Ch 29 - urine sediment analysis Flashcards
Sediment examination is occasionally an aid in the diagnosis of?
systemic disease
Microscopic examination is?
important part of a complete urinalysis, many abnormalities cannot be detected by the reagent test strip, microscopy is performed for every urinalysis
Normal urine should not contain a lot of ____except ___ and ____.
sediment
horses and rabbits
___ ___ sample is best for sediment evaluation.
First morning
Sediment an normally include?
epithelial cells, mucus threads, RBCs, WBCs, Hyaline casts, crystals
Always examine when fresh or if sits too long what can occur?
casts dissolve
crystals form
The urine of horses and rabbits usually has large amounts of ____ _____ crystals
calcium carbonate
How do you separate sediment and supernatant?
- centrifuge urine for 3-5 min. at 1000 - 2000 rpm
5 - 10 mL of sample is ideal - supernatant is poured or pipetted off, leaving approx. 0.5 mL in the tube
- remix by gently flicking tube with finger to resuspend sediment
How do you prepare unstained sediment slide?
1 . place a drop on a slide
- cover with a cover slip
- turn down light on microscope
How do you prepare a stained sediment slide?
- add a tiny drop of sediment stain (Sedi-stain) or 0.5% new methylene blue to sample
- cover with a cover slip
- turn down light
Can stain introduce artifacts?
How can you rule artifacts out?
yes
examine both stained and unstained slides
Can you have both stained and unstained sample side by side on the same slide?
yes
How do you do a microscopic examination?
- start on low power - evaluate larger elements, casts or aggregates of cells - report as number per low power field (#/lpf)
- 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)
Microscopic findings - normal you might see?
few - casts, crystals, epithelial cells, RBCs, WBCs, mucus threads, fat droplets, sperm (intact males)
Microscopic findings - abnormal you might see?
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
What cell types will you find in urine?
epithelial cells (intact, ghost, crenated) squamous, transitional, renal, caudate, WBCs, yeast bodies, sperm
erythrocytes in Urine may look different, how?
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
Leukocytes are?
larger than RBCs and smaller than epithelial cells - spherical, dull gray or greenish yellow - granules or lobed nucleus
What is pyuria?
WBCs withpus
Epithelial cells are?
few = normal increased = inflammation three types: squamous - distal, urethra, external transitional - smaller from bladder etc. renal - any number is significant
Casts are?
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
Hyaline casts look?
clear and colorless, composed only of protein, cylindrical, with parallel sides and usually rounded ends
Increased numbers of hyaline casts mean?
fever, poor renal perfusion, strenuous exercise or general anesthesia
Granular casts are?
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
