LESSON 6: URINALYSIS—MICROSCOPIC EXAMINATION OF URINE - PART 1 Flashcards
1
Q
May indicate the presence of certain sediments
A
Color
2
Q
Pathologic or non-pathologic causes of turbidity
A
Clarity
3
Q
Blood
A
RBCs, RBC Cast
4
Q
Protein
A
Casts, cells
5
Q
Nitrite
A
Bacteria, WBCs
6
Q
LE
A
WBCs, WBC Casts, bacteria
7
Q
Glucose
A
Yeast
8
Q
[?] of urine
A
10 to 15 mL
9
Q
Centrifuge at [?] FOR [?]
A
400 RCF for 5 mins
10
Q
Decant urine ([?] remains)
A
0.5-1 mL
11
Q
Transfer [?] to glass slide with [?] coverslip
A
20 uL
22 x 22 mm
12
Q
Examine (?)
A
10 LPF and 10 HPF
13
Q
Quantitative measure of formed elements using a hemocytometer
A
14
Q
Addis Count Specimen
A
12- hr urine
15
Q
Addis Count Preservative
A
NaF
16
Q
Used for routine urinalysis
A
Bright-Field Microscopy
17
Q
Visualization of elements with low refractive indices (hyaline, mixed cellular cast, MT, Trichomonas)
A
Phase-Contrast Microscopy
18
Q
Identification of cholesterol molecules in OFB, fatty casts and crystals
A
Polarizing Microscopy
19
Q
Identification of Treponema spp
A
Dark-Field Microscopy
20
Q
3-D microscopy image and layer-by-layer imaging of a specimen
A
Interference-Contrast Microscopy
21
Q
Interference-Contrast Microscopy Types
A
A. Nomarski (Differential)
B. Hoffmann (Modulation)
22
Q
Bright-Field microscopes can be adapted
A
Interference-Contrast Microscopy
23
Q
For fluorescent microorganisms or those stained with a fluorescent dye
A
Fluorescence Microscopy
24
Q
Delineates structure and contrasting colors of the nucleus and cytoplasm
A
SternheimerMalbin (CV + Safranin O)
25
WBCs, ECs, and casts
SternheimerMalbin (CV + Safranin O)
26
Enhances nuclear detail
0.5% Toluidine Blue
27
Differentiates WBCs and RTE cells
0.5% Toluidine Blue
28
Lyses RBCs and enhances nucleus of WBCs
2% Acetic acid
29
Distinguishes RBCs from WBCs, yeasts, oil droplets and crystals
2% Acetic acid
30
Stains TAG and neutral fats (orangered)
Lipid stains (ORO and Sudan III)
31
Identifies free fat droplets and lipidcontaining cells & casts
Lipid stains (ORO and Sudan III)
32
Differentiates Gram (-) to Gram (+) bacteria
GS
33
Bacterial casts
GS
34
Stains eosinophilic granules
Hansel Stain (Eosin Y + Methylene blue)
35
Urinary eosinophils
Hansel Stain (Eosin Y + Methylene blue)
36
A. CELLS
1. Red blood cells
2. White blood cells
3. Epithelial Cells
37
3. Epithelial Cells
A. Squamous epithelial cell
B. Transitional epithelial cell
C. Renal tubular epithelial (RTE) cell
38
C. Renal tubular epithelial (RTE) cell Variations
Oval Fat Bodies
Bubble cells
39
Lipid-containing RTE cell
Oval Fat Bodies
40
Seen in lipiduria (i.e. nephrotic syndrome)
Oval Fat Bodies
41
Identification of Oval Fat Bodies
Lipid Stains
Polarizing Microscope
42
Lipid Stains for OFB
TAG and Neutral Fats
43
Polarizing Microscope for OFB
Maltese-cross appearance
44
RTE cell with nonlipid-filled vacuoles
Bubble Cells
45
Seen in acute tubular necrosis
Bubble Cells
46
Glitter cells in Sternheimer-Malbin Stain
(Pale blue)
47
Leukocytes in Sternheimer-Malbin Stain
(Pale pink)
48
The nucleus of the [?] is about the same size of an RBC
squamous epithelial cell
49
An increase in [?] exhibiting an abnormal morphology may be indicative of malignancy or viral infection
TEC
50
[?] from the distal convoluted tubules may be mistaken for WBCs
RTEs
51
Reporting of Epithelial Cells
RFMoMa
o Squamous [?]
o Transitional [?]
Reporting of Epithelial Cells
RFMoMa
o Squamous [?]
o Transitional [?]
o RTE Cell [?]
o Oval Fat Bodies [?]
(LPF)
(HPF)
Ave. number per HPF
Ave. number per HPF
52
most frequently associated with UTI
gram negative bacteria
53
Most common cause of UTI:
Enterobacteriaceae
54
Parasites
o Trichomonas vaginalis
o Schistosoma haematobium ova
o Enterobius vermicularis
55
Most frequent parasite encountered in urine
o Trichomonas vaginalis
56
o Trichomonas vaginalis
Pear-shaped flagellate (_________ motility)
Rapid-Darting Motility
57
o Trichomonas vaginalis
Method of reporting: ___________
Rare, Few, Moderate, Many
58
Blood fluke with terminal spine
Schistosoma haematobium ova
59
Causes hematuria;
Schistosoma haematobium ova
60
associated with bladder cancer
Schistosoma haematobium ova
61
Schistosoma haematobium ova
Specimen:
24hr unpreserved urine
62
Most common fecal contaminant
Enterobius vermicularis
63
o True yeast infection: ____________________
With WBC
64
o Small, refractile oval structures that may or may not bud
Yeast
65
= seen in DM patients and IMMUNOCOMPROMISSED
o Candida albicans
66
Mucus thread
o Major constituent:
Tamm-Horsefall Protein (Uromodulin)
67
Hematuria
67
Hematuria
Red blood cells
68
Pyuria
White blood cells
69
Red blood cells Normal value range:
0 to 4 PER HPF
70
White blood cells Normal value range:
0 to 5 PER HPF
71
Normal Red blood cells
Smooth, non-nucleated, biconcave disks-shaped sediment
72
Red blood cells Size
(7um in diameter)
73
Hypertonic urine = __________________________
Crenated
74
Hypotonic urine = __________________________
Ghost Cell/Large Empty Cell
75
Glomerular bleeding/damage= __________________________
RBC Casts
76
RBC Sources of error:
Yeast, oil droplets, air bubbles, CaOx monohydrate
77
Remedy to lyse RBCs
Addition of 2% HAc
78
Glomerular membrane damage
Red blood cells
79
vascular injury within GUT
Red blood cells
80
glomerular bleeding
Red blood cells
81
glomerulonephritis
Red blood cells
82
renal calculi
Red blood cells
83
malignancies
Red blood cells
84
Schistosomiasis
Red blood cells
85
strenuous exercise
Red blood cells
86
White blood cell Normal value range:
0 to 5 per HPF
87
predominant WBC
Neutrophils
88
Granulated and multilobed
Neutrophils
89
Swells in
hypotonic (dilute and alkaline) urine
90
Neutrophils
91
granules undergo Brownian Movement
Neutrophils
92
*clinically insignificant
Glitter Cells
93
o Shrinks in
hypertonic (acidic) urine
94
Eosinophils Normal value range: __________
<1%
95
Eosinophils Clinically significant - associated with drug-induced interstitial nephritis
Urinary Eosinophils
96
Mononuclear cells
Lymphocytes, Monocytes, Macrophages, Histiocytes
97
Present in small amount
Mononuclear cells
98
An increase indicates an inflammatory response or renal transplant rejection
Mononuclear cells
99
Mononuclear cells
Clinical Significance:
infection or inflammation in the GUT
100
Mononuclear cells
Bacterial infection:
cystitis, pyelonephritis, prostatitis, urethritis
101
Mononuclear cells
Non-bacterial infection:
glomerulonephritis, SLE, tumors
102
o Largest cell (30-40 um) with abundant, irregular cytoplasm and prominent nucleus
Squamous epithelial cell
103
o Folded cell may resemble casts.
Squamous epithelial cell
104
Found in the linings of vagina, female urethra and lower portion of male urethra
Squamous epithelial cell
105
SEC studded with Gardnerella vaginalis; associated with bacterial vaginosis
Clue Cells
106
Squamous epithelial cell Size
(30-40 um
107
Transitional epithelial cell (____________)
Urothelial
108
o Spherical, polyhedral or caudate with centrally located nucleus
Transitional epithelial cell
109
o From linings of renal pelvis, calyces, ureter, urinary bladder and upper portion of male urethra.
Transitional epithelial cell
110
o Significant numbers can be seen after catheterization (single, pairs, or in clumps {syncytia})
Transitional epithelial cell
111
in clumps {?)
syncytia}
112
o Most clinically significant epithelial cell
Renal tubular epithelial (RTE) cell
113
o Oblong or round to oval or rectangular and contain an eccentric nucleus and coarsely granulated cytoplasm
Renal tubular epithelial (RTE) cell
114
o >2 RTE/HPF indicates ___________________
Tubular Damage
