Microscopic Examination Flashcards
1
Q
Spx volume
A
10-15 mL
Ave: 12 mL
2
Q
Centrifugation of spx
A
400 RCF for 5 mins
3
Q
Centrifuge calibration
A
Every 3 months
4
Q
Centrifuge disinfection
A
Weekly basis
5
Q
Volume after decantation
A
0.5-1 mL
6
Q
Volume of sediment examined
A
20 uL
7
Q
Ave# / 10 HPF
A
Rbc
Oval fat bodies
Wbc
RTE cells
[ROWR]
8
Q
Ave # / 10 LPF
A
Cast
Abnormal crystals
[Cast Crab]
9
Q
RFMoMa/ 10 HPF
A
Transitional
Trichomonas
Bacteria
Yeast
Normal crystals
[TT- BaYN]
10
Q
RFMoMa/ 10 LPF
A
Mucus threads
Squamous epithelial cells
[ Mucus Secs]
11
Q
Used in routine urinalysis that appears dark against light bg
A
Bright- field
12
Q
Enhance visualization of elements with LOW REFRACTIVE INDICES
A
phase contrast
13
Q
Aids in identification of cholesterol in oval fat bodies, crystals, and fatty acids
A
Polarizing
14
Q
Identification of T. palidum
A
Dark-field
15
Q
3D image and layer-by-layer imahingtof spx
A
Interference contrast
16
Q
Types of interference contrast
A
Nomarski and Hoffman
17
Q
Identifies WBC, epithelial cell, and cast
A
Sternheimer-malbin
18
Q
Example of Sternheimer-malbin
A
Crystal violet and safranin
19
Q
It enhances nuclear details and differentiate WBC AND RTE cells
A
Toluidine blue
20
Q
It stains TAG and neutral fats and identifies free fat droplets and lipid containing cell and cast
A
Oil Red O and Sudan 3
21
Q
Use for gram pos and neg bacteria
A
Gram stain
22
Q
Stains eosinophil granules
A
Hansel stain
23
Q
Example of hansel stain
A
Methylene blue and Eosin Y
24
Q
Stains structures containing iron and identifies yello-brown granules of hemosiderin
A
Prussian blue
25
RBC in HYPOTONIC urine appears
Swollen/ ghost cell/ shadow cells
26
RBC in HYPERTONIC urine appears
Crenated or shrink
27
Hypotonic means
Dilute urine
28
Hypertonic means
Concentrated urine
29
Norml value of RBC
0-2/3 per HPF
30
RBC are frequently confused with
Air bubbles
Yeast cell
Oil droplets
Calcium oxalate
[AYOC]
31
WBCs are usually distinguished from RBC by the addition of
2% HAc (acetic acid)
32
Increased WBC in urine
Pyuria
33
Normal value of WBC
0-5/8 per HPF
34
WBC in dilute hypotonic urine is called
Glitter cells
35
Why they are called glitter cells
Because of the Brownian movement it produces sparkling appearance
36
What stain is used for glitter cells
Sternheimer-malbin
37
Most predominant WBC in urine that has a characteristic if cytoplasmic ganules and multi-lobed nuclei
Neutrophils
38
T or F:
In hypertonic urine, thr WBC becomes smaller as water lost osmotically from the cell, but NOT crenated
True
39
Eosinophil is considered significant if
> 1%
40
Eosinophil is associated with
Drug induced interstitial nephritis
41
Stain used for eosinophils
Hansel stain
42
Renal transplant rejection in lymphocytes can readily identify using
Supravital stain or cytodiagnosis
43
WBC Look alikes
RTE cells
Dead trichomonas
Crenated RBC
44
It is the largest epithelials cells that has abundcant irregular cytoplasm with central nucleus
SECs
45
How to examined SECs
LPO
46
T or F:
SECs are considered most frequently seen and least significant
True
47
What do u call the SECs covered with Gardnerella vaginalis/ Mobiluncus
Clue cells
48
Epithelial cells that appears spherical, caudate, or polyhedral with central nucleus
TECs
49
T or F:
TECs has the ability to reabsorb large quantity of water
True
50
Epithelial cells that are round and slightly large with single eccentrically nucleus
RTE cell
51
Presence of > 2/HPF indicates
Tubular injury
52
T or F:
RTE cells are the most clinically significant epithelial cell
True
53
Precursor of oval fat bodies
RTE cells
54
Lipid containing RTE cells found in lipiduria
Oval fat bodies
55
Oval fat bodies exhibit ________ under polarized light
Maltese cross appearance
56
Identification of oval fat bodies is confirmed by
Sudan 3 or Oil Red O
57
RTE cellz containing large, non lipid filled vacuoles
Bubbles cell
58
It is a RTE/ TEC that are infected with BK strains
Decoy cells
59
What cells produces uromodulin
RTE cells
60
Major constituent of cast
Uromodulin
61
Where does cast primarily formed
DCT and collecting ducts
62
It is the ONLY urine sediments that are UNIQUE TO THE KIDNEY
Cast
63
Presence of urinary cast is called
Cylinduria
64
It resembles cast but with TAPRED END that is a product of incomplete cast formation
Cylindroids
65
What produces cylindroids
ALH and Collecting duct
66
Degeneration of cast
Hyaline cast -->
Cellular cast -->
Coarsely granular -->
Finely granular -->
Waxy cast
67
It is the MOST FREQUENTLY seen cast in urine
Hyaline cast
68
Normal value of hyaline cast in urine
0-2/ lpf
69
Hyaline cast consist almost entirely ______
Uromodulin
70
T or F:
Hyaline cast is considered a prototype cast
True
71
Using sternheimer-malbin and KOVA stain, hyaline cast produces what color?
Pink
72
Cast matrix that contains RBC and appears orange-red color
RBC cast
73
RBC cast is associated in the
Bleeding within the nephron
74
Cast matrix containing WBC
WBC cast
75
T or F:
WBC cast signifies infection or inflammation within the nephron
True
76
WBC cast are associated with
Pyelonephritis and Acute Interstitial Nephritis
77
Predominant WBC seen in acute pyelonephritis Nephritis
Eosinophils
78
It helps differentiate WBC cast from RTE cells
Supravital stain and Phase contrast
79
RTE cellz attached to protiein matrix
Epithelial cell cast
80
Non specific marker of tubular injury
Epithelial cell cast
81
Considered renal failure cast according to brunzel
Waxy cast
82
Appearance of waxy cast
Fragmented with jagged ends and have notches in their sides
83
It is the FINAL degeneration form of all thpe of cast
Waxy cast
84
Using supravital stain, eaxy cast appears what color
Homogeneous dark pink
85
Seen in conjunction with oval fat bodies and free fat droplets causing lipiduria
Fatty cast
86
T or F:
Fatty cast can be stained using sternheimer-malbin
False
87
Polarize microscopy can identify ......
cholesterol on fatty cast ( shows Maltese cross formation)
88
Sudan 3 and Oil Red O can identify .....
TAG and neutral fats on fatty cast
89
It appears maltese cross formation
Fatty cast and Oval fat bodies
90
Types of Granular cast
Coarsely and Finely
91
Two most commonly seen broad cast in urine
Granular and waxy
92
Considered as renal failure cast according to strasinger
Broad cast
93
Broad cast indicates....
Destruction (widening) of the tubular walls
94
Where does broad cast produce
DCT and collecting duct due to anuria
95
Bile stained broad and waxy cast are seen as the result of
Tubular necrosis in viral hepatitis
96
Urine sediments that have uromodulin as the major constituent
Mucus and Cast
97
Ribnonlike structure produced by glands and epithelial cells in genitourinary tract and RTE cell
Mucus
98
Mucus threads can be confused with
Hyaline cast
99
In order to be considered significant in UTI, bacteria should be accompanied by
WBC
100
Bacteria is confirmed with
Positive urine culture
101
T or F:
Presence of bacteria may indicate lower and upper UTI
True
102
It is a smooth, colorless with DOUBLY REFRACTILE WALLS
Yeast cell
103
Yeast cell often shows
Budding
104
Yeast can be condused with
RBC
105
How to differentiate yeast cell and RBCA
Add 2% acetic acid which can lyse
106
Most common yeast cell
Candida albicans
107
True yeast infxn should be accompanied with
WBC
108
________ is used to identify T. vaginalis when no moving
Phase microscopy ( to enhance visualization of the flagella or undulating membrane)
109
Formed by precipitation of urine solutes
Crystals
110
Most valuable in the identification of crystals
pH
111
Brick dust or yellow brown crystals that produces pink sediment
Amorphous urates
112
Yellow- brown color that has a rhombic or whetstone or diamond-shaped crystals
Uric Acid
113
Most pleomorphic of all crystals
Uric acid
114
Uric acid can be seen in px with
Gout
Lesch Nyhan Syndrome
Chemotherapy
[GLC]
115
Most frequently observed crystals
Calcium oxalate
116
2 forms of CaOx
Dihydrate/ Wheddelite
Monohydrate/ Whewellite
117
What is the shaped of Wheddelite CaOx
Octahedral or enveloped shaped
118
What is the shape of Whewellite CaOx
Dumbbell or ovoid shaped
119
Whewellite may resemble as
RBC
120
CaOx is associated with
Renal calculi
Ethylene glycol poisoning
Food high in oxalic acid
121
Pencil-like prism with blunt end crystals
Monosodium urates
122
Ball or sphere shaped that resembles biurates and leucine
Acid urates
123
Cigarette -butt apperance that almost identical to CaOx
Calcium sulfate
124
Colorless or yellowish needle or slender prism occuring in sheaves
Sodium urates
125
Colorless ELONGATED prism
Hipouric acid
126
Mnemonics for NORMAL ACIDIC URINE
SHeesh--- MACCAU
127
Microscopically indistinguishable from amorphous urates
Amorphous phosphate
128
Amorphous phosphate produces
White precipitates
129
Only urate found in alkaline urine that has a sphere with striations ( THORNY APPLES)
Ammonium biurates
130
Crystal commonly seen in OLD URINE SAMPLES
Ammonium biurates
131
Ammonium biurates resembles
Sulfonamide crystals
132
Formation of gas (effervescence) after adding acetic acid
Calcium carbonate
133
Common constituent of renal calculi
Calcium phosphate
134
Calcium phosphate is also known as
Apatite
135
Alkaline urine that has the presence of urea- splitting bacteria
Ammonium biurates and
Triple phosphate
136
Coffin lid or fern-like crystals
Triple phosphate
137
Triple phosphate is also known as
Struvite
138
Triple phosphate is associated with
Staghorn calculi
139
Mnemonics for Normal Alkaline Urine
CACAT
140
Colorless, hexagonal plates of crab
Cysteine
141
Cysteine is associated with
Sulfur odor
142
Crab that is Flat rectangular plates with notched corners ( staircase patter or broken window panes)
Cholesterol
143
Cholesterol resembles as
Radiographic contrast media
144
Cholesterol is associated with
Nephrotic syndrome
145
Crab that appears fine delicate needles or sheaves
Tyrosine
146
Tyrosine is associated with
liver disease
147
Crab that appears oily looking spheres with a delicate radiating and concentric striation
Leucine
148
T or F:
Leucine is precipitated with cholesterol after adding alcohol
False ( with tyrosine)
149
Leucine is associated with
Liver disease
Oasthouse urine disease
MSUD
150
Yellow or ruby red clumped needle crab
Bilirubin
151
Positive bilirubin reagent strip
Diazo reaction
152
Test used for sulfonamide
Lignin test
153
Lignin test
Urine + 25% HCl = yellow-orange color
154
Refrigeration forms bundles
Ampicillin
155
Feather like crystals that aggregate into wing like bundles
Indavir sulfate
156
Resembles cholesterol crystals
Radiographic dye
