Lesson 1Crystals: common types (calcium oxalate, uric acid, struvite, cystine), pH dependence, and clinical implicationsDetails usual urine crystals, their shapes, and how pH affects them. Reviews calcium oxalate, uric acid, struvite, cystine, and medicine crystals, stressing health links, stone risks, and telling from false things.
Calcium oxalate forms and stone riskUric acid crystals and metabolic causesStruvite crystals and infection stonesCystine crystals and inherited disordersDrug and iatrogenic crystal identificationEffect of urine pH and storage on crystalsLesson 2Use of stains (Gram stain, Sternheimer-Malbin, toluidine blue) for enhanced identification and when to performReviews colors used in urine bits, including Gram, Sternheimer-Malbin, and toluidine blue. Discusses when to use, preparing, steps, and how each helps see bacteria, cells, and casts in hard cases.
Indications for performing special stainsSternheimer-Malbin stain principlesGram stain for bacteria and yeastsToluidine blue for nuclear detailSlide preparation and fixation choicesInterpreting stained vs unstained findingsLesson 3Recognition of bacteria, yeasts, parasites and differentiating contamination from significant bacteriuria (presence of WBCs, casts)Explores spotting bacteria, yeasts, and bugs in urine bits under scope. Stresses telling real infection from dirt using white cells, casts, skin cells, and health story to guide reading.
Morphology of urinary bacteria on wet prepRecognition of budding yeasts and pseudohyphaeCommon urinary parasites and artifactsCriteria for significant bacteriuriaIndicators of contamination vs infectionCorrelation with WBCs, casts, and symptomsLesson 4Quantitative reporting: RBCs, WBCs, epithelial cells per high-power field and reporting conventionsExplains counting and reporting red cells, white cells, and skin cells per high view. Reviews counting ways, averaging areas, half-count ranges, and standard words for steady, useful health reports.
Selecting representative microscopic fieldsCounting RBCs and WBCs per HPFEpithelial cell types and quantitationConverting counts to reportable rangesStandard report phrases and abbreviationsCommon pitfalls in cell quantitationLesson 5Identification and classification of casts: hyaline, granular, RBC, WBC, waxy, fatty (oval fat bodies) and pathologic significanceCovers making, shapes, and types of urine casts, including clear, grainy, red cell, white cell, waxy, and fat forms. Highlights sickness meaning, disease links, and reporting for right health match.
Pathophysiology of cast formation in tubulesHyaline and finely granular casts morphologyRBC and WBC casts and renal diseaseWaxy and broad casts in chronic damageFatty casts and oval fat bodiesStandardized cast reporting conventionsLesson 6Resuspension best practices and preparation of multiple slides (wet mount, fixed/stained) for comprehensive examCovers best ways to mix bits again and make many slides. Compares wet slides with fixed and colored ones, saying when each fits for full scope check.
Techniques for gentle sediment resuspensionPreparing high-quality wet mount slidesWhen to prepare fixed and stained slidesHandling limited-volume specimensLabeling and organizing multiple slidesStorage and reuse limitations of slidesLesson 7Microscope selection and setup: brightfield requirements, condenser settings, phase contrast use and when to apply itDiscusses picking and setting scopes for urine bits, including bright light needs, light and hole settings, and when to use phase contrast. Stresses best contrast and clearness for small finds.
Essential features of a urine microscopeKöhler illumination and brightfield setupCondenser and diaphragm adjustmentsAdvantages of phase contrast for sedimentWhen phase contrast is most beneficialRoutine maintenance and performance checksLesson 8Microscopy quality assurance: eyepiece calibration, inter-observer comparison, image capture and archivingFocuses on checks in urine scope work, including eye piece setting, area standards, and watcher compares. Addresses taking pictures, storing, skill checks, and noting check activities.
Eyepiece micrometer use and calibrationField size equivalence between microscopesInter-observer comparison and consensusImage capture and secure archivingOngoing competency and proficiency testingDocumentation of QC and corrective actionsLesson 9Systematic microscopic examination protocol: low-power scan (10x) for casts and crystals, high-power (40x) for cells and bacteria, oil immersion (100x) for confirmationDescribes step-by-step scope check for urine bits. Covers low power scan for casts and crystals, high power for cells and bacteria, and oil high for checking unsure parts.
Slide placement and initial focusingLow-power scan for casts and crystalsHigh-power review of cells and bacteriaUse of fine focus to assess morphologyWhen to apply oil immersion objectivesRecording findings during the scanLesson 10Standard sediment preparation: recommended centrifugation speed and time (g and minutes), sample volume and decanting techniqueGives steps for usual urine bit prep, including mixing sample, spin speed and time, amount picked, pouring off, and cutting cell loss or false makes during work.
Specimen mixing and pre-centrifugation checksCentrifugation speed, time, and g-forceChoosing and measuring sample volumeSafe supernatant decanting techniquesResuspending the sediment uniformlyAvoiding artifacts during preparation
