MICROSCOPIC EXAM OF URINE Flashcards
spx for addis count
12 hour urine
preservative used for addis count
formalin
used to clean the optical surfaces of the microscope
lens paper
performs initial focusing (used for LPO and SO)
coarse adjustment knob
secondary magnification
oculars or eyepiece
lenses which form primary/initial image of specimen
objectives
order from light source to oculars
light source > condenser > stage > objectives > oculars
microscope used for routine urinalysis
bright field microscope
microscope used that enhances visualization of translucent elements (low refractive indices like casts)
phase contrast microscope
microscope that detects the presence or absence of birefringence
polarizing microscope
microscopy used for identification of cholesterol in oval fat bodies, fatty casts, and crystals
polarizing microscopy
to convert bright field into polarizing, add _____ filters
2 filters
microscopy used for the identification of Treponema pallidum
dark field microscopy
to convert bright field to dark field, __________ with a darkfield condenser that contains an opaque disk
replace the condenser
3D microscopy image and layer by layer imaging of a specimen
interference contrast microscopy
________ can be adapted for interference contrast microscopy
bright field microscopes
two types interference contrast micrscope
Nomarski (differential interference contrast)
Hoffman ( Modulation contrast)
delineates structure and constructing colors of the nucleus and cytoplasm
sternheimer-malbin
components of sternheimer malbin stain
crystal violet and safranin O
differentiates wbcs and rte cells
toluidine blue
most commonly used supravital stain
sternheimer malbin stain
distinguishes rbcs from wbcs, yeast, oil droplets and crystals
2% acetic acid
stains triglycerides and neutral fats orange red
lipid stains (oil red o and sudan III)
identifies hemosiderin granules
prussian blue (rous test)
stains DNA
phenathridine (orange)
stains nuclear membranes, mitochondrial, and cell membrane
carbocyanine (green)
stains used by sysmex UF-100 urine cell analyzer
phenathridine
carbocyanine
rbcs normal value per HPF
0-2 or 0-3
appearance of rbc in hypotonic urine
swell/lyse (ghost cells) / shadow cells
rbcs appearance in glomerular membrane damage
dysmorphic with projections fragmented (acanthocytes)
sources of error in rbc sediment
yeast, oil droplets, air bubbles, monohydrate calcium oxalate crystals
remedy for rbc error
add 2% acetic acid
most predominant wbc seen in pyuria
neutrophils
in _____ urine, neutrophils swell, and granules undergo ________ ________ producing sparkling appearance (______ ______)
hypotonic urine ; brownian movement ; glitter cells
normal value of eosinophil in pyuria
1%
significant value of eosinophil seen in pyuria
> 1%
> 1% eosinophil is seen in what condition
acute interstitial nephritis
sternheimer malbin cells that appear pale blue
glitter cells
sternheimer malbin cells that appear pale pink
leukocytes
largest cell
squamous epithelial cell
squamous epithelial cell covered with Gardnerella vaginalis
clue cells
associated with bacterial vaginosis
clue cells
spherical, polyhedral or caudate with CENTRALLY LOCATED NUCLEUS
transitional epithelial (urothelial) cell
epithelial cell derived from renal pelvis, calyces, ureter
transitional epithelial cells
most clinically significant epithelial cell
renal tubular epithelial cell
epithelial cell with eccentric nucleus
renal tubular epithelial cell
shape of rte cell if found in collecting duct
cuboidal with flat edge, polygonal, columnar
> 2 RTE / hpf indicates
tubular injury
renal tubular fat bodies
oval fat bodies
highly refractile RTE cell
oval fat bodies
seen in lipiduria (nephrotic syndrome)
oval fat bodies
sediment that forms MALTESE CROSS FORMATION as seen in polarizing microscope
cholesterol
- rte cell with non lipid vacuoles
- injured cells in which the endoplasmic reticulum has dilated prior to cell death
- seen in acute tubular necrosis
bubble cells
most frequent parasite encountered in urine
Trichomonas vaginalis
agent of ping pong disease
t. vaginalis
parasite associated with bladder cancer
schistosoma hematobium
urinary bladder cancer markers
NMP - nuclear matrix protein
BTA - bladder tumor antigen
urinary sediment with low refractive index
mucus threads
major constituents of mucus threads
tamm-horsefall protein (uromodulin)
BACTERIA: rare
0-10
BACTERIA: few
10-50
NORMAL CRYSTALS: moderate
5-20
NORMAL CRYSTALS: moderate
5-20
squamous epithelial cells reporting
rare, few, moderate, or many per LPF
transitional epithelial cells, yeast reporting
rare, few, moderate, or many per HPF
renal tubular epithelial cells reporting
average number per 10 HPFs
oval fat bodies reporting
average number per HPF
abnormal crystals, cast reporting
average number per LPF
casts primarily formed in the
DCT, CD
major constituent of cast
uromodulin / tamm horsefall protein
cylindroids have the same significance as cast ( true or false)
trueeee
examination of cast is performed in what region of slide
along coverslip edges with subdued light
prototype cast
most frequently encountered and most difficult to discover
hyaline cast
type of cast that is colorless and translucent ; subdued light is required when using bright field microscope
hyaline cast
_______ light used to for hyaline cast when using bright field microscope
subdued light
hyaline cast normal value
0-2 per lpf
physiologic cause of hyaline cast
strenuous exercise, stress
cast that indicates bleeding
rbc cast
easily identified by its orange red color
rbc cast
rbc cast clinical significance
strenuous exercise
indicates inflammation or infection within the nephron
wbc cast
cast seen in tubular damage
epithelial (rte) cast
casts seen in strenuous exercise
hyaline cast
rbc cast
bacterial cast
final degenerative form of all type of cast
waxy cast
cast seen in chronic renal failure
waxy cast
often referred to as the renal failure cast
broad cast
this cast indicates destruction or widening of the tubular walls
broad cast
most common type of broad cast
waxy and granular
factors that contribute to crystal formation
pH
SOLUTE CONCENTRATION
TEMPERATURE
normal crystals are reported as
rare, few, moderate, many per HPF
abnormal crystals are reported as
average number per LPF
normal acid crystals
amorphous urates
uric acid
calcium oxalate (dihydrate and monohydrate)
fluffy orange or pink sediment (BRICK DUST) due to erythryin
amorphous urates
a normal acid crystal with yellow brown granules
amorphous urates
a normal acid crystal that is soluble in heat (60 deg c) and alkali
amorphous urates
rhombic (diamond) 4-sided flat plate (whetstone), LEMON SHAPED
URIC ACID CRYSTAL
hexagonal forms may be mistaken as cystine crystals
uric acid crystal
envelope/pyramidal/octahedron crystal
caox dihydrate
oval/dumbbell shaped crystal
caox monohydrate
cigarette butt appearance
calcium sulfate
yellow brown or colorless elongated prism
hippuric acid
“pickup sticks” when in clusters
sodium urates
yellow brown “thorny apples”
ammonium biurate
prism shaped or coffin lid ; fern lid
triple phosphate (magnesium ammonium phosphate, struvite)
feathery appearance when they disentegrate
triple phosphate (magnesium ammonium phosphate, struvite)
rhomboid plates, end or corner may be notched
magnesium phosphate
flat plate, thin prisms in ROSETTE FORM that may resemble sulfonamide crystals
calcium phosphate
solubility of uric acid in dilute HCl
insoluble
solubility of cystine in dilute HCl
soluble
birefringence is present
uric acid
absence or weak (thick) of birefringence
cystine
cyanide nitroprusside reaction in uric acid
negative
cyanide nitroprusside reaction in cystine
positive
rectangular plate with notch in one or more corners (staircase pattern)
cholesterol
it resembles cholesterol crystal
radiographic dye
fine colorless to yellow needles
tyrosine
spheres with concentric circles and radial striations
leucine
precipitated with tyrosine after adding alcohol
leucine
fan shaped needles, SHEAVES OF WHEAT, rosettes, arrowheads, PETALS, round shaped. whetstones
sulfonamide
colorless needles that tend to form bundles following refrigeration
ampicillin
stain for hemosiderin in ROUS TEST
prussian blue stain
capable of maltese cross formation
oval fat bodies
fatty casts
fat droplets
starch granules
spheres with dimpled center ( y indentation)
starch granules
mistaken for parasite ova
pollen grains