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6- UA > 4- Micro-examination: Cells > Flashcards

4- Micro-examination: Cells Flashcards

1
Q

Urinary Sediment: Specimen preparation steps

A

• Centrifuge 10-15 ml of urine, 2000 rpm for 5 min.
• Pour off the supernatant fluid.
• Button mass remains at bottom of tube.
• Add one drop of sedi-stain.
• Place one drop of sediment on a slide and cover slip.
• Examine immediately.

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2
Q

Normal amount of RBC _____ per high power field

A

0-3

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3
Q

Describe RBCs

A

Round smooth cells

slightly red colour or yellowish

normal specific gravity of urine

disc shaped

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4
Q

If specific gravity is more than 1.025 (hypertonic), what happens to RBCs

A

Lose their smooth texture

look like crenated (shrinked)

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5
Q

If specific gravity less than 1.008 (hypotonic urine),
RBC appear as

A

“ghost” (partially lysed)

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6
Q

More than 3 - 5 RBC per high power field is called

A

hematuria

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7
Q

RBC in the slide may be confused with

A

oil droplets
or yeast cells.

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8
Q

Oil droplets, however, exhibit a great variation in

A

size and are highly refractile

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9
Q

Yeast cells usually are

A

ovoid

how budding and do not stain

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10
Q

RBC vs Yeast

(picture)

A
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11
Q

Exercise-induced hematuria is

A

self-limited,

benign condition.

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12
Q

The results of Exercise-induced hematuria should be
negative after?

A

48 to 72 hours

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13
Q

urinary tract diseases that causes hematuria

A
  • other urinary tract tumors
  • cystitis
  • urolithiasis
  • trauma
  • tuberculosis
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14
Q

Pathology outside the urinary system that cause hematuria

A
  • liver failure
  • radiation disease
  • prostate diseases
  • diseases of uterus
  • overdoses of anticoagulants
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15
Q

White Blood Cells Normal amount _____ per high power field

A

0-5

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16
Q

More than 30 WBC per hpf indicated

A

pyuria

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17
Q

WBCs size

A

Larger than RBCs but smaller than renal cells

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18
Q

What type of WBCs is usually seen in urine

A

neutrophils
(Contain nuclei and granules/ Colourless)

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19
Q

WBC vs RBC

(picture)

A
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20
Q

WBC, RBC, Yeast presence indicate

A

UTI

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21
Q

number of WBCs in an alkaline and hypotonic urine decreases by 50% within ___ hour after collection @ room temp

A

1

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22
Q

Def: when WBCs expand in a dilute or hypotonic urine their granules are in Brownian motion

A

glitter cells

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23
Q

Glitter cells were previously considered to be specific
for

A

pyelonephritis

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24
Q

Increased WBC could be found in some physiological states:

A
  • dehydration
  • strenuous exercises
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25
Q

Renal Diseases that raises WBCs

A

pyelonephritis
kidney stones

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26
Q

Extra Renal Diseases that raises WBCs

A

inflammation of ureter, bladder, urethra
urolithiasis
prostatitis
balanitis

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27
Q

How many tyoes of epithelial cells can be seen in urine

A

3

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28
Q

The three types of epithelial cells

A

Renal
Transitional
Squamous

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29
Q

Renal epithelial cells originate from

A

tubular portion of the nephrons and collecting ducts

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30
Q

Transitional cells originate from

A

the renal pelvis (caudate cells)
upper 1/3 of the bladder and ureters (urothelial
cells)

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31
Q

Squamous cells originate from

A

lower bladder

urethra

vagina

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32
Q

Epithelial Cells

(picture)

A
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33
Q

Describe Renal Tubular Epithelial Cells

A

few seen in urine
Larger than leukocytes
large round nucleus
flat, cuboidal, or columnar shaped

34
Q

Increased numbers of renal epithelial cells
(15 cells per 10 hpfs) suggest tubular damage in

A
  • pyelonephritis
  • acute tubular necrosis
  • acute trauma of kidney
  • kidney transplant rejection
  • neoplasms
35
Q

Oval Fat Bodies are

A

renal tubular epithelial (with lipoproteins, cholesterol and triglycerides)

macrophage, or polymorphonuclear leukocytes (ingested lipids or degenerated)

36
Q

The presence of lipid accompanied by marked proteinuria is characteristic of

A

nephrotic syndrome

37
Q

Polarized anisotropic fat droplets aka

A

Maltese crosses

38
Q

Maltese crosses are composed of

A

cholesterol

39
Q

Fat bodies consist of triglycerides or neutral fat will not polarized but will stain with:

A

Sudan III

40
Q

detection of fat and oval fat bodies must be done through

A

microscopic examination

41
Q

Lipiduria develops due to:

A
  • Degeneration of tubules in nephrotic syndrome
  • Extensive superficial injuries with crushing of the subcutaneous fat
  • Fractures of the major long bones or pelvis
42
Q

nephrotic syndrome is caused by

A

– chronic glomerulomephritis
– diabetes mellitus
– eclampsia
– lipid nephrosis (minimal change disease)
– toxic renal poisoning

43
Q

Transitional epithelial cells are ____ times as large as white blood cells

A

2- 4

44
Q

Transitional cells line the urinary tract are from

A

renal pelvis
ureters and upper 1/3 of the bladder

45
Q

Identify the type of cell:

teardrop, pear-shaped cells, or may have
tail-like projections with large nucleus
located in the renal pelvis

A

caudate cells

46
Q

Identify the type of cell:

ounded cells (look like hard boiled egg), occasionally may contain two nuclei
located in the ureters and upper 1/3 of the bladder
A

urothelial cells

47
Q

Normal amount of Transitional Epithelial Cells (TEC) in the urine of healthy persons is

A

0 to few

48
Q

Increased amount of TEC could be found in

A
  • urinary tract infection (upper or lower UTI)
  • catheterisation of the ureter (ureteroscopy)
  • transitional cell carcinoma (large clumps of the TEC)
49
Q

Squamous Epithelial Cells shapes:

A
  • Large, flat, irregularly shaped cells
  • Flat scale-like shape, (fried egg)
50
Q

describe the nucleus of Squamous Epithelial Cells

A

small central nucleus

51
Q

Squamous Epithelial Cells Normal amount in urine?

A

up to 30 cells per field of vision

52
Q

Large numbers of Squamous Epithelial Cells could represent:

A
  • vaginitis
  • urethritis/ cystitis (low UTI)
  • testicular tumor
  • cystoscopy (diagnostic exam)
53
Q

what’s the bacterial count shoud be in normal urine?

A

0

urine is normally free of bacteria

54
Q

where does the bacterial contamination occur?

A

from bacteria present in the urethra or vagina, or from other external sources

55
Q

Bacteria are reported according to

A

the number that is present

(few, moderate, many)

56
Q

bacteria is easily recognized when the sediment is viewed under

A

highpower magnification

57
Q

describe the shape of yeast

A

Smooth

colorless

ovoid cells with doubly refractile walls

58
Q

yeasts replicate by

A

budding

59
Q

yeast can be mistaken for

A

RBCs

(not insoluble in acid and alkali)

60
Q

most common yeast to appear in the urine is

A

Candida albicans

61
Q

Yeast may be found in patieths with

(diseases)

A

UTI

Diabetes

skin or vaginal contamination

62
Q

describe the shape of Spermatozoa

A

Oval bodies with long, thin, delicate tails

63
Q

Spermatozoa May be seen in urine of men after

A

epileptic convulsions

or

diseases of the genital organ

64
Q

Spermatozoa May be seen in urine of women

A

after sex

65
Q

Parasites can be found in urine due to

A

Vaginal or fecal contamination

66
Q

Can chemical analysis detect parasites in urine?

A

No

67
Q

how to detect parasites in urine?

A

Microscopic evaluation

(WBCs may be present)

68
Q

the most frequently occurring parasite in the urine is

A

Trichomonas vaginalis

69
Q

Trichomonas vaginalis is a flagellate organism that is about the same size as a

A

large white cell

70
Q

In the unstained wet mount, Trichomonas vaginalis should not be reported unless

A

it is motile

71
Q

Trichomonas vaginalis more common in (males/females)?

A

more common in females

may be found in males​

72
Q

T. vaginalis is frequently accompanied by

A

WBCs and epithelial cells

73
Q

Enterobius vermicularis aka

A

pinworm

74
Q

what forms of Enterobius vermicularis (pinworm) are found in urine

A

ova

and

female adult

75
Q

describe ova

A

one flat and one rounded side

76
Q

define the parasite:

a blood fluke that inhabits the veins in the wall of the urinary bladder

A

Schistosoma haematobium

77
Q

The adult Schistosoma haematobium deposits eggs in the capillaries of

A

mucosa

78
Q

what can develop around the Schistosoma haematobium eggs?

A

Abscess

79
Q

Schistosoma haematobium can be found in the urine accompanied by

A

RBCs and WBCs

80
Q

what can be listed as Confusing Artifacts?

A

Fecal contamination

Air bubbles

Oil droplets

81
Q

Air bubbles can assume a variety of shapes if

A

the coverslip is moved or depressed

82
Q

Oil droplets in the urine are the result of contamination from

A

lubricants

6- UA (9 decks)

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