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Clinical Chem - Vic > Ch 29 - urine sediment analysis > Flashcards

Ch 29 - urine sediment analysis Flashcards

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1
Q

Sediment examination is occasionally an aid in the diagnosis of?

A

systemic disease

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2
Q

Microscopic examination is?

A

important part of a complete urinalysis, many abnormalities cannot be detected by the reagent test strip, microscopy is performed for every urinalysis

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3
Q

Normal urine should not contain a lot of ____except ___ and ____.

A

sediment

horses and rabbits

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4
Q

___ ___ sample is best for sediment evaluation.

A

First morning

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5
Q

Sediment an normally include?

A

epithelial cells, mucus threads, RBCs, WBCs, Hyaline casts, crystals

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6
Q

Always examine when fresh or if sits too long what can occur?

A

casts dissolve

crystals form

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7
Q

The urine of horses and rabbits usually has large amounts of ____ _____ crystals

A

calcium carbonate

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8
Q

How do you separate sediment and supernatant?

A
  1. centrifuge urine for 3-5 min. at 1000 - 2000 rpm
    5 - 10 mL of sample is ideal
  2. supernatant is poured or pipetted off, leaving approx. 0.5 mL in the tube
  3. remix by gently flicking tube with finger to resuspend sediment
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9
Q

How do you prepare unstained sediment slide?

A

1 . place a drop on a slide

  1. cover with a cover slip
  2. turn down light on microscope
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10
Q

How do you prepare a stained sediment slide?

A
  1. add a tiny drop of sediment stain (Sedi-stain) or 0.5% new methylene blue to sample
  2. cover with a cover slip
  3. turn down light
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11
Q

Can stain introduce artifacts?

How can you rule artifacts out?

A

yes

examine both stained and unstained slides

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12
Q

Can you have both stained and unstained sample side by side on the same slide?

A

yes

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13
Q

How do you do a microscopic examination?

A
  1. start on low power - evaluate larger elements, casts or aggregates of cells - report as number per low power field (#/lpf)
  2. move to 40x - look for bacteria, differentiate cells (epithelial cells, RBCs, WBCs, - report as (3/hpf), look for bacterial - report as few, moderate, many - report morphology (shapes) (cocci, bacilli)
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14
Q

Microscopic findings - normal you might see?

A

few - casts, crystals, epithelial cells, RBCs, WBCs, mucus threads, fat droplets, sperm (intact males)

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15
Q

Microscopic findings - abnormal you might see?

A

more than a few - RBCs - small, round, smooth in fresh urine
shrink - crenate - in old urine
swollen - in dilute urine
WBCs, casts, crystals, hyperplastic or neoplastic epithelial cells, parasite ova, bacteria, yeast

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16
Q

What cell types will you find in urine?

A 
epithelial cells (intact, ghost, crenated)
squamous, transitional, renal, caudate, WBCs, yeast bodies, sperm
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17
Q

erythrocytes in Urine may look different, how?

A

RBCs - small, round, smooth in fresh urine
shrink - crenate - in old urine
swollen - in dilute urine
2 - 3 RBCs/hpf is not abnormal depending on patient and collection methods

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18
Q

Leukocytes are?

A

larger than RBCs and smaller than epithelial cells - spherical, dull gray or greenish yellow - granules or lobed nucleus

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19
Q

What is pyuria?

A

WBCs withpus

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20
Q

Epithelial cells are?

A 
few = normal
increased = inflammation
three types:
squamous - distal, urethra, external
transitional - smaller from bladder etc.
renal - any number is significant
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21
Q

Casts are?

A

we see on low power not high power
formed in the lumen of the distal and collecting tubules
classified by appearance:
- hyaline, epithelial, cellular, granular, waxy, fatty, mixed

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22
Q

Hyaline casts look?

A

clear and colorless, composed only of protein, cylindrical, with parallel sides and usually rounded ends

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23
Q

Increased numbers of hyaline casts mean?

A

fever, poor renal perfusion, strenuous exercise or general anesthesia

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24
Q

Granular casts are?

A

hyaline casts with granules that come from tubular epithelial cells, RBCs or WBCs that become incorporated within the cast and then degenerated, they are common

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25
Q

Granular casts increase with?

A

acute nephritis

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26
Q

Epithelial casts consists of?

A

epithelial cells from the renal tubules

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27
Q

Epithelial cells occur with?

A

acute nephritis, and degeneration of renal tubular epithelium - more skin cells collected

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28
Q

Erythrocyte casts are what color?

A

deep yellow to orange
membranes may not be visible
Contain RBCs - renal bleeding

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29
Q

Leukocyte casts contain?

A

WBCs -neutrophils

inflammation in renal tubules

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30
Q

Waxy casts are?

A

waxy - dull with a waxy appearance

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31
Q

Fatty casts are?

A

contain small droplets of fat, seen in cats with renal disease, sometimes seen in dogs with diabetes mellitus

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32
Q

Crystalluria is?

A

the presence of crystals

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33
Q

Crystalluria may lead to?

A

urinary calculi

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34
Q

Crystalluria is dependent on?

A

pH, concentration, temperature, and elements

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35
Q

Crystals are reported as?

A

type, quantity (occasional, moderate, many) or 1+ to 4+

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36
Q

What are some types of crystals found in urine?

A

struvite, calcium oxylate, uric acid, amorphous, calcium carbonate, ammonium biurate, sulfonamide, cystine, other crystals

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37
Q

How do you recognize struvite?

A

eight-sided prisms with tapered ends - most often a “coffin lid” shape

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38
Q

AKA struvite?

A

triple phosphate crystals or magnesium ammonium phosphate crystals

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39
Q

Where are struvite found?

A

in alkaline to slightly acidic urine

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40
Q

What types of calcium oxalate crystal are there?

A

dihydrate and monhydrate

41
Q

What do calcium oxalate dihydrate crystals look like?

A

small square with an X across the crystal - resembles the back of an envelope

42
Q

Where are calcium oxylate dihydrate crystals found?

A

in acidic to neutral urine

43
Q

What species is oxylate dihydrate crystals found?

A

common in dogs and horses

44
Q

What do calcium monohydrate crystals look like?

A

small, dumbell-shaped or elongated and pointed at each end - often called fence posts

45
Q

Where is calcium monohydrate crystals seen?

A

ethylene glycol poisoning - antifreeze

46
Q

Uric acid crystals have a variety shapes but usually are?

A

diamond or rhomboid

47
Q

What color are uric acid crystals?

A

yellow or yellow brown

48
Q

What breed of dogs is uric acid found?

A

dalmations - (not common with other breeds of dogs or cats)

49
Q

Amorphous crystals look like?

A

granular precipitate

50
Q

Amorphous crystals are named for?

A

acidity of urine

51
Q

Amorphous crystals that are acidic are called?

A

Amorphous urates

52
Q

Amorphous crystals that are alkaline are called?

A

Amorphous phosphates

53
Q

Calcium carbonate may appear to look?

A

round with lines radiating from the center, round granular masses, dumbbell shaped

54
Q

Calicum carbonate are common in what species?

A

horses and rabbits

55
Q

Calcium carbonate are not ___ significant.

A

clinically

56
Q

Ammonium biurate crystals are seen in slightly ___, ___, or ___ urine.

A

acidic, neutral, alkaline

57
Q

What color are Ammonium biurate crystals?

A

brown

58
Q

Ammonium biurate crystals look like?

A

long irregular spicules

59
Q

Ammonium biurate crystals are common in what species?

A

animals with severe liver disease

60
Q

Sulfonamide crystals are seen in animals treated with?

A

suflonamides - drugs

61
Q

Sulfonamide crystals look like?

A

round, dark with a radiating center

62
Q

Sulfonamide crystals are prevented by?

A

encouraging water consumption during treatment

63
Q

Cystine look like?

A

flat, thin, six-sided, colorless

64
Q

Cystine is associated with?

A

rental tubular dysfunction, cystine urolithiasis

65
Q

Leucine crystals looks like?

A

a wheel or pincushion shape - spikey

66
Q

Leucine crystals are what color?

A

yellow to brown

67
Q

Leucine crystals are associated with?

A

liver disease - uncommon in dogs or cats

68
Q

Urolithiasis is?

A

a condition of having urinary calculi (stones)

69
Q

Urolithiasis may cause?

A

blockages or remain in bladder

70
Q

Urolithiasis is important to determine type/compostion for what?

A

prognosis and prevention

treatment and removal

71
Q

Urolithiasis is common in what species?

A

castrated male ruminants, in dogs and cats, typically struvite crystals (in dalmations usually are urate crystals)

72
Q

Tyrosine crystals look like?

A

dark, needle-like projections

73
Q

Tyrosine crystals are associated with?

A

liver disease - uncommon in dogs or cats

74
Q

Crystals associated with Melamine toxicity look like?

A

golden-brown round to oval crystals with radial striations

75
Q

Crystals associated with Melamine toxicity may be present in animals that have been fed diets contaminated with?

A

melamine or cyanuric acid

76
Q

Microorganisms are found in urine such as?

A

bacteria, fungi, and protozoa

77
Q

Normal urine is free of bacteria. T/F

A

True - can be contaminated by bacteria residing on the epithelium of the vagina, vulva or prepuce during urination

78
Q

Bacteria is ____ if urine is left standing.

A

proliferate (increase rapidly in numbers)

79
Q

Bacteria can be identified under ____. What do they look like?

A

magnification

round - (cocci) or rod-shaped - (bacilli)

80
Q

Bacteria can be reported as?

A

few, moderate, many, or TNTC

81
Q

Bacteria is indicative of?

A

infection or inflammation

82
Q

Bacteria should be submitted for bacterial ____.

A

culture

83
Q

Parasite ova and microfilaria can be seen in?

A

Fecal contamination and parasite of the urinary tract

84
Q

What is Pearsonema plica?

A

bladder worm

85
Q

What is Dictophyma renale?

A

kidney worm (of dogs)

86
Q

What is Microfilaria imitis?

A

adult heartworm

87
Q

What are mucus threads?

A

resemble twisted ribbons - confused with casts

88
Q

Mucus threads are in large numbers in what species?

A

horses

89
Q

Mucus threads in other species indicates what?

A

urethral irritation or contamination with genital secretions

90
Q

Spermatozoa found in?

A

intact males

91
Q

Spermatozoa in large numbers can give?

A

false -positives for protein

92
Q

fat droplets look like?

A

lightly green-tinged, highly refractile, spherical

93
Q

If a sediment smear sits for a few moments, fat droplets will rise to the ___ . Higher plane of focus than rest of slide

A

surface

94
Q

Lipuria?

A

fat in urine

95
Q

Lipuria is seen in some degree in most?

A

cats

96
Q

Lipuria is seen with?

A

obesity, diabetes millitus, hypothroidism, and , rarely, after a high-fat meal

97
Q

Artifacts enter during?

A

collection, transport, or examination

98
Q

Examples of artifacts are?

A

air bubbles, oil droplets, hair, feces, pollen, dust

Clinical Chem - Vic (29 decks)

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