Microscopic Flashcards
specific gravity of urine for microscopic exam
less than 1.010
when abnormal macro and chemical results obtained —>
request microscopic exam
what kind of complexity is CLIA’88
moderate
what is the specimen of choice for microscopic exam
fresh first morning, midstream clean catch
how long should you centrifugal urine
5 min
conc of urine volume to sediment
12 to 1
how much sediment is used for a slide
0.02
what are hematopoietic cells
RBC
WBC
what kind of epithelial cells are in urine sediment
transitional
squamous
renal tubular
what stains cytodiagnostic UA sediment
papanicolaou stain
def? fragmented red cells accompanied with protein
dysmorphic red cells
what causes dysmorphic red cells
glomerular bleeding
what other cells are confused with RBC
yeast
how can you tell if it’s a RBC or yeast
add acid–> if RBC they lyse
yeast have buds
what shape are neutrophils
granular spheres
nucleus? neutrophil
multilobed
if a pt has pyuria, pyelonephritis, cystitis, prostatitis, or urethritis what will show in the micro exam
neutrophils
if a pt has drug induced interstitial nephritis or renal transplant rejection what will show in the micro exam
eosinophils
if a pt has drug induced interstitial nephritis or renal transplant rejection what will show in the micro exam
eosinophils
what stain is used on eosinophils
Hansel stain
who has more squamous cells in sediment males or females
females
what kind of epithelial cells are large irregular, abundant cytoplasm, and has a small prominent nucleus
squamous epithelial cells
what kind of epithelial cells are pear, spheric, or caudate (tails) with a round central nucleus
transitional epithelial cells
what would you see in the sediment of a pt with bladder cancer
transitional epithelial cells
what kind of epithelial cells are round or oval, large prominent eccentric nucleus
renal tubular epithelial cells
if a pt has acute tubular necrosis, acute viral or bacterial infection, renal toxicity, glomerulonephritis what will show in the micro exam
renal tubular epithelial cells
what do renal tubular epithelial cell have with them
oval fat body
what stains oval fat body
sudan III
if a pt has lipiduria or nephrotic syndrome what will show in the micro exam
oval fat body
if urine acidity increase, proteinuria, stasis, or conc increases what will form
cast
what protein are hyaline cast made up of
Tamm-horsfall
what cast is homogeneous, transparent, colorless, cylinder with parallel sides, and rounded ends
hyaline cast
what causes hyaline cast
strenuous exersice
what casts is transparent cylindrical matrix with embedded WBCs
WBC cast
what cast would you see in a pt with pyelonephritis or inflammatory renal disease
WBC cast
what is the most common WBC in a WBC cast
neutrophils
what cast is transparent reddish-orange brown, cylindrical matrix with embedded RBCs
Red cell cast
what cast would you see in a pt with glomerulonephritis, glomerular bleeding, or strenuous exercise
red cell cast
what cast is transparent clinical protein matrix with embedded RTE cells
renal tubular cell cast
what cast would you see in a pt with renal tubular damage, acute nephrictis, and tubular necrosis
renal tubular cell cast
what cast is Transparent cylindrical matrix with course or fine embedded granules
granular cast
what cast is Homogeneous, smooth, glassy opaque cylinder with cracked margins and broken off edges
waxy cast
what do waxy indicate
renal failure
what cast is Transparent cylinder filled with refractile fat droplets.
fatty cast
what cast would you see in a pt with Nephrotic syndrome, Crush injuries, Toxic tubular necrosis, Diabetes mellitus
fatty cast
how are crystals formed
increase solute formation
decreased urine flow
most common crystals
uric acid crystals
what crystals would you see in a pt with leukemia, gout ,Lesch-Nhyan
uric acid crystals
crystal? colorless envelop shape. Associated with foods high in oxalic acid
dehydrate calcium oxalate
crystal? oval dumbbell shape. Can be seen in ethylene glycol poisoning
monohydrate calcium oxalate
crystal? granular, white sediment
amorphous phosphates
crystal? coffin lids
triple phosphate
crystal? Yellow-brown “thorny apples” seen in old urine
ammonium biurate
crystal? bow ties and
dumbbell forms gas from acetic acid
calcium carbonate
crystal? colorless hexagonal plates seen in cystinuria, a metabolic disorder resulting in renal stones
cystine
crystal? notched plates seen in lipiduria produced in nephrotic syndrome
chlesterol
crystal? spheres with concentric striations
leucine
crystal? needles forming clumps
tyrosine
crystal? reddish brown clumped needles
bilirubin
