystine crystal; POL. Urine sediment; 200�. 216
7-14. Cystine crystals. Urine sediment; 100�. 216
8-1. Forces governing the exchange of fluid at the
capillary level. 220
8-2. Exchanges through capillary membranes in the
formation and removal of interstitial fluid. 221
8-3. Neubauer hemocytometer diagrams. 222
8-4. Cytocentrifuge. 223
8-5. Cytocentrifugation method of body fluid
concentration. 223
8-6. Cytocentrifuge-prepared smears are marked
with a wax pencil to outline the area of cell
deposit. 223
9-1. Anatomy of the central nervous system. 229
9-2. Detail of meninges. 229
9-3. Placement of the needle for CSF collection. 230
9-4. Specimen containers for cerebral spinal fluid
specimens. 230
9-5. Comparison of cerebral spinal fluid
appearance. 231
9-6. Cells that can normally be found in cerebral
spinal fluid (Wright stain 1000�). 231
9-7. Neutrophilic pleocytosis in cerebral spinal fluid
(Wright stain 1000�). 232
9-8. Lymphocytic pleocytosis in cerebral spinal fluid
(Wright stain 1000�). 232
9-9. Plasma cells in cerebral spinal fluid (Wright
stain 1000�). 232
9-10. Eosinophils in cerebral spinal fluid (Wright
stain 1000�). 232
9-11. Cerebral spinal fluid with mixed pleocytosis
(Wright stain 1000�). 234
9-12. Macrophage in cerebral spinal fluid (Wright
stain 1000�). 234
9-13. Macrophage demonstrating erythrophagocytosis
in cerebral spinal fluid (Wright stain
1000�). 234
9-14. Macrophage with iron inclusions (siderophage) in
cerebral spinal fluid (Wright stain 1000�). 235
9-15. Macrophage with hematin inclusions in cerebral
spinal fluid. 235
9-16. Macrophage with possible fat inclusions
(lipophage) in cerebral spinal fluid. 235
9-17. Ependymal cells in cerebral spinal fluid (Wright
stain 1000�). 235
9-18. Nucleated red blood cells in cerebral spinal fluid
(Wright stain 1000�). 235
9-19. Clumped choroid plexus in cerebral spinal fluid
(Wright stain 1000�). 235
9-20. Comparison of Wright stained and Gram stained
bacteria in cerebral spinal fluid. 237
9-21. Positive india ink stain. 237
9-22. Wright stained cytocentrifuged CSF. 240
9-23. CSF specimen tubes one, two, and three. 240
9-24. Wright stained cytocentrifuged CSF. 240
10-1. Mesothelial lining of serous body cavities. 242
10-2. Cytospin preparation of pleural fluid containing
RBCs and lymphocytes in acute inflammation.
Wright stain 400�. 243
10-3. Cytospin preparation of pleural fluid containing
RBCs, neutrophils, and a mesothelial cell in
bacterial infection. Wright stain 200�. 243
10-4. Cytospin preparation of peritoneal fluid
containing RBCs, lymphocytes, monocytes, and
mesothelial cells. Wright stain 200�. 243
10-5. Cytospin preparation of pericardial fluid
containing RBCs, WBCs, and cells resembling
adenocarcinoma. Wright stain 200�. 243
10-6. Cytospin preparation of peritoneal fluid
containing RBCs, WBCs, and many bacteria.
Identified by culture as Escherichia coli. Wright
stain 1000�. 244
10-7. Cytospin preparation of peritoneal fluid
containing WBCs and few bacteria. Identified
by culture as Staphylococcus. Wright stain
1000�. 244
10-8. Cholesterol crystals in pleural fluid. Bright light
(400�). 245
10-9. Cholesterol crystals in pleural fluid (400�). 246
10-10. The heart and pericardium. 246
10-11. Aspirating pericardial fluid. 247
10-12. The pleural cavity with effusion. 248
10-13. Thoracentesis. 248
10-14. The organs of the abdomen. 249
10-15. Paracentesis of the abdominal cavity in
midline. 249
10-16. Wright stain of ascites fluid. 250
10-17. Pleural fluid. 251
11-1. Articulated joint. 254
11-2. Synovial membrane from a normal knee joint. 254
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11-3. Bulge test of joint for the detection of synovial
effusion. 254
11-4. Placement of needle in arthrocentesis of (A) elbow
and (B) knee joints. 255
11-5. Synovial fluid. 255
11-6. Synovial fluid inclusions. 256
11-7. String test showing normal synovial fluid
viscosity. 256
11-8. Mucin clot test of normal synovial fluid. 257
11-9. Normal cellular elements found in synovial fluid
(Wright–Giemsa). 257
11-10. Synovial fluid with acute inflammation
(Wright–Giemsa). 258
11-11. LE cell is a neutrophil containing a phagocytized
homogeneous nucleus (Wright–Giemsa). 258
11-12. Tart cell: a macrophage containing a
phagocytized nucleus that retains some nuclear
detail (Wright–Giemsa). 258
11-13. Reiter cell is a macrophage that has phagocytosed
one or more neutrophils. 258
11-14. Lipid-laden macrophage in synovial fluid
(Wright–Giemsa). 259
11-15. Synovial fluid with acute inflammation and
monosodium urate crystals (Wright–Giemsa stain
and polarized light). 259
11-16. Synovial fluid with acute inflammation and
monosodium urate crystals (Wright–Giemsa stain
and polarized/compensated light). 259
11-17. Synovial fluid with acute inflammation and
calcium pyrophosphate dihydrate crystals
(Wright–Giemsa stain and polarized light). 259
11-18. Synovial fluid with acute inflammation and
calcium pyrophosphate dihydrate crystals
(Wright–Giemsa stain and polarized/compensated
light). 259
11-19. Image A for Case Study 11-1 261
11-20. Image B for Case Study 11-1. 262
11-21. Image A for Case Study 11-2. 262
11-22. Image B for Case Study 11-2. 262
12-1. Detail of the male reproductive system. 264
12-2. The process of spermatogenesis in the
seminiferous tubules. 265
12-3. Stages of transformation from human spermatid
into spermatozoon. 265
12-4. Normal semen viscosity test. 266
12-5. Inclusion criteria of counting cells. 267
12-6. Wet mount of semen. Many sperm are present
(450�). 267
12-7. Wet mount of semen (450�). 267
12-8. Viable sperm do not take up the eosin stain and
remain colorless, thus appearing white
(eosin/nigrosin stain 1000�). 268
12-9. Nonviable sperm take up the eosin stain and
appear various shades of red (eosin/nigrosin stain
1000�). 268
12-10. Features of a normal spermatozoon. 269
12-11. Normal sperm (Papanicolaou stain,
1000�). 269
12-12. Normal sperm (Papanicolaou stain,
1000�). 270
12-13. Normal sperm, side view (Papanicolaou stain,
1000�). 270
12-14. Double-headed sperm (Papanicolaou stain,
1000�). 270
12-15. Double-tailed sperm (Papanicolaou stain,
1000�). 270
12-16. Coiled-tailed sperm (Papanicolaou stain,
1000�). 270
12-17. Flat-headed sperm (Papanicolaou stain,
1000�). 271
12-18. Various sperm head sizes (Papanicolaou stain,
1000�). 271
12-19. Normal sperm shown with sperm at arrow that
has a constricted (or pinched) head and excessive
cytoplasmic membrane (Papanicolaou stain,
1000�). 271
12-20. Various sperm anomalies (Papanicolaou stain,
1000�). 271
12-21. Sperm with bent neck pieces (Papanicolaou stain,
1000�). 272
12-22. Sperm with round heads rather than oval
(Papanicolaou stain, 1000�). 272
12-23. Sperm with tapered heads rather than oval
(Papanicolaou stain, 1000�). 272
12-24. Sperm with heads containing vacuoles
(Papanicolaou stain, 1000�). 272
12-25. The necks of these sperm have excessive
cytoplasmic membrane remaining (Papanicolaou
stain, 1000�). 273
12-26. Immature spermatids (Papanicolaou stain,
1000�). 273
12-27. Figure for review questions 12–14. 275
13-1. Fecal leukocytes. 279
13-2. Guiac fecal occult blood test. 280
13-3. Steatorrhea with fecal fat Sudan III stain for
neutral fats. 280
13-4. Steatorrhea with fecal fat Sudan III stain for
fatty acids. 280
13-5. Creatorrhea. Undigested meat fiber. 281
13-6. Creatorrhea. Undigested meat fibers
tangled. 281
14-1. Schematic drawing of the amniotic
cavity. 285
14-2. Spectrophotometric scan of amniotic fluid
indicating bilirubin and oxyhemoglobin
peaks. 286
14-3. Liley graph for assessment of fetal risk. 288
14-4. Wet mount showing characteristic clue
cells. 289
14-5. Gram stain (1000�). Lactobacillus
predominating in a healthy vagina with
squamous epithelial cells. 289
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14-6. Trophozoites of T. vaginalis obtained from in vitro
culture, stained with Giemsa. 289
14-7. Wet preparation of Candida albicans yeast and
pseudohyphae with white blood cells. Yeast
(including pseudohyphae), RBCs, and WBCs
(200�). 290
14-8. Candia albicans with germ tube development in a
calcofluor white preparation. 291
14-9. Cell block preparation of BAL showing cysts of
P. jiroveci, GMS-P stain (1000�). 291
14-10. Cell block preparation of BAL showing cysts of
P. jiroveci, GMS-P stain (1000�). 292
14-11. Histopathologic changes indicating aspergillosis
of the lung caused by Aspergillus fumigatus. 293
14-12. Methenamine silver stain. 293
14-13. Bronchial washing cell block. H&E stain
(1000�). 293
14-14. Bronchial washing cell block. GMS-C
stain (1000�). 294
14-15. Bronchial washing cell block. PAP stain
(1000�). 294
15-1. A. Iris Diagnostics Division iQ®200 Automated
Urinalysis System (AUTION plus iQ®200). B. Iris
Diagnostics close-up of the AUTION barcode
reader and tube carrier. 297
15-2. Iris Diagnostics iChem®VelocityTM. 297
15-3. Iris Diagnostics iQ®200ELITETM. 298
15-4. Iris Diagnostics iQ®200SELECTTM. 298
15-5. Iris Diagnostics iQ®200SPRINTTM. 298
15-6. Siemens Medical Solutions Diagnostics
manufactures the Clinitek® Status. 298
15-7. Siemens Medical Solutions Diagnostics
manufactures the Clinitek® Atlas. 298
15-8. Sysmex UF-100® Urine Cell Analyzer. 298
15-9. Sysmex UF-100® Flow Cell Diagram. 298
15-10. Sysmex UF-100® Lateral Fluorescent Light
System Diagram. 299
15-11. Sysmex XE-5000 Automated Hematology
System. 299
15-12. SQA-V Sperm Analyzer. 300
List of Figures xvii
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