KLUBSY: MICROSCOPIC ANALYSIS OF URINE Flashcards
This is the first procedure to standardize the quantitation of formed elements; used a hemocytometer
Addid count
Addis count utilizes what instrument
Hemocytometer
What is the specimen used for the Addis count
12-hours urine preserved in formalin
What is the preservative used in Addis count?
Formalin
Normal value of Addis count for RBCs:
0 to 500,000 cells/uL
Normal value of Addis count for WBCs:
0 to 1,800,00 cells/uL
Normal value of Addis count for epithelial cells:
0 to 1,800,000 cells/uL
Normal value of Addis count for hyaline casts:
0 to 5000 cells/uL
T/F: To correct the differences in the diameter of centrifuge heads, RCF rather than revolutions per minute (RPM) is used.
T
This is a supravital stain consisting of Crystal vioelt abd safranin
Sternheimer-Malbin
What stain acts by delineating the structure and contrasting colors of the nucleus and cytoplasm
Sternheimer-Malbin
This stain identifies WBCs, epithelial cells, and casts
Sternheimer-Malbin
This is a metachromiatic supravital stain
0.5% Toluidine blue
This stain acts by enhancing nucelar detail
0.5% Toluidine blue
This stain differentiates WBCs and renal tubual epithelial (RTE) cells
0.5% Toluidine blue
This stain acts by lysiing RBCs and enhancing nuclei of WBCs
2% acetic acid
This stain distinguishes RBCs from WBCs, yeat, oil, droplets, and crystals
2% acetic acid
These are lipid stains in sediment stains
Oil Red O and Sudan III
These stains act by staining triglycerides and neutral fats orange-red
Oil Red O and Sudan III
This stain identifies free fat droplets and lipid containing cells and casts
Oil Red O and Sudan III
This stain acts by differentiating gram-POSITIVE and gram-NEGATIVE bacteria
gram stain
This stain identifies bacterial casts
gram stain
This stain acts by staining eosinophilic granules
Hansel stain
A Hansel stain composes of what
Methylene blue + Eosin Y
Methylene blue + Eosin Y =
Hansel stain
This stain idenfities urinary eosinophils
Hansel stain
This stain acts by staining structures containing IRON
Prussian blue stain
This stain identifies yellow-brown granules of hemosiderin in cells and casts
Prussian blue stain
This stain is a.k.a as the Modified Sternheimer Malbin
Sedi and KOVA stain
The Sedi and KOVA stain is a.k.a
Modified Sternheimer Malbin
This dye is absorbed well by WBCs, epithelial cells, and casts, providing clearer delineation of structure and contrasting colors of the nucleus and cytoplasm
Sedi and KOVA stain
In this stain, Hyaline casts appear as pink
Sedi and KOVA stain
In this stain, motile bacteria are unstained
Sedi and KOVA stain
In this stain, non-motile bacteria stains purple
Sedi and KOVA stain
In this stain, T. vaginalis stains as light blue-green
Sedi and KOVA stain
In the Sedi and KOVA stain, hyaline casts appear as what?
pink
In the Sedi and KOVA stain, these are unstained
Motile bacteria
In the Sedi and KOVA stain, non-motile bacteria stains as what?
purple
In the Sedi and KOVA stain, this bacteria stains light blue-green
T. vaginalis
In Oil Red O and Sudan III, cholesterol and cholesterol esters do NOT stain and must be confirmed by what?
By polarizing microscopy
With these stains, cholesterol and cholesterol esters do not stain and must be confirmed by polarizing microscopy
Oil Red O and Sudan III
These stains also distinguishes urinary eosinophils, but Hansel stain is preferred
Wright’s stain or Giemsa stain
This stain is preferred for distinguishing urinary eosinophils
Hansel stain
This plays an important role in the early detection of renal allograft rejection and in the differential diagnosis of renal disease
Cytodiagnostic urinalysis
This involves making a 10:1 concentration of a first morning urine specimen, followed by cytocentrifugation of the urine sediment and Papanicolaou’s staining
Cytodiagnostic urinalysis
In cytodiagnostic urinalysis, it involves making a concentration of what ratio of the first morning uring spx, followed by cytocentrifugation of the urine sediment and Papanicolaou’s staining
10:1 concentratio
What are the Commercial systems for Urine sediment preparation
-UriSystem
-KOVA system
-Count-10 system
this is designed such that after centrifugation, it can be decanted with a quick smooth motion and consistently retains 0.4 mL of urine for sediment resuspension
UriSystem
The UriSystem consistently retains how much of urine for sediment resuspension
0.4 mL of urine
This uses a specially designed pipette that snuggly fits the diameter and shape of the tube to retain 1 mL of urine during decanting
KOVA system
The KOVA system retains what volume of urine during decanting?
1 mL of urine
This system offers several options to retain 0.8 mL for sedimen resuspension
Count-10 System
The Count-10 System retains a volume of how much urine for sediment resuspension
0.8 mL for sedimen resuspensions
This technique is used for routine urinalysis
Bright field microscopy
With this technique, objects appear dark against a LIGHT background
Bright field microscopy
This technique is MOST FREQUENTLY used in the clinical laboratory
Bright Field Microscopy
This is the oldest and most common type of illumination system used on microscopes
Bright field microscopy
T/F: All other types of microscopes are adapted to bright-field
T
This tehcnique enhances visualization of elements with low refractive indices, such as hyaline casts mixed cellular casts, mucous threads, and Trichomonas
Phase contrast microscopy
Type of microscopy in which variations in the specime’s refractive index are converted into VARIATIONS IN LIGHT INTENSITY OR CONTRAST
Phase contrast microscopy
This is an adaptation of a bright-filed microscope with a phase-contrast objective lens and a matching condenser.
Phase contrast microscopy
This technique has 2 phase rings that appear as “targets” are placed in the condenser and the objective
phase contrast microscopy
this technique forms a halo of light around the specimen
Phase contrast microscopy
In phase contrast microscopy, light passes to the specimen through the clear circle in the phase ring in the condenser, forming a what?
forming a halo of light around the specimen
This aids in identification of cholesterol in oval fat bodies, fatty casts, and crystals
Polarizing microscopy
Polarizing microscopy aids in identification of what?
identification of cholesterol in OVAL FAT BODIES, FATTY CASTS, and CRYSTALS
In polarizing microscopy, a substance that rotates the plane of polarized light of how many degrees in a clockwise direction is said to have positive birefringence.
90 degrees
In polarizing microscopy, a substance that rotates the plane of polarized light of 90 degrees in what direction is said to have positive birefringence.
in a clockwise direction
In polarizing microscopy, a substance that rotates the plane of polarized light of how many degrees in a clockwise direction is said to have what?
positive birefringence
T/F: Brightfield microscopes can be adapted for polarizing micrscopy
T
In polarizing microscopy, 2 polarizing filters must be installed in what way?
in a crossed configuration
In polarizing microscopy, how many polarizing filters must be installed in a crossed configuration?
two polarizing filters
This aids in identification of spirochetes such as Treponema pallidum
Dark field microscopy
Dark field microscopy aids in identification of what?
spirochetes such as Treponema pallidum
T/F: Bright field microscope is easily adapted for dark-field microscopy by replacing the condenser with a dark-field condenser that contains an opaque disk
T
Brightfield microscope is easily adapted for darkfield microscopy. How is this done?
Replacing the CONDENSER with a dark-field condenser that contains an OPAQUE disk
In this technique, the specimen appears light against the BLACK background or dark field
Dark field microscopy
This technique produces a three-dimensional microscopy image and a layer-by-layer imaging of a specimen
Interference contrast micrscopy
Type of microscopy in which the difference in optical light paths through the specime is converted into intensity differences in the specimen image
Interference contrast microscopy
Two types of interference-contrast microscopy:
- modulation contrast (Hoffman)
- differential-interference contrast (Nomarski)
*brightfield microscopes can be adapted for both methods
What is required to convert a brightfield microscopy to differential interference contrast?
1- polarizer placed between the light source and condenser
2-special condenser containing a modified Wollaston prisms for EACH objective
3-Wollaston prism placed between the objective and the eyepiece
4-analyzer (polarizing filter) placed behind this Wollaston prism and BEFORE the eyepiece
Allows visualization of naturally fluorescent microorganisms or those stained by a fluorescent dye
Fluorescence microscopy
What is the use for the 2 filters in a fluorescence microscopy?
1-excitation filter - to select a specific wavelength of illumination light
2-barrier filter - to transmit the different, longer-wavelength light emitted from the specimen to the eyepiece for viewing
A microscope component that regulates the angle of light presented to the specimen
Aperture diaphragm
The ability of a substance to refract light in two directions
Birefringement / doubly refractile
Unequal refraction of light rays by a lens that occurs because the different wavelengths of light refract or bend at different angles
Chromatic aberration
Microscope component that gathers and focuses the illumination of light onto the specimen for viewing
Condenser
the microscope lens or system of lenses located closest to the viewer’s eye.
Eyepieve
It produces the secondary image magnification of the specimen
Eyepieve
Microscope component that controls/regulates the diameter of light beams that strike the specimen and hence reduces stray light
Field diaphragm
The circular field observed through a microscope
Field of view
Type of microscope illumination in which a a lamp condenser (located above the light source) focuses the image of the light source (lamp filament) onto the front focal plance of the substage condenser (where the aperture diaphragm is located)
Kohler illumination
Microscope component that holds the microscope slide with the specimen for viewing
Mechanical stage
The lens or system of lenses located closest to the specimen
Objectives
This microscopes component produces the primary image magnification of the specimen
Objectives
term describing objective lenses that RETAIN THE SAME FIELD OF VIEW when the user switches from on objective to another of a differing magnification
Parcenter
Term describing objective lenses that REMAIN IN FOCUS when the user switches from one objective to another of a differing magnification
Parfocal
Ability of a lens to distinguish two points or objects as separate
resolution
a technique used to produce permanent microscope slides of urine sediment and body fluids.
Cytocentrifugation
the end result of this technique is a monolayer of the urine sediment components with their structural details greatly enhanced by staining
Cytocentrifugation
Process of enlarging or magnifying an object’s size without affecting its actual or physical size
Magnification
T/F: Do not use the 10x and 40x objectives without oil
F.
Do not use the said objectives WITH oil
T/F: Always hold the microscope in a vertical position
T
Parts of a micrscope: Lens system
- Oculars
-objectives
-adjustment knobs
Parts of a microscope: Illumination system
- light source
- condenser
- stage field
- iris diaphragms
Parts of a microscope: Body
- base
- body tube
- nose piece
Initial/Primary magnification of sample occurs in the …
Occurs in the OBJECTIVES
Final/second magnification of sample occurs in the …
Occurs int he EYEPIECE
How to calculate for the TOTAL MAGNIFICATION
Eyepiece x Objective
What is the indiv. magnification for the eyepiece
10x
What is the indiv. magnification for the scanner
5x or 4x
What is the indiv. magnification for the LPO
10x
What is the indiv. magnification for the HPO
40x
What is the indiv. magnification for the OIO
100x
What is the total magnification for the eyepiece
N/A
What is the total magnification for the scanner
50x or 40x
What is the total magnification for the LPO
100x
What is the total magnification for the HPO
400x
What is the total magnification for the OIO
1000x
This appears as smooth, non-nucleated, biconcave disk measuring approximately 6-8 um in diameter
RBCs
Size of RBCs
Approx 6-8 um in diamater
This sediment in the urine is the MOST difficult to recognize
RBCs
The observation of this sediment is critical to the early diagnosis of glomerular disorders and malignancy of the urinary tracy and to confirm the presence of RENAL CALCULI
Observation of microscopic hematuria
These cells may be seen following strenuous exercise
- RBCs
- hyaline
- granular
- RBC casts
Erythrocytes may appear as faint, colorless circles or “shadow cells,” because??
because the hemoglobin may dissolve out if the specimen is NOT FRESH when it’s examined
these are difficult to see using brightfield microscopy because their hemoglobin has been lost
Ghost cells
Ghost cells are readily visible using these microscope techniques
-phase contrast
- interference contrast micrscopy
What shape do RBCs make when viewed from the SIDE?
RBCs have an hourglass shape
When viewed from above, RBCs appear as ..
appear as disks with a central pallor
These promote the formation of ghost cells in urine
-hypotonic and alkaline urine
Normal RBC in normal urine is …
0-2 cells/hpf
How much more RBCs in the urine is considered abnormal
3 cells/hpf
Source of identification error in RBCs
-yeast cells
- oil droplets
- air bubbles
Look-alike crystal of RBCs
Monohydrate calcium oxalate crystals
Urine condition: Crenated cells
concentrated urine / hypersthenuric
Urine condition: Echinocytes
Concentrated urine / hypersthenuric
Urine condition: Irregularly shaped
Concentrated urine / hypersthenuric
In this condition, cells appear as small, rough cells with CRINKLED edges
Concentrated urine / hypersthenuric
Urine condition: Ghost cells / swollen RBC
Diluted urine / Hyposthenuric
Hyposthenuric / diluted urine appears as …
ghost cells / swollen RBCs
Urine condition: Dysmorphic or distorted RBC
Glomerular bleeding
This condition has cells that appear in varying size and are mainlly acanthocytes
Glomerular bleeding
In this condition, cells appear as small, rough cells with CRINKLED edges
Concentrated urine / hypersthenuric
In this condition, cells appear as CRENATED CELLS/ECHINOCYTES/IRREGULARLY SHAPED
Concentrated urine / hypersthenuric
In glomerular bleeding, the cells appear as…
dysmorphic or distorted RBC
This stain can be used to further analyze the dysmorphic RBCs
Wright’s stain
Examples of ISOMORPHIC cells
- Normal cell / Discocyte
- Burr cell / Echinocyte or crenated cell
- Ghost cell
examples of Dysmorphic cells
- Acanthocyte or G1 cell
- Target cell / Codocyte
- Schistocyte / Shizocyte
- Stomatocyte
This is a.k.a Burr cell
Echinocyte or crenated cell
this is a.k.a G1 cell
Acanthocyte
This is a.k.a codocyte
Target cell
Bull’s eye appearance; can be bell- or cup-shaped
Target cell / codocyte
Cell with central pallor that appears slitlike
Stomatocyte
T/F: The shape change in stomatocytes is “reversible.”
T
Cell fragment often with two or three pointed ends
Schistocyte
Cell in a ring form (donut shape) with one or more cytoplasmic blebs (i.e., vesicle-shaped protrusions or bulges)
Acanthocyte
Cell with thin membrane and WITHOUT hemoglobin
Ghost cell
Cell with evenly spaced projections or spicules over cell surface; this “reversible” shape change progresses from a “crenated” disk to a “crenated” sphere
Echinocyte or crenated cell / Burr cell
T/F: The shape change for Burr cells are irreversible
F.
Reversible
T/F: WBCs are larger than RBCs
T
Average measurement size of WBC diameter
12 um in diameter
Term used to denote increase urinary WBCs and is associated with urinary tract infection (UTI), interstitial nephritis, and SLE
Pyuria or leukocytoruia
This is the predominant WBC found in urine
Neutrophils
T/F: Neutrophils lyse rapidly in dilute alkaline urine and begin to lose nuclear detail
T
What happens to WBCs in HYPOTONIC URINE?
- WBCs swells and become spherical balls
- lyse rapidly as 50% in 2 to 3 hours at RT
What happens to WBC in hypertonic urine?
- leukocytes become smaller as water is lost osmotically from the cells, but they do not crenate
These result from the breakdown of the cell membrane
Myelin forms
The presence of these are primarily associated with drug-induced interstitial nephritis
urinary EOSINOPHILS
T/F: Eosinophils are not normally seen in the urine
T
T/F: the finding of more than 1% eosinophils is considered significant
T
These cells predominate in urine from patients experiencing renal transplant rejection
Lymphocytes
Normal WBC value in urine
male: 0-5 WBC/hpf
female: 0-8 WBC/hpf
They are found in diluted or hypotonic urine
Glitter cells
This is a WBC with sparkling appearance due to Brownian movement of the granules
Glitter cells
Glitter cells are large cells that stain blue as opposed to the violet color usually seen with neutrophils
When stained with Sternheimer-Malbin
T/F: Glitter cells are of no pathologic significance
T
When stained with Sternheimer-Malbin, the large cells stain what color as opposed to the violet color usually seen with neutrophils
LIGHT BLUE
Originates from linings of the vagina and female urethra and the lower portion of the male urethra
Squamous Epithelial cells
these are the largest cells found in the urine sediment
Squamous epithelial cells
These contain abundant, irregular cytoplasm and a prominent nucleus about the size of an RBC.
Squamous epithelial cell
The may appear as flagstone-shaped with distinct cell borders
Squamous epithelial cells
This is the point of reference in microscopic analysis
Squamous Epithelial cells
They may occasionally appear folded, possibly resembling a cast, and will begin to disintegrate in urine that is not fresh
Squamous epithelial cells
T/F: Increased amounts of squamous epithelial cells are more frequently seen in males.
F.
frequently seen in females
These are pathologic squamous epithelial cell covered with the Gardnerella vaginalis coccobacillus
Clue cells
Clue cells are pathologic squamous epithelial cells covered with what?
Gardnerella vaginalis coccobacillus
To be considered a clue cell…
the bacteria should cover MOST OF THE CELL SURFACE and extend BEYOND THE EDGES of the cell
Transitional Epithelial cells is a.k.a
Urothelial or BLADDER EPITHELIAL CELLS
These cells originate from the lining of the renal pelvis, calyces, ureters, and bladder, and from the upper portion of the male urethra
Transitional epithelial cells
These cells are smaller than squamous cells and appear in several forms, including spherical, polyhedral, and caudate. These differences are caused by the ability to absorb large amounts of water
Transitional epithelial cells
What are the several forms of TRANSITIONAL EPITHELIAL CELLS
- spherical
- polyhedral
- caudate
They are 2 to 4 times as large as WHITE CELLS
Transitional epithelial cells
These may be round, pear-shaped, or may have tail-like projections
transitional epithelial cells
Occasionally, these cells may contain two nuclei
Urothelial
What form of transitional epithelial cells are sometimes difficult to distinguish from RTE cells?
Spherical forms of transitional epithelial cells
These can aid in in the differentiation of transitional epithelial cells
-presence of a centrally located rather then eccentrically placed nucleus
- supravital staining
T/F: Increased numbers of transitional cells seen singly, in pairs, or in clumps (syncytia) are present following invasive urologic procedures such as catheterization and are of NO CLINICAL SIGNIFICANCE
T
An increase in transitional cells exhibiting abnormal morphology such as vacuoles and irregular nuclei may be indicative of what?
indicative of malignancy or viral infection
these cells vary in size and shape depending on the area of the renal tubules from which they originate
Renal tubular epithelial (RTE) cells
T/F: the cells from the PCT are SMALLER than other RTE cells
F.
Larger
They tend to have a rectangular shape and are referred to as COLUMNAR or CONVOLUTED CELLS.
RTE cells
T/F: Cells from the DCT are SMALLER than those from the PCT, and are round or oval
T
These cells are cuboidal and are NEVER ROUND.
Collecting duct RTE cells
These are cells from the collecting duct that appear in groups of three or more
Renal fragments
These are indication of severe tubular injury with basement membrane disruption
Renal fragments
This condition is seen in the presence of more than 2 RTE/HPF
Tubular injury
These are the MOST CLINICALLY significant of the epithelial cells
RTE cells
The presence of increased amounts of RTE cells is indicative of what?
indicative of necrosis of the renal tubules
These are the precurosr of oval fat bodies
RTE cells
What are the 3 locations of RTE cell?
- PCT
- DCT
- Collecting Duct
What is the appearance of RTE cells located in the PCT?
Rectangular
What is the appearance of RTE cells located in the DCT?
Round or oval
What is the appearance of RTE cells located in the collecting duct?
Cuboidal and can be seen as large sheets of cells
These are RTE cells containing large, nonlipid-filled vacuoles that is mainly associated with Acute Tubular necrosis
Bubble cells
Bubble cells are RTE cells containing large, nonlipid-filled vacuoles that is mainly associated with what?
Acute tubular necrosis
These appear to represent injured cells in which the endoplasmic reticulum has dilated prior to cell death
Bubble cells
These are lipid-containing RTE cells
Oval fat bodies
These are highly refractile RTE cells
Oval fat bodies
They are usually seen in conjunction with free-floating fat droplets
Oval fat bodies
How is the identification of oval fat bodies confirmed?
1- by staining the sedimen with Sudan III or Oil Red O fat stains
2- examining the sediment using POLARIZED MICROSCOPY
In Oval fat bodies, the examination of the sediment using polarized light results in the appearance of characteristic what??
Maltese cross formations
These cells are present in disorders such as: Nephrotic syndrom, DM, Severe Tubular necrosis, trauma cases that cause release of bone marrow fat from the long bones
Oval fat bodies
T/F: In lipid-storage diseases, large fat-laden histiocytes may also be present in urine.
T.
How can large fat-laden histiocytes be differentiated from oval fat bodies?
By their large size
These appear as small spherical and rod-shaped structures in the urine
Bacteria
T/F: Bacteria are normally present in the urine
F.
NOT NORMALLY present
To be considered significant for UTI, what should be present in the urine?
Bacteria accompanied by WBCs
T/F: Bacteria in the urine are motile.
T.
They are useful from similar appearance, amorphous urates and phosphates
Bacteria
T/F: The actual bacteria producing UTI cannot be identified with the microscopic examination
T.
These cells appear in the urine as small, refractile oval structures that may or may not contain a bud
Yeast cells
In severe infections, these cells may appear as branched mycelial forms
Yeast cells
Yeast cells, primarily this bacteria, are seen in the urine of diabetic, immunocrompomised patients and women with vaginal moniliasis
Candida albicans
A true yeast infection should be accompanied by the presence of ….
presence of WBCs
What is the FAVORABLE urine condition for yeast cells?
ACIDIC urine and with GLUCOSE
Most frequent parasite encountered in urine
Trichomonas vaginalis
Bladder parasite, associated with bladder tumors
Schistosoma haematobium
Most common contaminant ova
Enterobius vermicularis
Observed in urine sediments as the result of fecal contamination of infected individuals
Cyst of Giardia lamblia
When NOT MOVING, this is more difficult to identify and may resemble a WBC, transitional/or RTE cell
Trichomonas
The use of this microscope technique may enhance visualization of the flagella or undulating membrane
phase microscopy
These are easily identified in the urine by their oval, slightly tapered heads and long, flagella-like tails
Spermatozoa
T/F: Urine is toxic to spermatozoa
T
T/F: Observation of exhibited motility are rarely obserbed when examining a semen specimen because urine is toxic to spermatozoa
T.
Spermatozoa are rarely of clinical significance except in cases of what?
- male INFERTILITY
- Retrograde ejaculation
This is the term when sperm is expelled into the bladder instead of the urethra
Retrograde ejaculation
This is a protein material produced by the glands and epithelial cells of the lower GENITOurinary tract and the RTE cells
Mucus
These appear microscopically as thread-like structures with a LOW REFRACTIVE INDEX
Mucus
The major constituent or matrix of the mucus
Uromoduliln / Tamm-Horsfall protein
T/F: Mucus is more frequently present in male urine specimens.
F.
more frequently present in female urine specimens
T/F: Increase in numbers of mucus are found in cases of UTI
T
These are found in the urine sediment 2 to 3 days after a severe hemolytic episode (e.g., transfusion reaction, paroxysymal nocturnal hemoglobinuria)
Hemosiderin granules
Hemosiderin granules are found in the urine sediment how many days after a severe hemolytic episode
2 to 3 days after a severe hemolytic episode
These may be found free floating or within macrophages, casts, or tubular epithelial cells
Hemosiderin granules
This is a.k.a Rous test
Prussian blue reaction
The Prussian blue reaction is a.k.a
Rous test
This is used to identify hemosiderin in the urine sediment and in tissues
Prussian blue reaction/Rous test
In a Rous test, how long should the urine stand at room temperature?
10 minutes
In preparing a Rous test, the urine sediment is suspended in a freshly prepared solution of what?
solution of potassium ferricyanide-HCl
presence of RBCs in urine
hematuria
what is the normal color of neutrophils in a sternheimer-malbin?
purple
What are the 2 possible appearances of RBCs in a hypotonic urine?
1-swells and becomes spherical balls
2- produces a Brownian movement, then has a sparkling appearance, and is then called a GLITTER CELL
What WBC is predominant in interstitial nephritis?
eosinophils (>1% eosino)
medical term for the presence of WBCs in the urine?
Pyuria
What type of cells are these: monocytes, lymphocytes, macrophages, and histocytes
Mononuclear cells
What are the mononuclear cells?
- monocytes
- lymphocytes
- macrophages
- histocytes
Mononuclear cells are generally mistaken for what?
mistaken for RTE cells
T/F: Lymphocytes resemble as RBCs
T.
These are seen in cases of early renal transplant rejection
Increased urinary lymphocytes
These stains can be used to diff. mononuclear cells from RTE cells
supravital stain & acetic acid
Considered as the largest sediment in urine
Squamous epithelial cells
T/F: Squamous epithelial cells are significant when results are TOO NUMEROUS TO COUNT (tntc)
F.
Squamous epithelial cells are NOT significant kahit sobrang dami. Nagiging significant lang kapag merong kasamang bacteria na Gardnerella vaginalis
What is the precursor of clue cells?
Squamous epithelial cells
How to differentiate spherical transitional epithelial cells from RTE cells?
check the nucleus and can use a supravital stain
*for transitiona epithelial cells, the nucleus is CENTRALLY LOCATED. meanwhile, RTE cells have an ECCENTRIC nucleus
out of the epithelial cells, these are considered SIGNIFICANT
Renal tubular epithelial cells
what is the value of renal tubular epithelial cells that indicate tubular injury?
more than 2 RTE/HPF
The most clinically significant of the epithelial cells
RTE cells
Cuboidal RTE cells located in the collecting duct can be seen as large sheets of cells. The large sheet of cells is called …
renal fragments
The largest RTE cell is found/located where?
PCT
RTE cells located in the PCT are referred to as …
Columnar or convoluted cells
Columnar or convoluted cells are located in the …
PCT
DCT RTE cells can be mistaken for what?
WBCs and spherical transitional epithelial cells
These are associated with SEVERE TUBULAR INJURY
Renal fragments
These are seen in cases of salicylate poisoning
Single cuboidal RTE
Single cuboidal RTE are seen in cases of what?
in cases of salicylate poisoning
This is the precursor of oval fat bodies
RTE
*monocyte/macrophage (2nd ans)
When the appearance of the RTE is highly refractile and lipid filled, this is called …
OVAL FAT BODIES
when the appearance of RTE cells is vacuolated and non lipid-filled, this is called …
BUBBLE CELLS
These are non lipid-filled RTE
Vacuolated RTE
These are lipid-filled RTE
Highly refractile RTE
How to differentiate oval fat bodies RTE from oval fat bodies macrophages (fat-laden histiocytes) ?
check the size
*fat-laden histiocytes are LARGER in size
What to check if T. vaginalis is not motile?
1 - check for motility
2- checl the flagella or undulating membrane
In a Prussian blue stain, what color is positive?
BLUE
