Microscopic Examination Flashcards
Polarized Light
2 things
Maltese cross pattern: cholesterol, starch, 4 glowing orbs in a clover pattern
Birefringent: glowing, most crystals, fibers, radiographic dye
Cells: Red Cells
causes, where, test result
Damage to vascular system, renal disease
RBC cast and proteinuria: kidney/upper UT
No RBC cast or proteinuria: lower UT
Test: positive blood pad
Cells: White Blood Cells
3 types, appearance and test result
Leukocyturia: inflammation, disease, infection
Casts and proteins: upper/kidney
Trace protein, no casts: lower/bladder
Appearance and test result: cloudy, smelly, positive leukocyte esterase
Cells: SEC
Poor collection, normal
Cells: TEC
Increased in what
Normal: 0-2
Increased: UTI, urinary inflammation
Cells: RTE
significance
Tubular cells, collecting duct cells
Always significant: upper kidney infection, renal disease, sheets = tubular injury/death
Cells: Oval Fat Bodies
RTE with absorbed fats, glomerular dysfunction with renal cell death
- Refractive
- Polarized microscope
- Fat stain
Casts: Basics and Formation
increased in what, disintegration?, significance
Formed in tubules, formation of Tamm-Horsfall protein
Increased: acidic, more solutes, stasis, more proteins
Disintegration: alkaline, dilute
Significance: more in number type and size
Casts: Homogenous - Hyaline
increased
Low refractile
Pretty normal
Increased: dehydration, exercise
Casts: Homogenous - Waxy
significance
NOT NORMAL
Highly refractile
Significance: chronic renal disease, renail failure, advanced stage cast
Casts: Inclusion - Granular
significance
Protein/cell degradation products, very refractile
NOT NORMAL (or heavy exercise)
Significance: renal disease
Casts: Inclusion - Fatty
signif.
Free fat or OFB, maltese cross pattern
NOT NORMAL
Significance: some renal diseases
Casts: Inclusion - Other
Elements: hemosiderin, crystals
Pigmented: hyaline with colo from myoglobin, hemoglobin, etc.
Casts: Cellular - RBC
NOT NORMAL
Significance: glomerular disease
Casts: Cellular - WBC
NOT NORMAL
Significance: glomerular disease, infection/inflammation
Casts: Cellular - Other
Mixed cells, bacterials
Broad casts: poor prognosis, urinary stasis, can be any type
Casts: Cellular - Renal Tubular
Severe cell death
ALWAYS PATHOGENIC, rare
Significance: tubular necrosis
Crystals: Formation
Depends on concentration, pH, temp/time, flow through tubules
Form outside of body
Crystals: Acidic - Amorphous Urates
No significance
Increased: fridge
Dissolve: alkaline, heated
Crystals: Acidic - Uric Acid
Diamond, rhombus, rosette
- Very acidic
- Colorful birefringence
Increased: gout, cytotoxic drugs
Crystals: Acidic - Calcium Oxalate
Pretty normal
- Dissolves in HCl, large pH range
- Birefringent
Increased: food, kidney stone
Crystals: Acidic - Hippuric Acid
No significance
- Ethylene glycol poisoning
Crystals: Acidic - Sodium Urate
Nor important, amorph
Crystals: Acidic - Bilirubin
Amber, large granules, fine needles
- Fridge
- Always abnormal, check chemical exam
Crystals: Acidic - Tyrosine
Sheaves, yellow, needles
- Rare
Abnormal: congenital overflow, causes damage from needles
Crystals: Acidic - Leucine
Tree trunk
- Dissolves in alkaline
Abnormal: congenital overflow, liver issues
Crystals: Acidic - Cholesterol
Clear, flat, corner notch
- Colorful birefringence
Abnormal: tissue breakdown, renal disease, lymphatic rupture
Crystals: Acidic - Cystine
pH less than 8
Hexagon plates, clear, refractile
Abnormal: tubule damage, congenital overflow
Crystals: Acidic - Radiographic Dye
Large needles or plates
- Birefringent
- Specific gravity of over 1.040
Crystals: Alkaline - Amorphous Phosphates
pH 7.0, colorless grains
Increased: fridge
- Soluble in acetic acid
- Does not dissolve when heated
NO BIGGIE
Crystals: Alkaline - Triple Phosphate
Coffin lid
- Normal urine
- Sometimes kidney stones
Crystals: Alkaline - Calcium Phosphate
Short prisms
- Normal urine
- Kidney stones
Crystals: Alkaline - Calcium Carbonate
No biggie, large amorph
Crystals: Alkaline - Ammonium Biurate
Very alkaline, yellow/brown spheres, spicules, old urine
Normal in vitro
NOT normal in body (vivo)
