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AUBF Lec > Microscopic Examination Of Urine > Flashcards

Microscopic Examination Of Urine Flashcards

1
Q

Urine Sediment Preparation

A

10-15 mL urine ( average: 12 mL)

Centrifuge for 5 minutes @ 400 RCF

Decant urine (0.5 or 1.0 mL remains)

Transfer 20uL (0.02 mL) sediment to glass slide with 22x22 mm coverslip

Examine microscopically

10 LPF, 10 HPF under subdued light (reduced light/dim light)

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2
Q

Quantitative measure of formed elements of urine using hematocytometer

A

Addis Count

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3
Q

Addis Count specimen

A

12 hours specimen

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4
Q

Addis count preservative

A

Formalin

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5
Q

Addis Count normal values: RBCs

A

0-500,000/12hr urine

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6
Q

Addis Count normal values: WBCs

A

0-1,800,000/ 12hr urine

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7
Q

Addis Count normal values: Hyaline Casts:

A

0-5,000/12hr urine

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8
Q

Used for routine Urinalysis

A

Bright-field microscopy

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9
Q

Enhance visualization of elements with low refractive index (ex: hyaline cast)

A

Phase-contrast microscopy

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10
Q

Identification of cholesterol in oval fat bodies, fatty casts and crystals

A

Polarizing microscopy

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11
Q

Identification of Treponema pallidum

A

Dark-field microscopy

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12
Q

Visualization of fluorescent microoganisms or those stained by a fluorescent dye

A

Fluorescence microscopy

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13
Q

-used for 3D imaging & layer-by-layer imaging of specimen

A

Interference contrast microscopy

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14
Q

2 types of Interference contrast microscopy

A

a. Nomarski (Differential)
b. Hoffman (Modulation)

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15
Q

-adapted in Bright field microscopy

A

a. Nomarski (Differential)
b. Hoffman (Modulation)

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16
Q

Delineates structure and contrasting colors of the nucleus and cytoplasm

Identifies WBCs, epithelial cells, and casts

A

Sternheimer-Malbin

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17
Q

Enhances nuclear detail

Differentiates WBCs from RTE cells

A

Toluidine blue

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18
Q

Lyses RBCs and enhances nuclei of WBCs

Distinguishes RBCs from WBCs, yeast, oil droplets, and crystals

A

2% acetic acid

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19
Q

Stain triglycerides and neutral fats orange-red; do not stain cholesterol

Identify free fat droplets and lipid-containing cells and casts

A

Lipid stains: Oil Red O and Sudan III

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20
Q

Differentiates gram-positive and gram- negative bacteria

Identifies bacterial casts

A

Gram stain

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21
Q

Methylene blue and eosin Y stains eosinophilic granules

Identifies urinary eosinophils

A

Hansel stain

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22
Q

Stains structures containing iron

Identifies yellow-brown granules of hemosiderin in cells and casts

A

Prussian blue stain

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23
Q

Combination stain for Sternheimer

A

crystal violet + safranin o

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24
Q

Combination stain for Hansel

A

Methylene blue + eosin y

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25
Q

stains DNA

A

Phenathridine (orange)

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26
Q

stains nuclear membranes, mitochondria and cell membranes

A

Carbocyanine (green)

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27
Q

Sediment Constituents

A

RBCs (Hematuria)

WBCs (Pyuria or Leukocyturia)

Epithelial Cells

Bacteria

YEASTS

PARASITES

Spermatozoa

Mucus threads

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28
Q

Smooth, non-nucleated, biconcave disks (HALO)

A

RBCs (Hematuria)

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29
Q

RBCs (Hematuria) Normal value:

A

0-2, 0-3/HPF

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30
Q

RBCs in Hypertonic solution

A

crenated/ shrink

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31
Q

RBCs in Hypotonic solution

A

swell/burst , hemolyze (Ghost cells)

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32
Q

RBCs in Glomerular membrane damage:

A

RBC look dysmorphic w/ projections and fragmented

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33
Q

RBCs (Hematuria) Sources of Error (4)

A

Calcium oxalate, oil droplets, yeast, air bubbles

34
Q

RBCs (Hematuria) Remedy

A

add 2% acetic acid. It will lyse the RBCs but not the others

35
Q

presence of WBC in urine

A

Pyuria

36
Q

WBCs Normal value:

A

0-5 or 0-8/ HPF

37
Q

Increase number of WBCs indicates the presence of

A

infection or inflammation

38
Q

Predominant WBC in urine

A

Neutrophils

39
Q

Neutrophils in Hypotonic urine they swell & the granules undergo ________ movement which
produce ________ appearance=________ cells

A

Brownian; sparkling; Glitter

40
Q

Eosinophils normal value

A

<1%

41
Q

Eosinophils significant value?; increase eosinophils assoc. w/ ________

A

> 1%; acute interstitial nephritis

42
Q

monocytes, lymphocytes, macrophages, histiocytes Present in small numbers

A

Mononuclear cells

43
Q

REPORTING of RBCs & WBCs; Numerical ranges:

A

10 fields per HPF

0-2, 2-5, 5-10, 10-25, 25-50, 50-100, >100

44
Q

point of reference when focusing the microscope

A

Squamous epithelial cells

45
Q

LARGEST CELLS; From lining of vagina, female urethra and lower portion of male urethra

A

Squamous epithelial cells

46
Q

Irregular cytoplasm and prominent nucleus

A

Squamous epithelial cells

47
Q

squamous epithelial cells covered with Gardnerella vaginalis
which causes bacterial vaginosis

A

CLUE CELLS

48
Q

CLUE CELLS- squamous epithelial cells covered with _________
which causes bacterial vaginosis

A

Gardnerella vaginalis

49
Q

Transitional epithelial cell is also known as (2)

A

Urothelial Cells or Bladder Cells

50
Q

Spherical, polyhedral, caudate w/ centrally located nucleus

A

Transitional epithelial cell

51
Q

Derived from the linings of renal pelvis, ureter, urinary bladder and upper portion of male urethra

A

Transitional epithelial cell

52
Q

High T.E.C came from Catheterization procedure.
abnormal morphology may indicate _____ or _____.

A

malignancy or viral infection

53
Q

T.E.C Can be seen in

A

in pairs, or in clumps (syncytia)

54
Q

Most clinically significant epithelial cells

A

Renal tubular epithelial (RTE) cells

55
Q

Rectangular, polyhedral, cuboidal or columnar, eccentric nucleus

A

Renal tubular epithelial (RTE) cells

56
Q

_______ RTE/HPF􏰀 indicates Tubular injury (ex. Glomerulonephritis, acute tubular necrosis, etc.)

A

> 2 RTE/HPF

57
Q

Larger than leukocytes (WBCs)

A

Renal tubular epithelial (RTE) cells

58
Q

lipid containing RTE
􏰀 seen in Lipiduria (ex. Nephrotic syndrome)
􏰀 Identified by:
• Lipid stains (TG and neutral fats)
• Polarizing microscope (+) Maltese cross
appearance

A

Oval Fat Bodies

59
Q

Oval Fat Bodies are identified by? (2)

A

• Lipid stains (TG and neutral fats)
• Polarizing microscope (+) Maltese cross
appearance

60
Q

RTE with non-lipid filled vacuoles Seen in ACUTE TUBULAR NECROSIS

A

Bubble Cell

61
Q

Reporting of Epithelial Cells Rare, Few, Moderate, Many

•Squamous (_____)
• Transitional (_____)

Average number per HPF (2)

A

0-5
5-20
20-100
>100

LPF
HPF

• RTE cells
• Oval fat body

62
Q

presence of WBC and Bacteria

A

UTI

63
Q

If presence of bacteria only-contamination, it is an?

A

old specimen

64
Q

most common cause of UTI

A

Enterobacteriaceae (ex. E. coli)

Staphylococcus, Enterococcus

65
Q

Bacteria Reporting: Rare, few, moderate, many /HPF

A

0-10
10-50
50-200
>200

66
Q

True yeast cell infection= _____ + _____

A

WBC + Yeast

67
Q

If presence of yeast cells only-

A

contamination

68
Q

Small, refractile oval structures that may or may not bud

A

YEASTS

69
Q

seen in DM & vaginal moniliasis

A

Candida albicans

70
Q

YEASTS Reporting:

A

Do not quantitate but only note the presence.
Yeast cells seen / budding yeast cells/ mycelial form/ budding yeast cells with hyphae

71
Q

most common parasites in urine

A

Trichomonas vaginalis

72
Q

”Ping pong disease”

A

Trichomonas vaginalis

73
Q

Pear-shaped flagellate with jerky motility

A

Trichomonas vaginalis

74
Q

PARASITES
• Trichomonas vaginalis reporting

A

Reporting: Rare, few, moderate, many/ HPF
***Do not quantitate but only note the presence.

75
Q

Blood fluke with terminal spine
Causes hematuria and cancer in the bladde

A

Schistosoma haematobium ova

76
Q

Schistosoma haematobium ova Specimen

A

24 hours unpreserved urine

77
Q

Schistosoma haematobium ova Bladder cancer marker: (2)

A

• NMP (nuclear matrix protein) • BTA (Bladder Tumor Antigen)

78
Q

Most common fecal contaminant

A

Enterobius vermicularis ova

79
Q

After sexual intercourse
Reporting: Present
***Do not quantitate but only note the presence

A

Spermatozoa

80
Q

Mucus threads
Major constituent:

A

TAMM-HORSFALL PROTEIN (uromodulin)

81
Q

Mucus threads Reporting: Rare, few, moderate, many/ LPF

A

0-1
1-3
3-10
>10

AUBF Lec (8 decks)

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