microscope exam Flashcards
1
Q
ghost cells
A
lysis/swelling of the RBCs
2
Q
glitter cells
A
lysis/swelling of WBCs
3
Q
hematuria
A
increased # of RBCs
4
Q
pyuria
A
increased # of WBCs
5
Q
pyuria is associated with…
A
an inflammatory process in or adjacent to the urinary tract
6
Q
urine should not be left in refrigerated for more than ** hours
A
2 hours
7
Q
yeast cells are smaller than?
A
RBCs and clump together
8
Q
WBCs usually bigger than?
A
RBCs
9
Q
where are RTEs found
A
from the tubules of the nephrons in the kidney
10
Q
where are transitional cells found
A
from the renal pelvis, ureters, urinary bladder and proximal 2/3 of the urethra
11
Q
where are squamous cells found
A
the terminal end of the urethra and from the vagina
12
Q
increased # of RTEs in the sediment indicate?
A
inflammation within the kidney or lower urinary tract
due to:
- agents like heavy metals
- renal infections such as pyelonephritis (damage to kidney)
- blood is not reaching the kidney (necrosis)
13
Q
RBCs companied with casts is an indication of?
A
bleeding from kidney
14
Q
affect on urine sample sitting for over 2 hours
A
start to get bacterial growth
15
Q
progressive loss of functioning nephrons that occurs over time?
A
chronic renal failure
16
Q
WBC 30/HPF + RBC 10 - 15/HPF + bacteria?
A
urinary tract infection (notice no casts)
17
Q
glucose interferences
A
false negative: high levels of ascorbic acid, improperly stored specimens
false positive: oxidizing agents like hydrogen peroxide or bleach contamination
18
Q
bilirubin interferences
A
false negative: (same as glucose + nitrites) ascorbic acid, nitrites, improper storage
false positive: medications that induce colour in urine (phenazopyridine, indican, lodine)
19
Q
false positive medication in bilirubin
A
phenazopyridine (UTI)
indican (over growth of anaerobic bacteria)
lodine (arthritis)
20
Q
interferences of urobilinogen
A
false negative: nitrites, formalin, urine not at room temp or fresh
false positive: some drugs, atypical urines
21
Q
what analytes does not react to tests?
A
urobilinogen and conjugated bilirubin
22
Q
what analyte is insoluble and less reactive
A
conjugated bilirubin
23
Q
what are the 3 ketone bodies & their percent
A
acetone 2%
acetoacetic acid 20%
B-hydroxybutyric acid 78%
24
Q
ketonuria
A
elevated levels of ketone bodies in blood that results in their excretion into the urine
25
ketosis or ketoacidosis
diabetes mellitus and decreased carbohydrates supply
26
diabetes mellitus
body unable to use carbohydrates as an energy source, uses fat stores instead
27
symptoms of decreased carbohydrates
starvation, fever, prolonged exercise, dietary imbalance
28
interferences of ketones
false negative: improper storage specimens
false positive: highly pigmented urine, compounds containing free sulfhydral groups
29
what are the compounds containing free sulfhydral groups?
phthaleins (in laxatives) and levodopa (used to treat parkinsons)
30
low SG
dilute
- over hydration
- diabetes insipidus
- renal tubular damage
- diuretics
31
high SG
concentrated
- dehydration
- glycosuria
- proteinuria
-xray contrast dye
32
ketone interferences for SG
false low SG: (diluted urine) urines containing large amounts of nonionic solutes (ex glucose)
- these solutes are not readily detected on the dipstick
false high SG: (concentrated urine) patients that have elevated protein levels or patients with ketoacidosis (increased ketones)
33
if the pH of the urine is >6.5 how much do i add to the SG reader?
0.005
34
kohler illumination
provides optimum contrast and resolution by focusing and centring the light path by spreading it evenly over the field of view.
35
eye piece (ocular)
magnifies the image formed by the objective and produces a virtual picture
36
inter-pupillary adjustment
allows for individual adjustment for the distance between my pupils
37
ergonomic head and body tube
holds objectives and oculars in proper alignment
38
light path selector
pull out lever directs the image to a camera
39
revolving nose piece
holds the objectives and allows the changing from one objective to another
40
objective lenses
produces initial, magnified, real image of object
41
stage
platform on which a slide is placed for viewing
42
slider holder
holds a slide securely in position
43
coaxial stage controls
moves stage on horizontal plane; back and forth and side to side
44
condenser assembly
lens system that focuses light onto the specimen (includes aperture diaphragm, centring screws and height adjustment))
45
condenser aperture diaphragm
adjusted in kohler illumination to match the numerical aperture of the objective in use and improve resolution
46
condenser centering screws
adjuster in kohler to ensure light is in the center of the field of view
47
condenser height adjustment
adjusts the condenser position up or down. used in kohler to focus light onto specimen
48
coarse focus
moves the stage up and down for initial focusing. used only with low power objectives (10X)
49
fine focus
final focusing of specimen. may be used with all objective sizes
50
radiant field diaphragm (RFD)
controls the amount of light from the light source to the condenser lens
51
brightness control
adjusts the intensity of light
52
light source
electrical lamp located in the backside of the base
53
base and arm
supports the microscope parts
54
hpf for RBCs
3-5 hpf
55
hpf for WBCs
6-10 hpf
56
example of cellular casts
RTE, RBC, and WBC casts
57
example of non cellular casts
hyaline, granular, fatty, waxy casts
58
lipids/fats + massive proteinuria is what condition?
nephrotic syndrome
59
casts with long renal transit time is what condition?
waxy casts
60
increased WBCs + WBC casts + minimal proteinuria is what condition
pyelonephritis
61
epithelial casts are an indication of what condition?
tubular necrosis
62
miscellaneous elements are
yeast, bacteria, spermatozoa etc
63
if the SG is high what will happen?
RBCs will appear shrunken or crenated
64
if the SG is low what happens
RBCs will be swollen or will rapidly break apart
65
the matrix of casts are primarily composed of
tamm-horsefall protein & uromodulin
66
the presence of casts in urine is what condition?
cylinduria
67
hyaline casts are
colourless and transparent
68
RBC casts are an indication of what condition?
glomerulonephritis
69
waxy casts typically have
cracked or notched outlines
70
free fat casts are
globular and a yellow brown colour
71
oval fat bodies are
RTEs in which fat has accumulated
72
crystals are found in urine when?
chemicals are present in excess of their solubility and the excess solutes in the urine form a solid
73
most crystals are
diagnostically insignificant
74
budding or branching is what cell?
yeast
75
irregular shapes with dark outlines is what cell?
artifact
76
what cell doesn’t have a nucleus?
RBCs
77
what cell is large, flat, and may be rolled?
squamous
78
what cell is nucleated, round or oval?
WBCs
79
what cell has a round central nucleus?
RTEs
80
what cell has a lumpy nucleus and granular?
transitional cell
81
amorphous phosphates are?
white precipitate and can NOT be dissolved when warmed
82
triple phosphate are?
described as “coffin lids”
83
what crystal is colourless dumbbells, retractile envelopes?
calcium oxalate
84
what crystal comes in a variety of shapes?
amorphous urates
85
what crystal has a pink precipitate and can be dissolved when warmed
uric acid
86
what abnormal crystal is delicate needles, red brown in colour?
bilirubin
87
what abnormal crystal is colourless transparent plates with notched corners?
cholesterol
88
what abnormal crystal is yellow, oily looking spheres with radial striations?
leucine
89
what abnormal crystal is colourless hexagonal plates?
cystine
90
what abnormal crystal is fine needles or sheaves?
tyrosine
91
what miscellaneous element has dark outline and irregular shapes and sizes?
artifacts
92
what miscellaneous element is same size as leukocytes, and motile due to flagella?
trichomonas vaginalis
93
what miscellaneous element is oval in shape, slightly smaller than RBCs, buds?
yeast
94
what miscellaneous element is long, ribbon like strands with tapered ends?
mucus threads
95
what miscellaneous element is not identified by motility, but by morphology?
spermatozoa
96
what are the 5 abnormal crystals?
bilirubin, leucine, tyrosine, cholesterol, cystine
97
what is the most common type of leukocyte seen in urine sediment?
neutrophil
98
what is the most common cast seen in microscopic urine examinations?
hyaline casts
99
is cholesterol found in acidic urine?
yes
100
are cystine crystals found in normal urine?
no
101
do amorphous urates or amorphous phosphates dissolve by warming the outside of the tube?
amorphous urates DO
102
the order of setting kohler
close RFD
open condenser aperture
raising condenser to highest position
103
the renal threshold of glucose is approximately
10mmol/L
104
which gland sits on the top of each kidney?
adrenal
105
dysuria
painful urination
106
daily volume of urine excretion for an average adult is
1000 mL to 2000 mL per day
107
where are urinary cast formed?
DCT and CD
108
which of the following sediment elements has clinical significance in a microscopic examination?
waxy granular cast
109
what is one way to differentiate between RBC and WBC?
check the leukocyte result on the chemical dipstick
110
which crystal appears as granular sediment in an acidic urine?
amorphous urates
111
which crystal is best describes as ‘coffin lid’ and are seen in alkaline urine?
triple phosphate
112
what portion of the spun urine is used for microscopic examination?
bottom 1mL sediment
113
what protein is the commercial reagent dipstick specific for?
albumin
114
which protein do renal tubular epithelial cells exude?
uromodulin
115
which hormone is being tested for using a urine pregnancy test kit
human chorionic gonadotropin
116
which enzyme activity is being measured on the leukocyte test strip on the commercial dipstick?
granulocytic esterase
117
key components involved in the kohler procedure
RFD, height adjustment & centering screws, and condenser aperture diaphragm
118
if cloudy urine what is the microscopic findings
WBC, RBC, bacteria, yeast, crystals, mucous
119
if red colour what is the microscopic findings
RBCs
120
if High SG what is the microscopic findings
crystals and CRENATED RBCs
121
if Low SG what is the microscopic findings
glitter cells
122
if acid pH what is the microscopic findings
crystals
123
if alkaline pH what is the microscopic findings
crystals, WBCs, bacteria
124
if glucose positive what is the microscopic findings
yeast
125
if protein positive what is the microscopic findings
casts, WBC, RBC, and bacteria
126
if nitrite positive and or leukocyte positive what is the microscopic findings
bacteria and WBCs
