1030 Unit 3 Flashcards

Question

what is a primary characteristic used to identify renal tubular epithelial cells?

Answer 1

eccentrically located nucleated

Answer 2

hemosiderin granules

Answer 3

Renal tubular cell (RTE cell)

Answer 4

cholesterol

Answer 5

diabetes mellitus

Answer 6

uromodulin

Answer 7

all type of casts

Answer 8

--free-floating RBCs --intact RBCs in the cast matrix --a positive reagent strip blood reaction

Answer 9

pyelonephritis

Answer 10

attached to the surface of a matrix

Answer 11

--nephrotic syndrome --crush injuries --diabetes mellitus

Answer 12

cellular lysosomes

Answer 13

--represent extreme urine stasis --may have a brittle consistency --contain degenerated granules

Answer 14

--destruction of tubular walls --formation in the collecting ducts

Answer 15

--pH --solute concentration --temperature

Answer 16

--tyrosine --bilirubin --leucine

Answer 17

polarized light

Answer 18

calcium oxalate dihydrate

Answer 19

amorphous urates

Answer 20

calcium oxalate monohydrate

Answer 21

triple phosphate

Answer 22

amorphous phosphate

Answer 23

calcium phosphate

Answer 24

ammonium biurate

Answer 25

calcium carbonate

Answer 26

cholesterol

Answer 27

ampicillin

Answer 28

radiographic dye

Answer 29

bright field

Answer 30

dark-field

Answer 31

fluorescent

Answer 32

interference contrast

Answer 33

--color --clarity --blood --nitrite --protein --leukocyte esterase --glucose

Answer 34

--hematuria vs. hemoglobinuria/myoglobinuria --confirm pathological and non pathological cause of turbidity

Answer 35

RBC and RBC cast

Answer 36

bacteria and WBC

Answer 37

casts and cells

Answer 38

WBC, WBC casts, bacteria, and yeast

Answer 39

provides a tube is specially designed to permit direct reading of urine sediment

Answer 40

—well mixed urine is essential —how the sediment is prepared —volume of sediment to examine —method and instrumentation used to visualize the sediment or elements —the nomenclature is which the results are reported

Answer 41

— RBC And WBC cells, casts disintegrate in dilute alkaline urine —has precipitation after refrigeration, amorphous urates and amorphous phosphates —warm specimen to 37 C before centrifugation —type of collection may prevent contamination (mid stream)

Answer 42

—standard: 10-15 ml —quantities <12 ml should be documented (too small will reduce formed element amount

Answer 43

—speed and length of time —speed 2 ways to measure centrifugation: relative centrifugal force (RCF) and revolutions per minute (RPM) —RCF = 1.118 x 10^ -5 x radius in cm x RPM^2 —5 minutes

Answer 44

—uniform amount should remain after decanted = 1.5 - 1.0 ml —after decanting, the sediment may be resuspended using a puppet. NOT vigorous because it will result in destruction of cellular content

Answer 45

—could use commercial system —needs to be consistent each time, each tech — in pipet, place one drop of urine on to glass slide. Place cover slip on top of urine —do not overflow — examine 10 fields under low and high power

Answer 46

—Kova — urisystem — count-10 — quick-prep

Answer 47

—epithelial cells —crystals — RBC and WBC

Answer 48

Increases visibility of the elements

Answer 49

—contrasting color between the nucleus and the cytoplasm —Sternheimer-Malbin:helps visibility of epithelial cells, WBCs, cast —toluidine blue: helps distinguish between WBC and RTE cells p

Answer 50

— triglyceride, neutral fats and cholesterol. Stain orange-red —oil red O —Sudan III

Answer 51

—helps distinguish eosinophils from WBC -renal transplant -pyelonephritis -allergic reaction -dry fixed slide

Answer 52

Stains hemosiderin (iron)

Answer 53

Helps with nuclear detail. Can not use initial sediments because it will lysis the RBCs

Answer 54

— detection for malignancies of lower urinary tract —provides more definite information about renal tubular changes associated with transplant: viral, fungal are parasitic infections, cellular inclusions, pathologists casts, and inflammatory conditions

Answer 55

Papincolaou stain

Answer 56

—used for routine analysis —objects appear darker against light background —do not use in high light

Answer 57

—enhances visualization of elements with low refractive indices (hyaline cast, mixed cellular cast, mucous, and trichimonas — as light ray pass an object, they are slowed in comparison to rays passing through air, thereby decreasing the intensity of light and producing contrast. This is called pause difference and is affected by thickness of object

Answer 58

—aids in identification of cholesterol in oval fat bodies, fatty cast and crystals —lipids and crystals have the ability to rotate the path of undirectional polarized beam to produce characteristic colors in crystals and Maltese cross in lipids

Answer 59

—aides in identification of Treponema pallidum —used to enhance specimen visualization that can not easily be seen —field of view is black. Light refracts/refracts off specimen and is captured by objective lens

Answer 60

—-allow naturally fluorescent microorganisms or those stained by fluorescent, including tagged antigens or antibodies (indirect fluorescent antibodies IFA) —immunofluorescence method

Answer 61

—produces a 3D image and layer by layer —shows very fine structure structure details by splitting the light ray so that the beams pass through different areas

Answer 62

Used for investigation of ultrastructure in biological and inorganic specimens

Answer 63

—oculars —objectives —adjustment knows (fine and coarse)

Answer 64

—light source —condenser — field —iris diaphragm

Answer 65

—base —body tube —nose piece —mechanical stage

Answer 66

—type of objective (4x, 10x, 40x) — magnification (0.1, 0.25, 0.65) —numerical aperature —tube length —cover slip thickness to be used

Answer 67

—Refractive Index in material needed between the slide and the outer lens (air or oil). —higher the aperture, the better the light yielding better resolution

Answer 68

The diameter of the light beam

Answer 69

Controls the uniformity of the light. Condenser up and down

Answer 70

The aperture diaphragm

Answer 71

—epithelial cells —RBC —WBC —hyaline cast

Answer 72

—concentration —pH —presence of metabolites

Answer 73

—has smooth non-nucleated RBC —biconcave disk

Answer 74

—cause the RBC to shrink due to loss of water from being in a concentrated urine —> creanted

Answer 75

—Caused from being in dilute urine — RBC take in too much water, swell and lysis —> ghost cells

Answer 76

—normal range: 0-2/ hpf —indicates a glomerular problem either with membrane damage or vascular injury to genitourinary tract — the number is indicative of the.l damage —hematuria —glomerulonephritis, toxic/immunologic reaction, menstrual cycle

Answer 77

—cloudy, red to brown > 100/lpf —advance glomerular damage —vascular integrity of urinary tract due to trauma, infection or inflammation or coagulation disorders

Answer 78

—clear urine with RBCs present — is helpful for early detection —glomerular disorders —malignancy of urinary tract —presence of renal calculi

Answer 79

Neutrophils

Answer 80

—they contain granules and multi-loved nucleus —in alkaline urine —> neutrophils lose their nuclear detail

Answer 81

—eosinophils: seen in drug induced interstitial nephritis, a few in UTI, and renal transplant. 1% is significant because not normally found in urine — mononuclear cells: lymphocytes, monocytes, macrophages, histocytes. Early stage renal transplant rejection

Answer 82

—migrate from tissue to site if infection/inflammation —Pyuria indicate infection or inflammation —WBC + bacteria = important!!! —normal range = 0-5/hpf

Answer 83

—pyelonephritis —cystitis —prostatitis —urethritis

Answer 84

—glomerulonephritis —lupus —interstitial nephritis —tumors

Answer 85

Epithelial cells. They slough off with age

Answer 86

—squamous —transitional —RTE

Answer 87

—largest cell seen in urine —abundance of irregular cytoplasm —report as numerical range from hpf —originate from lining of vagina, male/female urethra. —mid stream clean catch reduces squamous cell count —clue cells (cell surface must be covered 70% in bacteria to be considered this)

Answer 88

Squamous cell with bacteria in the cell which is an indication of vaginal infection with Gardenerella vaginalis

Answer 89

— several forms: ——> spherical - direct contact with water in bladder become large and round ——> polyhedral - multiple sides ——> caudate - appear to have a tail — distinct nucleus that is centered —originates I’m lining of renal pelvis, calyces, ureters, and bladder. Male upper urethra —increase after catheterization —if it has vacuoles and irregular nuclei: may indicate malignancy or viral infection

Answer 90

—larger than other RTE cells —rectangular or columnar or convoluted cell — cytoplasm has coarse granules with a nucleus

Answer 91

—round or oval —nucleus is eccentrically

Answer 92

—cuboidal (NEVER ROUND) —eccentrically nucleus —one straight edge —appear in groups of three or more = renal fragment —can be seen in sheets

Answer 93

—report in defined ranges under hpf — >2 RTE = tubular injury — most significant epithelial cell —can take in bilirubin, hemosiderin (Prussian blue)

Answer 94

—necrosis of the renal tubules ——>exposure to heavy metals ——>drug induced toxicity, salicylate poising ——> viral infection (Hep. b) ——> pyelonephritis ——> malignancies ——> allergic reaction or transplant rejection

Answer 95

— RTE that have absorbed lipids — dry refractive. Hard to see nucleus —usually seen with free floating fat —Susan III or oil Red oil O —can be seen better with polarizer scope: Maltese cross

Answer 96

—lipiduria = damage to the glomerulus caused by nephrotic syndrome —tubular necrosis —diabetes mellitus —trauma case where fat from the bone marrow is released

Answer 97

—not normal in urine —urine is sterile, contaminated on way out —wbc + bacteria = UTI —nitrite test may be positive —cocci and bacilli may be present — refer to ranges and reports as 1+, 2+, 3+, 4+

Answer 98

—presence of bacteria indicates a lower UTI (urethra or bladder) or upper UTI (ureter and kidney) —most frequent organisms ——> Enterobacterales (GNR) (klebsiella, e. Cool, proteus sp., pseudomonas sp.) ——> Staphylococcus ——> enterococcus

Answer 99

—single, refractive, budding structures —use reference range to report — diabetic urine: high glucose and acid ideal for yeast growth —immunocompromised and vaginal moniliasis —acetic acid aids in identification of yeast cells (will lysis RBC)

Answer 100

—most common: trichomonas vaginalis ——> pear shaped ——> “darts” around — enterobius vermicularis = pinworm —schitsisoma haematobium

Answer 101

—urine toxic to Sperm so no movement —may cause positive protein —if seen in child, must be confirmed by supervisor

Answer 102

—protein from glands ~ epithelial squamous cells of lower genitourinary and RTE —Threadlike, low refractive index —in females: no clinical significance

Answer 103

—unique to kidney —formed in lumen of DCT and collecting duct — take form of these lumens —examine on low power to locate — high power to identify —report on lpf — low light is needed

Answer 104

— major component: uromodulin (Tamm Horsefall) protein secreted from RTEs of the DCT and collecting duct — rate of excretion is constant (can increase with stress and exercise) —form during urine-flow stasis, acidity, high Na and Ca

Answer 105

PROTEIN MATRIX 1) aggregated uromodulin fibrils attached to RTEs 2) interweaving to form loose network, traps elements 3) more interweaving to form a solid matrix 4) attachment of elements to matrix 5) detachment of fibrils from RTEs 6) excretion of cast

Answer 106

—entirely uromodulin — colorless — low refractive index —use low light — normal range: 0-2/lpf

Answer 107

—non pathological ——> stress ——> exercise ——> fever and dehydration ——> heat exposure —pathological ——> acute glomerulonephritis ——> pyelonephritis ——> chronic renal disease ——> congestive heart disease

Answer 108

—bleed in nephron —primary damage to glomerulus —protein + dimorphic RBC —orange-red in color

Answer 109

—may see granular, dirty, brown cast produced by hemoglobin breakdown — see in acute tubular necrosis

Answer 110

—most frequently composed of neutrophils —look for granules and multilevel nucleuses

Answer 111

—appear infection and inflammation of the nephron —-pyelonephritis (aid in identifying if lower or upper infection) —acute interstitial nephritis (no bacteria) —glomerulonephritis

Answer 112

—may be pure or mixed with WBC — confirm with gram stain — seen in pyelonephritis

Answer 113

— cast with RTE = advance tubular destruction —urinary stasis with tubular lining disruption —form in DCT —round or oval

Answer 114

—see in toxicity if heavy metals, chemicals, drugs, viruses and transplant rejections —pyelonephritis —liver issues (hepatitis) bilirubin can stain the cast yellow

Answer 115

— fatty cast+oval fat bodies+free floating fat= lipiduria= nephrotic syndrome —seen in tubular necrosis, diabetes mellitus, crush injuries —highly retractile —

Answer 116

— fine or coarse (do not need to report) —non-pathological: RTE lysosomes excrete in normal metabolism, after exercise and Activity —pathological: disease states- granules could be a result of deterioration of cellular cast — if stays in tubules too long, becomes brittle and turns into waxy cast

Answer 117

Waxy cast Broad cast

Answer 118

— brittle, high retractile —often fragmented with jagged ends and notches —degenerated hyaline and granular cast —extreme urine stasis —renal failure

Answer 119

—renal failure casts —destruction and widening of DCT —formation in upper collecting duct

Answer 120

—include: inorganic salts, organic compounds, and latrogenic (due to medication or treatment) — change can occur due to: temperature, solute concentration, and pH

Answer 121

— most important —> pH — size, shape, color —normal or abnormal —polarization

Answer 122

—Results from refrigeration and dissolved if warmed — 5.5 pH —normal —will see pink sediment (uroerythrin) in tube —looks like speckles

Answer 123

— acidic — rhomboid, whetstones, wedges, rosettes —colorless to yellow-brown —Highly birefringement — seen in samples with high purines, high nucleic acids, leukemia patient receiving chemo, lesch- Nathan syndrome

Answer 124

—normal but rare —acidic —colorless

Answer 125

—most frequently seen —normal —dihydrate —> envelopes or X —monohydrate—> oval or dumbbell —both birefringement under polarized light —foods: tomatoes, asparagus, and ascorbic acid —monohydrate crystals = antifreeze poisoning

Answer 126

—alkaline/neutral —white precipitant that does not disappear after warming —normal

Answer 127

—normal —alkaline/neutral —not common —colorless flat rectangular plates —common constituent of renal stones

Answer 128

— ammonium magnesium phosphate —alkaline —normal — prism shape or coffin lids —retractile — no clinical significance — seen with bacteria that split urea

Answer 129

—alkaline —normal —yellow brown in acidic urine —thorny apples —indication of old sample —associated with urea splitting bacteria

Answer 130

—alkaline —normal —dumbbell or spherical —not significant

Answer 131

—abnormal —acidic — inherited metabolic disorder that prevents the reabsorption of cystine —results in cystinuria. Forms stones at early age —colorless hexagonal plates

Answer 132

—abnormal —acidic — rectangular plate with a notch in one or more corners —highly birefringment —see with lipiduria

Answer 133

—abnormal —acidic — yellow brown spheres with circles and striations — seen less than tyrosine — look like tree trunk life rings —liver disease

Answer 134

—abnormal —acidic —colorless to yellow —needles — liver disease

Answer 135

— abnormal — acidic — clumped needles —yellow —liver disease —viral hepatitis

Answer 136

— acid —appears like cholesterol — will result in very high specific gravity

Answer 137

—An antibiotic to treat UTI —inadequate hydration will cause crystallization causing turbulence may damage