May 6, 2016 - Urine Microscopy Flashcards
Urine Dip - Blood
Measures blood, protein, and WBCs in the urine.
On the blood side of things that will dip positive for blood are RBCs, free hemoglobin, and myoglobin.
Urine Dip - Protein
Used to detect blood, protein, and WBSs in the urine.
On the protein side, generally only detects albumin and will turn positive at 300mg/day of albumin. Normal is
Albumin to creatinine ratios are more accurate.
Urine Dip - WBCs
On the WBC side, if it comes back positive for WBCs this is suggestive of an infection whether it be acute or chronic.
Nitrates further support the diagnosis of an infection.
Urine Microscopy
Can be used to determine many pathologic processes and can be exceedingly helpful at directing further investigation or indicating a diagnosis.
Hyaline Casts
Outline of the tubule.
Normal finding in everyone, more commonly seen after periods of dehydration.
Isomorphic Blood
Strongly suggestive of a lower urinary tract or post-glomerular blood.
Dysmorphic RBCs
AKA “acanthocytes”
Look like little mickey mouses.
This is called active urine and is indicitive of glomerular blood.
Yeast
May be an active urine (dysmorphic RBC) mimic.
Granular Casts
Indicitive of ATN.
WBC Casts
Indicitive of AIN.
Note the nucleus in the cells.
Urine Eosinophils
Don’t always get them, but it is a slam dunk for a drug-induced allergic reaction affecting the kidneys.
Calcium Oxalate Stones
Look like evenlopes, dumbbells, or needles (ethylene glycol).
The most common kidney stone.
Treatment is water, sodium restriction, liberal calcium (calcium binds oxylate), and restricted oxylate.
Uric Acid Stones
Less common cause of kidney stones.
Look like rhomboids.
Patients also frequently have gout.
Struvite Stones
Struvite is magnesium ammonium phosphate.
Coffin-shaped.
Staghorn calculi associated with chronic urinary tract infections and is extremely difficult to treat, generally requiring surgery.
